PCOS Diva http://pcosdiva.com Polycystic Ovarian Syndrome help and diet plans Wed, 23 Aug 2017 01:07:16 +0000 en-US hourly 1 https://wordpress.org/?v=4.8.1 Support PCOS Awareness! [podcast] http://pcosdiva.com/2017/08/support-pcos-awareness-podcast/ http://pcosdiva.com/2017/08/support-pcos-awareness-podcast/#respond Tue, 22 Aug 2017 19:29:58 +0000 http://pcosdiva.com/?p=14303 Did you know that only .0.1% of the National Institute of Health budget goes to PCOS research despite being the #1 hormone syndrome in women? Two major events are happening […]

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Did you know that only .0.1% of the National Institute of Health budget goes to PCOS research despite being the #1 hormone syndrome in women?

PCOS Podcast 65 - Sasha OtteyTwo major events are happening in the world of PCOS!  Sasha Ottey, founder of PCOS Challenge, a leading patient support and advocacy group visited the podcast to share the news.

First, House Resolution 495 is making its way through Congress. This bill advocates for national PCOS awareness and to make September officially national PCOS Awareness month. Make your voice heard! Listen in to find out easy ways to get in touch with your representative or go to PCOSChallenge.org/resolution or pcoschallenge.org/prioritize-pcos for more information.

Second, PCOS Challenge is holding its annual Symposium and BOLT 5K walk on September 15 & 16. This is one of my favorite events of the year. It is an uplifting weekend as women from around the country gather to share information and support. To learn more, visit PCOSweekend.org or PCOS5k.org.

All PCOS Diva podcasts are now itunes-button

A full transcript follows.

Sasha Ottey is Founder and Executive Director of PCOS Challenge: The National Polycystic Ovary Syndrome Association. PCOS Challenge is the leading support and patient advocacy organization globally that is advancing the cause for women and girls with polycystic ovary syndrome. Sasha started PCOS Challenge after she was diagnosed with PCOS and experienced great dissatisfaction with the availability of support resources for women and girls with the condition. Under Sasha’s leadership, PCOS Challenge has quickly grown to nearly 45,000 members and has helped many women find answers that have helped them overcome their struggles with infertility, weight gain, anxiety and depression and reduce their risk for numerous life-threatening related conditions. Sasha is Executive Producer of the national award winning cable television series, PCOS Challenge®. She is also host of the PCOS Challenge radio show and publisher of PCOS Challenge magazine. Sasha is a Clinical and Research Microbiologist with a Bachelor’s degree in Clinical Laboratory Science from Howard University and a Master’s in Health Administration from the University of Phoenix. Prior to founding PCOS Challenge, Sasha was a contract research microbiologist at the National Institutes of Health (NIH). For more information, visit PCOSChallenge.org

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PCOS Basics: Insulin & Insulin Resistance http://pcosdiva.com/2017/08/14261/ http://pcosdiva.com/2017/08/14261/#respond Wed, 16 Aug 2017 17:24:14 +0000 http://pcosdiva.com/?p=14261 By Amy Medling, Founder of PCOS Diva Description: One of the major symptoms of PCOS is elevated insulin levels. Elevated insulin levels in the body is considered a key indicator […]

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By Amy Medling, Founder of PCOS Diva

Description: One of the major symptoms of PCOS is elevated insulin levels. Elevated insulin levels in the body is considered a key indicator in acquiring insulin resistance (IR) which, unchecked, eventually leads to diabetes. This article will provide you with ample information with regards to insulin resistance and how you can help treat it without relying on drugs like Metformin.

What is Insulin?

Insulin is a hormone secreted by our pancreas. Its purpose is to take the glucose (sugar) from the carbohydrates you eat and use it for energy or store it for future use in the muscles, fat, and liver. This storage reduces the amount of glucose in the blood and signals the body to slow insulin production.

Insulin’s main function is to keep your blood sugar levels from getting too high.  In this way, the pancreas works in conjunction with the liver which adds glucose to the bloodstream to keep blood sugar levels from dipping too low. Together, they keep blood sugar levels even. This constant balancing of blood sugar is key to giving our bodies the energy they need to function.

Insulin is also responsible for regulating carbohydrate, fat, and protein metabolism, as well as promoting healthy cell growth. When this hormone is out of whack, it can increase the risk of gestational diabetes, as well as produce symptoms like weight gain, anxiety, brain fog, and fatigue. Insulin plays a critical role in many functions of the body, so anything that makes it less effective will cause negative effects on our health.

One of the most common “insulin issues” is insulin resistance (IR), a symptom women with PCOS know all too well.

What is Insulin Resistance?

Insulin resistance is an impairment of your body’s ability to control your blood sugar levels. Just like it sounds, your body’s cells begin to resist incoming insulin. This resistance can occur for many reasons including a defect in messaging from your hypothalamus, poor diet, ethnicity, certain diseases, hormones, steroid use, some medications, older age, sleep problems, cigarette smoking, and the birth control pill [1] [2]. In all cases, the cells are trying to protect themselves from chronically high levels of insulin as a result of too much glucose (sugar) in the bloodstream since insulin at high levels can be toxic.

Ideally, the body detects if the level of glucose in the blood is too high and signals the pancreas to create more insulin to manage the excess and store the glucose in cells. The hope is that since there is more insulin being produced, more glucose will be picked up.

The result of the body’s attempt to balance blood sugar encountering insulin resistance is a tremendous amount of insulin in the blood. This leads to two problems. This demand on the pancreas to produce higher levels of insulin than normal is not sustainable. If the pancreas becomes overwhelmed and cannot produce enough insulin to absorb the glucose, or if the cells become insulin resistant as a result of constant bombardment, blood sugar builds up in the bloodstream and could lead to diabetes, prediabetes, and other serious health disorders.

This kicks off the insulin resistance cycle wherein insulin resistance of cells and tissues create chronically high levels of insulin, and those chronically high levels of insulin bombard cells and perpetuate insulin resistance.

Symptoms of Insulin Resistance:

weight gain

sugar cravings

skin tags


rough or red bumps on upper arms

dark skin patches on neck, knees, elbows, knuckles, chest, groin


Between 50-70% of women with PCOS have some degree of insulin resistance. While insulin resistance is often associated with obesity, women with PCOS often struggle with IR even if they are lean. [4, 5, 6]

Effects of Insulin Resistance

The ability to regulate blood sugar levels is probably one of the body’s most important functions, and to have it impaired due to insulin resistance is a lot like throwing a wrench in the works. In fact, insulin resistance is at the heart of most of your PCOS symptoms including infertility, obesity, hirsutism, hyperandrogenism, chronic fatigue syndrome, immune system defects, eating disorders, hypoglycemia, gastrointestinal disorders, depression, and anxiety.  In the long term, when insulin levels rise too high, type II diabetes, atherosclerosis and an increased risk of high blood pressure and stroke can result.

Below are just a few of the sites in the body that requires efficient insulin action and what happens to them when you are insulin resistant.


Muscular glucose uptake – how our muscles absorb glucose for biological functions – is essentially insulin dependent, and our muscles account for up to 70% of the entire body’s insulin mediated uptake [7]. After eating, insulin promotes glucose processing and enables the release of energy, especially during intense physical activity such as weightlifting or sports that require physical strength. If you are insulin resistant, the energy transfer to your muscles will be impaired and your performance will suffer.


Our own body fat helps insulin absorb blood sugar properly and is responsible for at least 10% of the process. In fact, insulin is a fat storage hormone, concentrating fat in the belly region.


While glucose uptake into the liver is not insulin-dependent, it accounts for about 30% of the body’s overall “blood-sugar disposal.” When you have insulin resistance, your liver takes a beating despite having no significant effects on fat itself. As it turns out, being insulin resistant promotes very low density lipoprotein (VLDL) production in the liver. VLDL is the kind of cholesterol specifically known to cause heart disease [8] as well as increase risks of fatty liver disease [9].


While the brain is not insulin-dependent so far as glucose uptake is concerned, insulin receptors are located in the brain. Insulin in the brain is involved in various sensations [10] such as satiety, appetite regulation, olfaction, memory, and cognition.

The possibility that syndromes associated with insulin resistance in obesity and type 2 diabetes may also be associated with insulin resistance in the brain, with dysregulation of appetite and body weight, is intriguing. In fact, current research has called Alzheimer’s Disease “Type 3 Diabetes” since it mostly occurs when there is insulin resistance in the brain [11].


For women with PCOS, insulin resistance will particularly alter their hormonal balance and is at the root of most of our PCOS symptoms. The cells in the ovaries produce estrogen, progesterone, and a small amount of testosterone. These hormones are responsible in the breast development as well as primary controllers of the menstrual cycle.

Elevated insulin levels in women with PCOS can cause the ovaries to produce too much testosterone [12] and can lead to increased body hair, acne, and irregular or few periods. In many cases, it can lead to reduced fertility as well as thinning of scalp hair.

Amy Medling is a certified health coach, who specializes in working with women with Polycystic Ovarian Syndrome, or PCOS, who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill and live with their symptoms. In response, Amy founded PCOS Diva and developed a proven protocol of supplements, diet and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health and happiness.  



[1] Adeniji, A. A., P. A. Essah, J. E. Nestler, and K. I. Cheang. “Metabolic Effects of a Commonly Used Combined Hormonal Oral Contraceptive in Women with and Without Polycystic Ovary Syndrome.” Journal of Women’s Health (2002). U.S. National Library of Medicine, June 2016. Web.

[2] “Prediabetes & Insulin Resistance | NIDDK.” National Institutes of Health. U.S. Department of Health and Human Services, Aug. 2009. Web. 30 Mar. 2017.

[3] Yki-järvinen H. Fat in the liver and insulin resistance. Ann Med. 2005;37(5):347-56.

[4] Gerozissis K. Brain insulin and feeding: a bi-directional communication. Eur J Pharmacol. 2004;490(1-3):59-70.

[5] De la monte SM, Wands JR. Alzheimer’s disease is type 3 diabetes-evidence reviewed. J Diabetes Sci Technol. 2008;2(6):1101-13.

[6] Moghetti P. Insulin Resistance and Polycystic Ovary Syndrome. Curr Pharm Des. 2016;22(36):5526-5534.

[7] Smith, U. “Impaired (‘Diabetic’) Insulin Signaling and Action Occur in Fat Cells Long before Glucose Intolerance–Is Insulin Resistance Initiated in the Adipose Tissue?” International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity., International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity., July 2002, www.ncbi.nlm.nih.gov/pubmed/12080441/.

[8] Prenner, Stuart B, et al. “Very Low Density Lipoprotein Cholesterol Associates with Coronary Artery Calcification in Type 2 Diabetes beyond Circulating Levels of Triglycerides.”Atherosclerosis, Atherosclerosis, Oct. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4209900/.

[9] Yki-Järvinen, H. “Fat in the Liver and Insulin Resistance.” Annals of Medicine., Annals of Medicine., 2005, www.ncbi.nlm.nih.gov/pubmed/16179270.

[10] Gerozissis, K. “Brain Insulin and Feeding: a Bi-Directional Communication.” European Journal of Pharmacology., European Journal of Pharmacology., 19 Apr. 2004, www.ncbi.nlm.nih.gov/pubmed/15094073/.

[11] Monte, Suzanne M. de la, and Jack R. Wands. “Alzheimer’s Disease Is Type 3 Diabetes–Evidence Reviewed.” Journal of Diabetes Science and Technology (Online), Journal of Diabetes Science and Technology, Nov. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/.

[12] Moghetti, P. “Insulin Resistance and Polycystic Ovary Syndrome.” Current Pharmaceutical Design., Current Pharmaceutical Design., 2016, www.ncbi.nlm.nih.gov/pubmed/27510482.

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Eating on the Run with PCOS http://pcosdiva.com/2017/08/eating-run-pcos/ http://pcosdiva.com/2017/08/eating-run-pcos/#respond Mon, 14 Aug 2017 20:15:36 +0000 http://pcosdiva.com/?p=14236    Guest post by Martha McKittrick, RD, CDN, CHWC  I have specialized in nutrition and lifestyle for PCOS for 15 years. Most of the women I work with have hectic lives […]

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   Guest post by Martha McKittrick, RD, CDN, CHWC 

I have specialized in nutrition and lifestyle for PCOS for 15 years. Most of the women I work with have hectic lives and find it really difficult to stick to the optimal nutrition plan for PCOS. When you work long hours and try to juggle family/social obligations, good nutrition, sleep and exercise takes a back seat to life! Most meals and snacks on the run are carb laden or highly processed. Combine this with inadequate sleep and stress, and you have the perfect storm for carb cravings, mood swings, and weight gain. The good news is that with a little planning, you can stick to your healthy diet and lifestyle and take charge of your PCOS.

A healthy diet for PCOS includes lean protein, healthy fats, plenty of veggies, low glycemic carbs and minimal processed foods. An important part of the PCOS treatment plan also includes regular exercise, adequate sleep, and stress management. Unfortunately, knowing what the plan “should” be and actually being able to implement it are two different things. It’s even more difficult when you have PCOS as your body is very sensitive to what you eat. If you could only wave a magic wand and make this happen!

There is no magic wand, but you can take control.

Step 1: Determine Your Problem Areas
First you’ll need to be aware of the areas that are most problematic for YOU before you can strategize solutions. Here are some of the common problem areas I see in my patients with hectic schedules:

All of these problem areas can trigger poor choices and ultimately cause carb cravings, worsened insulin resistance, weight gain and long-term health issues.

Step 2: Identify Solutions

The trick is to analyze your current work/life/eating situation and come up with a plan. We problem solve in many other areas in our lives – why not this one?

First, collect data. Keep a food log including the time and what you eat/drink for a week or two. I suggest a good old-fashioned paper food log versus an app because you’re more likely to record more data. Record any physical or emotional feelings before and after eating. For example, record if you are tired after breakfast or having craving carbs at 4 pm. Include where your meals came from.

Second, analyze data. Notice patterns as well as how various foods make you feel. Do you go too long without eating? What does a poor night’s sleep do to your appetite the next day? Does that bowl of cereal in the morning lead to hunger two hours later?

Now you’re ready to make little changes based on your challenges. Here are some of my favorite tips:

#1. Make yourself a priority! You’re probably thinking, “I don’t have time” to make myself a priority, but it’s time to find time. Change your mindset. It’s time to start taking care of YOU! Focus on one tip at a time, so you won’t feel overwhelmed.

#2. Plan your meals & snacks. This will take a little work, but it is really the key to eating healthier! Plan a few meals for the week. Put together a shopping list so you’ll be prepared once you get to the store. Include plenty of proteins (poultry, fish, canned salmon, eggs, lean beef), vegetables, fruit and whole grains. Portion out the protein into single servings and freeze. This will defrost more quickly so you can make a fast dinner. Frozen vegetables are a good back up in case your fresh veggies go bad!

#3. Stock up your “PCOS- Friendly Kitchen.”  Take a thorough look in your kitchen and clean house! This means to get the sugary, processed, or trigger foods out of the kitchen and replace them with some of the healthier options.

#4. Cook meals on weekends so you’ll have options for the beginning of the week.

#5. Cook extra food for dinner and freeze leftovers in individual containers for an easy meal later on.

#6. Take advantage of supermarket pre-washed salad greens and veggies that have already been sliced, diced, or spiralized. I’m also a fan of frozen veggies – they’ve come a long way from frozen peas and corn! You can even find frozen cauliflower rice.

#7. Invest in a crockpot. Throw a few ingredients in, and you’ll have dinner ready when you get home.

#8. Eat breakfast at home or pack it to bring to work. Most breakfast on the run choices are loaded with carbs. Studies have shown that a high protein breakfast can help control cravings later in the day. Some healthy choices include: eggs, nut butter on an apple, steel cut oats with nuts and seeds, protein shake made with your favorite protein powder, almond milk, ground flaxseeds, spinach, and berries.

#9. Don’t let too much time go between meals. Pay attention to your schedule and try not to let more than 4-5 hours at the most go by between meals or snacks. Getting over-hungry will only backfire and lead to overeating at the next meal as well as exacerbate carb cravings.

#10. Bring snacks for during the day. Some of the snacks I recommend are: nuts (buy mini bags or make your own), healthy jerky, nut butter on ½ apple, hummus + veggies, mini guacamole + veggies. Keep them in your office and non-perishable ones in your car or bag.

#11. Bring lunch from home. Add leftover protein and vegetables to greens make a tasty salad. Limit the carbs (chick peas, quinoa, sweet potato, brown rice) to ½ cup.

#12. Survey your surrounding take-out options. There will be days that you just don’t have time to cook and need a back-up. While most take-out food is not ideal, you can probably find something that is moderately healthy. Examples:
-Chinese steamed protein + veg + sauce on side + ½ cup brown rice
-sushi – one roll with brown rice + sashimi + miso soup
-rotisserie chicken, green beans, salad

Many people with hectic schedules eat out or order in at least once a day. Often, restaurants list the nutritional content of menu items online. Preview the menus of local places so you will know what to order ahead of time.

BONUS TIPS: There are important habits that will benefit a busy woman beyond how you eat on the go.

  • Get adequate sleep. Being sleep deprived can worsen insulin resistance[i],[ii],[iii], make weight loss more difficult and intensify your carb cravings. Inadequate sleep decreases the satiety hormone leptin and can increase in appetite-stimulating ghrelin[iv].
  • Stress management. Try not to overbook yourself. Use a meditation app, or find an activity to do that relaxes you.
  • Build exercise into your schedule. This doesn’t mean you must join a gym. Walking is a great way to start, but prioritize exercise and put it in your calendar like any other appointment.
  • Write a weekly goal list.  Don’t feel that you have to accomplish everything on your list. Pick one or two goals that you really want to work on and write them down in a notebook. Stay focused on these 1-2 goals. At the end of the week, check off if you were able to meet them. Pick another goal for the next week. Baby steps add up!

The bottom line is that making changes in your eating habits isn’t easy, but it is important and can be done. This doesn’t have to be done overnight. Working on one little change each week will eventually add up to big changes. The trick is to start with small goals. As you meet them, you’ll gain confidence and momentum and will be able to add more changes. Focus on how healthy eating makes you feel!

Feel free to contact me on my Facebook page PCOS Nutritionist Martha McKittrick to share the changes you’ve made! https://www.facebook.com/PCOSnutritionist/

And make sure to sign up for my blog PCOS Nutrition & Lifestyle Solutions http://marthamckittricknutrition.com/pcos-blog/  to get my latest blog posts and free downloads on how to help manage your PCOS.

Martha McKittrick, RD, CDN, CHWC

Martha McKittrick is a Registered Dietitian, Certified Diabetes Educator, Wellcoach®-Certified Health and Wellness Coach with a private practice in NYC.  With over 25 years’ experience in the field of nutrition, Martha specializes in PCOS, weight management, cardiovascular health, diabetes, IBS, and preventive nutrition. Martha was the nutrition editor for Dr. Walter Futterweit’s book: A Patient’s Guide to PCOS – Understanding and Reversing Polycystic Ovarian Syndrome. She has lectured across the country on PCOS to both health professionals as well as women with PCOS. She is currently on the Health Advisory Board for PCOS Challenge.

Martha is passionate about helping women take charge of their PCOS with healthy diet and lifestyle. She does not believe in a “one-size-fits-all” plan and provides individually tailored recommendations for her patients. She takes an integrative approach and focuses on sleep, stress, physical activity, supplements in addition to diet. Living in NYC, Martha specializes in helping women with PCOS find practical ways to incorporate healthy nutrition and lifestyle into their hectic schedules! Martha blogs at PCOS Nutrition & Lifestyle Solutions http://marthamckittricknutrition.com/pcos-blog/  Like her Facebook page PCOS Nutritionist Martha McKittrick https://www.facebook.com/PCOSnutritionist/

To learn more about Martha:
Website: Martha McKittrick Nutrition 

Email: Martha@MarthaMcKittrickNutrition.com
Phone: 212.879.5167

[i] http://www.mdedge.com/ccjm/article/95530/diabetes/does-lack-sleep-cause-diabetes

[ii] https://academic.oup.com/jcem/article/95/6/2963/2598810/A-Single-Night-of-Partial-Sleep-Deprivation

[iii] http://www.onlinepcd.com/article/S0033-0620(08)00090-X/fulltext

[iv] http://www.medscape.org/viewarticle/502825

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A Functional Approach to Treating PCOS [Podcast] http://pcosdiva.com/2017/07/a-functional-approach-to-treating-pcos-podcast/ http://pcosdiva.com/2017/07/a-functional-approach-to-treating-pcos-podcast/#respond Wed, 26 Jul 2017 19:26:09 +0000 http://pcosdiva.com/?p=13999 “Think of PCOS symptoms like the rays of the sun. They’re all peripheral to that one pivotal central situation, which is your hormone imbalance.”  -Dr. Margarita Ochoa-Maya, MD Dr. Margarita […]

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“Think of PCOS symptoms like the rays of the sun. They’re all peripheral to that one pivotal central situation, which is your hormone imbalance.”  -Dr. Margarita Ochoa-Maya, MD

PCOS Podcast 64 Ochoa-MayaDr. Margarita Ochoa-Maya, MD is a functional endocrinologist, author, PCOS Diva, and personal friend of mine. She joins the podcast to explain why a functional integrative approach to PCOS can be the most effective treatment. If you are looking for a way to treat PCOS which considers your type of PCOS and aims to treat the cause instead of only individual symptoms, listen in as we discuss:

  • The difference between an endocrinologist and a functional integrative approach
  • The role of biology and micro and macro nutrient levels
  • Facilitating the elimination of excess hormones which can relieve acne, hair loss, and more
  • Emotional and spiritual health as an important component of biological health
  • How to develop the best doctor patient relationship

I start with a diet plan, an exercise plan, a mood plan, a sleep plan, and then we also use supplements to further supplement our food and nutrition, and then we come to the use of prescriptions.” -Dr. Margarita Ochoa-Maya, MD

All PCOS Diva podcasts are now itunes-button

A full transcript follows.

Originally from Medellin Colombia, Dr. Ochoa-Maya graduated from ‘Instituto de Ciencia de la Salud, CES’ and completed her Internal Medicine Residency at Boston City Hospital affiliated with Boston Medical Center in Boston, Massachusetts. She is Board Certified in Internal Medicine. She then completed a fellowship in Hypertension, Endocrinology and Metabolism at Brigham and Women’s Hospital affiliated with Harvard Medical School. She is Board Certified in endocrinology and metabolism.

Dr. Ochoa-Maya, MD, CDE, established Advanced Health and Wellbeing, PC in 2010. She has been practicing endocrinology since 1999 and has been an MD since 1994. Dr. Ochoa-Maya is well-known in southern New Hampshire, Massachusetts, Florida and Colombia, and Puerto Rico.

Full Transcript: 

Amy Medling:                    Hello, and welcome to the PCOS Diva podcast. My name is Amy Medling, I’m a certified health coach, and I’m the founder of PCOS Diva. My mission is to help women with PCOS find the tools and knowledge they need to take control of their PCOS so they can regain their fertility, femininity, health, and happiness. If you haven’t already, make sure you check out pcosdiva.com. There I offer tons of great, free information about PCOS and how to develop your PCOS diet and lifestyle plan so you can begin to survive like a Diva. Look for me on iTunes, Facebook, Instagram, Pinterest, Twitter, and Google Plus as well.

Today, I have the absolute privilege of talking with Dr. Margarita Ochoa-Maya, she is a personal friend of mine and she is a functional endocrinologist here in Nashua, New Hampshire, where it’s my hometown. And she just wrote a fabulous book called “The Hormone Link” and she’s here to join us on the PCOS Diva podcast to talk about her book and her work with women with PCOS. So, welcome, Dr. Margarita.

Dr. Margarita:                   Hi, Amy, how are you? It’s so awesome to be on your podcast today.

Amy Medling:                    Well, I just want to give our listeners a little bit of your background, you completed your internal residency at Boston City Hospital and Boston Medical Center, which is affiliated with Boston University. And then you completed a fellowship in endocrinology and metabolism at Brigham Women’s Hospital and that is the teaching hospital for Harvard Medical School. And you have a private practice here in Nashua, New Hampshire, called Advanced Health and Wellbeing. And of course you wrote this fabulous new book called “The Hormone Link”, so I’m excited to dive into our podcast, we have lots of great things in store for our listeners. But first I just wanted to just to help you sort of define for us what the difference is between kind of like an endocrinologist and this functional integrative approach to endocrinology and health and wellness, how does that look different for a patient?

Dr. Margarita:                   I think what is important is really bringing into their official reason why one becomes a doctor, so in my personal situation I found that I was having a little void in understanding my medicine as I wanted to practice it and so I took foundational education that was a little bit beyond my basic medical school and my fellowship training. I furthered my education in nutrition, and I have a physician certificate in nutrition and furthermore, I have done a lot of education on psychology and trying to understand our behavior and our mind and our mood. And I decided to kind of name it functional integrative approach to endocrinology in the sense that I start with a diet plan, an exercise plan, a mood plan, a sleep plan, and then we also use supplements to further supplement our food and nutrition and then we come to the use of prescriptions. So, in that regard we really try to have a very comprehensive approach to a medical condition and look at it from the real origin and cause and trying to fix it rather than just patch it up as a symptom.

I also feel that when we are not feeling well, so the biology of the body has really a lot of influence by how we feel and how we perceive what is going on. So, I call that more like the psychology or emotional intelligence relative to our body and how it reacts to the outside world and how we’re feeling. And that blended with our inner language and our inner understanding of us being part of a community and a whole, that requires a little bit more integration and learning. And so it’s important to learn about our body, learn about what’s going on, it doesn’t have to be that everybody has to get a medical degree but at the same time, really understand to one’s capacity what is going on. And when that happens, that doctor patient relationship or when it comes to my patients, we have a much deeper conversation that can affect change as compared to just getting a prescription or just doing something without knowing why. Did that explain that a little bit, Amy?

Amy Medling:                    Yeah, and it’s really I think for a lot of women listening, it’s such a refreshing approach because typically we’re handed a prescription first and the diet and lifestyle kind of factors are sort of, “Yeah, well, you know you need to go on a low carb diet,” sort of as you’re heading out the door. So, that’s one of the reasons I wanted you on the show ’cause I just love your whole approach to wellness and treating women with PCOS, which I know you do a lot in your practice and over the course of your career. And you’ve sort of figured out different types of PCOS, which I think is really fascinating and I’d love for you to kind of talk about those different types of PCOS that you mention in your book and maybe some women listening can kind of identify with those different types.

Dr. Margarita:                   Well, kind of foundationally started with what we talked earlier, I think endocrinology is very complex and extremely difficult, even when I was in med school trying to grasp the hormones and the world of hormones, it’s just like trying to delve into the ocean because we know a lot about endocrinology but the truth is there’s so much more to discover and to learn. And thank God, technology in terms of laboratory testing, interesting things like that. I personally have PCOS, and so I had my own personal quest to find what was going on and really tackle this and actually I’ve come across your podcast, personally, before I met you and it was such an honor when I now, indeed, found out you were in my neighborhood.

So, the different types of PCOS, the way I think of them, is that PCOS stands for polycystic ovarian syndrome, as we all know, and syndrome is a collection of symptoms. It doesn’t really have to have everybody present the same way, which makes it so much more elusive because if you are unfortunate and you don’t access somebody who would know what we’re talking about, they might say it’s in your mind or it’s in your mood. Or the way PCOS can affect the mood, it could be you have depression or whatnot. The way PCOS affects the body, some people who suffer from polycystic ovarian syndrome might present with more of a metabolic problem and their issue would be more their weight and acne and the extra hair and some of those features. In some, it might present more because they’ve been trying to get pregnant and they can’t. And in others it could be mainly because their periods are so irregular and now there are some consequences at the uterine level where it’s extremely unhealthy to have less than six periods a year.

So, it all depends on kind of what drive the individual person. But I divide it in kind of four different categories, so we have the overweight category where there has been an issue more with the metabolism. And then there’s a lean category where there would be more ruptured ovarian cysts, problems in the pelvic area, severe pelvic pain, and problems of that nature. And then we also have those that have regular cycles which seem to be daunting because one of the hallmarks of polycystic ovarian syndrome would be that you have irregular periods, so for those women that do have regular bleeding, considering a hormonal imbalance is a little kind of harder to grasp. And then those that do have, of course, the irregularity in their menstrual cycle.

So, the way we see that is more that when you are overweight, hormones tend to store in our fat tissue and our liver is having a little harder time eliminating these hormones, and so as they are stored in the fat tissue, they continue to create havoc in the cycle and the delicate harmony that needs to be in process for all our hormones to be talking and synchronizing to keep the cycle regular and ovulating and metabolism and linked a little bit with insulin resistance and prediabetes. So, we have the overweight, then we have the lean. And those that are overweight tend to have very high hormones or circulating high hormones. And those that have the irregular cycle have even more of a predominance of that irregular concept and they have more of the presentation of the typical polycystic ovarian syndrome as compared those that are lean and might have some more ability to metabolize their hormones but on the other hand other problems such as these cysts that sometimes when they rupture, they hurt so much and problems of that nature. So, each one of them, each type of PCOS might have a different approach on what it is and how to take care of it. And so it’s really individualized, truly.

Amy Medling:                    Mm-hmm (affirmative). Yeah, I always say there’s really no one size fits all approach to managing PCOS because it affects everyone so differently, and I think that’s at the problem with a lot of diet advice. For some reason, they do well on a paleo, some on a keto diet, some women really feel well on eating more of like a vegetarian kind of approach, and so I try to stress with listeners that just like there’s no one type of PCOS, there’s really no one approach to managing it except looking at broad, like you had mentioned earlier, you’re looking at your stress, your sleep, your moods, and kind of figuring out what works best for you.

Dr. Margarita:                   What we can learn from the opportunity of being able to do more sophisticated testing, we have the ability to look at micronutrient levels and one of the important things is that hormones, especially ovarian hormones, they are based on a cholesterol ring, so they’re fat soluble and I really like the fact that it’s important to realize that we are very low on Omega oils and now we’re talking a little bit more about MCT oil and the important of fish oil because what happens is that these hormones kind of get accumulated in the body and we don’t have a means by which we can eliminate them. So sometimes in PCOS it might be an irregular production and a true ovarian dysfunction and in some it could be a liver problem in which you are not able to really eliminate these hormones well, if you don’t have good levels of these fish oils or these Omega oils. And so they get kind of clogged in the liver and in the fat tissue.

So when you talk about diet, it’s really important to realize that we need to have a high fiber diet, regardless of what choice of specifics, if it’s vegetarian, if it’s paleo, if it’s macrobiotic, but really try to have a high fiber so that when those hormones are eliminated via the bile and the skin, that’s why sometimes the acne, you really want to have the fiber to then eliminate them fully rather than having them reabsorb in the small bowels. And then furthermore, having those oils to help lubricate and eliminate these hormones. So, again, it’s sometimes in the source in making them and sometimes it’s in the way we eliminate them. Meaning hormones, of course.

Amy Medling:                    For somebody listening that is not taking fish oil right now, what kind of dosage do you recommend for beginning with?

Dr. Margarita:                   So the fish oils we divide them in EPA and DHA, those are the two molecular concepts when you think of fish oil. So, fish oil can be a bit fishy, you want to have a very good source because they could have some mercury in it, and so the source of the fish oil is gonna be really important. We can go down to the smaller fish called krill but it really has to be the small little fish, so sardines. We can also do salmon and herring and mackerel, but those sometimes are a little contaminated. So if we’re gonna get it a supplement level, the dose should be at least 1,700 milligrams a day so I would recommend. And then doing them morning and night. So you get a very good, high quality fish oil and you at least take 1,000 milligram in the morning and 1,000 milligrams at night.

Amy Medling:                    So, what I really loved about your book, Dr. Margarita, is that your section on PCOS, you really take this holistic approach and I would love for you to talk to us a little bit more about how emotional and spiritual health is as important to the biological health in women with PCOS is, making sure you have the right macronutrients and the right supplements. Because working on PCOS Diva and my journey with PCOS, I found that I had to really heal both emotional and spiritual side to help heal myself and manage my PCOS, so I feel like we’re kindred spirits because I loved reading that section in your book, so I would love for you to talk more about that.

Dr. Margarita:                   I have to say that that section is probably my favorite, as well, only because as women, we are now driven into many different aspects of our life where we have to be really good at pretty much everything and so one of the things that PCOS does havoc is in our hormones and our mental emotional health. And in a subgroup of women who suffer premenstrual disorder, which means it’s a really, really bad PMS, usually they have hormonal imbalance and what those hormones do within our mind. So, unfortunately, that already sets the tone for us to be a little more sensitive, a little bit more vulnerable, and so we are exposing ourselves to be being slightly tramatized and so self-esteem is super important, self-confidence, self-acceptance. And when we start having that inner language that could be going on a negative tone, then of course we’re a little bit more stressed, we have a little bit more problems interacting with other people, and then it really then kind of affects us with our motivation so in regards to our diet and exercising, if you’re exhausted, if you’re having problems connecting with other people, going outside, and having things like that, then of course the treatment should be starting to focus on really empowering yourself to really feel that you can conquer PCOS. That’s the first thing.

Or you can conquer anything, mind you, but if you set your mind to it, you have your proper team, you learn about this situation, and you set a goal to say that PCOS is not gonna rule you, can control PCOS. And it’s challenging, mind you, but really important to keep a check on our emotional health and not let that become a problem of its own. Furthermore, when you start feeling a little bit more empowered and you really feel hope that this can be taken care of, then you will be more apt to follow a diet and not surrender to certain desires that would be at the office place, somebody brought cake or such-and-such, and trying to get out of that realm of your diet and what you need to do.

Because clearly, the PCOS diet does require attention. You can’t eat anything and everything, you want to really focus on your high fiber, your vegetables, if you are not a vegetarian, choosing your meats appropriately, trying to find things that don’t have a lot of pesticides or herbicides and how to handle the budget. So, it really is comprehensive at a financial level, at a personal, intrapersonal, language, and spiritual level, and then also healing those wounds that might have happened in our past and knowing that every day is a new day. And if maybe you weren’t that good with your diet yesterday, well, today’s a new day to start on and treat yourself with a lot of love and compassion. That’s super important.

Amy Medling:                    Another thing that has really helped me is to really work on staying in the moment. I know the worry about the future, it can be so consuming for me and sometimes it seems so silly, my husband’s really a great reality check to realize that that present moment is really all we have and to focus on the moment. I think it gets rid of a lot of that needless stress that we put on ourselves that really disrupts our hormones.

Dr. Margarita:                   I totally agree and then it’s, again, the chicken or the egg because those hormones also put our brain in a very vulnerable position so almost knowing like when you get a scrape or a burn in your skin, you’re a bit more raw, and if you can just say, “Okay, I’m a bit more raw, so I just need to make sure I protect my skin,” like you would put some aloe. In our mind, you really want to protect yourself from the negativity because it’s so easy now with the media and it’s so easy to get into a negative mindset but being mindful and also in a meditative step, we’re going step-by-step and just being patient and yet disciplined. That’s really important because you don’t want to get too lackadaisical, but on the other hand, knowing that humanity, as the humans that we are, we’re not perfect but doing it every day and being mindful, it’s true with having that reality check and then also understanding being grateful and appreciating the good things that we have is a good check and balance. I find that very, very important.

Amy Medling:                    Yeah, and I think something that causes women a lot of anxiety and negativity, especially younger women with PCOS, is the thought of infertility, and I know I’ve shared my story with you, Dr. Margarita, I was 17 and a doctor told me that they’d have to jump through hoops one day to get me pregnant. And I think a lot of women hear that, this story, but I’d love for you to give women some hope based on your experience in practice. For those who feel like having a baby might be hopeless for them because they’ve been told by a doctor that they’ll have to jump through hoops or they’re struggling with infertility right now, I’d love for you to give them some words of wisdom.

Dr. Margarita:                   Yes, well, I want to share with you the fact that I, too, was told that exact same thing and that’s what made me want to become an endocrinologist and challenge PCOS. It’s personal for me. I was given an ultrasound and it was full of cysts, but I focused on one that didn’t look like a cyst, it looked like an egg and I pretty much had to say to myself … Because the doctor gave me the Clomid prescription, and personally my aunt had quadruplets in the ’80s due to an overdose of Clomid so she was like the Octomom of the ’80s, I think. But in that regard, you don’t need to take those words so deeply because that can also empower you to say, “I’m gonna show you different.”

And what I did is I changed my diet, I started doing my cardio and my physical activity with some weights, and really it didn’t have to be like a massive change in my diet in the sense that I just focused on my fiber, I focused on my nutrition, I made healthy choices, instead of delving in the negativity of this very daunting possibility that I would never be able to have children, I actually focused on me and made myself healthy. Because in case I would get pregnant, because I knew I would, was more that I was gonna be as healthy as possible and whatever I could do to make that happen, I was going to do. And miraculously, through delving into my exercise, my mental health, my kind of spirituality and connecting with nature, and then it really might be a matter of blood testing, that’s when it comes to the bottom line where it’s like, “I’ve been doing my diet, I’ve been doing my exercise, I’ve been taking my supplements, now what?”

And so there might be the case where you might need some medication that might help but the truth is, there is hope and don’t stop at any words that are negative if you really are interested in doing a transformation. But it has to be personal, it has to be at a level of oneself. So in the sense the babies will come, once you sort out things that are blocking you and then make sure you get your proper team in place. And that might mean buying some books, getting on your beautiful podcast and your website, and trying some things that might not be as conventional but at the same time, as long as you’re healthy mentally, spiritually, financially, and biologically, then things will come into place. So I do believe that don’t stay stuck. Keep reading, keep asking questions, because you have infinite wisdom. We do have wisdom within that will help us come out of our state of being stuck.

Amy Medling:                    As I’m listening to your story, I heard you say, “I got myself healthy,” or, “I wanted to kind of get myself to a place where I was at optimal health because I knew I would have babies one day, one way or the other,” and I think that is key, too, not taking what the doctor may or may have not said as your truth. And that’s something that I think I share with you. When I was told that, in the back of my head I thought, “Yeah, well, that’s what they’re just saying, but I know one day I’ll be a mom, one way or another.” And I think that is a key to the whole journey, as well, is you define your truth not somebody else.

Dr. Margarita:                   I think that’s so positive in every way, shape, and form. Things do happen and life does get in the way but we have to keep a mentality of being survivors and being fighters and being warriors and goddesses and divas because it is true, if we start going into the negative path, then of course those words will become true. And so it’s a matter of like, “Well, you’ve been doing everything, how do we connect?” Well, we read blogs like yourself, we connect with people out there that can give you hope. So, it’s really not that easy, it’s a little easier to say than to do, but like in your story and in my story, which it does go personal, and especially with our right to have babies for those that want to, that is something that should not be denied. And we have come a far, long way with technology and medicine and so in a way, the information is out there. Now, we just have to go get it.

Amy Medling:                    Yeah, and I really like what you said about be a survivor, be a goddess, a warrior, something that I just wanted to kind of mention, and I don’t know if some listeners realize, but PCOS is really this ancient disease. And it can be traced back to ancient times of famine when our PCOS bodies were set up to be able to withstand famine and be able to carry on with childbearing when others may not. And it’s just the hard part is that in this time kind of on the human timeline and the place that we’re living with all of the abundance of food in modern society, it kind of takes a toll on our PCOS bodies but we really are innately programmed to be survivors. So, let that work for you.

Dr. Margarita:                   Absolutely. And I think the basic goals of the treatment of PCOS would be really looking at your metabolism, looking at that food because despite the fact that we are in a world of abundance, we also have abundantly low calorie, not so healthy, pretty much junk food and so even though we are feeding ourselves or we’re satisfying that chewing and eating, it’s really not nourishing you or nourishing us. And so when you’re eating some kind of image of what would be a tomato, like ketchup for example, ketchup is not a tomato, and so we have filled our food shelves with things that are like make-believe almost that they have flavor but the nutrient content is not as good. And so, really looking at what your body needs. Good protein, if you’re gonna have carbohydrates have them with good, high fiber.

And then really within the oils, it’s not really a fat free world, it’s more looking at good, important oils that are important for your brain, for your nervous system. And again, when it comes to hormones, it’s really important to know that hormones are fat soluble and only an oil can take care of an oil. And so that fish oil paradigm or MCT oil, coconut oil, which is the ALA part, and the EPA, and DHA, so those would be the good molecules. To think in reference to PCOS is trying to find ways that you can also help these hormones eliminate from your body since you’re producing them daily.

Another one that I think is really important is increasing the muscle to fat ratio. Exercise in polycystic ovarian syndrome is pivotal, we really need to circulate these hormones, help them move around the body and not get clogged in our fat tissue. Also really important is to make sure to regulate the periods and vaginal bleeding, very, very unhealthy to have less than six periods a year because that tissue within the uterus is accumulating and does really need to come out and so if it’s not under other forms of treatment but naturally, a woman should have a regular cycle to avoid cyst formation. And then when they rupture, it really hurts and whatnot. So, it’s important to have your periods regulated. That will boost your fertility, if that’s what is desired.

Also, acne. There’s so many products that we can use to cover up acne or to treat acne but acne is indeed a symptom of those hormones kind of clogged within your system and the skin, using the oil gland, is trying to eliminate them. And so acne is not just a symptom as much as it is a hormonal imbalance for some. Hair loss, for example, if you’re having hair loss it might be a hormonal imbalance as well, so promote healthy and abundant hair. Sometimes those B vitamins are crucial if we’re not getting them from our nutritional sources. And lastly, but really super important is promoting healthy self-esteem, healthy relationship with oneself and with others so that we can reduce risks of getting traumatized or having problems arise with depression and anxiety and other conditions.

Amy Medling:                    So I wanted to tell people a little bit more about your book, which is really so comprehensive, like 680 pages of everything you want to know about your thyroid, adrenal, and sex hormones, it’s so comprehensive. And one part that I especially liked for PCOS Divas is you, in the beginning of the book, you give great advice about how to develop for that doctor patient relationship and I think it’s so valuable because you want to make the most of the little time that we get with our doctors these days.

Dr. Margarita:                   Yeah, I think we have to work with what’s going on in the sense that sometimes we have all the time to discuss it, but truly that is not the natural norm. So, in preparation for the visit with your doctor, it would be great to prepare what you’re gonna ask, what your concerns are, if you have actually been to PCOS Diva or read other books or like my book “The Hormone Link”, try to grab some questions and focused points to discuss so that when you’re there and you’re in the rush of the moment, you’re able to remember those questions or those points that you wanted to address during the visit. But that doctor-patient relationship is very important because in some cases as women, now I’m talking to you now as if I was a patient because I have been, we want to not just focus on the mental and then get labeled as anxiety or depression or focus on just the acne and then get acne treatments but not really deal with the hormones and so these are all kind of, I would think of it like the rays of the sun. They’re all peripheral to that one pivotal central situation, which is your hormone imbalance and why that is. Could it be a genetic predisposition? Could it be an environmental situation with how your lifestyle is? Could it be a combination of all of those things?

So, it’s a matter of trying to go inside and try to piece out what your real questions are and what you can address and those that you might want to address later. But, I usually make three lists, all the things that I think I have a problem with, those that I have maybe some solutions for, and the third list would be those that I’m going to affectively make a change. And try not to get too overwhelmed with a list that would be too long because if you create and endless list, then of course there’s gonna be that sense of never being able to accomplish it. So, you really want to start with that list of the things you want to change or address, those that have solutions, and of those that have solutions, pick one or two or three, but no more, and then change them and really make affective interventions. And then readdress those lists as time goes by but try not to get overwhelmed.

Amy Medling:                    That’s great advice and your book is a great resource to kind of dive into and kind of develop your question list. So can you tell us where we can find it, give us just the name again, and wherever we can find the book.

Dr. Margarita:                   Yes, thank you so much, Amy. Yes, so it’s called “The Hormone Link.” I thought it was an important title because we talk a lot about hormones, we talk a lot about what they are, but sometimes trying to connect them to really how we understand them, so the book is that big, I made it in a big font so it’s big letters so it’s easy to read. It’s really not meant to be a front to back read, it’s chapters that are unique to you, so I did focus a little bit on the doctor patient relationship because I think that’s really important in endocrinology since some complaints that we have can be so vague and applied to so many things. But then we delve into, for example, the thyroid gland because as women and women who suffer from PCOS have much higher risk of having a thyroid problem, I thought it would be important to really address that and the chapter starts with a questionnaire. And so if you happen to find that through the questionnaire, you have some issues, then it might be worth reading that thyroid chapter.

We have another one on the adrenal gland, and that’s really a powerhouse where let’s say we suffer from anxiety, we release adrenaline, and that’s what makes us shake a little bit and feel the butterflies in the stomach. And so it’s really important to understand that adrenal gland. And so we start also with a stress questionnaire and then again, if that’s interesting then we can read that chapter. And then, of course, we talk about what is the period? What is a normal period? Sometimes we don’t even know what is normal or we think that’s who we are and that’s how we were made and so we might just be unusually different but if we understand what is the period, then we can say, “Hey, my period is not like that.” So, let me read on to the next chapter, which is a little bit more understanding of polycystic ovarian syndrome or infertility and the different options that we might have. And then let us not forget that when a woman who has polycystic ovarian syndrome or any women in general, when we reach the perimenopause phase, the menopause, sometimes with PCOS, menopause can be far more complicated because then again, it’s another big change in hormones and another period of hormonal imbalance that just makes things really complicated.

And so, I tried to explain that in a sense where we talk about diet, we talk about exercise, we talk about supplements that would be good, and then when to really seek a prescription or an intervention with the doctor. If it’s thyroid disease, you might want to have them tested. It’s important to have those laboratory tests because without them, it’s just an opinion. The tests really are confirmatory when it comes to some of these problems.

Amy Medling:                    Yeah, it’s really a great book to have for your resource, like on your resource shelf. And I was lucky enough to have you sign mine.

Dr. Margarita:                   Well, we’ll make some book signings or we’ll do some activities, I promise you.

Amy Medling:                    Well, thank you so much and please come back and we’ll have to talk about another PCOS topic ’cause being a woman that has had hormone issues yourself, I think it just makes it so much easier to share and we kind of all learn from each other and what works for us. So, please come back to PCOS Diva podcast.

Dr. Margarita:                   Thank you so much, Amy. Thank you.

Amy Medling:                    Well, thank you everyone for listening. That wraps up our podcast today. I hope you enjoyed it and if you liked this episode, please don’t forget to subscribe to PCOS Diva on iTunes or wherever else you might be listening to the show. And if you have a minute, please leave me a quick review on iTunes because I love to hear from you. Don’t forget to sign up for my free newsletter. I send it out once a week with new content and recipes and lots of stuff to make your life easier. And just enter your email on PCOS Diva to get instant access. This is Amy Medling wishing you good health, I look forward to being with you again soon, bye -bye.

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Best & Worst Sweeteners for PCOS http://pcosdiva.com/2017/07/sweeteners-for-pcos/ http://pcosdiva.com/2017/07/sweeteners-for-pcos/#comments Thu, 13 Jul 2017 15:43:51 +0000 http://pcosdiva.com/?p=13358 by Amy Medling, founder of PCOS Diva Refined sugar is one of the most vilified food ingredients in the last 15 years for good reason. Excessive consumption of table sugar […]

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sweeteners for PCOS

by Amy Medling, founder of PCOS Diva

Refined sugar is one of the most vilified food ingredients in the last 15 years for good reason. Excessive consumption of table sugar has been linked to health issues such as obesity, heart disease, cognitive disease, cancers, and of course Type 2 Diabetes just to name a few.

It goes without saying that people would be better off if they consumed their sugar in the form of fruit or just avoid it all together. This is particularly true for women with PCOS since we already have to go the extra mile when it comes to regulating our insulin levels. For that reason, let’s explore alternative sweeteners women with PCOS should consider in place of sugar as well as discuss the ones we should avoid altogether.

Sweeteners I Recommend For PCOS


Stevia is one of the latest entries in the sweetener industry and is becoming a healthy mainstream alternative to other sweeteners. One reason for its popularity is that it’s a “bio sweetener” since its sweetness is not artificially sourced. Stevia’s sweetness is traced back to glycoside (bound to sugar) compounds of steviol, with the two most important steviol glycosides being stevioside and rebaudioside A.

Stevia is truly a natural sweetener with actual health benefits. Low dose consumption of stevia is associated with anti-inflammatory and anti-oxidative effects, both of which have been linked to protection of the pancreas, brain, kidneys, and liver. [1][2]

Stevia is also 200-300 times sweeter than refined sugar on a per gram basis which means the amount of stevia you have to carry to is 200-300 times smaller and more portable. [3]

All that on top of stevia’s antihyperglycemic effect makes stevia a worthy sugar substitute. [4]

Caveat: Not all stevia products are created equally. Stevia is actually quite an expensive sweetener, so some companies compromise on purity and quality so they can sell it for less. Brands like Truvia use up to 40-steps to manufacture their patented stevia-ish product and make use of additives and other alternative sweeteners like xylitol and erythritol.

Xylitol and Erythritol are sugar alcohols and both are often touted for being natural additives. There’s really nothing wrong with these two sweeteners since the side effects associated with them often involve excessive consumption and the amount included in products are usually on the safe side.

The problem is that most stevia companies try to outsmart consumers by using more alternative sweeteners than the actual stevia itself.

Be vigilant and learn to read your labels. When a box says “all natural” or “pure” stevia, be skeptical. Look for organic green stevia powder. If you have no other options, look for the ones that put stevia as the first ingredient (being listed first means stevia is the primary ingredient) and make sure the ingredient count is no more than three. Remember: you’re buying stevia for the stevia, not for the additives.

Raw Honey

There’s something to be said for what is probably the world’s oldest sweetener. Honey can have a variety of flavors and levels of sweetness depending on the source. Some can appear dark while others are crystal clear. On top of having a low glycemic index (which means less impact on your blood sugar) ranging from 40-55, honey has been studied for its potential antimicrobial activity. [5]

Maple Syrup

On top of being a household product, maple has been shown to have potential diabetes benefits due to its low glycemic index of 54. [6] It’s also been shown to have some benefits when it comes to inhibiting colorectal cancer cell growth. [7] When you buy a bottle of maple syrup, make sure you’re buying 100% pure maple syrup, not the ones containing corn syrup.

Yacon Syrup

Yacon syrup supplies a good amount of fructooligosaccharides, carbohydrates that are prebiotic in nature. Yacon, on top of not spiking blood sugar levels compared to refined sugar, may have benefits for intestinal health and reduce appetite (by means of increasing insulin sensitivity) which can contribute to weight loss. [8][9]

Diva Note: The glycemic indexes of yacon, maple syrup, and honey are all relatively lower than that of refined sugar. Regardless, consumers should still be wary of using too much, or you’ll end up offsetting their benefits. This is specially the case when you already have high insulin. Also, remember that excessive consumption of any sweetener can trigger cravings for more sweets.

Sweeteners We Should Avoid

Remember back when zero-calorie and artificial sweeteners were said to be the best thing since sliced bread? We got the likes of Aspartame, Acesulfame potassium, Equal, NutraSweet, Sucralose, and other artificial alternatives entering the market and making everyone think they’d finally solve all their weight problems one sachet at a time.

Fast forward decades later and we’re still seeing the same problems. Diabetes is still at an all-time high, people still suffer from chronic inflammation, and America is still really, really fat.

So what went wrong? In fact, artificial sweeteners have some serious drawbacks when it comes to your health. They have been linked to potential cancer risks, metabolic syndrome disorders like PCOS, autism, and general toxicity. [10-13]

The Case Against Agave Nectar

For years, people flocked to agave nectar (or agave syrup) for its natural sweetness. It’s true, agave does taste much sweeter than sugar while still having a low glycemic index of 11. While that seems to be quite an advantage, people are unaware agave is actually 90% fructose, and as we all know, the high concentration of fructose is the reason why we don’t like high fructose corn syrup. Not only that, the nutritional value associated with agave is all but gone after processing.


Having PCOS doesn’t have to mean you can’t satisfy your sweet cravings anymore. It only means you have to go the extra mile in making sure you don’t overload your system with refined sugar or even its artificial alternatives. The sweeteners I recommend here are not only palatable, but also much better than refined sugar or any other form of artificial alternative because of their potential health benefits and low glycemic indexes.

Regardless of any ingredient’s health benefits, it’s always good to play it safe and moderate your consumption.

As a certified health coach, Amy Medling often hears from women with Polycystic Ovarian Syndrome (PCOS) who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill and live with their symptoms.  In response, she founded PCOS Diva and developed a proven protocol of supplements, diet and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health and happiness.


  1. Shivanna N, Naika M, Khanum F, Kaul VK. Antioxidant, anti-diabetic and renal protective properties of Stevia rebaudiana. J Diabetes Complicat. 2013;27(2):103-13.
  2. Assaei R, Mokarram P, Dastghaib S, et al. Hypoglycemic Effect of Aquatic Extract of Stevia in Pancreas of Diabetic Rats: PPARγ-dependent Regulation or Antioxidant Potential. Avicenna J Med Biotechnol. 2016;8(2):65-74.
  3. Soejarto DD, Kinghorn AD, Farnsworth NR. Potential sweetening agents of plant origin. III. Organoleptic evaluation of Stevia leaf herbarium samples for sweetness. J Nat Prod. 1982;45(5):590-99.
  4. Gregersen S, Jeppesen PB, Holst JJ, Hermansen K. Antihyperglycemic effects of stevioside in type 2 diabetic subjects. Metab Clin Exp. 2004;53(1):73-6.
  5. Mandal MD, Mandal S. Honey: its medicinal property and antibacterial activity. Asian Pac J Trop Biomed. 2011;1(2):154-60.
  6. Nagai N, Ito Y, Taga A. Comparison of the enhancement of plasma glucose levels in type 2 diabetes Otsuka Long-Evans Tokushima Fatty rats by oral administration of sucrose or maple syrup. J Oleo Sci. 2013;62(9):737-43.
  7. Yamamoto T, Uemura K, Moriyama K, Mitamura K, Taga A. Inhibitory effect of maple syrup on the cell growth and invasion of human colorectal cancer cells. Oncol Rep. 2015;33(4):1579-84.
  8. Geyer M, Manrique I, Degen L, Beglinger C. Effect of yacon (Smallanthus sonchifolius) on colonic transit time in healthy volunteers. Digestion. 2008;78(1):30-3.
  9. Caetano BF, De moura NA, Almeida AP, Dias MC, Sivieri K, Barbisan LF. Yacon (Smallanthus sonchifolius) as a Food Supplement: Health-Promoting Benefits of Fructooligosaccharides. Nutrients. 2016;8(7)
  10. Soffritti M, Padovani M, Tibaldi E, Falcioni L, Manservisi F, Belpoggi F. The carcinogenic effects of aspartame: The urgent need for regulatory re-evaluation. Am J Ind Med. 2014;57(4):383-97.
  11. Araújo JR, Martel F, Keating E. Exposure to non-nutritive sweeteners during pregnancy and lactation: Impact in programming of metabolic diseases in the progeny later in life. Reprod Toxicol. 2014;49:196-201.
  12. Kalkbrenner AE, Schmidt RJ, Penlesky AC. Environmental chemical exposures and autism spectrum disorders: a review of the epidemiological evidence. Curr Probl Pediatr Adolesc Health Care. 2014;44(10):277-318.
  13. Van eyk AD. The effect of five artificial sweeteners on Caco-2, HT-29 and HEK-293 cells. Drug Chem Toxicol. 2015;38(3):318-27.

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The Biggest MYTH Keeping Your Bones Weak… And How to Strengthen Your Bones After 50 http://pcosdiva.com/2017/06/bone-strength/ Wed, 21 Jun 2017 18:57:08 +0000 http://pcosdiva.com/?p=13581 One of the most dangerous myths that so many women over 50 buy into is the idea that excessive bone loss, and even osteoporosis, is inevitable as we age and […]

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bone strengthOne of the most dangerous myths that so many women over 50 buy into is the idea that excessive bone loss, and even osteoporosis, is inevitable as we age and enter midlife.  The truth is, some bone loss is normal throughout our lives, but excessive bone loss is not!

While there are some fixed risk factors that lead to excessive bone loss and osteoporosis that you can’t control (like your age and gender), the good news is there are many risk factors that you can control.

So this means you can have strong bones well into your 90’s if you’re willing to take the right steps and make the healthy diet and lifestyle changes necessary to nourish and strengthen your bones naturally.

And here’s more good news!  Despite what the pharmaceutical industry wants you to believe, bone loss and osteoporosis can actually be reversed with the right lifestyle plan, without the need for bone drugs.

Here are the top 5 diet and lifestyle steps you can take to build healthy bones naturally:

  1. Eat at least one serving of good quality animal protein per day.

Protein is needed to repair and build all tissues throughout the entire body.  Research suggests that eating adequate amounts of protein can reduce aging bone loss and decrease fracture risk when combined with the right amounts of other key bone nutrients.  Whenever possible, eat proteins from organic, grass-fed/pastured sources.  Beef cattle raised exclusively on grass have been shown to have more omega-3 fatty acids and higher levels of conjugated linoleic acid (CLA) than conventionally raised, grain-finished beef. (CLA is an antioxidant that’s been shown to increase bone density and improve bone mass.)

  1. Get enough vitamin D. (But not too much!)

Vitamin D helps your body properly absorb and metabolize calcium, phosphorus, and other key nutrients from your diet to make your bones strong and flexible.  Without enough vitamin D your bones will suffer.  With that said, too much vitamin D is bad for your bones.  Excessive vitamin D pulls too much calcium into the bone.  Vitamin D requires lots of magnesium to convert it from the “storage” form to the “active” form and this can cause a drop in magnesium levels.  Some signals that vitamin D has overused magnesium are migraines, heart palpitations and leg cramps.  It’s a good idea to get your vitamin D levels tested to determine your unique needs.  You can get a simple blood test called 25(OH)D to determine your current vitamin D levels.  Getting exposure to sunlight and taking a vitamin D supplement are great ways to boost your vitamin D levels naturally.

  1. Do strength-building exercises.

As bones weaken, muscles weaken and vice versa.  Doing strength building exercises not only helps strengthen muscles, they also help to strengthen bone. A study done at Tufts University found that through strength-building exercises they could make a 65-year-old as fit and strong as a 30-year-old!  The study also found that bone density could be increased, the risk of hip fracture could be reduced and osteoporosis could be stopped.  Exercise in and of itself halts bone loss because bones strengthen in response to the strain put upon them.  So even doing something as simple as walking 20 minutes per day can reduce your fracture risk.

  1. Reduce emotional stress.

Very few people are aware of the link between stress and bone loss. When we feel stressed out, our bodies release the stress hormone cortisol.  Over time, excessive cortisol production weakens bones.  While some degree of stress in your life is normal—even healthy—too much can lead to excessive bone loss.  In fact, it’s becoming more recognized that depression and anxiety are linked to weaker bones, and there’s now medical articles identifying “stress-induced osteoporosis.”  So there’s no doubt it’s critical to practice daily stress reduction.

  1. Take a top-grade multivitamin–mineral complex and essential fatty acids (Omega-3s).

It’s a myth that simply taking high amounts of calcium will ensure healthy bones.

To protect your bones and keep them strong and flexible, you need the right amounts of 19 other essential bone-building nutrients—not just calcium.  “Essential” means your body can’t make them so you need to get them from outside sources like food, water and top quality supplements.  Eating a variety of whole foods, preferably organic (like good quality proteins, healthy fats, fruits, vegetables, and raw nuts and seeds), and taking a top-quality multivitamin–mineral complex and essential fatty acids feeds your cells the right amounts of nutrients to prevent bone loss.

When it comes to building healthy bones and maintaining a healthy body, the most important thing to remember is that YOU are the most important part of your wellness plan.  It’s not enough to know what to do.  You must be willing to make changes in your life, and most importantly, apply what you learn and take action every day in small, simple steps.


Melissa Koerner is a Certified Nutrition & Fitness Coach, and the creator of Better Beyond 50, an online holistic health coaching program and community designed to help women at midlife break free from the ageist stereotype that getting older means feeling “old,” and blaze a whole new trail filled with renewed hope for a life full of youthful vitality after 50.

A program and community like no other, Better Beyond 50 provides women a sustainable 4-step lifestyle plan and support system to reduce inflammation and balance hormones naturally, so they can gain more energy, heal their digestion, eliminate aches and pains, build strong bones, muscles & joints, and lose excess weight naturally.

To learn more about Better Beyond 50 go to www.BetterBeyond50.com.

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Medicinal Teas for Hormone Health and PCOS http://pcosdiva.com/2017/06/tea-for-pcos/ http://pcosdiva.com/2017/06/tea-for-pcos/#comments Wed, 14 Jun 2017 15:22:45 +0000 http://pcosdiva.com/?p=13318 Guest post by Kathryn Flynn There is nothing more soothing than a hot cup of herbal tea to bring calm to a busy day. As women, we are often managing […]

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Tea for PCOSGuest post by Kathryn Flynn

There is nothing more soothing than a hot cup of herbal tea to bring calm to a busy day. As women, we are often managing many roles. The simple act of sipping a cup of tea gives us an opportunity to reconnect with the natural cycles of our bodies and reflect on what we need.  Not only is herbal tea calming, but as tea continues to grow in popularity, the medicinal values held within the tea leaves are also becoming more well-known and appreciated.

As we dig deeper into the intrinsic healing potential of herbal teas, we can also find ways to support our health and find balance using herbal teas to reconnect our bodies with the natural rhythms of our monthly cycle.  New research is indicating that herbal teas can positively impact some of the most common symptoms of PCOS including skin problems, hirsutism (abnormal hair growth), weight management, irregular menstrual cycles and fertility.

What are Medicinal Herbal Teas?

Herbal Teas, often called tisanes, are caffeine free infusions that contain a combination of herbs, flowers, seeds, fruits and other extracts seeped in boiling water. Just as food has been used as medicine for thousands of years, the benefits of herbal teas for women have been well known since ancient times.

Why Choose Organic?

Numerous studies are linking chemicals to endocrine disruption.  There are over 3000 known hormone disruptors among the many chemicals that are produced every day.  By choosing organic, you are ensuring the you are ingesting chemical and pesticide free products.  Whenever possible, choose 100% organic certified teas which ensures the highest level of purity.

3 Good Reasons to Quit Caffeine and Switch to Herbal Teas:

While caffeine disrupts the body, naturally caffeine-free herbal teas hydrate.  Caffeine can cause physiological stress to our bodies, creating a surge of cortisol which can disrupt testosterone and insulin and negatively impact PCOS symptoms.

  1. Adrenal health and energy levels: Many of us are accustomed to relying on caffeine to give us the energy we need to make it through the day. However, on a physiological level, we are giving ourselves a false lift and actually stealing from our true energy reservoirs.  Though you may initially crave the “caffeine boost,” as your body adjusts and hydrates, your adrenals will replenish and you will walk away with increased, steady energy.
  2. Endocrine disruption and miscarriage prevention: Equally as important as adrenal health, reducing caffeine intake is essential to the 60 million women of reproductive age in the US. Caffeine has been shown to disrupt endocrine function and deplete the body of micronutrients.  One Kaiser Permanent Study linked caffeine to miscarriage and recommended keeping caffeine intake to under 200 mg per day.
  3. Cortisol and the Fight – Flight Response: Caffeine is may also heighten agitation and impact sleep, potentially causing a release of cortisol. Physiological and psychological stress are known to impact the menstrual cycle, reproductive health and increase cortisol in the body. We also know that cortisol negatively impacts testosterone and insulin resistance thereby exacerbating symptoms of PCOS.

Organic Super Teas for Hormonal Health and PCOS

While most people have sipped chamomile to relax, the power of herbal teas extends well beyond its calming properties.  Research continues to confirm many different ways herbal teas can support woman from inflammation to blood sugar balance, insulin resistance, weight loss, hirsutism, skin conditions, detoxification and even hormonal health.

Here is a list of 4 medicinal teas to enjoy:

1. Turmeric

Turmeric is a beautiful yellow spice, commonly used in Indian curry dishes.  It contains the powerful antioxidant curcumin, and studies are showing that it is helpful reducing inflammation which is believed to be the root cause of many imbalances including PCOS.  It may also help with period cramps, skin health as well as insulin resistance and weight loss according to a Journal of Nutrition Study from 2009.

2. Ginger-

Ginger is a wonderfully aromatic tea with known benefits for women including fighting nausea in pregnancy and helping to ease any pain associated with the menstrual cycle. It is believed to have anti-inflammatory properties and is also being studied for its benefits on the brain in Alzheimer’s prevention research. In addition, ginger has been shown to help lower blood sugar levels, which is essential to regulating insulin levels and hormone balance for PCOS.

3. Spearmint Tea

Spearmint Tea is wonderfully refreshing and also has noted benefits for helping with hormone regulation related to hirsutism. One study showed spearmint tea to have “anti-androgen effects” in PCOS and additional research has also indicated that women who consumed 1-2 cups of spearmint tea a day lowered they testosterone levels which could potentially help to reduce the symptoms of hirsutism.

4. Cinnamon-

Both delicious and aromatic, cinnamon is being closely observed for its connection to balancing blood sugar levels, supporting insulin resistance and boosting metabolism. A recent study in the American Journal of Obstetrics & Gynecology has indicated that “cinnamon improves menstrual cyclicity in women with polycystic ovary syndrome.” This finding has also indicated cinnamon may help to increase pregnancy rates in those with PCOS.  Cinnamon has also been shown to regulate blood sugar levels.  Addressing insulin resistance not only supports hormone health, but it is the first step in supporting steady weight loss.

How to Make Your Own Infusions

Boil Water.  If using loose tea, add tea to a diffuser.  Place diffuser or tea bags in desired cup or tea pot and pour boiling water over tea to steep.  Let sit for 3-5 minutes or more.  Remove diffuser or tea bag and enjoy.  Experiment with different tisanes and combinations for taste and healing benefits.


SPecial Offer for PCOS Divas from Moontime Tea.

Use code “pcosdiva15” for 15% off anything in the store. One coupon per customer. 

As the author of Cooking for Fertility and the Founder of FertileFoods.com, Kathryn Flynn has had had the privilege of working with hundreds of women in fertility and pregnancy nutrition consultations. One of the foundational recommendations is to give up caffeine, which is often met with resistance. In response to this need, Kathryn created Moontime Tea for Women: a collection of herbal tea blends for women’s wellness at every stage of life.  Moontime Tea is intentionally blended with 100% organic certified herbs and packed in convenient, chlorine-free tea bags. The first of Moontime Tea’s blends was developed to fulfill this need—a naturally caffeine free alternative to coffee designed to replenish reproductive health. Moontime Tea is based in Southern Oregon where Kathryn lives with her husband Michael and their two children, Emerson and Abigail.


Caffeine During Pregnancy. (n.d.). Retrieved May 26, 2017, from https://healthy.kaiserpermanente.org/health/care/consumer/health-wellness/conditions-diseases/he2/!ut/p/a1/hZDBboJAEIafpQeOMoNrEXtDW2HdorY1le6lQdgC6bpLcCvh7QVrDyZtOrdJvu-f_AMcYuAqOZZ5YkqtEtnv3H2fL15W06njYxCEc6ThfeAwJxii58IWFsBzqXdn-K0wprqz0MJUKyOUqYXKRC1qC4EXTZlBbNSYePgfm5i2EhAXIpGmGAiVtqnUlcjKpDd9tSNeDrwWH71gf9Xd8T7ucM5rmsbOtc6lsFO9t_A3pdAHA_E12ZXh131Xo4mHNJqFM7pkiMHwAqx9pF6Etw76xEXqbggbR0sHg9EFQEKfvj-2drFj2Ya9ThhB_EnAP8ZHqPZeS-TxUWwHn88P_s0JWHrnDw!!/dl5/d5/L2dBISEvZ0FBIS9nQSEh/

Turmeric. (n.d.). Retrieved May 26, 2017, from http://www.umm.edu/health/medical/altmed/herb/turmeric

Ejaz, A., Wu, D., Kwan, P., & Meydani, M. (2009, March 18). Curcumin Inhibits Adipogenesis in 3T3-L1 Adipocytes and Angiogenesis and Obesity in C57/BL Mice1–3 . Retrieved from http://jn.nutrition.org/content/139/5/919.full

Khandouzi, N., Shidfar, F., Rajab, A., Rahideh, T., Hosseini, P., & Taheri, M. M. (2015). The Effects of Ginger on Fasting Blood Sugar, Hemoglobin A1c, Apolipoprotein B, Apolipoprotein A-I and Malondialdehyde in Type 2 Diabetic Patients. Retrieved May 26, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4277626/

Grant, P. (2010, February). Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial. Retrieved May 26, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/19585478

Kort, D. H., MD, & Lobo, R. A., MD. (2014, November). Preliminary evidence that cinnamon improves menstrual cyclicity in women with polycystic ovary syndrome: a randomized controlled trial. Retrieved May 26, 2017, from http://www.ajog.org/article/S0002-9378%2814%2900446-3/abstract





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How to Talk to Your Doctor about PCOS http://pcosdiva.com/2017/06/how-to-talk-to-your-doctor-about-pcos/ Thu, 01 Jun 2017 14:17:22 +0000 http://pcosdiva.com/?p=13249 Guest post from Rashmi Kudesia M.D., M.Sc., RMA of New York During a new patient consultation, I can frequently sense that a patient is very nervous – What am I going […]

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Guest post from Rashmi Kudesia M.D., M.Sc., RMA of New York

During a new patient consultation, I can frequently sense that a patient is very nervous – What am I going to ask? What will I tell her? Will I be giving bad news? These are all natural reactions, but today’s post is an effort to help de-mystify the process of seeking care for PCOS, and to help make you less anxious talking to your doctor!

Often times, making the appointment and going in for it are truly the scariest parts. Honestly, I say all the time, “You’ve already done the hardest part by making this appointment and coming in – now we’re going to figure out what’s going on and make you a plan!”. So, when you’re considering whether to see a specialist, just remember: you are going in to try and get some information and understand your condition and your options. You are not obligated to follow those recommendations if they don’t seem right or if you don’t feel a good fit with that particular office; the goal is to just try and get in the driver’s seat of controlling your PCOS diagnosis. If the visit does not make you feel this way, you can try again with someone who gives you peace of mind!

Next, make sure you’ve selected the right doctor for your goals. If you’re not looking to conceive, a medical endocrinologist or reproductive endocrinologist & infertility specialist (REI) who specializes in PCOS would be a good choice. For fertility treatment, you should specifically see a REI (and again, one who lists a specific interest in PCOS is always a plus!). This is important because not all REIs provide longitudinal non-fertility care for PCOS women, and medical endocrinology offices are not going to have the capacity for cycle monitoring that may be helpful in fertility treatment.

Alright. Once you’ve got your appointment lined up with the right provider, make sure you’ve got all your records handy. If you have had routine bloodwork with your gynecologist or another doctor (this could include testing of the androgen, or male hormone, levels, which are often elevated in PCOS, diabetes screening, Pap smears, infectious disease testing, reports of any prior surgeries, and so forth), request a copy to take in with you. You have a legal right to your records, so do not hesitate to ask – but keep in mind, many offices take 1-2 weeks to process these requests, so call early!

Also, for most women not on a hormonal contraceptive, a method for keeping track of your period is very handy. Nowadays, there are many great smartphone applications that can track your cycle, which is helpful so your doctor can understand your menstrual pattern. Download one, and keep track of your cycles – at least a few months of data is helpful if possible! If you have specific questions, keep a running list and bring it with you to the visit. If you are trying to conceive with a partner, you may want him or her to join you so you both hear all the information, but if this will make you self-conscious, do the first visit alone!

Finally, the actual visit itself! Make sure to fill out any pre-appointment paperwork ahead of time, or arrive early to do so, so your doctor has time to review your history before seeing you. In the visit itself, make sure all your PCOS-related concerns are discussed. I personally think of 5 specific domains that were suggested to me through a very useful validated questionnaire called the PCOSQ – PCOS-related Quality of Life Questionnaire – and they include: weight, infertility, menstrual irregularities, hirsutism (excess facial or body hair), and mood. These are certainly all interrelated, but your doctor may not specifically address each of them unless you mention the symptoms that are bothering you most. Make sure all your questions and complaints have been addressed!

For those specifically looking for fertility treatment, even if weight is not an issue for you, your doctor should speak to you about the risks for metabolic disease such as gestational diabetes, type 2 diabetes, heart disease, metabolic syndrome and so on. The appropriate screening should be offered, and if needed, recommendations for nutritionist consultation and exercise regimens made. In many instances, young PCOS women are better served by spending a few months optimizing their overall health before getting pregnant than rushing into treatment and ending up with a complicated pregnancy. Ask if such services are available – a good PCOS diet could not only help you be healthier, but also decrease the chances of developing diabetes during pregnancy (women with PCOS are at greater risk). Remember that your health during pregnancy not only affects you, but has lifelong consequences on your child, and so the time investment is very worth it when improvements can be made!

Lastly, make sure you understand your treatment plan: which medications do what, the risks and benefits of different approaches, and so forth. Many women with PCOS are over-prescribed metformin, not offered letrozole (the first-line oral medication for fertility treatment in PCOS women), pushed into using injectable medication (high risk for developing too many follicles!) or IVF (not usually the first-line treatment). Get the success rates for each treatment, so you can form a reasonable expectation of the timeframe at hand. Find out which parts your insurance might pay for, and what a long-term plan might look like if it takes longer than expected to conceive. The key thing here is that PCOS is actually one of the fertility diagnoses with the highest prognosis of success, so don’t lose hope!

So, I hope those of you looking to see a new doctor for PCOS feel more confident now about how to approach the visit. Though it may not feel like it at times, there is a lot you can control about your diagnosis, and the first step is to assemble the right care team to help you do so! Good luck!

Dr. Rashmi Kudesia is a reproductive endocrinologist and infertility specialist who leads RMA of New York’s Brooklyn office. Dr. Kudesia specializes in treating couples who are trying to build their families.
Dr. Kudesia earned her medical degree from Duke University. She completed her residency in obstetrics and gynecology at New York Presbyterian Hospital/Weill Cornell Medical College. She completed her fellowship training in Reproductive Endocrinology and Infertility as well as a Masters of Science in Clinical Research Methods at Albert Einstein College of Medicine.

Dr. Kudesia has received numerous grants and awards for her academic accomplishments and medical research. She was awarded a Global Women’s Health certificate by Mount Sinai School of Medicine in 2011, and was nominated into the Duke Engel Society, which recognizes intellectual development, service and clinical excellence. Dr. Kudesia is the recipient of the Joan F. Giambalvo Scholarship Research Grant from the AMA Foundation in 2013, as well as multiple in-training research grants. Dr. Kudesia served as a Theme Issue Editor for the American Medical Association’s Journal of Ethics’ issue on Innovation in Reproductive Care, and has held multiple regional and national leadership positions within organized medicine.

Dr. Kudesia is an accomplished lecturer and author and has written numerous scientific research articles and manuscripts in leading medical journals. She has presented many of her research findings at national meetings, including the American Society for Reproductive Medicine (ASRM).

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PCOS & GABA – What You Should Know http://pcosdiva.com/2017/05/pcos-gaba-what-you-should-know/ Mon, 22 May 2017 20:56:11 +0000 http://pcosdiva.com/?p=13144 By Amy Medling, founder of PCOS Diva Many women with PCOS have low GABA, and it is impacting their quality of life. Anxiety, trouble sleeping, and Irritable Bowel Syndrome are all […]

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By Amy Medling, founder of PCOS Diva

Many women with PCOS have low GABA, and it is impacting their quality of life. Anxiety, trouble sleeping, and Irritable Bowel Syndrome are all symptoms. The good news is, there is something you can do about it. Here’s what you need to know.

What is GABA?

Gamma-aminobutyric acid (GABA) is the main inhibitory neurotransmitter in the central nervous system, aka the part of the nervous system consisting of the brain and spinal cord. Being an “inhibitory neurotransmitter” simply means GABA is a compound capable of slowing down neuron or nerve cell activity.

Because it’s a neurotransmitter, there is also a corresponding GABA receptor which transmits the “messages” brought by neurotransmitters throughout the body.

Common functions

A good example of one of the main functions of GABA is in improving quality of sleep as one of its duties is to tell your brain that you’re about call it a day and you want some decent shuteye. Low levels of GABA will of course lead to poor sleep quality.

More than sleep, GABA is also responsible for a person’s behavior, cognition, and their response to stress. It also helps manage fear and anxiety levels since these are two types of behaviors that fire your neurons rapidly. GABA acts as a form of buffer or counter-firing activity to balance everything out.

GABA works a lot like alcohol. Alcohol is known to mimic GABA, which explains why people who drink feel relaxed, calm and happy, and even have a heightened sense of bravery to do irrational things. The hangover is when your brain realizes it had too much GABA, so now it deliberately crashes it which then causes headaches and nausea before it achieves balance again.

What does it have to do with PCOS?

Studies have documented the effects of PCOS on female behavior. Studies show those with PCOS commonly have reduced quality of life, anxiety, depression, body dissatisfaction, an eating disorder, and sexual dysfunction. [1]

In fact, a 2014 study by scientists in Turkey investigated the connection between PCOS and GABA. They found out various hormonal imbalances that lead to PCOS also contribute to lower GABA levels. [2] They also wrote:

These findings show that women with PCOS are under hormonal oppression. After all, undoubtedly, these hormonal changes affect the emotional state of the patients…The impaired psychosocial functions in patients with PCOS are associated with frustration feelings and anxiety.

If you have PCOS, there’s a good chance you also have low GABA levels.

How do I know if I am low in GABA?

As with any disorder, there are symptoms to having low GABA. Some of them are:

  • Trouble relaxing or loosening up
  • Anxiety or panic disorders
  • Feelings of helplessness
  • Irritable bowel syndrome (IBS)
  • Fibromyalgia
  • Easily agitated or angered
  • Difficulty in sleeping due to racing thoughts

When you constantly have your nerve cells running all over the place, you’re bound to experience restlessness, agitation, and eventually lack of sleep. Lack of sleep can snowball into illnesses linked to chronic sleep deprivation which will only worsen the situation with someone who is already diagnosed with PCOS.

So I’m low, what can I do?

Lifestyle changes

As with many diseases, one of the root causes of having low GABA is poor lifestyle choices. Even something as seemingly trivial as sleep can be a root cause of low GABA. Sleep and GABA go hand in hand. When you have low GABA, you have bad sleep and vice versa. If you can force your body to adapt to a regular sleeping pattern, and ultimately improve circadian health, your body will naturally have better GABA receptors and respond to GABA neurotransmitters faster.

Other lifestyle choices you can try include:

  • Dietary changes
    • When it comes to diet, you would want to eat foods where GABA is found. I say found because glutamine is a byproduct of fermentation in foods. Some of these foods are sauerkraut, kimchii, kefir, and kombucha.
  • Regular exercise
    • There’s a lot to say about the benefits of exercise, but regular movement is ideal for all neurotransmitters specially GABA. Low-intensity walking or calming exercises like yoga all help support healthy GABA levels.

Take supplements

There are supplements readily available in the market capable of raising GABA indirectly and products that are actual GABA supplements. We’re telling you right now, there’s a good chance GABA supplements don’t work, and it’s all thanks to a thing called the blood-brain barrier (BBB).

The BBB is a special line of defense produced by our body to prevent harmful substances from entering the brain. While the BBB is capable of detecting and filtering these harmful compounds, it also makes it difficult for beneficial substances such as GABA to directly affect the brain.

So what supplements can you take? You can choose to take supplements that indirectly increase GABA such as

  • L-Theanine
  • Passiflora
  • Valerian Root
  • Glutamine

Likewise, you can also take direct GABA supplements so long as they’re attached to a compound capable of penetrating the BBB. Common ingredients are niacin and phenyls, but those who like to use GABA analogs such as Phenibut and Picamilon will fare better when it comes to bioavailability. Phenibut and Picamilon has 65% and 50-88% GABA bioavailability respectively. [3][4]PCOS Diva supplement features


  1. Scaruffi E, Gambineri A, Cattaneo S, Turra J, Vettor R, Mioni R. Personality and psychiatric disorders in women affected by polycystic ovary syndrome. Front Endocrinol (Lausanne). 2014;5:185.
  2. Balikci A, Erdem M, Keskin U, et al. Depression, Anxiety, and Anger in Patients with Polycystic Ovary Syndrome. Noro Psikiyatr Ars. 2014;51(4):328-333.
  3. Dorofeev BF, Kholodov LE. [Pikamilon pharmacokinetics in animals]. Farmakol Toksikol. 1991;54(2):66-9.
  4. Lapin I. Phenibut (beta-phenyl-GABA): a tranquilizer and nootropic drug. CNS Drug Rev. 2001;7(4):471-81.
    As a certified health coach, Amy Medling often hears from women with Polycystic Ovarian Syndrome (PCOS) who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill and live with their symptoms.  In response, she founded PCOS Diva and developed a proven protocol of supplements, diet and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health and happiness.


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The 9 BEST Foods for PCOS http://pcosdiva.com/2017/05/the-9-best-foods-for-pcos/ Mon, 22 May 2017 19:49:52 +0000 http://pcosdiva.com/?p=13224 By Amy Medling, Founder of PCOS Diva PCOS Divas know that food is medicine. Women with PCOS can use their grocery stores and farmer’s markets like pharmacies in order to […]

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By Amy Medling, Founder BEST Foods for PCOSof PCOS Diva

PCOS Divas know that food is medicine. Women with PCOS can use their grocery stores and farmer’s markets like pharmacies in order to nourish our bodies and ease our symptoms. The best medicine for PCOS is also the best diet for PCOS.

In order for women with PCOS to thrive, we must “Eat the Rainbow” every day. Eating a colorful assortment of vegetables and fruits every day provides a broad spectrum of vitamins, minerals, and other beneficial plant components that we need to nourish our cells, balance our insulin, hormones and other body systems, and boost our energy.

Avoid endocrine (hormone) disrupting chemicals, by choosing organic and/or locally grown produce whenever possible. If fresh, local, organic choices are limited or unavailable, fresh-frozen organic vegetables and fruits are a good choice. Just make sure you read the ingredient label to avoid any unwanted additives, namely sugar and preservatives.

While most of the foods on this list are fruits and vegetables, I encourage you to include clean protein (fish, poultry, lean meat, and legumes) and whole grains. A well-rounded diet will keep you nourished, energized, and satisfied.

Load up your PCOS diet with:

  1. Dark Leafy Greens 

    Glorious greens such as romaine lettuce, red leaf lettuce, kale, chard, spinach, collards, beet greens, dandelions, endive, basil, parsley, and arugula are the very BEST low-calorie, high fiber, low glycemic index food sources of essential vitamins and minerals out there.

*Greens improve digestion and absorption of nutrients in the gut, improve glucose regulation and overall endocrine function, and reduce the risk of metabolic, cardiovascular and autoimmune diseases, and cancer.

*Leafy greens provide vitamin A and its precursors, the carotenoids, vitamin K, vitamin C and various flavonoids and also rich sources of iron calcium, magnesium, potassium, manganese, and numerous other trace minerals. These nutrients are essential cofactors in hundreds of physiological processes, such as regulating blood pressure, maintaining a strong and steady heartbeat, and producing the bio-energy adenosine triphosphate (ATP) in the mitochondria to name a few.

*Leafy greens are also a good source of many B vitamins, especially folate, the plant form of folic acid. Adequate intake of all the B vitamins are necessary for neurological and cardiovascular health, prevention of anemia, and to reduce risk of certain cancers.1,2

Tip: To improve the bioavailability of the fat-soluble vitamins (A, D, E, K) and other fat-soluble plant components, it is best to eat greens with a little oil (EVOO or avocado oil are my favorites) or other healthy fat, including butter from grass fed cows. Additionally, for best bioavailability of the minerals, a bit of acid is required. Vinaigrette to the rescue!

2. Colorful Vegetables  

Eat these nutritional powerhouses raw, steamed, boiled, broiled, roasted, grilled, or sautéed. Dip them in yogurt or hummus, drizzle them sparingly with a little vinaigrette or other salad dressing, or toss them with herbs and melted butter or a squeeze of lemon. Vegetables are an excellent source of vitamins, minerals, fiber, and unique bioactive phytocomponents that maintain glucose regulation, reduce meta-inflammation and the dangerous effects oxidative stress, and therefore, lower the risk of getting, and dying from, cardiovascular or any other chronic disease.

*The crucifers—broccoli, cauliflower, Brussels sprouts are a great source for dietary sulfur, essential for production of glutathione, the body’s master antioxidant

*String beans, wax beans, and pole beans are actually legumes, but we tend to think of them as veggies, provide protein, fiber and folate. As an excellent source of silica, a mineral essential for connective tissue and bone support, eating them regularly may reduce the risk of osteoporosis in menopausal women.3

*Asparagus is an outstanding source of the potent flavonoid Quercetin and also contains phytochemicals known as steroidal saponins that help reduce the inflammation cascade and fights cancer cells!4

*Artichokes – Containing 41% fiber, they are also a good source of Niacin, Magnesium, Phosphorus, Potassium and Copper, and a very good source of vitamin C, vitamin K, Folate and Manganese.5

*Carrots, sweet potatoes, beets, and other root vegetables provide potent antioxidant, anti-inflammatory and anti-cancer protections, and lower the risk of cardiovascular disease and other chronic conditions.

*Tomatoes, Potatoes, Bell Peppers, and Eggplant are all packed with antioxidant phytonutrients and an assortment of vitamins and minerals. Caution: Go easy with these members of the nightshade Eat occasionally in rotation. For people with arthritis, food sensitivities, chronic headaches or other conditions, eating nightshades may cause a flare in symptoms.

3. Berries 

Berries such as blueberries, raspberries, blackberries, strawberries, currants, and cranberries are packed with immune boosting, cancer-preventing, heart-protecting, obesity-preventing antioxidant components, including specific polyphenols, flavonoids, and other phytocomponents that fight inflammation and disease. Researchers are learning that phytonutrients in raspberries may prevent obesity and fatty liver by regulating certain enzymes. They are also studying varieties of squash and melons that offer protection against type 2 diabetes by down regulating insulin.6,7,8

4. Avocados and avocado oil 

Also technically a type of fruit known as a drupe, avocados are often misunderstood and overlooked as a nutritional superfood due to their high concentration of saturated fat. Fear not, PCOS Divas! Avocados are packed with vitamins, minerals, and heart healthy fatty acids that help quell systemic inflammation, promote healthy endocrine and immune system function, and make your skin glow! Adding an avocado per day to an already well-balanced diet has been shown to lower risk of heart disease, lower LDL cholesterol, and reduce oxidative stress.9

Tip: Use avocado oil for sautéing vegetables and lean protein. It has a high smoke point, so it won’t be damaged by the heat, tastes great, and has a superior fatty acid profile, high antioxidant content, and contains cholesterol-blocking phytosterols.

5. Nuts & Seeds 

Brazil nuts, almonds, cashews, walnuts, macadamia nuts, flax, chia, and hemp seeds are protein-packed powerhouses that provide an array of minerals including magnesium, calcium, and selenium. When eaten in combination with fruit or other high glycemic foods, nuts and seeds help lower the glycemic index and improve glucose-insulin Pumpkin seeds, in particular, contain essential fatty acids (EFAs) that our bodies need.  These EFAs help regulate hormone function, improve hair, skin and nails, lower insulin levels, stabilize blood sugars, and help regulate periods. These little powerhouses may also help with hirsutism, or male pattern hair growth.

6. Wild-Caught Fish

Fish such as salmon, tuna, mackerel, and sardines provide an excellent source of the essential, anti-inflammatory and heart healthy Omega-3 fatty acids DHA and EPA and other fat-soluble nutrients, including vitamins A & D. Buy only wild-caught fish to reduce potential for parasites and pesticides, and limit consumption of these fish to 3-4 times a week to limit mercury and other heavy metal exposure.

7. Stone fruits

Fruits with pits such as apricots, peaches, plums, nectarines also contain powerful phytonutrients that have anti-obesity, anti-inflammatory and anti-diabetic properties.10 These fruits also have the ability to modulate gene expression, reduce LDL cholesterol oxidation, and may help prevent metabolic syndrome and cardiovascular disease. Have insomnia? Eat a few cherries before bed to relax. The melatonin content of cherries has been shown to increase quality and duration of sleep.11
8. Dark Chocolate 

This is great news for chocolate lovers! Research shows that dark chocolate containing 70% cacao or more reduces hypertension, increases circulation, aids in preventing atherosclerosis, improves glucose regulation by preventing blood sugar spikes, and may actually promote weight loss by controlling hunger and promoting satiety!12 As every chocolate lover knows, chocolate may greatly improve the mood and soothe the nerves. Research also shows that chocolate prevents memory decline and improves overall cognitive function.13

9. Green Tea

Unsweetened, brewed green tea is a zero-calorie beverage, and is considered one of the world’s healthiest drinks due to its high concentration of powerful antioxidants that improve blood flow, lower cholesterol, improve hypertension and may prevent other the heart-related issues, including congestive heart failure and stroke. Because of its circulatory benefits, green tea also nourishes and stimulates the brain by boosting brain activity and memory and helps block the formation of amyloid plaques linked to Alzheimer’s disease.14 The antioxidant polyphenols in green tea may also prevent cancers of the breast, bladder, ovaries, esophagus, skin, lung, stomach, and bowels, although research is inconclusive.15 If green tea isn’t your cup of tea, most varieties contain health benefits. Try them all!

Remember—the more naturally colorful (no food dyes!) a food is, the healthier it is likely to be. The antioxidant components of plants provide the pigments that give vegetables and fruits their gorgeous colors. So, eat the rainbow daily, and thrive with PCOS!

Finally, women with PCOS should avoid foods which promote the meta-inflammation that leads to endocrine disruption, weight gain, and increased cardiovascular risks, among other undesirable effects. For a list of foods to avoid with PCOS, read, “The 7 Worst Foods for PCOS.”

As a certified health coach, Amy Medling often hears from women with Polycystic Ovarian Syndrome (PCOS) who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill and live with their symptoms.  In response, she founded PCOS Diva and developed a proven protocol of supplements, diet and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health and happiness.


  1. Brouwer IA, van Dusseldorf M, West CE, Meyboom S, Thomas CMG, et al. Dietary Folate from Vegetables and Citrus Fruit Decreases Plasma Homocysteine Concentrations in Humans in a Dietary Controlled Trial. Nutr. June 1, 1999; 129(6) : 1135-1139. Available at http://jn.nutrition.org/content/129/6/1135.long
  2. Dietary Supplement Fact Sheet: Folate. Office of Dietary Supplements, National Institutes of Health website. Available at https://ods.od.nih.gov/pdf/factsheets/folate-healthprofessional.pdf
  3. The George Mateljan Foundation. Green beans. World’s Healthiest Foods website http://whfoods.com/genpage.php?tname=foodspice&dbid=134
  4. The George Mateljan Foundation. Asparagus. World’s Healthiest Foods website http://whfoods.com/genpage.php?tname=foodspice&dbid=12
  5. Self Nutrition Data website.
  6. The George Mateljan Foundation. Squash. World’s Healthiest Foods website http://whfoods.com/genpage.php?tname=foodspice&dbid=62
  7. Joseph B, Jini D. Antidiabetic effects of Momordica charantia (bitter melon) and its medicinal potency. Asian Pac J Trop Dis. 2013 Apr; 3(2): 93–102. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4027280/
  8. Fact Sheet. Berry Health Benefit Network. Ohio State University. http://berryhealth.fst.oregonstate.edu/health_healing/fact_sheets/
  9. The George Mateljan Foundation. Avocados. World’s Healthiest Foods website http://whfoods.com/genpage.php?tname=foodspice&dbid=5
  10. Texas A&M AgriLife Communications. “Peaches, plums, nectarines give obesity, diabetes slim chance.” ScienceDaily. 18 June 2012. ScienceDaily https://www.sciencedaily.com/releases/2012/06/120618132921.htm
  11. Adams C. Cherries: Nature’s Anti-inflammatory Sleep Aid. 2014 February 6. GreenMedInfo website. http://www.greenmedinfo.com/blog/cherries-natures-anti-inflammatory-sleep-aid
  12. Katz DL, Doughty K, Ali A. Cocoa and Chocolate in Human Health and Disease. Antioxid Redox Signal. 2011 Nov 15; 15(10): 2779–2811. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696435/
  13. Nordqvist J. Chocolate: Health Benefits, Fact, Research. Medical News Today Reviewed by Butler N. Updated 2016 June 1. http://www.medicalnewstoday.com/articles/270272.php
  14. Scott PS. Health Benefits of Green Tea. WebMD.com website. http://www.webmd.com/food-recipes/features/health-benefits-of-green-tea#1
  15. Ware M. Green tea: Health benefits, side effects and research. Reviewed by Wilson DR. Updated 2017 March 28. Available at http://www.medicalnewstoday.com/articles/269538.php

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Nightshades, Inflammation & PCOS http://pcosdiva.com/2017/05/nightshades-inflammation-pcos/ Mon, 22 May 2017 14:40:53 +0000 http://pcosdiva.com/?p=13217 By Amy Medling, Founder of PCOS Diva You may have heard about celebrities and professional athletes who avoid nightshades. Have you ever wondered why? As it turns out, nightshades may […]

The post Nightshades, Inflammation & PCOS appeared first on PCOS Diva.

NightshadesBy Amy Medling, Founder of PCOS Diva

You may have heard about celebrities and professional athletes who avoid nightshades. Have you ever wondered why?

As it turns out, nightshades may aggravate inflammation, leaky gut and autoimmune diseases. Since women with PCOS are prone to these things, should you avoid nightshades too?

It depends upon your sensitivity to them. For many people, nightshades are not a problem. Those with a sensitivity should proceed with caution. Here’s the scoop:

What is a nightshade?

Nightshades are a group of about 2,500 plants (including fruits). Some people have a sensitivity to them, and when consumed may cause diarrhea, gas, bloating, nausea, heartburn, painful joints, irritable bowel disorders, headaches, gastrointestinal issues, heartburn, and depression.

Nightshades include:

  • tomatoes
  • potatoes
  • eggplant
  • goji berries, garden huckleberries, some types of blueberries and gooseberries
  • peppers (all varieties such as bell pepper, wax pepper, green & red peppers, chili peppers, cayenne, paprika, etc.- anything that contains “pepper” in the name)
  • tomatillos

What makes nightshades problematic?

Nightshades contain glycoalkaloids (the plants’ natural defence against insects, animals, and fungi which act as a form of active pesticide/fungicide) and alkaloids. Both of these produce irritations in your GI system and can worsen leaky gut (for a complete explanation of leaky gut, read “Leaky Gut and PCOS”). The result can seriously impact your immune system and hormone balance, and stimulate systemic inflammation.

The worst offender is the potato. A hallmark of many westerners’ diets, potatoes have been shown in lab rats to increase permeability of the colon, which allows undigested proteins and toxins in to the blood stream (leaky gut). The study showed that the higher the glycoalkaloid level, the more intense the inflammatory response. Glycoalkaoids remain stable in potatoes which have been boiled, frozen or dehydrated and the more you consume, the more the inflammation response ramps up in your body.

How can you avoid nightshades’ effects?

If you are sensitive to nightshades, avoid them. If you are unsure, consider a 30-day elimination diet and see if you experience a change in your inflammation levels. Watch out for potato starch as a filler or thickener in products (including medications and baking powders).

To be on the safe-side, avoid green tomatoes and potatoes or potatoes that are sprouting. Peel your potatoes and cook all nightshades (though this will minimally reduce the effects).

The potential benefits of nightshades are far outweighed by the increased inflammation they cause for those sensitive to them. Women with PCOS should be particularly aware of their effect since inflammation is the root of our symptoms. Consider eliminating nightshades and monitor your results. You might be surprised!

As a certified health coach, Amy Medling often hears from women with Polycystic Ovarian Syndrome (PCOS) who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill and live with their symptoms.  In response, she founded PCOS Diva and developed a proven protocol of supplements, diet and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health and happiness.


The post Nightshades, Inflammation & PCOS appeared first on PCOS Diva.

Practical Tips to Tame Your PCOS Inflammation [Podcast] http://pcosdiva.com/2017/05/pcos-inflammation/ Thu, 18 May 2017 13:55:12 +0000 http://pcosdiva.com/?p=12962 Inflammation is at the heart of many of your PCOS symptoms regardless of your body weight. Diet and lifestyle can play an important role in either increasing or decreasing inflammation. […]

The post Practical Tips to Tame Your PCOS Inflammation [Podcast] appeared first on PCOS Diva.

PCOS Podcast 63 McKittrickInflammation is at the heart of many of your PCOS symptoms regardless of your body weight. Diet and lifestyle can play an important role in either increasing or decreasing inflammation. Today’s podcast guest, well-known registered dietitian Martha McKittrick, shares her approach to help you tame the flames of inflammation with your diet and lifestyle choices.

She offers practical and specific nutrition and lifestyle tips to decrease inflammation as well as info about what tests you should request for inflammation indicators and what you should consider when exercising.

You will want to take notes on this one. Grab a pen.

Listen as we discuss:

  • what causes inflammation (specific foods and lifestyle choices)
  • top lifestyle tips to help decrease inflammation
  • suggestions for an anti-inflammatory diet
  • food sensitivity testing options

All PCOS Diva podcasts are now itunes-button

A full transcript follows.

Martha McKittrick is a Registered Dietitian, Certified Diabetes Educator, Wellcoach®-Certified Health and Wellness Coach with a private practice in NYC.  With over 25 years’ experience in the field of nutrition, Martha specializes in PCOS, weight management, cardiovascular health, diabetes, IBS, and preventive nutrition. Ms. McKittrick has had a special interest in nutrition for PCOS since 2000 and can be considered one of the pioneers in the field. She was the nutrition editor for Dr. Walter Futterweit’s book: A Patient’s Guide to PCOS – Understanding and Reversing Polycystic Ovarian Syndrome. She has lectured across the country on PCOS to both health professionals as well as women with PCOS. She is currently on the Health Advisory Board for PCOS Challenge.

Martha is passionate about helping women take charge of their PCOS with healthy diet and lifestyle. She does not believe in a “one-size-fits-all” plan and provides individually tailored recommendations for her patients. She takes an integrative approach and focuses on sleep, stress, physical activity, supplements in addition to diet. Living in NYC, Martha specializes in helping women with PCOS find practical ways to incorporate healthy nutrition and lifestyle into their hectic schedules! Martha blogs at PCOS Nutrition & Lifestyle Solutions http://marthamckittricknutrition.com/pcos-blog/  Like her facebook page PCOS Nutritionist Martha McKittrick https://www.facebook.com/PCOSnutritionist/

To learn more about Martha:
Website: Martha McKittrick Nutrition 

Email: Martha@MarthaMcKittrickNutrition.com
Phone: 212.879.5167

Complete Transcript:

Amy Medling:                    Hello, and welcome to the PCOS Diva podcast. My name is Amy Medling, I’m a certified health coach, and founder of PCOS Diva, and my mission is to help women with PCOS find the tools and knowledge they need to take control of their PCOS, so they can regain their fertility, femininity, health and happiness. And if you haven’t already, make sure you check out pcosdiva.com because there I offer tons of free information about PCOS, how to develop your lifestyle plan so you can begin to thrive like a Diva, and you can look for me on Facebook, Twitter, Pinterest and Instagram as well.

So, if you’re a frequent listener to the PCOS Diva podcast then you know PCOS is associated with chronic low-grade inflammation, regardless of your body weight. Diet and lifestyle can really play an important role in either increasing or decreasing inflammation. So today’s guest, registered dietician Martha McKittrick, is going to share her approach to help you tame the flames of inflammation with your diet and lifestyle choices. So, Martha, welcome to the PCOS Diva podcast!

Martha McKittrick:          Thanks, Amy, it’s great to be here!

Amy Medling:                    So, before we get started on today’s really important topic, I’m just gonna give our listeners a bit of your background. You’re a registered dietician, you’re a certified diabetes educator, well-coach, certified health and wellness coach, with a private practice in New York City. You have over 25 years of experience in the field of nutrition, and you specialize in PCOS weight management, cardiovascular health, diabetes, IBS and preventative nutrition. You have a special interest in nutrition for PCOS since 2000, and you’re considered one of the pioneers of the field as you helped Dr. Futterweit with the nutrition section of his book, “A Patient’s Guide to PCOS, Understanding and Reversing Polycystic Ovarian Syndrome.” Which is one of, really, the first books that helped me in my journey, and I kind of consider him the godfather of patient resources for women with PCOS, so what an honor to have contributed to his book. So, thank you so much for taking the time to join us today.

Martha McKittrick:          Thanks Amy, great to be here. As you mentioned, I did meet Dr. Futterweit. It was probably about 15, 17 years ago now, and I kind of fell into the area of counseling women with PCOS, and I was honored to get to write the two nutrition chapters in his book. I lectured across the country with various organizations on PCOS for women who had it, and also for health professionals, I do a lot of lectures for dieticians on PCOS and helping educate them with exactly what it is and what kind of nutrition guidelines are best.

What I find interesting is, when I first started working in this area, the thought that insulin resistance and PCOS went hand-in-hand was a pretty new concept, I think for many years we just thought of it as like a gynecological condition, and now we realize that insulin resistance stage plays a major role, and when I was doing counseling or even writing for Dr. Futterweit’s book, that’s what I focused on was mainly insulin resistance. But since that time, we have learned that inflammation also plays an important role in PCOS.

So when I’m counseling my patients for PCOS I definitely take into account factors that can help decrease inflammation. Inflammation’s a hot topic now, it’s on the news, it’s in all kinds of magazines, we’re hearing anti-inflammatory diets and anti-inflammatory supplements, and inflammation’s linked to obvious chronic disease including heart disease, Rheumatoid Arthritis, Alzheimer’s disease, and cancer. And what research has shown is that inflammation plays a role in PCOS. Including insulin resistance and cardiovascular risk disease factors, so I think it’s really important that women be aware of nutrition and lifestyle tips to decrease inflammation, not just insulin resistance, but let’s think about inflammation too.

Amy Medling:                    Right, and I think that kind of getting to understand what level of inflammation is sort of going on in your body is really important as well, and we can do that. Ask our doctor and advocate for ourselves for testing, to sort of look at our inflammation markers and maybe we could talk a little bit about that as well.

Martha McKittrick:          Yeah, sure. First thing, you know, not all inflammation is bad, okay. So let’s say for example, if you cut your finger and it gets kind of warm and red, basically what’s going on inside is there’s then like this inflammatory cascade that’s been triggered, and your body’s kind of repairing the cut in your finger. So we need some inflammation in the body, but what happens is when we have chronic inflammation, that’s what can increase the risk of disease. Dr. Susan Blum, who wrote “The Immune System Recovery Plan,” I like her kind of quote, she says: “Think of inflammation as an irritating chemical that’s released by your immune cells. If this occurs in an ongoing way, damage occurs, and health problems show up in any part of the body.” So any part of the body, these problems can occur.

You know, what I suggest is that you discuss your concerns with your physician, and there is certain blood tests that they can run that can show if you have any elevated inflammatory markers. And the ones that you would specifically be looking for, the most common one is called a C-reactive protein, the second one is Interleukin-18. Third one is monocyte chemoattractant protein 1, and then your white blood cell count. Or if you just tell your doctor you want the doctor to run a panel for your inflammatory markers they should be able to do that.

If it’s elevated, you definitely know that you do have a low-grade inflammation in the body. But even if they’re not elevated, you might still have a low line inflammation that’s not actually showing up in your blood work, so I really feel that every woman who has PCOS should be following an anti-inflammatory diet. I think all people in general should follow it, but especially women who have PCOS.

Amy Medling:                    Yeah absolutely, and I think that we have to shift our thinking, and I think that the generalized nutrition information is moving from that calories-in, calories-out model, that foods effect our bodies in different ways, that a burger, fries, and a shake, that might equal, I don’t know, 800 calories, is very different from 800 calories derived from plant-based foods.

Martha McKittrick:          Absolutely.

Amy Medling:                    Yeah, and I think if we can think about food as could either be our greatest form of medicine, in a way, or healing for PCOS, but it’s also, if we make poor choices, then it could be sort of our poison. And we have to sort of really manage our choices, and I think it’s important to have that knowledge of what foods are inflammatory versus what foods are anti-inflammatory. So I was kind of hoping that you could share some of your choices to look for, and those to watch out for, when it comes to food and including them in your diet.

Martha McKittrick:          Yeah, I mean, you look at maybe my typical client who has PCOS, I live in New York, we’re all stressed out. So basically, you have a woman who’s probably trying to be on a low-carb diet, and that probably means that they’re eating a lot of protein, probably a lot of animal protein, probably has high stress levels in general, just part of life and then maybe partly PCOS. Someone who’s not sleeping enough, and who has a busy schedule and doesn’t really have the time or the energy to fit in this perfectly balanced nutritional diet with adequate fruits and vegetables.

So kind of what you have right there is a setup for inflammation. You have stress, you have inadequate sleep, you have a lot of animal products, not enough fruits and vegetables, so that is definitely an inflammatory situation. So what you want to do is you want to do everything you can from a nutritional lifestyle standpoint to help decrease inflammation. Studies have definitely shown that women with PCOS do have increased rates in inflammation, they’ve compared thin women, women of average weight, and women who are overweight with PCOS compared to women who don’t have PCOS, and all the women, even the thinner women, still have increased levels of inflammation.

I think a lot of times we think of being overweight as associated with inflammation, and while that is true, women who are more overweight do have higher rates of inflammation, even thinner women do have inflammation, so I think it’s important that everybody follows these guidelines which I’ll go over.

So my top lifestyle tips to help decrease inflammation. The first one, and I’m sure you’ve heard this 100 times, but now I’ll say it 101 times, is if you are overweight, even losing a small amount of body weight will help decrease your inflammatory marker. 5% of your body weight is not a lot of weight, so just that in itself will help decrease. Let’s just say you weighed 170 pounds, that would be losing about 8 pounds. Don’t feel like you have to get to this perfect BMI to help increase your health overall.

The second one is to try and get enough sleep. This is a tough one. I just think we’re being pulled in so many different directions, we’re working long hours at work, family, social obligations, trying to fit in exercise. All this stuff going on, and then stress which might help decrease the quality of your sleep. Most of my patients do not get adequate sleep, or they have a poor sleep quality. Then studies have shown that this does increase inflammatory markers. So do everything you can to try to work on your sleep. Turn the computers off an hour before bedtime.

Amy Medling:                    I just wanted to add, quickly, that women with PCOS are also at an elevated risk of sleep apnea. So if you’re snoring in your sleep, you might want to talk to your doctor about that. I could tell you, so many of my clients that I’ve heard from that have had a sleep study and have gone and had treatment with a CPAP machine, they say that their life has changed dramatically for the better because of the quality of sleep that they’re getting due to their treatment for that sleep apnea, so I just wanted to put that out there.

Martha McKittrick:          Totally. Totally. CPAP machines have come a long way, they’re not quite as large as they used to be, but that’s a really important point. If you’re having trouble … You know, if your partner says, “It’s almost like you stop breathing in your sleep for a minute,” or if you’re having trouble sleeping, definitely seek some medical attention for that. And make sleep a priority. Turn down some social obligations, sleep is so important for everything. They’ve also done studies on inadequate sleep with obesity. If you don’t sleep enough, it can make it be more difficult to lose weight and increases your risk of diabetes and heart disease. Sleep is the hot topic now.

The next tip is stress management. Easier said than done, but chronic elevated stress will increase cortisol levels, which will influence your insulin levels and your metabolism, and it increases chronic inflammation in your body. There’s been a lot of research done on this, especially with depression and stress, there’s a rise in the C-reactive protein, which increases risk of heart disease, so easier said than done, but try to find ways that you can to manage your stress. Whether it’s medication or reading a book or talking to a friend who is a good listener, avoiding irritating situations as much as you can, but you really want to take care of your mental health.

The next tip is quit smoking if you smoke, I think we all know smoking is bad. I don’t think as many people smoke now as they used to, but smoking will definitely increase inflammation.

Now moving onto my area of expertise, which is the nutrition part of it. I’m sure everybody’s heard of the Mediterranean diet, and basically what that is is a very anti-inflammatory diet, and it contains an abundance of vegetables, beans like chickpeas, black beans, fruits, grains, and it has a high ratio of monounsaturated fat to saturated fat. And it has a lot of Omega 3 fats versus Omega 6 fats, and I’m gonna talk about that more in a second.

But this a very anti-inflammatory diet. Compared to the typical Western diet that tends to be higher in animal protein, unrefined or processed carbohydrates, and sugar. So most experts believe that the Mediterranean diet is really the diet of choice for decreasing chronic inflammation. So what does this diet actually consist of? Omega 3 fats. I’m sure everybody’s heard of that, that is the kind of fat that is found in fatty fish like salmon, sardines, herring, any kind of fish that’s higher in fat.

And basically these kinds of fats are anti-inflammatory. You can also get it from a vegetable source, plant-based source which would be walnuts, flax seeds, omega-enriched eggs and leafy greens. They have a lot less Omega 3 than the fish, but they do have some. Basically, these kinds of fats are converted into prostaglandins, and different types of prostaglandins either increase or decrease inflammation, and the Omega 3 fats actually decrease inflammation. I’d recommend if you do not consume fatty fish, consider taking a fish oil supplement, an Omega 3 supplement to help get you those healthy Omega 3 fats.

Amy Medling:                    I was just gonna say, would you mind clarifying the difference between the vegetable derived Omega 3s and more of the fish ALA?

Martha McKittrick:          Yeah, that’s a good question. Good question. Any of the Omega 3s that come from a plant source are called Alpha-Linolenic Acids, and it’s a much weaker form of the Omega 3 fats. You need ten of the Alpha-Linolenics to convert to one of the Omega 3s. So it’s pretty much impossible for the most part to meet your Omega 3 needs if you’re just getting it from the walnuts, flax seeds and the Omega-enriched eggs. So that’s why I do recommend that you try to get in a real Omega 3 source, either from the fatty fish or from the fish oil supplement.

It is recommend that you have fatty fish three or four times a week, which I think a lot of people don’t do. Especially with some concerns about some contamination in fish, so you’re probably best off taking a fish oil supplement. And if you did that, I would recommend a high grade fish oil supplement, and you would want to take about two grams a day of the Omega 3s.

Amy Medling:                    Okay.

Martha McKittrick:          Okay, so the next tip, part of the Mediterranean diet, would be to consume green, leafy vegetables. Pretty much all vegetables contain something nutritious about them, but the green leafy ones are especially nutritious. They contain powerful antioxidants and flavonoids and Vitamin C. These all help protect against cellular damage and help decrease inflammation. When possible, try and get locally grown vegetables, organic if you can. I’m not fanatical about organic, I’d just rather see you eat vegetables in general, but if you can get organic that’s always best. But definitely, you want to get in a wide variety of vegetables, include some leafy green vegetables in there.

The next one is fruit, and I know a lot of women with PCOS are wary of fruit because they do contain carbohydrates, but most fruits actually, believe it or not, have a lower glycemic load or a glycemic index than some grains, because it contains some fructose in it, but fruits, especially the berries, I’m a huge fan of strawberries, blueberries, even citrus like oranges, and even something like cherries which are sweet, but they contain a lot of antioxidants and polyphenols, and these again are high anti-inflammatory effects on the body. You want to try and find a way to fit them in, and if you are on a low-carb diet, maybe make some of your carbs come from fruit versus grains.

The next one is, include spices into the diet. I think this is something a lot of us don’t really think about, maybe you just use salt and pepper or garlic, but spices including turmeric and ginger, garlic, basil, cayenne pepper, rosemary, sage, nutmeg, oregano, thyme. These all have strong anti-inflammatory properties, so spice up your food! Not only will you make it taste good, but you’re giving your body something healthy.

Amy Medling:                    Yeah, that’s a great point. I think when people aren’t used to eating vegetables and lots of plant-based food, I think they think of the canned green beans that they grew up eating. But you can really make vegetables taste delicious, and a lot of times it’s just adding some delicious spices and herbs like you mentioned.

Martha McKittrick:          Absolutely. If that’s not your thing, Google it and find some recipes if you’re not used to doing something like that. There’s lots of great resources out there on the internet where you can find some really interesting recipes.

And then the next thing is fermented vegetables, and cultured foods. This is something I know I didn’t really grow up on eating kimchi and kefir and fermented pickles and all that, but the area of gut health, and I’m sure Amy you’ve done lots of podcasts on gut health, this is really where I think a lot of nutrition research is heading in this direction, and what we’re finding out is that the immune system really starts in the gut. If you can feed your gut healthy food, you can improve your immune system and you can help decrease inflammation.

So some examples of fermented foods would be kefir, and that’s almost like a fermented yogurt drink, but you would want to get the plain one, not the one that’s loaded with sugar, a lot of them have a lot of sugar in them. Kimchi, I’m addicted to kimchi now, basically this is like fermented cabbage. If you go to your local health food store, they have all different kinds of fermented vegetables. They have one that I love, it’s fermented carrots with ginger, it’s delicious.

Amy Medling:                    Yeah. I just wanted to point out to listeners that I have a great podcast with Summer Bock about this very topic, she’s a master fermentationist. Since I spoke with her, this is gosh, a couple of years ago I think, I medicinally take a couple forkfuls of raw sauerkraut every day. There’s a brand that I really like, it’s called Micro Mama’s, you can kinda get it on the East Coast. They have it at my Whole Foods. They also have a carrot and cinnamon, and it’s delicious! You don’t have to eat a lot, it’s just fermented foods like that we’re meant to eat, not as a main side dish, but as a little addition to your meal, and that’s really all it takes, so if the sauerkraut kinda scares you, don’t let it, just try a forkful a day. Especially those Divas struggling with acne, it can really improve the quality of your skin, so give it a try.

Martha McKittrick:          Yeah, it’s really good. You can even make it yourself too, did that person who was in your podcast, did they talk about how to make it?

Amy Medling:                    Yeah, and she actually has an online course, that’s really great, about how to make fermented vegetables and it’s not that expensive, so that’s something to look at as well.

Martha McKittrick:          Yeah, because I know when I do buy it in my health food store it’s not inexpensive, I think it might be like 10 dollars for a little bottle, but if you make it, it’s very inexpensive. The one thing I want to point out is make sure that it’s a real … It has live cultures in it and it’s really fermented. Sometimes, for example, there can be pickles that are fermented, but you can also buy pickles in a jar that have vinegar in them and they’re not really fermented. So look for the live, raw, fermented type products. And these products all contain probiotics, which we’ve all heard of, and that’s when you’re giving your body the good bacteria. But again, this is important, it can help decrease inflammation.

The next tip to help decrease inflammation is to try to include some green tea in the diet. Studies have shown that green tea can help decrease inflammation, and that’s something that we’re looking for. So, kind of to summarize, even losing 5% of your body weight can help, work on your sleep, work on your stress levels, quit smoking if you smoke, and then follow the anti-inflammatory diet where you’re having plenty of Omega 3 fats, taking a supplement if needed, also getting in those vegetable Alpha-Linolenic Omega 3 fats. Make sure your plate is half vegetables, and focus on green leafy vegetables. Spice up your food, and then look at some anti-oxidant rich fruits, such as berries, citrus fruits as well. And then the fermented vegetables, and cultured food like kafir, and then green tea.

So those are the top tips to help decrease inflammation, so now I want to go over what foods actually can fuel inflammation. The first one, which I’m sure you’ve all heard thousands of times, high glycemic index and high glycemic load carbohydrates. We know these are kind of the bad guys when it comes to insulin, but also when it comes to increasing inflammation. They’ve done studies where they’ve fed people higher glycemic index and load carbs, and their inflammatory markers do go up. So here’s another reason why you want to limit those foods.

So that’s the first one, basically I’m sure everybody kind of knows what this is, but it’s mainly sugary foods, tends to be highly processed carbohydrates, a lot of white carbohydrates, juices. These are the foods that have the higher glycemic index and loads, whereas carbohydrates such as vegetables, whole grains, beans, legumes, and most fruits have a lower glycemic index or load. I’m kind of a fan of looking at the glycemic load versus the index, because the load takes into account how much carbohydrate is actually in a food, like here’s an example, a watermelon has a fairly high glycemic index, but when you look at the glycemic load it’s actually very low. It’s because watermelon has so much water in it that you would have to eat a ton of watermelon to really make it shoot your blood sugar up. So, I think that’s an even better chart to look at, and there’s a lot of good charts on the internet that you can look up, to look at the glycemic load of foods.

The next kind of food that can increase inflammation, I think this something a lot of us don’t really think about much, it’s called advanced glycation end-products. I’ll shorten that to AGE, and what that is, it’s food that has been fried or charred, so you have a barbecue going and you’re getting your chicken on the grill and it’s getting all charred, or foods that are deep-fried, as well as sugary foods and highly processed carbohydrates.

Basically, these foods, they product this product called the advanced glycation end-products, and these are harmful components that can be a major cause of inflammation in the body, that can increase risk of insulin resistance and Type-2 Diabetes. They implicate it in the development and progression of various metabolic and chronic diseases, including PCOS. If you do a Google search on PCOS and these AGEs, you will find a fair amount of research out there. So there’s something about these detrimental products that can increase risk of PCOS or worsen PCOS. They need to do more research in this area, but in the meantime, this is another reason to avoid sugary and processed little packaged carbohydrate type foods, and also to be careful with how you are cooking your protein.

You want to try not to cook it at a really, really high heat, or to have them get charred. Maybe if you’re gonna grill something, maybe pre-cook it first and then cook it more quickly on the grill so it’s not getting charred, you can also cook something with a moist heat, like maybe poaching chicken or having a shorter cooking time. Also if you’ve used an acidic ingredient such as vinegar or lemon juice, if you marinate the chicken or the meat in that before you cook it, that can also help decrease the amount of the AGEs. There’s a good website called agefoundation.com, that talks a lot more about this and gives you cooking tips and ways to help decrease it.

But I think this an area that a lot of women with PCOS wouldn’t even think of, really.

Amy Medling:                    Yeah absolutely. I haven’t checked out that resource yet, so I’ll have to get on there after our call. I love the idea of marinating, because as we’re recording this podcast we’re getting into that summer barbecue season, certainly for people who are in the US, so it’s really important to know that information.

Martha McKittrick:          Exactly. And also cooking plant-based foods do not contain the AGE like the meat products do. So if you were to cook some vegetables on the grill or portobello mushrooms or something like that, or even fish, it’s going to have less of it as the red meat and the poultry.

Amy Medling:                    What do you think about … I know you had mentioned the Mediterranean diet, you’re not eating as much animal-based food, but what do you think about conventional raised meat versus organic, kind of grass-fed. Do you think there’s a difference in terms of inflammation?

Martha McKittrick:          Yeah, I definitely do. I definitely do. I think whenever you can get access to grass-fed, hormone-free beef or, the same kind of thing, hormone-free chicken. But definitely if you can get the grass-fed beef, it definitely does contain more of the … It has alpha-linolenic acid because the cattle are fed on grass versus corn or soy, so I’m definitely a fan of that, and then if you can get wild salmon versus farm raised salmon. Not everybody has access to that all the time, but when you can, I would definitely recommend to try and do it.

Amy Medling:                    I find that Costco is a good source for less expensive organic meats.

Martha McKittrick:          Yeah, yeah.

Amy Medling:                    That’s kind of one of my go-to places. I’ve got two hungry teenage boys to feed and it really does get expensive.

Martha McKittrick:          I bet! I bet. Okay, the next tip is to limit saturated fat, which is found in whole milk dairy products, fatty red meat and butter. Saturated fat has been linked to an increase in inflammation, and this is something again, women who are on very low carbohydrate diets want to pay attention to. I see lots of women loading up on lots of meat and butter, that kind of thing, and not enough plant-based type food.

The next one is interesting. Too much Omega 6 fat might increase inflammation in the body. Omega 6 fats are everywhere, and a lot of healthcare experts believe that we are consuming inadequate amounts of Omega 3 fat, and we’re having way too much Omega 6 fat. Omega 6 fats are found in corn oil, sunflower oil, soybean oil, peanut oil, safflower, grape seed, mayonnaise, a lot of salad dressings. If you go home and look at your bottle of salad dressing in your refrigerator, chances are it has one of these oils in there. So what you want to try and do, is don’t be fat phobic, I want you to eat fat, but I would prefer that you’re getting more of the healthier anti-inflammatory types of fats that you’d get in extra virgin olive oil, that you would get in nuts, natural nut butter like almond butter, avocado, and the fatty fish. Those are the healthier kinds of fats versus the Omega 6s.

It gets a little confusing, all these different kinds of fats. We have the saturated fats, now we have Omega 6 fats. The next fat I want to touch briefly on, although I think it’s been kind of wiped out, it’s been removed from products, is partially hydrogenated oils or fats. I’m from New York, our mayor, Mayor Bloomberg years ago banned trans-fats in New York City. So, I believe they’re gonna be banned everywhere, excess trans fats or partially hydrogenated fats are very inflammatory. So you want to make sure that you look at the food labels on some of your products and just make sure you don’t see that word, “Partially hydrogenated fats.” They tend to be in coffee creamers, stick margarine which I don’t think anybody’s really using much anymore these days. Even some yogurt might have it. Some brands of peanut butter might have it, fried foods, so you want to avoid that like the plague.

The last thing I want to talk about is individual food sensitivity may trigger an immune-based reaction which can lead to inflammation. This is kind of a tricky one, like Amy I know you are anti-gluten and anti-dairy, correct?

Amy Medling:                    Well definitely gluten, I think for most women it’s inflammatory, but that doesn’t mean go out and start buying gluten-free cookies and gluten-free or fine flours. When it comes to dairy, I think grass-fed butter is great, I think it’s more of the casein in dairy because I find most women with PCOS that I’ve encountered are addicted to cheese, and I think that that casein is really inflammatory for a lot of women. And there’s other reasons I don’t love dairy as well, but … Yeah. Kind of like a low-dairy diet is what I recommend.

Martha McKittrick:          I’m kind of open-minded on this, I really depend on my patients paying attention to how they feel. For example, I was working with a woman and she was doing everything we talked about, she was on a really anti-inflammatory diet, she changed her diet dramatically, cut out cold cuts, and her diet was really, really good. She didn’t have any real GI issues, but she definitely was feeling kind of off, so she did an experiment, and she cut out gluten, and she listened to her body, and two weeks later she said, “I feel amazing. I feel absolutely fantastic.”

So she probably had a food sensitivity to gluten. What you could do if you were concerned about this, number one, is you can ask your doctor to get an allergy test. They can see if you are truly allergic to certain foods, certain proteins, whatever. That’s conventional medicine. The second thing you could do, you could get food sensitivity testing. I live in New York, we are not allowed to do it in New York state, so my patient would have to cross the border to go to Connecticut or New Jersey to get tested, but they do have food sensitivity testing. A really good organization is called L E A P, LEAP Testing. If you look at the website you can find a LEAP-certified therapist, who can have you tested for food sensitivity, and they are probably one of the best tests out there.

What else you can do, if you don’t want to go through all that, is experiment. If you think you have an issue with certain foods, cut it out. Cut it out for two weeks, see do you feel better? Only cut out one thing at a time, you can’t cut out two things. Maybe cut out dairy or cut out gluten, or whatever, MSG, and see if you feel better. Then you know that maybe you do have a real issue, and maybe you could challenge yourself, put it back, in one day have a lot of it, if you get symptoms, you know you probably have a food sensitivity.

And again, this could trigger inflammation, if you keep eating the food that you’re sensitive to. So I’m really open-minded to women paying attention to their own bodies, I think everybody’s different. And then of course if you get a lot of gas or bloating after you have something dairy like milk or something, that’s lactose-intolerant, that’s not the same thing as a food sensitivity like I’m talking about which is more immune-based, but listen to your body.

Amy Medling:                    I just want to quickly point out that I just did a podcast with Dr. Margaret Mikulis about the food sensitivity testing, so if you could also check out that podcast.

Martha McKittrick:          Okay.

Amy Medling:                    I was gonna just ask you, what are your thoughts on exercise and inflammation? I find that a lot of women are signing themselves up for half-marathons, and the single exertion long-distance running that I think can be really inflammatory, and a lot of these women say, “I dunno what’s going on, I’m running every day, training, and I’m putting on weight.”

And I do think that there’s sort of this inflammation factor that we have to look at in terms of exercise as well.

Martha McKittrick:          It’s funny that you say that, because right now I’m training for this absurd bike race, it’s 100 miles. It’s up all these hills in New York state Bear Mountain, and I did a training ride this past week and it was like 70 miles, and I feel like I’m a mess. My entire body’s inflamed, I can barely walk.

No, I absolutely believe that too much exercise can trigger inflammation, absolutely. I see the same thing you do, Amy, I see women who are like really gung-ho, they want to go out and they want to beat their PCOS, they’re gonna spend hours in the gym, and I just don’t think it’s doing anything, I think if anything it could be hurting you, and I do think it can be increasing inflammation, so I think we need to find a middle ground. What is a middle ground?

I mean I do believe adding a weight training component is important, and then a cardio or aerobic component, but not going overboard. Get your steps in, get up and move, that’s important for insulin resistance, but don’t go overboard with the exercise.

Amy Medling:                    Yeah, I would agree.

Martha McKittrick:          So, those are my tips!

Amy Medling:                    Yeah. Well, you know what, there was really some great tips. I hope that listeners will take at least one thing and apply it. It’s one thing to listen to these podcasts, but you have to take action, and apply these really wonderful ideas from our experts to your life. So think about what you’re going to take away from Martha’s podcast today.

But Martha, I want you also to tell us, where can we find you online? If somebody listening wants to work with you, how can they find you?

Martha McKittrick:          Sure, sure. My website is called marthamckittricknutrition.com, and when you go to my website, one of the tabs in the top says “PCOS.” And if you click on that, you will see a little bit about me and my background with PCOS, but I also have a blog which is under that tab, and it’s called “PCOS Nutrition and Lifestyle Solutions.” I just started the blog about a month ago, but I am putting articles up there, practical tips to help you deal with PCOS, eating tips, exercise tips, stress management tips. So you can get a lot of information there.

All my contact information is on my website, and I do specialize in PCOS and weight management, diabetes, irritable bowel syndrome. I’m kind of known for giving really practical information, something that you’ll be able to follow, something that’s realistic. And then I also have a Facebook page called “PCOS Nutritionist, Martha McKittrick.” And I’ll be putting a lot of information on that page as well.

Amy Medling:                    Awesome. Well, thank you so much for joining us, and thank you for listening to the PCOS Diva podcast. I hope you enjoyed it. And if you liked this episode, don’t forget to subscribe on iTunes, or wherever else you might be listening to the show, and if you have a minute please leave me a quick review on iTunes because I’d love to hear from you. If you think of someone else that might benefit from this free podcast, please share it with a friend or family member so she can benefit from it too.

And please don’t forget to sign up for my free newsletter, it goes out every Thursday. Just enter your email at pcosdiva.com to get instant access and make sure you never miss a future podcast. This is Amy Medling, wishing you good health. I look forward to being with you again soon, goodbye.

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7 Tips for Beginner Cyclists http://pcosdiva.com/2017/05/7-tips-for-beginner-cyclists/ Tue, 16 May 2017 12:55:27 +0000 http://pcosdiva.com/?p=13125 We need to “move it” every day. Make movement a joyful experience by engaging in an activity that you actually enjoy! Try something new or embrace an old favorite. I […]

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We need to “move it” every day. Make movement a joyful experience by engaging in an activity that you actually enjoy! Try something new or embrace an old favorite. I asked Denise Nelson to share a few pro tips for one of my old favorites- biking. Give it a go!

Guest post by Denise Nelson

When I was first getting started in cycling, I didn’t understand or know much about cycling or my bike. There was a lot of information I could’ve learned at the time that would have saved me a lot of time and money. I didn’t take advantage of learning as a beginner, rather I just got on my bike and thought it would all work out.

It didn’t.

In fact, I think I was riding in the wrong gear for about a month before I noticed that the bike I was using was the wrong type of bike, and I wasn’t prepared to maintain my bike, so I didn’t. That bike did not last long.

  1. Learn Maintenance – This is important because if you don’t know how to do basic maintenance on your bike, your bike will not have a long life. There is routine daily maintenance, where you clean your bike off after you ride it, check for any damage to the tire and frame, and clean your chain.

Weekly maintenance includes all the above, as well as tightening any loose bolts, cleaning and lubing the chain, checking your brakes, lubing your bike frame, and checking your gear shift. Maintaining your bike will give it a longer life, give you an easier ride, and make you a better cyclist.

2. Change Position – Seriously, this is vital. Otherwise, you will never be comfortable when riding. For the first two to three months, I didn’t learn this. I sat down when I was riding my bike, uphill, downhill, to work, back from work, and never once did I stand, lean, shift my position or adjust how I sat.

I was completely uncomfortable. Adjust your position and change throughout your ride, or you will be stiff, uncomfortable, and you’ll want to stop riding. It’ll be no fun once you start aching while you ride.

3. Learn the Gears – You need to change gears for uphill, downhill, different terrains, and different resistance. It’s important to learn your gears to make your riding easier. I didn’t touch my gears until the second month of riding. Once I did figure out what they were for and why they were there, I felt angry at myself for not trying it sooner.

Shifting gears makes riding so much easier and more relaxed, so my advice is to learn your gears as soon as you can. It will be beneficial to you in the long run.

4. Wear a Helmet – Safety is important. If you fall, you may get some scrapes on your arm or knees, but if you fall and hit your head, you could be in danger. Wearing a helmet protects your head, and helmets are designed to ease impact and make sure your head is cared for. You may still end up with some bruising or scrapes, but you are less likely to be critically injured.

5. Don’t Block Your Sound – I used to ride with headphones in until I realized that I couldn’t hear anything when I did that. I couldn’t listen to the people, the cars, honking, and even ambulances and firetrucks were hard to hear.

Blocking your sound doesn’t just put you in everyone else’s way, but it also puts you in danger. If you don’t listen to what’s happening around you, then you can’t prevent an accident, listen to the people running around you, or risk have an accident happen to you.

6. Know the Bike You Need – I was riding my bike to and from work daily, and that’s all. I needed a simple road bike to get the job done, but I thought I needed the best.

You know what the best got me? A full-suspension carbon framed mountain bike with disc brakes- a super fantastic, super expensive bike that I didn’t take care of and used improperly. Now I have a road bike, and that mountain bike has been kindly donated to someone who I hope has better sense than me in caring for it.

7. Learn the Laws – Know bike laws and motor vehicle laws as well. Knowing the rules of the road will ensure your safety along with knowing how to ride your bike in the road alongside cars.

When I started, I didn’t know basic things like you should walk your bike across a crosswalk, and if there is no bike lane, you use the road like you were a car (in some states). Knowing how the law works for cyclists and motor vehicles will keep you safe.

Knowing these seven tips will ensure that you are a safer rider, will increase quicker in skills, and be better equipped with knowledge that will make your riding experience so much easier.

Denise Nelson is a profound lover of the cross country mountain bike and has worked as a trainer for 6 years. She is co-founder of a private biking lessons school and owns a small fitness store in NY.

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The 7 WORST Foods for PCOS http://pcosdiva.com/2017/05/6-worst-foods-to-eat-for-pcos/ http://pcosdiva.com/2017/05/6-worst-foods-to-eat-for-pcos/#comments Thu, 04 May 2017 13:47:18 +0000 http://pcosdiva.com/?p=12975 If you’re a Diva and have been following my blog for a while now, you know I always say that “food is medicine”. Eating the best foods for the body, […]

The post The 7 WORST Foods for PCOS appeared first on PCOS Diva.

worst foods for pcos

If you’re a Diva and have been following my blog for a while now, you know I always say that “food is medicine”. Eating the best foods for the body, in their most natural and nourishing state, can balance and heal even the most challenging symptoms of PCOS. Inflammation, infertility, overweight and obesity, insulin resistance, type 2 diabetes, hypertension, and other serious health risks associated with PCOS may be controlled and eliminated OR irritated and increased by the foods we eat. The choice is up to us, and knowledge is the key to making the best choices possible that empower ourselves to improve our health and well-being. That’s what being a Diva is all about!

Chronic, persistent, low-grade inflammation is now understood to be an important underlying factor in chronic diseases including PCOS.1,2 This “meta-inflammation”3 contributes to the onset of an extensive list of undesirable physiological responses, including insomnia, weight gain and obesity, hormone disruption, insulin resistance, diabetes, dysmenorrhea and fertility issues, cardiovascular disease, digestive issues, allergies, and auto-immune dysfunction, especially in women who have PCOS.

To further complicate things, when we feel anxious and stressed, which we most likely do if we have any of that going on, we seek out our favorite sweet or salty, ooey-gooey, convenient comfort foods in an attempt to soothe, comfort, or distract ourselves. Unfortunately, any satisfaction derived is purely momentary because these foods are often pro-inflammatory and boost systemic inflammation, which in turn causes problems with glucose regulation, insulin resistance and the functions of other hormones. These processes are complicated and intertwined; when one is affected, all are affected.

Chronic inflammation affects mood, cognitive processing, and memory function; and promotes unhealthy weight gain around the middle, a factor for cardiovascular disease, liver dysfunction, and cancer. When this runaway inflammation is simmering throughout the body, it’s only a matter of time before serious autoimmune conditions such as Hashimoto’s Thyroiditis or Systemic Lupus Erythematosus (SLE) arise. In fact, because of its inflammation- and hormone-related features, some researchers now actually consider PCOS to be an autoimmune issue.4,5

There is no one-size-fits-all diet for women with PCOS, but there are guidelines from which we all benefit. PCOS Diva Jumpstart can walk you through the diet and lifestyle changes that will help you feel better and get on track the thrive with PCOS. Until then here are 7 foods to avoid and why:

  1. Sugar – Refined sugar, cane syrup, corn syrup, high fructose corn syrup, or “natural” sugars in any processed form, are top on the list of the worst foods to consume if you have PCOS. Sugary foods have a high glycemic index and load, cause immediate spikes in blood sugar and insulin release, and are directly linked to the onset of obesity, type 2 diabetes, cardiovascular disease, metabolic syndromes (including PCOS), cancer, and other diseases, due to insulin resistance.6 Sugar also increases the production and release of testosterone and estrogen,7 which contributes to belly fat and unwanted facial hair. Also, please make sure to limit alcohol intake. Like sugar, alcohol affects glucose-insulin balance and robs the body of vital B-vitamins, especially Thiamin (B1). Thiamin, incidentally, is a necessary factor for maintaining blood sugar stability. It’s a no-win situation if you eat sugar or drink alcohol regularly.
  2. Processed and refined white flour from wheat – the main ingredient of most breads, cakes, pastries, breakfast cereals, pasta, and many other starchy foods, offers very few beneficial nutrients. It is another high glycemic, pro-inflammatory food that causes the same physiological effects as processed sugar. White flour, unless further processed, contains gluten, a protein associated with inflammation of the digestive tract, mood and attention disorders, allergies and sensitivities to foods, perfumes, and other substances, and causes many other miserable effects. Furthermore, wheat is highly allergenic grain that, due to large-scale agricultural practices, often contains dangerous pesticide and herbicide residues that irritate the mucosa of digestive tract, cause leaky gut syndrome, and further increase the cellular and systemic damage of meta-inflammation. Incidentally, pesticide residue is one factor of the controversy surrounding GMO corn, wheat and soy.
  3. Artificial sweeteners such as aspartame, sucralose, and saccharine may provide zero-calories, but they wreak havoc on the body! New research has associated the use of artificial sweeteners with a higher risk for stroke, dementia, and other cognitive issues.8 A link to leukemia, lymphoma, and other cancers has also been suggested.9 That can of Diet Coke is not helping your diet and may worsen your PCOS symptoms.
  4. Dairy—Cow’s Milk, Cream, Cheese – Pasteurized and homogenized milk from cows, especially in reduced-fat and skim forms, is considered a common yet potent food allergen that contributes to meta-inflammation. Recent research has shown that consuming dairy may trigger acne outbreaks, while also directly affecting obesity and insulin-resistance.1 However, the offending component of milk is not lactose as you may think; it is the milk protein casein. When A1-casein is digested, it is broken down to form beta-casomorphin 7 (BCM7), a potent opiate. BCM7 is known to cause inflammatory and immune responses within the gastrointestinal system,11  and like other opiates, it is addictive.
  5. Red Meat and Deli Meats – The World Health Organization (WHO) International Agency for the Research on Cancer (IARC) has recently declared red meat as “probably carcinogenic to humans” and processed meats as “carcinogenic to humans”.12 The IARC’s final assessment is that consumption of red meat can increase the risk of diabetes, heart disease, cancer, and other chronic diseases, and may lead to a higher risk of dying from these diseases.13  In simple language this means: Not only do they cause cancer, they cause cancers that are more likely to kill you. If you must eat read meat, be sure it is organic and grass-fed.
  6. Processed, pre-packaged convenience foods – Most pre-packaged, highly-processed convenience foods are made from the unhealthy ingredients we just discussed: refined flour, high fructose corn syrup and other refined sugars, processed meats, artificial sweeteners, or dairy products. They are also likely to contain too much salt or high amounts of other hidden forms of sodium, as well as artificial flavorings, colors, and preservatives. Processed foods are usually made from low quality, high calorie, pro-inflammatory ingredients that may cause leaky gut and other digestive conditions, create even more meta-inflammation, contribute to hormone disruption which further increases the inflammation cascade, and can, eventually, kill you. There are better options for eating on the go.
  7. Omega-6 essential fatty acids, Trans-fats, and Hydrogenated Oils — these pro-inflammatory, disease-causing, heart-damaging oils and fats are, perhaps, the most offending components of processed, pre-packaged convenience foods. We need some omega-6 fatty acids for our bodies to work, but the standard American diet (SAD) delivers way more than needed (up to 30 times more)14 in the form of cheap vegetable oils, lard, margarine, shortening and deep fried foods. Having these “bad fats” in your diet is directly associated with cardiovascular disease, hypertension, blood clots, arthritis, cancer, and every other chronic, inflammation-based condition, which covers pretty much everything. When these unhealthy oils and fats are digested, they form chemical components that cause inflammation—Arachidonic acid and its metabolites. When combined with the other low quality, high calorie, pro-inflammatory ingredients of processed foods, the arachidonic acid inflammation cascade becomes perpetual, meaning it never stops.  This is what’s referred to as “runaway inflammation”, an effect that snowballs within the body. Starting with leaky gut and other digestive conditions, this unstoppable cascade continuously creates even more meta-inflammation, which further increases the level and complexity of hormone disruption, increases the frequency and severity of PCOS symptoms, and almost guarantees cardiovascular or other disease and death from it.

Remember – food provides information, and hormones are chemical messengers delivering information to their target tissues. When that signaling is damaged or disrupted by inflammation and other agents (as it is with PCOS) the regulation of blood pressure, immune function, cardiovascular circulation, weight control, and other important physiological processes regulated by hormones are greatly affected.

In our next post, we will discuss the best types of food for you to eat that reduce meta-inflammation and its far-reaching effects so you can be the healthiest, most vibrant Diva you can be!

  1. ILSI Europe. Controlling inflammation to reduce chronic disease risk. ScienceDaily. ScienceDaily website, 7 August 2015. Available at https://www.sciencedaily.com/releases/2015/08/150807092555.htm and accessed April 21, 2017.
  2. Shapiro H, Lutaty A, Ariel A. Macrophages, Meta-Inflammation, and Immuno-Metabolism. 2011; 11: 2509–2529. Available at  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253544/ and accessed April 21, 2017.
  3. Sharma P. Inflammation and the Metabolic Syndrome. Indian J Clin Biochem. 2011 Oct; 26(4): 317–318. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210244/  and accessed April 21, 2017.
  4. Mobeen H, Afzal N, Kashif M. Polycystic Ovary Syndrome May Be an Autoimmune Disorder. Scientifica (Cairo). May 5, 2016; 2016: 4071735. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871972/ and accessed April 21, 2017.
  5. Arora S, Sinha K, Kolts S, Mandal A. Endocrinal and autoimmune linkage: Evidences from a controlled study of subjects with polycystic ovarian syndrome. J Hum Reprod Sci. 2016 Jan-Mar; 9(1): 16-22. Available at  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4817282/ and accessed on April 21, 2017.
  6. Micronutrient Information Center. Glycemic Index and Glycemic Load. Linus Pauling Institute. Oregon State University. Updated and Reviewed March 2016. Available at http://lpi.oregonstate.edu/mic/food-beverages/glycemic-index-glycemic-load and accessed on April 21, 2017.
  7. Arora S. Is sugar sabotaging your hormones? Women’s Health Network website. Available at https://www.womenshealthnetwork.com/hormonalimbalance/hormonal-imbalance-caused-by-sugar.aspx and accessed on April 21, 2017.
  8. Hughes S. Diet Drinks Linked to Increased Stroke and Dementia Risk. Medscape website. April 20, 2017. Available at http://www.medscape.com/viewarticle/878894 and accessed on April 21, 2017.
  9. Aune D. Soft drinks, aspartame, and the risk of cancer and cardiovascular disease. Am J Clin Nutr. 2012 Dec; 96(6): 1249–1251. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3497921/)
  10. Rajaeieh G, Marasi M, Shahshahan Z. Hassanbeigi F, Safavi SM. The Relationship between intake of dairy products and Polycystic Ovary Syndrome in women who referred to Isfahan University of Medical Science Clinics in 2013. Int J Prev Med. 2014 June; 5(6): 687-694. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4085920/ and accessed on April 23, 2017.
  11. Pal S, Woodford K, Kukuljan S, Ho S. Milk Intolerance, Beta-Casein and Lactose. 2015 September; 7(9): 7825-7297. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586534/ and accessed on April 24, 2017.
  12. International Agency for Research on Cancer. IARC Monographs evaluate consumption of red meat and processed meat. IARC Press release No. 240. World Health Organization. October 26, 2015. Available at http://www.iarc.fr/en/media-centre/pr/2015/pdfs/pr240_E.pdf and accessed on April 24, 2015.
  13. Phares EH. WHO report says eating processed meat is carcinogenic: Understanding the findings. The Nutrition Source. November 3, 2015. Harvard TH Chan School of Public Health website. Available at https://www.hsph.harvard.edu/nutritionsource/2015/11/03/report-says-eating-processed-meat-is-carcinogenic-understanding-the-findings/ and accessed on April 24, 2015.

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Finding Your Unique Carb Tolerance For PCOS http://pcosdiva.com/2017/05/pcos-and-carbs/ http://pcosdiva.com/2017/05/pcos-and-carbs/#comments Mon, 01 May 2017 14:54:31 +0000 http://pcosdiva.com/?p=12919 Guest post by Dr. Brooke Kalanick PCOS nutrition advice often falls into two camps: eat a diet rich in whole grains or simply, go low carb. While women do need […]

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pcos and carbs

Guest post by Dr. Brooke Kalanick

PCOS nutrition advice often falls into two camps: eat a diet rich in whole grains or simply, go low carb. While women do need to be mindful of carbs, as they trigger the hormone insulin which is one key hormone issue (insulin resistance) for PCOS, it’s certainly more complicated than good carb (whole grain) vs. bad carb (bread, pasta, candy, etc.) OR merely low carb vs. high carb.

First, let go of the idea that some carbs are “good” (i.e. whole grains) and other are “bad” and instead think of carbs as fibrous or as starch/sugar.

Fiber carbs (vegetables): any greens, cucumber, asparagus, celery, broccoli, cauliflower, etc.

Starch/sugar carbs (all grains): all grain based products (breads, cereals, pastas, etc.), all legumes (kidney beans, soy, etc.) and all root veggies (beets, sweet potato, turnip, etc.).

As far as fruits go, again it comes back to fiber.

Highest fiber fruits: apple, pear and berries

Lowest fiber fruits (aka: highest sugar): melons, grapes, tropical fruits and banana

Other fruits are somewhere in the middle.

This doesn’t mean starch/sugar carbs have no fiber; it means its starch or sugar load outweighs its fiber content when it comes to insulin and blood sugar response. It’s this hormone reaction we’re trying to manage when it comes to carb sources for PCOS and insulin resistance. And because insulin resistance – the decreased ability for your body to respond to insulin’s message to shuttle glucose, vitamins, etc. out of the blood stream for use and storage – varies from woman to woman with PCOS, and even from tissue to tissue (i.e. liver, muscle, fat) within that same woman, how many carbs, what type and even when to eat them needs to be customized. Luckily, you can do that through a bit of detective work.

Finding your Unique Carb Tolerance


You must understand your Unique Carb Tolerance (UCT) to best manage insulin and your PCOS. With it, you can suss out your own ideal diet for optimal health, great energy, managing your PCOS symptoms (cycle irregularities, fertility, clear skin, etc.) and maintaining or losing body fat.

  1. This goes beyond good carb/low carb templates which fall so short for women with PCOS for several reasons: Other hormones are often involved (i.e. cortisol, thyroid)
  2. Certain foods cause more inflammation and trouble for some of us (i.e. gluten or dairy)
  3. Food combining (i.e. too much fat with too many carbs) are harder for some of us to metabolize.

Learning to let your symptoms guide you to find the amount, type and frequency of carbs that work for you is the best nutrition strategy for PCOS that I’ve found.


Now back to you and your detective work. Did you know insulin is talking to you all day? It is a key hormone in the symptoms or signals you experience such as appetite, craving, energy and sleep (ACES). The other hormone involved it cortisol. And yes, there are many other hormones involved these ACES symptoms, but insulin and cortisol are largely within our control and adjustable in real time. (More on this here.)

The symptoms having to do with insulin resistance happen mostly after meals whereas the symptoms of struggling to have cortisol keep your blood sugar regulated between meals happens just then: between meals. So, if your ACE symptoms are off between meals, think adrenals and dysregulation in the HPA (the brain-adrenal axis) and symptoms after meals are related to insulin resistance and a stressing of your blood sugar lowering mechanism, commonly an issue with PCOS. And it’s not uncommon to experience both trouble between and after meals (insulin and cortisol issues).

Here is what you’re looking for:

After eating: fatigue, sleepiness, craving for sugar/starch (cravings not typically relieved by eating those things), increased appetite (just want a little something more….) or craving stimulants like a cup of coffee. These are all signs you overshot your UCT either with the amount or type of carb you choose.

If you’re getting symptoms between meals such as fatigue, forgetfulness, irritability, sugar cravings, lightheadedness, headache etc., this is likely more difficulty keeping your blood sugar up vs. insulin resistance. However, these two are closely linked, and insulin issues can be part of reactive hypoglycemia (blood sugar rollercoaster). More on that here.

Ready to experiment?

Be scientific. Use the same meal and only change the carb source. Pick one starch or sugary fruit and eat it with the same combo of protein, fiber and fat.  Here’s an example:

Mixed green salad dressed w/olive oil & vinegar, 4oz chicken breast ½ cup or 6 bites of sweet potato

Watch for symptoms above immediately after eating or 2 hours after eating.

If right after eating you get symptoms of sleepiness, craving for coffee/stimulants, cravings for more starches or sweets, try cutting the amount of sweet potato back at next meal of mixed greens salad and chicken.

If you get symptoms 1-2 hours after eating of cravings, ravenous hunger, irritability, lightheadedness, cranky, etc. then at the next meal, up protein slightly, up fiber slightly (i.e. bit more chicken and bit more greens), but do not adjust carbs yet.  If this doesn’t relieve the issue, add a touch healthier fat (olive oil or avocado to the meal we’re using as an example, or a few nuts).  If none of these work, then up the sweet potato by 2 bites.

Continue this experimental eating for different types of carbs and different amounts.  This may seem tedious, but most women find they get in tune with these symptoms within a couple of days and can then infer how they will feel for multiple foods based on one food reaction.  For example, I can tolerate about 2 bites of gluten free grain whether it is quinoa or brown rice.  I can tolerate a fair amount more of legumes, but sweet potato – although I love it – seems to make me crave more sweet potatoes no matter if I have 1 bite or 10.  So not a good carb for me, right?

And note that many women with PCOS have food intolerances when it comes to dairy, gluten or grains in general. This means if you get sleepy or craving sugar/starch after eating these foods, it can be related to either an exaggerated insulin response OR inflammation from that particular food. I actually coach women with PCOS to think of dairy as a carb, although it has plenty of protein, the insulin response can be increased to dairy, and it tends to cause more inflammation when you have insulin resistance.

You will notice that if you’re trying to do this for more processed foods like breads and sugars, then your symptoms will be more severe – the reason these foods made the “bad carb” list in the first place.  But you’ll also notice that you’ve got some unique tendencies, and while some nutrition expert may say legumes are the best carb out there, you may not do so great with them.

Get yourself a journal or notebook and make some notes – you’re literally learning your chemistry and seeing what makes it work better or worse.  Writing it down in real time – although a pain in the rear – is far more accurate and effective than trying to recall if you were cranky because of your lunch or your boss an hour after you ate.

Struggling to get a clear message from your symptoms alone? Here’s where you pull out the glucose meter and during this experiment you’ll take your blood sugar…a lot. But don’t’ worry it’s not forever.

Get a reading fasting as well as just before eating, 1 hour after the start of eating (to see the peak doesn’t go over 200) and 2 hours after eating (to see if you get back down below 100). Then use the same experiment above to make adjustments and get the blood sugars within range.

Here’s to learning what works for you.

A licensed Naturopathic Doctor (ND), Dr. Brooke attended Seattle, Washington’s Bastyr University, where she earned a Doctorate in Naturopathic Medicine and Masters in Acupuncture and Chinese Herbal Medicine.

Dr. Brooke takes a balanced approach to health, using both conventional and alternative therapies. Metabolic nutrition, fat loss resistance, and fitness remain her area of focus and in her Manhattan clinic she primarily treats women with Hashimoto’s Hypothyroidism and PCOS – as well as other female hormone imbalances.

With these women she works to reset their hormones, their heads, and their habits, so they can finally feel at home in their bodies.  Learn more about Dr. Brooke on her website, and connect with her on Facebook and Twitter.

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How to Keep a Positive Mindset with PCOS http://pcosdiva.com/2017/04/keep-positive-mindset-pcos/ http://pcosdiva.com/2017/04/keep-positive-mindset-pcos/#comments Thu, 27 Apr 2017 13:00:58 +0000 http://pcosdiva.com/?p=12750 Guest post by Shelby Eckard Being diagnosed with PCOS can be an overwhelming experience. With the disorder affecting so many aspects of our lives, it can feel isolating and scary. It’s […]

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positive mindset

Guest post by Shelby Eckard

Being diagnosed with PCOS can be an overwhelming experience. With the disorder affecting so many aspects of our lives, it can feel isolating and scary. It’s very easy to slip into a negative head space. Staying in a confident and productive mindset can be done.

Here are my favorite tips to keeping the positive outlook despite your diagnosis:

Find Support– It is very easy to feel alone when diagnosed. With PCOS being greatly underdiagnosed and vastly misunderstood by even healthcare providers, it can leave you feeling like you are drowning. Seek out support. PCOS affects 1 in 10 women, possibly more- but most don’t know how PCOS Diva Jumpstart programcommon it is. Seek out support in forums and online communities. Take to social media and find other women sharing their stories. Contact a PCOS non-profit, who often have built in support communities. Although PCOS affects each woman differently and at different stages of life, there are worlds of support and community out there. You don’t have to face your struggles alone.

Be patient but persistent
– After diagnosis, you can feel lost. I found myself saying, “Now what?” With the lack of resources and differing opinions within the healthcare community and beyond, I felt frustrated and eager to find answers. When you are given a perceived problem, we often want to ‘fix’ it-fast. However, it is not that simple. PCOS affects multiple aspects of your health and fixing one thing is often not the end all solution. It is important to be patient. Unfortunately, being a condition that affects many aspects of your health, it can take time to find what treatment is best for you and your life. But as a patient, you need to be your own health advocate and be persistent in receiving appropriate care and treatment for whatever you are dealing with.

Don’t forget to care for your emotional and mental health– It is very easy to focus on the physical health issues that may come along with PCOS- but we often neglect the other important components that create a complete health care plan. Losing weight and lowering BMI can do great things for your health, but if you are neglecting that uncontrolled anxiety or battling the demons of body image issues, your health can still feel out of control. Losing weight and lowering numbers are often important, but so is treating your mind and heart. I suggest valuing your mental and emotional health on the same level as your regular physical health.

Practice self-forgiveness- You have to just forgive yourself. So you’re 60 lbs heavier than you were on your wedding day? So you ate a whole pizza and drank a whole bottle of wine last night because they killed McDreamy on Grey’s? It happens. Everyone struggles. Everyone falls down. It’s not the falling down and failing and binge eating cheeseballs that makes it a failure. You’re human. Welcome to the club. There’s like, 7 billion of us. The failure comes in not getting back up. Wake up the next day, get your butt to the gym or get to the grocery store or quit rescheduling that doctor’s appointment you’re afraid to go to. Just keep going. And if you get stuck, find help to get you unstuck. We are not meant to be perfect. We are meant to be flawed, so quit beating yourself up and focus on your next step. Take it one day at a time.

Practice self-love- You have PCOS. So what? PCOS sucks, but you don’t have to. Your diagnosis doesn’t define you. Start with self-love. Loving yourself is not easy. Whoever says it is, is a liar. It’s a deliberate decision. And you have to work at it every day. And hating yourself is exhausting. But confidence is a decision, made daily. It’s not always an easy one-but a worthy one.

These tips are just a starting point to deciding to live positively with PCOS. We all have to find our own way to maintain a healthy lifestyle and mindset- and that looks a little bit different for everyone. Just remember your journey is your own. Stop comparing it to others. That is the first step to failure. I promise you.

You can survive. You can overcome. You can live life fully.

Shelby Eckard is a blogger, health and fitness coach, social media manager and advocate for women with PCOS. She has written for Huffington Post, The Mighty and Ravishly, discussing her journey to self-love and living positively despite her PCOS diagnosis. She is passionate in creating a community of women who empower and encourage each other to make positive change.

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2 Big Benefits of N-Acetyl Cysteine (NAC) for PCOS http://pcosdiva.com/2017/04/2-big-benefits-n-acetyl-cysteine-nac-pcos/ http://pcosdiva.com/2017/04/2-big-benefits-n-acetyl-cysteine-nac-pcos/#comments Wed, 19 Apr 2017 14:35:34 +0000 http://pcosdiva.com/?p=12735   by Amy Medling, founder PCOS Diva N-Acetyl Cysteine: Detoxification and Insulin Balancing Properties Research suggests women who suffer from PCOS would benefit from using N-Acetyl Cysteine (NAC), a slightly […]

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NAC for PCOSby Amy Medling, founder PCOS Diva

N-Acetyl Cysteine: Detoxification and Insulin Balancing Properties

Research suggests women who suffer from PCOS would benefit from using N-Acetyl Cysteine (NAC), a slightly modified form of the sulfur-containing amino acid, cysteine. NAC’s main benefits include providing insulin support as well as promoting efficient detoxification in the body, both of which support hormonal balance- something we all need. In this article, we’ll dive in to some of the key benefits of NAC for PCOS symptoms.

What is N-Acetyl Cysteine?

We have discussed NAC in the past and defined it as a potent derivative of the sulfur containing semi-essential amino acid L- cysteine. When taken internally, it helps replenish our body’s glutathione levels and helps restore our cells’ ability to reduce oxidative stress. In medicine, NAC has been used mostly as a treatment for coughs and phlegm by means of inhalation.

There are 2 main ways NAC can help women with PCOS.

  1. Detoxification

Women with PCOS should periodically detox since endocrine disrupting chemicals (EDCs) from our food and environment build up in our bodies. When the liver can’t keep up, they end up disrupting our hormones. [1] NAC is able to improve glutathione levels in the body and leads to an efficient detoxification process. In a nutshell, the detoxification property of NAC helps reduce the adverse effects of endocrine disruption and balances hormones. [2]

Air Pollutants

Lung inflammation is a key response to increased levels of particulate air pollution. NAC has been shown to prevent lung inflammation caused by concentrated particles in the air. The observed preventive effect of NAC in a recent Harvard study suggests that treatment with low doses of this antioxidant could be used to ameliorate the toxic effects of particulate air pollution. [3] Other studies suggest NAC is also able to prevent cigarette smoke-induced airway alterations [4] as well a potent antioxidant as treatment for carbon monoxide poisoning. [5]

Lead Toxicity

Lead is a heavy mineral and causes the inactivation of glutathione. The toxic effects of lead are primarily influenced by glutathione depletion in cells. This is due to how lead is greatly attracted to thiol groups. NAC has a direct mineral chelating effect and forms bonds between metals and its corresponding thiol group which helps alleviate the toxic effects of lead. [6][7]

2. Insulin Sensitivity

Inflammation and oxidative stress are linked to insulin resistance as well as elevated levels of glucose in the blood. These effects are not specific to the diabetic population, but in fact are even found in obese, non-diabetics, and those with metabolic syndrome, particularly those afflicted with PCOS. In fact, insulin resistance is the root of many of our worst PCOS symptoms. There are multiple steps which can lead oxidation to insulin resistance. NAC, an antioxidant, helps target many of those steps independently. [8]
NAC helps improve insulin sensitivity by:

  • reversing impaired insulin responses caused by advanced glycation end-products
  • reducing fat tissue inflammation caused by increased blood sugar levels
  • helping inhibit the effects of common sweeteners such as hypertension, reduced insulin levels, and elevated triglycerides

Women who suffer from PCOS have issues with their ovulatory cycles and are particularly prone to insulin resistance. Two recent studies demonstrated the beneficial effects of taking NAC orally which lead to a trend towards regular ovulatory cycles as well as an improvement in insulin sensitivity. [9] [10]


PCOS increases the chances of having metabolic syndrome, and one of the main drivers of metabolic syndrome involves hormonal imbalances. Hormonal imbalances in women with PCOS are often caused by glutathione depletion, impaired detoxification, and insulin resistance. NAC has been shown to be broad-spectrum compound which unfortunately is still largely underused in conventional medicine.
Clinical research suggests NAC is more than just a treatment for coughs and phlegm as it has demonstrated its benefits on detoxifying the body and boosting insulin sensitivity. Together, NAC helps reduce hormonal imbalances in women with PCOS and could help prevent metabolic syndrome.


1) Kato T, Tada-oikawa S, Takahashi K, et al. Endocrine disruptors that deplete glutathione levels in APC promote Th2 polarization in mice leading to the exacerbation of airway inflammation. Eur J Immunol. 2006;36(5):1199-209.
2) Jallouli, Manel et al. Disruption Of Steroidogenesis After Dimethoate Exposure And Efficacy Of N-Acetylcysteine In Rats: An Old Drug With New Approaches. Environmental Science and Pollution Research 23.8 (2016): 7975-7984.
3) Rhoden CR, Lawrence J, Godleski JJ, González-flecha B. N-acetylcysteine prevents lung inflammation after short-term inhalation exposure to concentrated ambient particles. Toxicol Sci. 2004;79(2):296-303.
4) Rubio ML, Sanchez-cifuentes MV, Ortega M, et al. N-acetylcysteine prevents cigarette smoke induced small airways alterations in rats. Eur Respir J. 2000;15(3):505-11.
5) Oh S, Choi SC. Acute carbon monoxide poisoning and delayed neurological sequelae: a potential neuroprotection bundle therapy. Neural Regen Res. 2015;10(1):36-8.
6) Wang L, Wang Z, Liu J. Protective effect of N-acetylcysteine on experimental chronic lead nephrotoxicity in immature female rats. Hum Exp Toxicol. 2010;29(7):581-91.
7) Nehru B, Kanwar SS. Modulation by N-acetylcysteine of lead-induced alterations in rat brain: reduced glutathione levels and morphology. Toxicol Mech Methods. 2007;17(5):289-93.
8) Evans JL, Maddux BA, Goldfine ID. The molecular basis for oxidative stress-induced insulin resistance. Antioxid Redox Signal. 2005;7(7-8):1040-52.
9) Masha A, Manieri C, Dinatale S, Bruno GA, Ghigo E, Martina V. Prolonged treatment with N-acetylcysteine and L-arginine restores gonadal function in patients with polycystic ovary syndrome. J Endocrinol Invest. 2009;32(11):870-2.
10) Fulghesu AM, Ciampelli M, Muzj G, et al. N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome. Fertil Steril. 2002;77(6):1128-35.

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The Progesterone & PCOS Connection [Podcast] http://pcosdiva.com/2017/04/progesterone-pcos/ http://pcosdiva.com/2017/04/progesterone-pcos/#comments Fri, 14 Apr 2017 15:02:05 +0000 http://pcosdiva.com/?p=11886 Women with PCOS typically have low progesterone. Symptoms include absent, irregular or very heavy or long periods. Unfortunately, it also increases the risk of miscarriage. Whether you are TTC or […]

The post The Progesterone & PCOS Connection [Podcast] appeared first on PCOS Diva.

PCOS Podcast 62 Dr. PoppyWomen with PCOS typically have low progesterone. Symptoms include absent, irregular or very heavy or long periods. Unfortunately, it also increases the risk of miscarriage. Whether you are TTC or not, it is important to get your progesterone balanced. Dr. Poppy joins the podcast today to explain why women with PCOS have low progesterone and what we can do about it. Listen in to this important conversation as we discuss:

  • Why the pill is not a good long term choice for women with PCOS
  • Progestin v. progesterone v. Provera
  • Her pregnancy protocol for progesterone treatment
  • What test you should ask for and when you should take it
  • The connection between progesterone, your thyroid and adrenal glands

All PCOS Diva podcasts are now itunes-button

A full transcript follows.

Dr. Poppy Daniels was born in Boston and raised in Missouri. She attended undergraduate and medical school at the University of Missouri-Columbia.  She completed a residency in Obstetrics and Gynecology at Drexel University in Philadelphia, PA.  She worked for a short time for Drexel University Division of Infectious Diseases & HIV Medicine, on a project to institute rapid HIV testing for women presenting in labor with poor prenatal care. She and her husband, Dr. Dennis Daniels who is a Pulmonary/Critical Care/Sleep Medicine specialist, moved to Missouri where she has been in private practice since 2003.  They have 5 sons and one daughter, enjoying football, family time, gardening and raising chickens.  Dr. Poppy, as she is known to her patients and social media followers, has a wide variety of special interests including: Physician-Midwifery Collaboration, Functional Obstetrics, Bioidentical Hormone Therapy, Progesterone Support in Pregnancy, Recurrent Pregnancy Loss, Infertility, Polycystic Ovarian Syndrome, Clotting Disorders, and Vaginal Birth After Cesarean (VBAC).


Full Transcript:

Amy Medling:                    Hello, and welcome to the PCOS Diva Podcast. My name is Amy Meddling, and I am a certified health coach and founder of PCOS Diva. My mission is to help women with PCOS find the tools and knowledge they need to take control of their PCOS so they can regain their fertility, femininity, health and happiness.

If you haven’t already, make sure you check out PCOSDiva.com, because there I offer tons of great, free information about PCOS, and how to develop your PCOS diet and lifestyle plan so you can begin to thrive like a Diva. Look for me on iTunes, Facebook and Instagram, as well.

Today, I have the privilege of talking to Dr. Poppy Daniels. Dr. Poppy Daniels attended the undergraduate and medical school at the University of Missouri Columbia. She completed a residency in obstetrics and gynecology at Drexel University in Philadelphia, and she’s known as Dr. Poppy to her patients and social media followers. She has a wide variety of special interests, including physician midwifery collaboration, functional obstetrics, bioidentical hormone therapy and Polycystic Ovarian Syndrome and infertility, just to name a few. I’m just really thrilled to have you on the PCOS Diva podcast, Dr. Poppy.

Poppy Daniels:                  Thank for having me.

Amy Medling:                    So I found you through your social media Facebook page at Facebook at Dr. Poppy, and you post some really fantastic information and links and your own blog posts, and I really encourage everyone listening to follow you. I really reached out to you because you posted a great article about the importance of progesterone in early pregnancy and to avoid miscarriage. I think that this is a really valuable topic for women with PCOS, because women with PCOS tend to be low progesterone anyway. So, I thought we could talk a little bit about progesterone and kind of the PCOS connection. Why women with PCOS are low, and what we can do about it. So, you know, I’m gonna kind of give you the stage, and we can get started on the topic.

Poppy Daniels:                  Okay, great. Well, this is a very important topic for PCOS patients, and it sort of points to one of the major problems hormonally with PCOS, but unfortunately, at least in mainstream treatment of PCOS, it’s hardly addressed which is a problem because progesterone is the cornerstone of PCOS therapy, in my opinion, whether a woman is trying to get pregnant or not. So it’s important in either situation. That’s because most women who have PCOS have ovulatory dysfunction. As you know, that can manifest in a lot of different ways. Some women, they don’t have periods at all. Sometimes, they’ll have very irregular periods. Sometimes, they’ll actually have fairly regular periods, but they’re very, very heavy, or long or painful.

As you know, PCOS is associated with infertility, and that is stemming from the ovulatory dysfunction. So whether or not you’re trying to get pregnant, you need progesterone, and progesterone comes from the ovulated egg or the corpus luteum so if you’re not consistently ovulating, which most women with PCOS are not, then you are going to be progesterone deficient. Progesterone is an often overlooked hormone. Most women think about estrogen when they think about female hormones and, for whatever reason, progesterone has not been given the same attention as estrogen, but progesterone is just as important as estrogen, and even more so in pregnancy because progesterone is the pro gestational hormone. You need it to get pregnant, you need it to stay pregnant, you need it to have a full term birth.

So if we know that women who have PCOS have progesterone issues, because they’re not ovulating consistently, then that increases the likelihood that their progesterone may not be optimal when they are pregnant. That’s very concerning, of course, in terms of risk for miscarriage, and that’s something that women with PCOS are at higher risk for. So if you look at traditional mainstream treatment for PCOS, you usually have, they sort of lump you into two categories. Either trying to get pregnant, or not trying to get pregnant.

Amy Medling:                    Right.

Poppy Daniels:                  If you’re not trying to get pregnant, a lot of times you’re offered birth control. There’s sort of two different traditional camps when it comes to that approach. The first camp says, “Well, these patients are not having a period regularly, so they need to shed their lining of their womb so that they’re not at risk for uterine cancer.” So obviously birth control is sort of gonna force you to have a withdrawal bleed every month, and so that sort of takes care of that problem. Then the second thing that happens with birth control is that in general women with PCOS over produce male hormone, and that can be DHEA, testosterone, androstenedione, all of the male hormones that can cause excess hair growth or acne, oily skin, oily hair, thinning of the hair on top of the head. The elevated androgens is what we call that.

Well, when you’re on birth control, birth control makes you produce a protein called sex hormone binding globulin. This protein can increase or sort of suck up some of that extra male hormone that women are producing with PCOS, so some of those women do better on birth control with their acne or hair growth on their face. So that sort of, in one line of thinking, is helping the symptoms of PCOS.

The problem with that, and this is sort of the other camp of clinicians or people who treat a lot of PCOS, is that birth control of course is not, there’s no natural birth control pills or any of the options that are medical options for birth control are not natural hormones. They’re all synthetic hormones, and so when it comes to progesterone, you’re not getting natural progesterone in birth control. It’s not gonna give you the progesterone you’re not making, so it doesn’t really help that problem. Then birth control, of course, has different problems that it can affect you metabolically. The birth control pills can increase insulin resistance, which most PCOS patients are dealing with in one form or another. Of course, it has cardiovascular risk factors … heart attack, blood clot, stroke. Again, PCOS patients tend to be at higher risk for these things anyway.

So it’s somewhat problematic, and I think that I view birth control, if it is used in PCOS, as maybe a temporary, short term solution for some women. It certainly doesn’t fix PCOS. I think that’s important for women to know.

Amy Medling:                    Yeah, I’m so glad you brought that up. I mean, I kind of view it more as a band aid. It’s not really getting to the root cause, the root issue, and it also … I just recorded a podcast with Dr. Keesha Ewers about libido, and that’s another thing that birth control can really rob us of is our libido.

Poppy Daniels:                  Yeah.

Amy Medling:                    You did mention blood clots, and I can’t tell you how many women that I hear from when I post my articles kind of about the risks of the pill, and I mention that women with PCOS are two times more likely to experience blood clots while on the pill. Women are posting that that, you know, they’re in their 20s, their 30s, and they’ve had a life threatening blood clot while on the pill with PCOS.

Poppy Daniels:                  Yeah.

Amy Medling:                    So these are real risk factors, and I’m so glad that you brought that to our attention. The other thing …

Poppy Daniels:                  Well, and I want to mention. Well, I want to mention …

Amy Medling:                    Oh, go ahead.

Poppy Daniels:                  … One quick thing about birth control. For many years, probably less so now, but maybe eight to 10 years ago, a lot of PCOS women were being put on a birth control called Yaz, which you may be familiar with that birth control pill. It was felt to be a better birth control pill for women who had PCOS because it has less androgenic properties than some birth control pills, and it also had some similarities with another drug that’s used for PCOS called spironolactone. Spironolactone is a male hormone blocker, and a lot of women with PCOS are put on spironolactone for that reason. So this particular birth control actually had similar properties to spironolactone. The only problem is, and now, of course now, we find this out, after medications have been on the market for long enough for us to see the problems with them, that Yaz actually had an even higher risk for blood clots than some of the older first and second generation progestins that were in birth control pills.

So the particular progestin in Yaz was a fourth generation progestin that had … it depends on which studies you look at, but 100 to 300 times higher risk of blood clots than traditional birth control pills. So you have women, as you said, who already could be at higher risk, them taking the pill that puts them in the even highest risk category, and it’s really become an issue. Especially if doctors really are not keeping up with these things, and just sort of prescribing birth control sort of without knowing some of this newer information about the increased risk with the newer generation progestins. So you have a lot of PCOS women who were put on Yaz or Beyaz or Ocella, that’s a generic version of that pill, and they are actually at much higher cardiovascular risk with that particular type of pill.

Amy Medling:                    That’s why I really advocate digging into the information yourself, and knowledge is power, and listening to experts like yourself, Dr. Poppy, and other podcast recordings. Getting on PubNet, and kind of looking and researching yourself, and arming yourself with this information because sometimes you just can’t rely on, like you said, your doctor to be up to date with all of the latest information. There was something else that I wanted you to clarify.

So, a lot of women write in and say that their doctor has given them Provera so that they can get a period, and I think there’s a misconception again that Provera is progesterone.

Poppy Daniels:                  Right, very good point. This is a long standing problem, and that is that a lot of doctors sort of interchange the term progestin and progesterone so that a lot of people think that they are the same thing. They’re not. Natural progesterone is a different hormone than any of the synthetic progestins that are in birth control, so Provera is medroxyprogesterone acetate. That is the hormone that’s in Provera and Depo Provera, which is the birth control shot, and it’s also in the HRT drug Prempro and Premphase, there’s actually two HRT drugs that have Provera in them. Medroxyprogesterone acetate is certainly not real progesterone, and it always surprises me when I see people say that that’s progesterone, because it’s very clearly not. Completely different chemical structure, and has different side effects than natural progesterone.

However, it’s been used for years and years and years to induce periods. So basically, your typical scenario is someone hasn’t had a period for two or three months or longer, so they get put on 10 days of Provera to induce a period. The issue is that we do have natural progesterone available on the retail market as a pill. It’s called Prometrium, and so to me, why would you want to use a synthetic hormone that has other side effects, instead of the real hormone that your body isn’t making, which is progesterone? So Prometrium is generic, real progesterone, or bio identical progesterone, and I think a lot of older doctors just sort of grew up using Provera, and that’s just what they’re used to. The younger doctors I think are more open to using Prometrium, rather than Provera, but it’s still very commonly used to induce periods.

What’s disturbing, and what I like to point out to patients, especially if they’re also trying to get pregnant, is that Provera is pregnancy category X. That means it’s contraindicated in pregnancy, whereas natural progesterone, you have to have it or else you’re not gonna have a successful pregnancy. So that’s a very good way of contrasting the differences between synthetic hormones and natural hormones. So in my opinion, you know, why would we need to … Why would we need to use a synthetic hormone when we have the real one?

Amy Medling:                    So again if, you know, those listening, sometimes you have to be a Diva. If your doctor is prescribing Provera, certainly bring up Prometrium and ask your doctor about that as an alternative. So I wanted to ask you, Dr. Poppy, for women listening who are trying to conceive, or may be early in their … very early in their pregnancy, what do you usually, what is the protocol for your PCOS patients in regards to progesterone in trying to conceive or early in pregnancy?

Poppy Daniels:                  Well, my practice is different probably than your traditional practice. All of my patients get tested for progesterone in early pregnancy. The vast majority of PCOS patients, they need support. They need that hormonal support. Is that something that other doctors are talking about, do you know, to their patients? Have you heard of that before?

Amy Medling:                    Well, I can tell you when I hear, when women share that they’ve worked so, you know, tried, struggled so hard to get pregnant. They’re finally pregnant. I will say to them, “Please ask your doctor to test your progesterone, and make sure it’s rising as it should and, if not, ask for supplementation,” and a lot of doctors are not doing that. So maybe you could explain what test that you should ask for, and at what like … Like as early as like five, six weeks? You know, at what point are you testing?

Poppy Daniels:                  Sure. So I think that there’s such a disconnect between doctors sort of going back to physiology and thinking about normal pregnancy and normal hormone levels in pregnancy, because progesterone, as you know, after you ovulate you produce the corpus luteum. That is what produces the progesterone. If the corpus luteum is removed in the first trimester, so if the woman were to have surgery and have her corpus luteum removed, she would immediately lose the pregnancy. So that’s been … You know, we’ve known that for a long time. That’s just sort of basic hormone physiology. What I think most doctors do not understand is that number one, testing for progesterone levels, we do know that the majority of successful pregnancies in the first trimester need to have a progesterone above 20 by six to seven weeks.

So what I see a lot of times what happens is that a doctor will either go by whatever range is listed as normal by the lab test, you know. Different labs have different ranges of normal, so I’ve heard everything from, “Oh, as long as it’s in that range, it’s fine” or “As long as it’s above 10, it’s fine” or “As long as you’re not bleeding, it’s fine.” What it reveals to me is sort of an ignorance of what it should be, and that is that it should be above 20 by about seven weeks, it should be above 20. So what we have is a lot of doctors who will not give progesterone unless a patient has either had a miscarriage before, or is bleeding or cramping in early pregnancy. Even then, you have a whole contention of doctors who think that progesterone support in pregnancy is voodoo. I mean, I’ve literally had doctors say that to patients. That is voodoo, it’s not supported in literature, we only do it to make women feel better. Sort of all these very incorrect and sort of derogatory things that are said, basically like you know, “Yeah, women ask for it and we put up with it, and it doesn’t really do anything.”

Well, number one, again, I point back to normal physiology. Progesterone is the cornerstone of hormonal production and support in early pregnancy, so what the corpus luteum does is the progesterone that it produces, it actually prepares the womb, or the lining of the womb, the endometrium, for the arrival of the embryo. It actually secretes what we call uterine milk, so those are proteins and nutrients that help the developing baby to grow. We also know from lots of studies in women who are not pregnant that the main issue of having progesterone in the second half of the cycle is that those secretory proteins that they produce help to balance and stabilize the lining of the womb. That’s why so many women, when they do have periods with PCOS, have very long, heavy periods, because they’re getting all of this estrogen effect. Estrogen is the growth hormone, so it grows the lining of the womb, and then the point of progesterone is to stabilize that lining so it doesn’t bleed abnormally.

Well, we know most of the women with PCOS don’t have adequate progesterone, so when they do bleed it tends to be very heavy, long, irregular, breakthrough bleeding. Spotting that goes on for days, even after the period’s over, and these are all reflective of the hormonal imbalance. So then when you’re pregnant, you even more need those secretory nutrients that are produced by progesterone. So I think it just really lacks a general understanding and appreciation of how important progesterone is in early pregnancy, and an understanding that most women with PCOS are going to be going into the pregnancy with inadequate progesterone.

Then you also have common misconception number two, which is that magically at 12 weeks, the corpus luteum is not making the progesterone anymore. That the placenta is now making progesterone, and there’s suddenly no more need for progesterone. Sometimes, that is correct, but many times, women still are not making adequate progesterone, even after the first trimester. So what you have is a lot of women whose placentas are not doing that great of a job of making progesterone, and so some women are still having issues. If you just sort of randomly stop at that stage, you’re gonna have a lot of women who number one, can be symptomatic at that point. So we have a lot of women who say, “Yeah, they took me off at 12 weeks, and then I started spotting,” or “I started cramping,” or “I just didn’t feel good,” or “I felt like something wasn’t right,” and then they said, “No, you don’t need it anymore.” Or they are asymptomatic, but their levels drop. What’s the only way to know if your level is dropping is to test it, and unfortunately, most doctors are not testing the progesterone levels.

So I follow a progesterone support protocol in pregnancy that was established by Dr. Thomas Hilgers. He is the doctor at the Pope Paul Institute for Reproduction in Omaha, Nebraska at Creighton University. This is a Catholic institution, and they don’t use birth control, so they have for a long time worked on supporting pregnancy, supporting women trying to get pregnant and women with a history of miscarriage. They have always used natural progesterone, because they don’t use anything synthetic like birth control. So what Dr. Hilgers did is he took a whole bunch of normal, pregnant women who had normal, full-term births and he tested them all the way through their pregnancies with progesterone levels every week, and then he compared those to women who had pregnancy problems such as miscarriages, or preterm birth, or bleeding during pregnancy, or preeclampsia, or sort of any sort of obstetric complication. Out of that, he created a curve for what the normal progesterone levels should be for each gestational week of pregnancy.

So he established his protocol based on normalizing a woman’s progesterone level based on that curve, so that’s the protocol that we go by. So we don’t go by how far along you are, or even if you’re having symptoms or not. Now, in my practice, symptoms always trump lab levels, so if someone’s cramping or bleeding, they’re always going to get progesterone, even if their level looks okay. If they’re not having symptoms, so if they’re asymptomatic, then we try to normalize their progesterone level for where it should be for their gestational age. On top of that, what we do is if we take someone off, if we wean someone off of progesterone, then we always go back and test them after they’re off to make sure they don’t drop back down. That’s a much more objective way of doing progesterone therapy in pregnancy.

Amy Medling:                    So are you using suppositories or cream, or are you using Prometrium as a supplement?

Poppy Daniels:                  I use a lot of different kinds of progesterone. I use oral, so I do use Prometrium. And you can actually use Prometrium orally, or you can insert it vaginally. I do use compounded progesterone vaginal suppositories very commonly, then I do progesterone injections, progesterone in oil injections, and I’ll be honest with you. I have several patients that have had to be on multiple forms of progesterone in order to maintain their progesterone levels, and so every individual patient gets an individual care plan based on what’s going on with them. I just had a patient who came in with her baby last week. She just had her baby, and she has PCOS. She had had several miscarriages, and in this pregnancy she was on shots and oral, I believe.

She actually had to be on shots all the way up until the end. I usually wean people off by about 38 weeks, and she was telling me, she said, “The minute I stopped progesterone shots, I started having more Braxton Hicks contractions, and went into labor shortly after that.” So there are some women that, they just need a boat load of progesterone in order not to contract because we know that progesterone is what sort of causes the uterus to be quiet, and to not contract, and so it makes sense that if you don’t have enough, then your uterus is going to be more irritable and more likely to contact. Now obviously, there’s other things besides progesterone that can make your uterus contract. You can have infections, and you can have twins, and you can have other issues going on that is not hormonal, but since progesterone is the pregnancy hormone, and since it’s so vital, it is the problem for a large number of women.

Amy Medling:                    Yeah, and a large number of women with PCOS, because …

Poppy Daniels:                  Absolutely.

Amy Medling:                    … They tend towards low progesterone, and the other thing. I know this is kind of off topic, but the other thing that I tell women when you found out that you’re newly pregnant also to get your thyroid tested, because low thyroid can also be a problem in pregnancy. I think a lot of women with PCOS are hypothyroid, and they don’t know they are.

Poppy Daniels:                  Yeah.

Amy Medling:                    They’re not getting the proper testing, or the doctors aren’t using the right metrics, I think, to compare those tests, as well.

Poppy Daniels:                  Absolutely, and you know that’s another area that I think is not done well. I test everyone for thyroid, of course, but especially someone who’s had a miscarriage should absolutely have their thyroid tested, hopefully before they get pregnant again. We don’t want to … you know, it’s sort of one of my pet peeves that we don’t have universal thyroid testing in pregnancy. This is a big, controversial topic with ACOG. They refuse to kind of advocate for that. They still are of the position that only women who have a family history, or have risk factors for thyroid disease should be tested when the truth of the matter is that the majority of women who have thyroid issues don’t have any other indications that they would have that.

So, but I do think this goes back into your point about Dr. Briden’s statement about stress, because all of the hormonal systems talk to each other, right? So all of your hormonal production starts with your hypothalamus. Your hypothalamus talks to your pituitary, your pituitary talks to your thyroid, talks to your ovaries and talks to your adrenal glands. So this is a very big, important hormonal circuit, and what happens when women are under stress is they’re over producing cortisol which is a stress hormone. If that goes on too long, that can eventually burn out their adrenals, or have decreased adrenal function, so they’re not producing adequate cortisol. Then they will try to go over to the ovaries to get some progesterone, because these hormones all have the same backbone, and that is cholesterol. So the sex hormones are made from cholesterol, so they are interchangeable somewhat.

So the adrenals what, they’re under stress, they want to see if they can get some progesterone and make more cortisol. Well, if you don’t have adequate progesterone, then that’s not going to help that problem. So her point that the older you get, the less you’re ovulating consistently, the less progesterone you make, that’s gonna undermine your adrenal function, but that also undermines your thyroid function in a lot of different ways. So absolutely, every PCOS should automatically be tested for thyroid.

An interesting thing that you’ll see in women who have PCOS and hypothyroidism, sometimes those kinds of symptoms kind of cancel each other out. So if you have a woman with PCOS who has, you know, elevated male hormones, she may not actually be exhibiting the oily skin, the oily hair or acne, all of that, because if she has thyroid disease, then that’s sort of drying her out. So I will see a lot of women who are not clinically exhibiting your typical PCOS symptoms, but they still have elevated male hormones when you test their hormones, and the thyroid is kind of mitigating some of that, so you don’t see it as much. Yeah, I mean, and then thyroid function is incredibly important for fertility and reproduction, and so I know that you wanted to mention this paper that just came out because this is, again, evidence based medicine to present to your doctor.

This is the paper that was published in Fertility and Sterility, which is a mainstream peer reviewed journal put out by the American Society for Reproductive Medicine. This study is entitled, Luteal Start Vaginal Micronized Progesterone Improves Pregnancy Success in Women With Recurrent Pregnancy Loss.” I won’t go into the details on this paper, but I will tell you that it actually, progesterone support, and in in this case it was vaginal Prometrium, and at a dosage of 100 to 200 milligrams actually improved pregnancy in women who had recurrent pregnancy loss, and they didn’t have any other obvious reasons why they were losing the pregnancies.

It actually improved, compared to controls, 68% of women who took Prometrium had a successful pregnancy after pregnancy loss compared to 51% who did not take progesterone. So that was statistically significant, and given that women who have PCOS are at risk for pregnancy loss, one of my main statements is why would I want a woman to have to go through a miscarriage before I would give her progesterone?

Amy Medling:                    Oh, I know, and you’re saving lives.

I mean, what you just did for the patient that you described, you were able to help her have that baby because of the progesterone, so that’s wonderful. Couple things that I just wanted to … resources that I thought of, first of all we were talking offline about Dr. Lara Briden’s article about women in their 40s and decreasing progesterone and stress. You could find that on her blog, or I’ll try to put a link to it under the podcast article, under resources. Also, you had mentioned Dr. Hilgers and Creighton, the Creighton model and you know if … I know that I actually went to a NaPro doctor, which is trained in Dr. Hilger’s method. So that’s one thing that, if you’re listening and you’re concerned about progesterone, you could look for a NaPro trained doctor, and they would be familiar with the protocol that Dr. Poppy’s describing.

Then finally Hypothyroid Mom, she’s a blogger and she’s a real advocate in thyroid testing in pregnancy to avoid miscarriage, and she would be another great resource if you’re interested in more information there. Gosh, Dr. Poppy, there was so many other things that I wanted to ask you about, about thyroid beyond pregnancy, so I’m gonna have to invite you back on the podcast so that we can talk more about progesterone and stress. We kind of sort of touched the surface of that, but I would, I really want you to tell our listeners how they can find out more about your work, and connect with you on social media. If they’re in your area, even see you in your practice.

Poppy Daniels:                  Sure. So, on Facebook, my professional Facebook page is Dr. Poppy, and I do try to put up a lot of articles such as this progesterone paper, which got lots and lots of shares when I put it up. I put up information about a wide variety of subjects, but I do regularly post on PCOS. Post about progesterone a lot. You can follow me on Twitter, and that’s at Dr. Poppy B-H-R-T on Twitter. My website is DrPoppy.com, so I have information on there. I do want to say a couple of things for your listeners who are trying to sort of access some of these things, sort of running into road blocks.

If you go to fertilitycare.org, fertilitycare.org, they have the NaPro doctors listed on there by region, so those are doctors that usually follow Dr. Hilger’s progesterone support protocol. Unfortunately, if you’re more, in a more rural area, you may not have as much access to a NaPro doctor. I’m actually not a NaPro doctor. I just follow his protocol because I’ve always, progesterone has always been very important, and it made sense to have more of a structured guide to go by. I think that if patients can sort of talk to their doctors and sort of say some of these things in a very kind of non-confrontational way, I think that there are some doctors that will listen and will say, “Yeah, I’m willing to do that.” Especially if you sort of say, “Have you seen this paper? It really shows that women had good pregnancy success with using progesterone.” You’re always gonna have those docs that are not open minded, and so I always tell my patients, you know, talk with your feet.

You are a health care consumer. You have a right to engage with a provider who will respect you, and these are all very reasonable things that we’re talking about. Getting your thyroid checked, considering progesterone support when you have PCOS. These are not sort of unreasonable requests. So I do think it’s important for patients to try to identify those practitioners that are near them that would be more supportive, and that’s where social media has been greatly beneficial. So people can sort of crowd source and get on forums and get on Facebook and Twitter and listen to podcasts, and try to find doctors that are more supportive to the hormonal aspect of these things.

You know, I’ve had some women who just weren’t able to get anybody to listen to them, and they just went to the health food store and got progesterone cream over the counter, and just used that because that was the only thing that they had access to. It’s not my optimal way of using progesterone in pregnancy, cause it’s hard to monitor topically applied progesterone cream, but some women are desperate and they don’t want to lose their babies. I feel very sad that so many women have not been able to get the support they needed. As far as seeing me in person, I’m in Missouri, and so if you’re in Missouri and you wanted to come see me, you could do that. I also have a license in Pennsylvania, and I’m available to do Skype consults in Pennsylvania. If you are in any other state, I can do a Skype consult with you, but I cannot prescribe medication across state lines in the state that I don’t have a medical license in.

So I’ve had some patients who said, “If you’ll just sort of tell me what to do, I will share it with my local doctor, and my local doctor can prescribe this for me,” and that’s fine. If you have a nurse practitioner or a midwife or someone else who would be willing to prescribe what I recommend, that’s one option. Then, of course, I’ve had people that just decided to travel to see me because they wanted to work with me, and that’s an option, too, but I would suggest reaching out to see if there’s any fertility care or NaPro doctors close by if you have PCOS and you are interested in progesterone support in pregnancy.

Amy Medling:                    Well, really, that’s great resources, and it’s great that women can avail themselves of your help, and thank you so much for coming on the podcast and talking about this really important topic.

Poppy Daniels:                  Well, it is one of my favorite topics, and I always tell patients … I probably see 10 PCOS patients a week, on average … You know, this used to be a very rare condition, that some doctors would never see a case of it in their whole careers. Now we are seeing tons and tons and tons of PCOS, which does point to the food supply and the environment as big factors. Big factors for why we see so much of this, but the good news is PCOS is very treatable, very treatable, and especially if you have more of a holistic approach like what you recommend with dietary changes and more of a holistic approach. You can actually really have good results with PCOS.

Amy Medling:                    Yeah, well that’s what we teach here on PCOS Diva, and I hope that you’ll come back on to talk about another important topic sometime soon.

Poppy Daniels:                  Absolutely, I’d love to.

Amy Medling:                    Well, that wraps up our podcast today. Thank you all so much for joining us on the podcast. I hope you enjoyed it, and if you like this episode, please don’t forget to subscribe to PCOS Diva on iTunes, the app or wherever you might be listening to the show. If you have a minute, please leave me a quick review on iTunes. I’d love to hear from you, and if you think of someone else that might benefit from this podcast, please take a minute to share it with a friend or family member so she can benefit from it, too. Don’t forget to sign up for my free newsletter. Just enter your email on PCOS Diva, and you get instant access and make sure you never miss a future podcast or posting.

This is Amy Medling wishing you good health. Look forward to being with you again soon. Bye-bye.

The post The Progesterone & PCOS Connection [Podcast] appeared first on PCOS Diva.

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The Science Behind a Perfect Night’s Sleep [Infographic] http://pcosdiva.com/2017/04/science-behind-perfect-nights-sleep-infographic/ Tue, 11 Apr 2017 20:38:09 +0000 http://pcosdiva.com/?p=12629 No matter what stage of life you are in or what your day-to-day activities are, getting a good night’s sleep is important for overall well-being. Consistently having too few hours […]

The post The Science Behind a Perfect Night’s Sleep [Infographic] appeared first on PCOS Diva.

No matter what stage of life you are in or what your day-to-day activities are, getting a good night’s sleep is important for overall well-being. Consistently having too few hours of sleep over many years has been linked to both mild and serious health conditions.

Even having just a few nights of poor sleep can affect your memory, make you feel hungrier throughout the day, cause headaches and generally give you that brain fog feeling.

However, it is often only when our sleep pattern becomes disrupted that we realise just how important a good night’s sleep is. Getting a consistent amount of sleep every night is a challenge at the best of times, thankfully scientists have been concerned with sleep research for many years and the tips offered in the below infographic are based on years of research aimed at improving sleep quality.

But before we even consider how to get a good night’s sleep, it’s important to understand what a good night’s sleep is. The National Sleep Foundation recently explained exactly what a typical good night’s sleep is for an adult, with these four factors:

1. You take half an hour or less to fall asleep.
2. You wake up no more than once per night.
3. If you do wake up in the middle of the night, you fall back asleep within 20 minutes.
4. You’re asleep for at least 85% of the time you spend in bed.

If you are regularly meeting all four of these factors then, in general, you don’t have any problems with sleep. However, if you or your family are regularly failing to meet one of the factors then it is likely your sleep pattern has room for improvement.
For more information about the science behind a perfect night’s sleep check out the following infographic created by De Vere Hotels:

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10 Reasons Your PCOS Diagnosis Was Missed http://pcosdiva.com/2017/04/pcos-diagnosis/ Tue, 11 Apr 2017 20:22:57 +0000 http://pcosdiva.com/?p=12343 Guest post by Poppy Daniels, MD Polycystic ovarian syndrome (PCOS) is becoming a significant problem in women’s health. Between 1 in 10 to 20 women have the condition, although more […]

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Guest post by Poppy Daniels, MD

Polycystic ovarian syndrome (PCOS) is becoming a significant problem in women’s health. Between 1 in 10 to 20 women have the condition, although more than 50 percent remain undiagnosed. PCOS is the leading cause of female infertility and women who do become pregnant have higher rates of miscarriage, preterm birth, and gestational diabetes.
Women with PCOS have a greater likelihood of developing diabetes, cardiovascular disease, and endometrial cancer than women without the condition. Glucose intolerance is caused by associated insulin resistance that frequently, but not always, causes weight gain. Although there are diagnostic variances between national societies, PCOS is characterized by androgen excess, ovulatory dysfunction, and polycystic ovaries. Only two out of three criteria are necessary to establish the diagnosis.
However, many women see multiple physicians before they receive a correct diagnosis. I was trained at the Drexel Center for PCOS in Philadelphia, PA and have diagnosed and treated hundreds of PCOS patients. Through this experience, I have seen many different phenotypic presentations of PCOS. Experts publishing PCOS literature agree that these phenotypic differences contribute to the difficulty in making a diagnosis and many even suggest renaming the syndrome.

Here are some reasons your doctor might miss your PCOS:

1. Your periods are regular.

It’s important to clarify what “regular” means. You may be having prolonged cycles, but be regular (35 to 38 days). Many women report very heavy, but regular cycles. It is possible, and common, to have anovulatory cycles even though bleeding occurs at regular intervals. Many PCOS patients ovulate inconsistently, but periodically. Heavy periods are more likely with anovulation since there is inadequate progesterone to balance estrogen.

2. You’re not overweight.

Abnormal weight gain is common with PCOS, reflecting insulin resistance. But up to 1 in 5 women with PCOS have lean PCOS, that is, they have all of the diagnostic criteria but are under- or normal weight. Clinicians should remain suspicious of the condition in thin women presenting with infertility or irregular cycles. Lean PCOS patients often still have insulin resistance.

3. You don’t have ovarian cysts.

Since polycystic ovaries are not necessary to make the diagnosis, many specialists believe the syndrome should be renamed (e.g., androgen excess syndrome). Women can also have characteristic small follicular cysts (i.e., “string-of-pearls”) that are asymptomatic and thus are never assessed by pelvic ultrasound.

4. You’ve had a baby before.

PCOS sometimes worsens with age, so this clinical presentation is typical in a woman who had children in her early 20s and then developed symptoms later in life.

5. You don’t have acne or hirsutism.

Some women are plagued with clinical signs of androgen excess such as oily skin and hair, acne, male-pattern balding and hirsutism. However, some women have few of these symptoms even with elevated androgens, demonstrating the phenotypic variability. Testing should include testosterone, DHEA-S, and androstenedione.

6. You have no family history of PCOS.

There does seem to be a genetic component with PCOS. However, since the incidence is increasing, potentially due to an environmental component in the form of endocrine disruptors, it’s not unusual for a patient to have no significant family history. It’s also likely that family members may have not known they had the condition or not disclosed it. Family history of glucose intolerance is very commonly associated with PCOS.

7. You’ve never had trouble becoming pregnant.

Since ovulatory dysfunction is variable in presentation, there are some women who have no fertility problems but are symptomatic of androgen excess, insulin resistance and other menstrual abnormalities such as heavy periods.

8. You went to doctors for years, and no one mentioned PCOS.

Unfortunately, this is the norm for many PCOS patients, especially if they have a milder case of PCOS. Hopefully, there will be more primary care health care providers who will begin picking up on the diagnosis as more medical information is disseminated. Acne is a common presenting symptom with PCOS.

9. You didn’t start having problems until you got off birth control.

This is a common problem if women have been on birth control for prolonged periods of time and especially if they were started on birth control for abnormal cycles. Most women will revert to whatever their underlying hormonal issue was when they go off birth control.

10. Other than unexplained weight gain, especially belly fat, and sweet/carbohydrate cravings, you don’t have any other symptoms of PCOS.

Insulin resistance is often the presenting symptom of PCOS, so a careful history is in order. The 2-hour glucose tolerance test is commonly substituted with a Hemoglobin A1C and an insulin level. Hormonal testing should be considered if you have abnormal glucose metabolism and menstrual symptoms, or have darkened skin around your neck, axilla or groin (acanthosis nigricans).
Dr. Poppy Daniels was born in Boston and raised in Missouri. She attended undergraduate and medical school at the University of Missouri-Columbia.  She completed a residency in Obstetrics and Gynecology at Drexel University in Philadelphia, PA.  She worked for a short time for Drexel University Division of Infectious Diseases & HIV Medicine, on a project to institute rapid HIV testing for women presenting in labor with poor prenatal care. She and her husband, Dr. Dennis Daniels who is a Pulmonary/Critical Care/Sleep Medicine specialist, moved to Missouri where she has been in private practice since 2003.  They have 5 sons and one daughter, enjoying football, family time, gardening and raising chickens.  Dr. Poppy, as she is known to her patients and social media followers, has a wide variety of special interests including: Physician-Midwifery Collaboration, Functional Obstetrics, Bioidentical Hormone Therapy, Progesterone Support in Pregnancy, Recurrent Pregnancy Loss, Infertility, Polycystic Ovarian Syndrome, Clotting Disorders, and Vaginal Birth After Cesarean (VBAC).

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7 Fitness Tips and Exercises to Lose Weight http://pcosdiva.com/2017/04/lose-weight/ http://pcosdiva.com/2017/04/lose-weight/#comments Tue, 04 Apr 2017 15:00:37 +0000 http://pcosdiva.com/?p=11963 7 Fitness Tips and Exercises to Lose Weight Guest post by Jennifer O’Neal Losing weight is a tough job. Done right, it includes a well-balanced diet, regular exercise and fitness routines, […]

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lose weight

7 Fitness Tips and Exercises to Lose Weight

Guest post by Jennifer O’Neal

Losing weight is a tough job. Done right, it includes a well-balanced diet, regular exercise and fitness routines, and a happy outlook on life. When these factors are combined together, losing weight is almost a guaranteed success.

Try my favorite tips to achieve weight loss:

1. Exercise Is a Must

Regular exercise is definitely necessary, but the question is How Much Exercise Do We Need? If you’re new to exercise, 150 minutes per week should be a good start. Exercising doesn’t need to be harsh and strenuous. Instead, simple routines which can be done at home can be a good weight loss enhancer. One can choose from several exercises such as squats, crunches, lunges, and raises. Always remember to warm up before doing these moderate exercises and to cool down afterward. Another option is to use simple machines which can promote better exercise and give you full body workout. Consider rebounders, tread mills and exercise bikes.

2. Eat Low-Carbohydrate and High Fiber Foods

A proper diet should also be considered. The most effective diet plan includes foods with low carbohydrates and high fiber content. Low carbohydrate foods can get you the nutrients you need without calories you don’t, Mayo Clinic says. On the other hand, fiber rich foods provide a more satisfying effect for a longer period of time. When combined, these foods will help with weight loss management.

3. Include Plenty of Proteins In Your Diet

A proper diet should also include foods rich in protein. Protein-rich foods are responsible for boosting the metabolism. It can also reduce one’s appetite which can support the weight-regulating hormones present in the body. Protein can also help in losing belly fats through several mechanisms which will burn more calories.PCOS Meal Plans

4. Weight Training Is Better Than Cardio

Research proves that a combination of strength and cardio training should be done as both of these types of exercises offer different benefits. Weight training is more beneficial than cardio activities for weight loss. Regular weight training allows for changes in body composition, yielding muscle which burns more fat. These exercises should be done with proper guidance to ensure better and balanced results.

5. Proper Intake of Supplements

Supplements should be included in the everyday routine. With numerous supplements available today, be careful to choose one which will support your metabolism and help lose weight. Be certain to choose a high-quality, third party certified supplement so that you are assured of consistent quality and content. Proper dosage should be strictly followed when taking supplements to prevent unwanted results.

6. De-Stress Yourself with Proper Sleep

One should get enough rest and sleep to ensure best results. This should include approximately 8 hours a day. Sleeping can relieve stress which is often a cause of increased weight.

7. Keep a Positive Mindset

Always ensure a positive outlook on life. This positive thinking can make one feel better about oneself, increase confidence and belief in oneself which will flow into a better self-care cycle.

These fitness techniques and tips can serve as starting point to achieving and maintaining a healthy weight. There are endless ways to achieve weigh loss. Find the combination of exercise, diet and mindset that is right for you. Consult experts to guarantee the best results, which is a fit and healthy body.
Jennifer O’Neal is a lifelong cyclist, enjoying the thrill of an outdoor ride as much as the one on her indoor cycling bike. She regularly contributes to allexercisebikes.net, a leading provider of exercise bike reviews and education.

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PCOS and Hashimoto’s Shared Healing Protocol [Podcast] http://pcosdiva.com/2017/03/pcos-and-hashimotos/ Thu, 30 Mar 2017 01:17:22 +0000 http://pcosdiva.com/?p=11918 For me, it’s not about being on the perfect diet; it’s about tuning in to your body and figuring out what your body needs at this time and what’s not […]

The post PCOS and Hashimoto’s Shared Healing Protocol [Podcast] appeared first on PCOS Diva.


PCOS Podcast Dr. Wentz 61For me, it’s not about being on the perfect diet; it’s about tuning in to your body and figuring out what your body needs at this time and what’s not serving it. – Dr. Izabella Wentz

Women with PCOS are three times more likely to have Hashimoto’s Disease, a condition in which your immune system attacks your thyroid and the most common cause of hypothyroidism. In fact, there is quite a lot of overlap between Hashimoto’s and PCOS (fatigue, weight challenges, changes in brain function, depression, feeling unmotivated, anxiety, panic attacks, constipation, hair loss). Dr. Izabella Wentz has developed an effective protocol that may be helpful to women with PCOS whether they have Hashimoto’s or not. Listen in as we discuss:

  • Symptoms of Hashimoto’s Diesase and labs you should request
  • The role of toxins, adrenals and gut balance in thyroid and overall health
  • The necessity of detoxification and suggestions for liver support
  • Healing foods and the myth of cruciferous veggies
  • Protocol for healing your adrenal and cortisol issues


Link to Dr. Wentz’s book,Hashimoto’s Protocol, and free gift: thyroidpharmacist.com/gift

Link to my previous podcast with Dr. Wentz:

All PCOS Diva podcasts are now itunes-button

A full transcript follows.

Izabella Wentz, PharmD, FASCP is an internationally acclaimed thyroid specialist and licensed pharmacist who has dedicated her career to addressing the root causes of autoimmune thyroid disease after being diagnosed with Hashimoto’s Thyroiditis in 2009.

Dr. Wentz is the author of the New York Times best-selling patient guide Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause and the forthcoming protocol-based book Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back.

As a patient advocate, researcher, clinician and educator, Dr. Wentz is committed to raising awareness on how to overcome autoimmune thyroid disease through The Thyroid Secret Documentary Series, the Hashimoto’s Institute Practitioner Training, and her international consulting and speaking services offered to both patients and healthcare professionals.


Full Transcript:

Amy Medling:                    Hello and welcome to the PCOS Diva podcast. My name is Amy Medling and I’m a certified health coach and founder of PCOS Diva. My mission is to help women with PCOS find the tools and knowledge they need to take control of their PCOS so they can regain their fertility, femininity, health and happiness. If you haven’t already, make sure you check out pcosdiva.com because there I offer tons of great free information about PCOS and how to develop your PCOS diet and lifestyle plan so you can begin to thrive like a Diva. Look for me on iTunes, Facebook, and Instagram as well.

Today, I am welcoming back Dr. Izabella Wentz to the PCOS Diva podcast. If you haven’t listened to our podcast about what you need to know about Hashimoto’s and hypothyroid, then you definitely want to catch that. Today, we are going to be talking about her new Hashimoto’s protocol and I think that her protocol could be very helpful for women, whether you have Hashimoto’s or not.

Welcome, Dr. Izabella to the podcast today.

Izabella Wentz:                 Amy, thank you so much for having me. I’m so excited to connect with you and talk more about the Hashimoto’s and PCOS connection.

Amy Medling:                    Great. We’re going to do that and I just want to give listeners a little bit of your background first. You are a thyroid specialist and licensed pharmacist who has dedicated your career to addressing the root causes of autoimmune thyroid disease after being diagnosed with Hashimoto’s thyroiditis in 2009. You’re the author of the New York Times bestselling patient’s guide, Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause and the forthcoming protocol book, Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back.

I have to just let women that are listening know that PCOS actually makes you three times more likely to have Hashimoto’s and my bet is that there are women listening that have it, but don’t know yet. I find that a lot of doctors are just testing TSH to see how women’s thyroids are doing and they’re not getting into sort of some of these deeper labs. I was hoping to get started, you could kind of explain what Hashimoto’s is and maybe give some of the symptoms that we should be looking out for. Then, maybe, getting to some of the labs that we should request from our doctors.

Izabella Wentz:                 Absolutely. Hashimoto’s, you know, it kind of sounds like a rare Japanese flower or sword fighter …

Amy Medling:                    Mm-hmm.

Izabella Wentz:                 If you ask my husband, but it’s a very, very common condition and looking at advanced diagnostic studies, it’s going to affect about 27% of our population and the general population. Now, in women with PCOS, we see that 27% of them with … Sorry about that. Hashimoto’s is very, very common condition and effects about 27% of our population. I’ll talk a little bit about the symptoms and we’ll get into the tests in a little bit and then I’ll share how some of these tests might actually be even higher in women with PCOS.

Some of the more common symptoms of Hashimoto’s, which is essentially an autoimmune attack on the thyroid gland, are going to be having fatigue, so women who are really, really tired and then just having a hard time going about doing daily things. This is going to be a common symptom. It’s just thyroid tired is different than, you know, I just stayed up a little bit too late last night and I’m tired today. It’s a constant fatigue that’s with you throughout all the time. Then weight challenges are another big symptom, so people who have a hard time losing weight, or people who are just gaining weight without really doing anything differently. Then we’re looking at changes in brain function. This is the third biggest thing that women complain about and one of the cardinal signs of Hashimoto’s or thyroid disease is going to be brain fog where you just have a hard time remembering things, so you might have trouble with word finding. You might be walking into rooms and forgetting why you got there. You might be losing your keys.

There are some other symptoms as well, and these might include feeling depressed, feeling just very unmotivated, feeling like you have anxiety or even panic attacks have been reported. Then we’re looking at generally an overall slowing down of the body. In a person who has advanced Hashimoto’s because they become hypothyroid and so we’re going to see, perhaps, constipation, in the early stages it could be diarrhea. Then we’re going to start seeing hair loss. We’re going to start seeing a loss of the upper third of the eyebrow. Then cold intolerance, as well as heat intolerance are some other potential signs and symptoms. Now, all of these things don’t have to be present in order for one to have Hashimoto’s. One person might have all of these symptoms and then some. Another person might have just one or two of these symptoms.

I always recommend getting tested. In the general population, about 27% of people, men and women, have Hashimoto’s. Now, women are five to eight times more likely to have Hashimoto’s compared to men. When we do some more of these advanced diagnostics, we’re going to catch it. The current conventional test is known as the TSH test, the thyroid stimulating hormone test, and this test is going to be elevated when a person has an underactive thyroid, which is sort of the advanced stage of Hashimoto’s. For the first, maybe 10-15 years that a person has Hashimoto’s, that test might actually come out in the normal range.

Hashimoto’s comes in five stages. The first stage is the genetic predisposition, where for all intents and purposes we don’t have the condition, we don’t have any of the markers of the condition, and we don’t have this immune attack on our thyroid gland. You would be asymptomatic from Hashimoto’s symptoms at that point.

The second stage is when we start seeing that our thyroid gland becomes recognized as an enemy by the immune system. This is the beginning of the attack of the immune system on the thyroid gland. This can actually be measured by thyroid antibodies. Thyroid antibodies, TPO antibodies and TG antibodies are the two to ask your doctor for. This can be elevated for 10-15 years before doctors will actually find your TSH test to be elevated. There’s also thyroid ultrasound test that can be done at this stage to find the earlier stages of Hashimoto’s because about 80% of women will have thyroid antibodies when they have Hashimoto’s, but about 20% will be thero negative Hashimoto’s, which means they do not have thyroid antibodies. In a study done with women with PCOS, 27% of them had thyroid antibodies, whereas 42% of them had abnormal thyroid ultrasounds that were consistent with what Hashimoto’s looks like on a thyroid ultrasound. As the condition begins to progress, we start seeing more and more changes in different lab values.

At stage three, we’re going to start seeing more symptoms and then a slight elevation of TSH, but this is not always reliable because it might go back and forth.

In stage four, we’re going to see the elevation of TSH and then we’re also going to see alterations in free T3 and free T4, where those will be low. These are the active thyroid hormones that are measured. For a full and comprehensive thyroid panel, I recommend doing the TSH test, T3, T4, which are the active thyroid hormones, and I always recommend getting both the total versions, then the free versions, which tell us how much thyroid hormone is there to interact with receptors.  Then we’re also looking at reverse T3. Now, this is something that becomes elevated in times of stress and adrenal stress. It’s always good to look at that. Then we’re also looking at the thyroid antibodies. Thyroglobulin antibodies, which are TG, and thyroperoxidase antibodies, which are TPO. Then for every woman, at least once in her lifetime, I recommend getting a thyroid ultrasound because like the studies have shown, thyroid ultrasounds can reveal Hashimoto’s more frequently than even the antibody tests can.

Amy Medling:                    This is really great information. I think a lot of people listening can see that a lot of the symptoms of PCOS sort of mimic these symptoms of Hashimoto’s. The other thing that I wanted to point out, is that I had to really fight with my doctor to get the antibody tests because my TSH was normal.  I didn’t end up having Hashimoto’s, but he did give them to me and I’m just glad that I was able to get that information. Part of being a Diva is really advocating for yourself and realizing that your doctor is working for you, and if they’re not willing to do these tests for you, then it’s important to find somebody that is because the number of women with PCOS … Did you say 27% of … What was that statistic that you mentioned, Dr. Wentz?

Izabella Wentz:                 Yeah. 27% would have elevated thyroid antibodies.

Amy Medling:                    Yeah. It’s important to advocate for yourself. There will be a transcript of this call so you can, you know, go back and look at the testing that is suggested. I wanted to kind of dive into your protocol. I’ve been reading your book at night over the past week …

Izabella Wentz:                 Mm-hmm (affirmative).

Amy Medling:                    And really as a woman with PCOS that does not have Hashimoto’s, I can tell you that so much of what you’re recommending in your book, I think could be so helpful for me. A lot of what you’re discussing, in terms of the role that toxins have to play in this autoimmune condition and your adrenal health, and then keeping your gut balanced, it’s all so appropriate for women with PCOS with or without Hashimoto’s. I tend to feel, after all of these years studying PCOS, that there’s definitely probably some underlying autoimmune issue for some women as well with PCOS. As you know, once you have one kind of autoimmune condition, you’re much more predisposed to have others, like Hashimoto’s and celiac. Maybe you could kind of touch a little bit upon the role of toxins, adrenals and gut balance and maybe give us a couple of tips on how to kind of reverse bad lifestyle choices, I guess, in each of those areas.

Izabella Wentz:                 Mm-hmm (affirmative). When I first started working with people with Hashimoto’s, I was kind of looking for ways to help them uncover their root causes and I was …

Amy Medling:                    Yeah.

Izabella Wentz:                 Really doing my due diligence to try to figure out what the triggers were for their condition. In some cases, this took a lot of time. People had to spend a lot of money to get expensive tests and this became a bit frustrating for me. Then I saw that there was a subset of women who just seem to react to everything that I recommended so I would give them a B vitamin and they would have an adverse reaction to it. They’d say that, “Wow, I just can’t tolerate any kind of supplements. I’m just really, really sensitive.” Then I did a little bit more research and I thought about, okay, how do we help people who are very, very sensitive? How do we help them kind of get to baseline, right, and how do we address that? I really started looking into the connection between the liver toxicity …

Amy Medling:                    Mm-hmm (affirmative).

Izabella Wentz:                 And thyroid health and generally autoimmune disease, right? What I found is that in autoimmune, we tend to have a very, very congested liver. I think that’s one fun way to say it. You can’t really catch it on a lab test, but that’s essentially what’s happening, is that the liver will have a backlog of these toxins and then it can’t process the toxins correctly. We end up walking around with a lot of toxicity within our bodies. I like to use the example of like an overworked office worker that has a stack of papers on her desk and people just keep putting more and more papers on her desk and things that would take her five minutes to do are just now taking weeks or days for her to complete and she’s overwhelmed and she’s stressed and nothing’s getting done and nothing’s getting out.

That’s sort of what happens with the liver, and we know that we’re constantly bombarded by various toxins in our environment, and our modern diet doesn’t necessarily include a lot of foods that help us detoxify, and, in fact, has a lot of toxins within it so we end eating foods that have hormones in them when we’re not eating organic meats. We’re eating things with potentially pesticides on them when we’re eating non-organic vegetables. Then also, we’re eating foods that are highly inflammatory to us, like gluten, dairy, and soy, which then have to get processed out as toxins essentially. In people who have food sensitivities, which are always present in Hashimoto’s, what they do is they produce circulating immune complexes, to the foods, and it’s basically a complex that forms an antibody into the food reaction and these complexes all get shunted to the liver.

A lot of times women with thyroid disease, they also will an impaired ability to sweat. Now, this is not something they commonly complain about. It’s like one of those things that seems like a side benefit, but it’s actually quite toxic because then we’re not clearing out the toxins because our skin is one of our biggest elimination organs. Again, those things that would normally be cleaned out through sweat and through the skin, end up going to the liver.

Then the gut is also impaired in Hashimoto’s and in a lot of women with chronic health conditions. This ends up in the toxins that would normally be cleared out of the gut going to the liver. In some cases, when you have a person who is really struggling with their health, getting them on liver support can produce a dramatic change. When I first started working with women who were sensitive to a lot of things, you could say multiple chemical sensitivity, quite a few of them had that as a diagnosis. I would put them on liver support for about two weeks, and I was actually surprised to see the results that they had.

One woman had headaches. She had anxiety. She had joint pains and she also wasn’t able to go to mall because of the scents there. What we ended up doing is doing the liver support protocol and this was a couple of weeks before Christmas where she called me and left me a message and said, “Hey, I’m actually able to go to the mall again. I’m no longer sensitive to all these things in my environment. My headaches have resolved. My pain has resolved.” Then, sure enough, the next time we tested her thyroid antibodies, which are an indication of how aggressive the autoimmune attack is on the thyroid gland, those were reduced as well.

What’s happening when you support the liver, you help your body get rid of some of that toxic backlog and then, once again, you have this happy office worker that can go on and process things effectively. How you do that, the few things that I recommend for liver support are going to be cleaning up your environment and cleaning up your personal care routine. Getting a reverse osmosis filter …

Amy Medling:                    Mm-hmm (affirmative).

Izabella Wentz:                 Is going to be very, very helpful because fluoride in our water supply can actually suppress thyroid function and it’s a toxin. Getting off of personal care products. A lot of our conventional personal care products have a lot of endocrine disrupting chemicals and chemicals that act like estrogen within our body. I know there was one study done in women with Hashimoto’s and PCOS and the researchers were trying to determine which women with PCOS were likely to get Hashimoto’s, which were not as likely, and they found that the women with higher levels of estrogen, or those who had estrogen dominance, were more likely to get Hashimoto’s and so this is something that can be actually induced by potentially some of our personal care products.

Then we start thinking about what foods are supportive. Let’s think of food as medicine and then trying to give people foods that are going to be helpful for detoxification. That’s going to be hot lemon water, doing some smoothies with cilantro, eating beets can be very, very helpful in helping to clear out some of those toxins through the methylation pathway. We go through just a two-week time period where we remove things and we add things and do some targeted supplements that include milk thistle and methylation support and within, I would say, 7 to 10 days, people start feeling a difference. About 65% of people in my experience will see a dramatic turnaround within just those two weeks of the liver support.

Amy Medling:                    Yeah. It’s amazing how your body can really heal itself when it’s given the right foods and supplements. I run a twice-a-year cleanse. It’s called the Sparkle Cleanse, and we talk a lot about how to get rid of the endocrine disruptors so that you avoid, kind of, the retox, but then it’s also a liver support cleanse. It’s amazing in those 14 days what a difference you can experience in your health. I’m so onboard with the whole idea of detoxifying and the role that toxins play in your health. Just a little shout out to beets. I know a lot of women, they remember those kind of canned candied beets, you know, that maybe their grandmother ate.

Izabella Wentz:                 Mm-hmm (affirmative).

Amy Medling:                    Beets can be so delicious when you roast them or you can even sort of julienne them raw and put them in your salads, and they really are delicious if prepared the right way.

Izabella Wentz:                 Mm-hmm (affirmative). Yeah. There are so many different ways to make them. You could ferment them. You can make soup out of them.

Amy Medling:                    Yeah.

Izabella Wentz:                 You could make almost like tomato sauce out of them. Then another food group that I think is really important and underappreciated in thyroid conditions and, in fact, sometimes some people have villainized them, are cruciferous vegetables.

Amy Medling:                    Mm-hmm (affirmative).

Izabella Wentz:                 Crucifers contain nutrients that help to support the liver’s detoxification. Vegetables like cabbage, broccoli, cauliflower, kale, turnips, these can be really, really helpful to help move out some of the toxins out of the body. There’s a myth, thyroid myth, that cruciferous vegetables contain goitrogens and that they cause thyroid disease …

Amy Medling:                    Right.

Izabella Wentz:                 But in reality, you’d have to eat, like, a lot of them. A lot of them. Even in modern times, the mechanism that they are … Goitrogen is kind of like a generic term for anything that interferes with thyroid hormone absorption production function. The way that they interact with the thyroid gland is that they prevent the absorption of iodine. With Hashimoto’s, we’re not really looking at iodine as a potential root cause for a majority of people. Maybe 5% of people might have an iodine deficiency, but for the rest of us, iodine deficiency is not really relevant with Hashimoto’s and autoimmune thyroid disease. It’s more of something you would see in developing nations where they don’t have the added iodine to the salt supply.

Amy Medling:                    I’m so glad that you clarified that question about the goitrogens and cruciferous veggies. I get that question a lot, because, of course, I’m recommending those types of vegetables for women with PCOS in my meal plans. The other thing that I wanted to mention, in your book you talk about the benefit of having a really rich fiber diet and that helps with kind of escorting that excess estrogen. Then, berries too. You kind of talk about the benefits of berries and berries are one of those fruits that I think are really fantastic for women with PCOS too, because they don’t affect your blood sugar like some of the other, maybe tropical fruits, that we might be eating.

Izabella Wentz:                 Mm-hmm (affirmative). Yeah. Exactly. They’re very, very tasty too. That’s always nice.

Amy Medling:                    Right.

Izabella Wentz:                 They have a lot of phytonutrients and antioxidants and blueberries are actually a rich source of myo-inositol, so this is something that can be taken as a supplement as well, but it’s a nutrient that can actually improve thyroid function and blood sugar. I know this is something that can be potentially helpful for women with PCOS as well.

Amy Medling:                    Yeah. I actually recommend a supplement called Ovasitol. It’s a combination myo-inositol and D-Chiro inositol supplement. It helps women with PCOS on so many different levels, with the blood sugar control, but also with egg quality, you know, if somebody is trying to get pregnant. You can read more about that on PCOS Diva. Since we’re kind of on the subject of foods, and we’re talking about some of the good sort of healing foods, what are some of … Before we talk a little bit more about adrenals, can you just mention some of what you sort of see as the trigger foods? I know you said gluten, dairy, and soy, but are there some other foods out there that you kind of want people to steer clear from?

Izabella Wentz:                 As a starting point for everybody, I have them go gluten free, dairy free, and soy free.

Amy Medling:                    Mm-hmm (affirmative).

Izabella Wentz:                 In some people that will completely turn their thyroid condition around and they might go into complete remission. For other people, we might need to dig deeper. One of the foods that can be reactive for some women with Hashimoto’s may also be eggs. Now, generally, eggs are going to be considered to be a relatively healthy whole food, but the protein structure may be difficult for people with intestinal permeability and some of those autoimmune responses to tolerate. Often times, I might have people get off of eggs as well. Then we’re also looking at nuts and grains. In many cases that’s potential trigger foods. For women who are struggling with pain, I might have them get off nightshades for a time period. These would be tomatoes, bell peppers, and eggplants. Sometimes these types of foods, even though they’re normally very healthy, can be problematic for certain individuals.

I have two approaches. One of them is a step-down approach where you start off with the autoimmune Paleo diet and then you start introducing more foods. Then there’s also the step-up approach where you get off of the gluten, dairy, and soy and see how you do, and then as time progresses, you might remove more foods. It just really depends on the person what they’re more comfortable with. I know for some people, they want to jump right in and others might say, “Okay, it’s going to take me a long time to make these changes.” Really it’s about moving in the right direction. For me, it’s not about, like, being on the perfect diet, it’s about tuning in to your body and figuring out what your body needs at this time and what’s not serving it.

There’s definitely processed foods that I think are a problem for most people in general and artificial sweeteners can be a problem. Like sucralose can be a potential issue for … Splenda can be potential issue for people with Hashimoto’s as well. Either whole foods diet, mostly organic, is what I recommend. I know this is something that you’re a big fan of as well.

Amy Medling:                    Yeah. I wanted to just mention too, if you’re interested, in kind of the step approach that you had mentioned.  You do have all the information in your book, which is really helpful. I wanted, before we run out of time, I want to talk a little bit about your adrenal protocol and I believe that most women with PCOS have some level of adrenal issues that they really need to stay on top of. I find that women that are really struggling with their PCOS are often … They’re either not exercising or they’re totally over exercising and just really stressed out and they have inadequate sleep and their adrenal health is really compromised. Again, that’s kind of another one of those areas that really, I think, overlap with Hashimoto’s and PCOS. Maybe you could talk a little bit about your experience with adrenal issues and kind of how you came about your recovery protocol.

Izabella Wentz:                 Mm-hmm (affirmative). Yeah. I found that about 95% of the women that I worked with, who didn’t get better with changing up their nutrition, so maybe they got slightly better, but they hit a plateau. 95% of them had low cortisol. Cortisol is a hormone that’s produced by the adrenals, and this is something that is going to be necessary. People oftentimes say that cortisol is bad. Well, it’s only bad when there’s too much of it. We actually do absolutely need it in the right amount for reducing inflammation within our bodies.

What happens is that initially people start producing too much cortisol and then as time goes on their body sort of stops wanting to produce more, where the body kind of says, “Okay, you’re telling me there’s an emergency, because cortisol is a stress hormone, and I’m putting out all this cortisol, but where is this emergency? You’re giving me an emergency every day, so I’m just kind of going to stop producing all the cortisol.” It’s sort of like the boy who cries wolf, right? You end up, over time, with really low levels of cortisol. A lot of times we see this as people who are just extremely, extremely tired and they’re having a hard time. They’re breaking their bodies down instead of building them back up so they’re in a catabolic state instead of an anabolic state and they’re often times going to have blood sugar issues …

Amy Medling:                    Mm-hmm (affirmative).

Izabella Wentz:                 Because cortisol helps us balance our blood sugar. The ways to turn that around, we’re going to want to make sure that we’re focusing on four things. Sleep, stress, blood sugar, and then inflammation. The things that we do is, one of the fastest ways to get your adrenals out of whack is sleep deprivation. What I recommend, and I don’t know if this is possible for everybody, but just trying to take elements of it when you can, is to do spa month where you do things for yourself that are promoting sleep and relaxation, blood sugar balance and reducing your inflammation. What do I mean by that? If you can commit to sleeping for 10 to 12 hours for a week straight, that can actually be helpful and restore the adrenals.

One of my good friends, Dr. Alan Christianson, he also sometimes will recommend that a woman check into a hotel room for the weekend, and just some black-out curtains, and try to sleep the entire weekend as much as possible. The other part of that is giving yourself frequent really nigh nutrient dense food a few times a day, so you’re basically kind of training your body that that’s supporting your blood sugar issues and you’re training your body to not be having those blood sugar swings.

Then we’re thinking about what are things you can incorporate into your life that can help you stress less and help you relax more. This might be things like going for a walk or getting a massage, meditation, sewing. Different people have things that love to do. I recently got into adult coloring books, which are just fabulous …

Amy Medling:                    Oh, yeah.

Izabella Wentz:                 And they’re supposed to, I think, the equivalent of meditation, I once heard. You go through and you do these things that are going to be targeted to send your body these safety signals because adrenals respond to stress. Adrenals are sort of like, “Okay, there’s danger around. Things are changing up.” We want to send these, like, everything is good, everything is safe, so we’re thinking positive thoughts. Then we can also do things that help the adrenals out. I like to recommend the ABCs, that’s adrenal adaptogens. They can be very, very helpful to balance some of the … A lot of times they’ll say, adrenal adaptogens make everybody else a nicer person, because when you’re on them, the world doesn’t seem as stressful. They help you balance out your stress response.

Then we’re looking at the B vitamins. Thiamine is one I really, really like. That can be helpful for restoring blood sugar balance and can be really helpful for energy levels. I recommend about 600 mg per day and within three days, those people will start seeing a big difference in that. Then vitamin C is really, really important for adrenal health. Then another nutrient that I really love is magnesium. Doing Epsom salt baths or taking magnesium as a supplement can be very, very helpful and very relaxing and put your body in that sort of like rest and digest mode and heal mode, rather than in the fight or flight mode. This is like a fundamental that I recommend for everybody across the board, whether they have Hashimoto’s, PCOS, any kind of root cause or triggers. I would argue that gut, adrenals, and liver are really the core body systems that these, really when we’re ill, this is what goes out of whack. We need to start supporting them to find our way back to health.

Amy Medling:                    Mmm. I think that that’s really a part about being a Diva is making sure that you have time for you as well and advocating for that time. I know for me, I found that weekly acupuncture … I found an acupuncture co-op where it costs me as little as $13 a visit. That really helps me keep my stress levels … And I love how you describe that it makes everybody else seem easier to get along with. That’s exactly kind of how I feel. I’ve actually missed it the last two weeks, and I’ve been kind of irritated with my husband lately, so I think I just need to go back and have another session. Such good wisdom and advice, Dr. Wentz. I want everybody to know that her book, Hashimoto’s Protocol, is excellent. Again, I believe it’s not just for women with Hashimoto’s. I think everyone listening with PCOS would benefit from picking up a copy of the book as well. Tell us where we can find the book and how we can find out more information about your work.

Izabella Wentz:                 Mm-hmm (affirmative). Thank you so much, and I so admire our work and I really love that you teach women to be Divas because that’s such an empowering way to be and that’s really the only way to take back your health. Nobody’s going to do it for you. Once you fill your own cup, you can actually give some from your overflow, because we all know that when you’re empty, you can’t fill another cup, right? My book, Hashimoto’s Protocol, is going to be available on Amazon, Barnes and Noble and bookstores all around the country. If people go to thyroidpharmacist.com/gift, I can also give them some wonderful resources and tools to get them started on their journey towards recovering their health with Hashimoto’s.

Amy Medling:                    Excellent. Yeah. We will post that link below the podcast as well. Thank you for joining us again. I hope you’ll be back again soon.

Izabella Wentz:                 Thank you so much for having me and thank you for the work that you’re doing.

Amy Medling:                    Well, that wraps up our podcast today. Thank you, everyone listening, for joining us. I hope that you enjoyed this podcast. If you like this episode, don’t forget to subscribe to PCOS Diva on iTunes or wherever you might be listening to the show. If you have a minute, please leave me a quick review. I’d love to hear from you. If you can think of anyone else that might benefit from this free podcast, please take a minute to share with family or friend so that she can benefit from it too. Don’t forget to sign up for my free newsletter. Just enter your email on pcosdiva.com to get instant access and make sure you never miss a future podcast. This is Amy Medling wishing you good health. Bye-bye.

The post PCOS and Hashimoto’s Shared Healing Protocol [Podcast] appeared first on PCOS Diva.

How to Balance PCOS, Exercise & Hormones [Podcast] http://pcosdiva.com/2017/03/exercise-hormones/ Tue, 21 Mar 2017 16:26:35 +0000 http://pcosdiva.com/?p=11921 “Every body is a good body, and we have to honor this body that we have. No one ever got anywhere, no one ever got happy, hating it into change. […]

The post How to Balance PCOS, Exercise & Hormones [Podcast] appeared first on PCOS Diva.


PCOS Podcast Dr. Brooke 60Every body is a good body, and we have to honor this body that we have. No one ever got anywhere, no one ever got happy, hating it into change. Embrace the body that you have and make it the best body it can be.” – Dr. Brooke

Women with PCOS are prone to adrenal fatigue and hormone shifts, making exercise a tricky, though very necessary, thing. I asked Dr. Brooke, a well-known expert on metabolic nutrition, fat loss resistance and fitness to help us navigate the delicate balance between our hormones and exercise. During our conversation, we discuss what your symptoms are trying to tell you about your work-out and how you can best tailor your exercise to your ever-changing hormones (whether due to menopause, PCOS, thyroid issues, or stress).

Listen as we talk about:

  • If you love intense training (marathons, CrossFit, etc.), how can you avoid exhaustion and adrenal issues?
  • What testing should we consider for adrenal issues?
  • What are your ACES (appetite cravings, energy & sleep) telling you?
  • Have you reached metabolic adaptation or stagnation?

All PCOS Diva podcasts are now itunes-button

A full transcript follows.

A licensed Naturopathic Doctor (ND), Dr. Brooke attended Seattle, Washington’s Bastyr University, where she earned a Doctorate in Naturopathic Medicine and Masters in Acupuncture and Chinese Herbal Medicine.

Dr. Brooke takes a balanced approach to health, using both conventional and alternative therapies. Metabolic nutrition, fat loss resistance, and fitness remain her area of focus and in her Manhattan clinic she primarily treats women with Hashimoto’s Hypothyroidism and PCOS – as well as other female hormone imbalances.

With these women she works to reset their hormones, their heads, and their habits, so they can finally feel at home in their bodies.  Learn more about Dr. Brooke on her website, and connect with her on Facebook and Twitter.


Full Transcript:

Amy Medling:                    Hello and welcome to the PCOSDiva podcast. My name is Amy Medling. I’m a certified health coach and the founder of PCOSDiva. My mission is to help women with PCOS find the tools and knowledge they need to take control of their PCOS so they can regain their fertility, femininity, health and happiness. If you haven’t already, make sure you check out PCOSDiva.com because there I offer tons of great free information about PCOS and how to develop your PCOS diet and lifestyle plan so you can begin to thrive like a diva. Look for me on iTunes, Facebook and Instagram as well.

Today I have the privilege of talking to Dr. Brooke Kalanick and I actually discovered Dr. Brooke on a fantastic blog, I don’t know if you’ve heard of it, it’s called Girls Gone Strong. I invited her to come on the podcast to kind of talk about how to train if you have PCOS. I know I’ve talked a lot about different exercise modalities like yoga and we’ve done some pieces on high-intensity interval training and really how to exercise to avoid adrenal fatigue. I’m hearing from a lot of women that are wondering, “Well you know what, I love running, I love training for marathons, I really like working out hard, Crossfit type exercises. How do I avoid exhaustion and adrenal issues if that’s how I want to work out?”

Dr. Brooke, I’m hoping that you can give us some advice on how to kind of customize our workout program so we can avoid aggravating our PCOS symptoms, so welcome.

Dr. Brooke:                         Thank you. Yeah, thank you for having me. It is a tricky balance, partly … You and I were just talking off-air that most of us with … I have PCOS myself so this is something really close to my heart. Part of the issue with women with PCOS is we don’t just have PCOS, we have a lot of other things going on and it’s very common to not only have some sort of dysregulation with your female hormones and the hormone insulin, but to also have issues with adrenal stress issues, thyroid issues, inflammation. There’s the whole usually symphony of stuff that’s going on with us and so it’s very rare that I ever see a woman who just simply is dealing with PCOS. They’re out there, but most women ask a lot of questions and some are struggling are trying to balance that and kind of synthesize all that they’ve learned for themselves and all that they hear about PCOS and try to help that work with how they should be working out and eating when they most often have some other hormone issues.

Of course we can do some testing to look at adrenal issues, thyroid issues, blood work for thyroid. I really like the saliva testing for looking at a cortisol rhythm throughout the day. You can learn a lot by just your symptoms. I think if women are on the line now going, “Well I don’t know if I have … I know I have PCOS but I don’t know if I have any of these other issues.” There are a lot of questions you could just answer and I do on my website have a free quiz that you can kind of walk through different hormones and take a look and they’re all laid out individually so if you just want to know if you have a thyroid problem you can look at that. Betterbydrbrooke.com is my website and those quizzes are free, you can kind of just take a look and walk through some symptoms of adrenal issues, whether they’re low or high, low thyroid issues, Hashimoto’s, all those sorts of things that are very, very common to have when you have PCOS.

Amy Medling:                    I just want to give everyone kind of an overview of your background too because you are a naturopathic doctor. You got your degree from Bastyr University and you have a clinic in Manhattan where you focus on treating women with Hashimoto’s hypothyroidism and PCOS as well as other female hormonal imbalances and you’re really an expert on metabolic nutrition, fat loss resistance and fitness is kind of your area of focus. That’s why I’m so thrilled that you are on our podcast today to talk about those topics.

I guess, what I wanted to ask you is, in addition to the testing to kind of figure out what type of PCOS you’re dealing with, finding out if you have a thyroid condition or if you have cortisol issues, do you think that there’s kind of different types of exercise that are better for these different phenotypes of PCOS? I know I am more of that thin phenotype but I also have a lot of adrenal issues. I find … It was funny, I remember being in college and running all the time and that was kind of my form of exercise and still could … At that time I was dealing with a lot of insulin resistance, basically because my diet was awful, and I couldn’t lose weight.

When I got a shin splint and had to walk, the weight started dropping off. It just didn’t really make a lot of sense to me. I remember later in my 20s and 30s I started taking up lifting and doing more heavy lifting and that really helped my PCOS symptoms, building that muscle. I’ve kind of learned from trial and error that I can’t do a lot of running, I do a lot of walking, or I rebound. I really like resistance training like Pure Barre or using exercise bands instead of like the heavy weights because I find that I bulk up too much with heavy weights. Maybe you could … I’m wondering if the best way to approach this is maybe look at sort of these different phenotypes of PCOS and maybe talk about the best types of exercise for us.

Dr. Brooke:                         Yeah. I work with a lot of women with PCOS that want to lose weight so there’s that whole thing, and then there’s other women who maybe are not looking to lose weight but they’re trying to improve their body composition just by being stronger or they’re just trying to be healthy and active or they’re just trying to help use exercise to be healthy and manage their PCOS symptoms, or they’re like some of the people you mentioned in the intro that there are just certain kinds of exercises that they really love to do and it may be flaring up their symptoms.

There is a categorization, I guess, going around of PCOS of there’s lean type and heavy type, and I just don’t love that because I think we kind of associate heavy with bad and lean with good, and I feel like a lot of us have a lot of body image stuff that goes on and we don’t really need that label, it’s one more thing to contend with. I like to keep it a little less personal and a little more about the biochemistry.

What’s going on with PCOS women and when they look so different. This is such a huge problem because you hear women that go into their doctor saying, “I really think I might be dealing with this …” or their personal trainer and that person says to them, “Well you don’t look like you have PCOS, so I’m not even going to bother looking past that.” Hopefully this is changing. I think more and more experts are talking about the range and hopefully we’ll have a new categorization and a different way to think about PCOS than the way we do now, which is I think it’s very limiting.

When we think of women that are all dealing with some form of insulin resistance, we have to remember that that’s not a black and white thing. There is a degree of insulin resistance and a degree of insulin sensitivity for women to women, throughout the day and tissue to tissue. Most of the time we’re thinking about are you resistant? Are your muscle cells resistant to the message of insulin? Are your fat cells resistant to the message of insulin? Some of the insulins that hormone helps whatever we eat, nutrients, get into our muscle cells for use or into our fat cells for storage.

When a woman doesn’t have a difficult time losing weight or they don’t tend to put on a lot of body fat, I tend to think of them, and this is sort of my own framework, if they’re having more trouble getting fuel into a fat cell, but they have a pretty easy time getting it into a muscle cell, so they’re using things a little bit better and they’re able to take things in, use them and not store as much fat. Whereas the other type of woman that’s dealing with more body fat, they’re more resistant at the muscle level and they’re accepting, basically more sensitive, at the fat level so they’re easy for them to put on fat and not as easy for them to utilize fuel that they eat in their muscles. They deal with more fatigue and less exercise intolerance, especially if it’s simple … Just looking at the insulin resistance piece of that.

Just remembering that the sensitivity or resistance that we have to this hormone can be a little bit different sort of throughout our body and that’s one of the reasons that it looks so different on different women. The women that tend to take in nutrients easier into their muscles and not as well into their fat, they tend to also be the ones with more adrenal stress issues, so more of that adrenal fatigue, dealing with lower cortisol, lower blood sugar problems, whereas women that put on body fat easier, they tend to deal with more higher cortisol issues.

That, again, is kind of a generalization because we can have a whole range of adrenal stress and cortisol issues throughout our lives. There’s going to be a time where we might be much more wiped out and lower cortisol. There might be just a time of day where currently we’re doing okay and we have a big dip in the afternoon. There’s a lot of variation with our stress hormones and our insulin resistance, even within just one woman having PCOS.

Then there’s the whole thyroid conversation, but just dealing with those things we have to really honor these two hormones, insulin and cortisol, I think first and foremost. One, because you do need a blood test to check your thyroid so there’s part of that we just have to get a little more help with and a little more information. With insulin and cortisol, I love these hormones because they’re major, master hormones. They have an effect on how your estrogen, your progesterone and your thyroid and everything else works. If they’re not in balance you’re going to have a really hard time sorting out estrogen dominance or low progesterone. We really have to honor them first.

The other thing that’s really great about these two is that you have a fair amount of control over them. We have a lot of control over what we eat and when we eat and how we decide to handle stress and how much we decide to put emphasis on sleep and stress management. We have a lot of say in how these go. We also have this beautiful thing that happens all day long which these hormones are talking to us. They’re giving us feedback constantly about how they’re doing and do they like what you’re doing. Do they like your lack of sleep? Do they like the fact that you’re eating the foods you might be sensitive to. Do they like the fact that you are over-carbing for your unique metabolism or under eating fiber.

These signals, I use the acronym ACES all the time, so appetite cravings, energy and sleep. If you’re having issues with appetite cravings or energy between meals, that tends to mean you’re dealing more with issues with lower blood sugar and lower cortisol problems. When we eat something and have appetite cravings, energy changes after we eat, that can mean that we have sort of overshot our insulin capacity and that can be hugely helped by fine-tuning our carb intake, maybe sometimes a little more lean protein, a little more vegetables, and then sleep. If we’re having an easy time going to sleep or staying asleep, that is a huge indicator that our adrenals are not happy if either one of those things are happening. A higher cortisol at bedtime can sometimes make it hard for people to fall asleep and sometimes difficulty staying asleep throughout the night can mean lower cortisol and lower blood sugar problems.

Those are some ways for you to kind of just know like right now, what type of PCOS might I have and do I maybe also have some of these other issues. When it comes to trying to train, so if you’re somebody that wants to work out, whether you enjoy it or you’re trying to lose weight, what we’ve always done is like we’ll just go do more, just go start doing some more stuff and eating less. For us, with the hormone intricacies that are already slightly off, it’s very easy for us to take the stress of exercise and drive ourselves into the ground further.

Honoring of the insulin and cortisol, so I said to honor those above the other hormones because you get information about them, you have more say in what’s going on and you can tell really quickly in real time from one day to the next, like am I making an impact on those hormones? Also, when it comes to the two of them, deal with cortisol first because if we are dealing with high cortisol or low cortisol as far as our stress response, it’s going to be really hard to not push that gas pedal one way or the other with exercise. For those of us that love high intensity training or sprint work, that’s going to be something we have to do some of but not too much when we have a high cortisol problem, when we’re kind of running on stress. When we’re wiped out we really don’t tolerate that well at all so these are any type of metabolic conditioning, sprint work.

Then when we think about cardio we’ve got … Walking is sort of I call the great cortisol normalizer, so whether you know where you know where your cortisol is, you should be able to walk a lot and have that for the most part. We do have some people that don’t even tolerate that well and we get into some issues with autoimmunity and thyroid. When we’re just dealing with stress, walking is great. It takes a lot of time and some women don’t like that aspect of it, but it is something you can do and trust you’re not going to push the scale in a negative way regardless of where your hormones are at and it’s another great way to utilize your muscle mass to improve your insulin sensitivity because it’s just sort of slow, gentle, doesn’t tweak the stress response too much.

Many women don’t … They kind of shy away from the weights and they go towards lots of cardio because it’s just kind of always what we’ve been told to do and it’s easy. Most people, even if you don’t have a gym membership, you can go running, so the trouble with those, especially when it comes to weight loss, is that longer distance cardio, so when we’re talking like that cruising along for 45 minutes to an hour jogging or on a stairmaster, it will raise cortisol, all exercise will, exercise removes stress, but if we’re going for weight loss or fat loss, we get this cortisol rise but we don’t trigger that kind of magic fat burning combo of cortisol plus growth hormone, and testosterone, more so growth hormone for women.

We spend a lot of time and effort, we can kind of push our adrenals in a negative way but we don’t get that kind of magic hormone groove to really dip into fat loss. If you’re a PCOS woman like me who struggles with the burning fat piece of it, that’s really frustrating. Not only am I making my metabolism a little less effective, I spent time and energy and didn’t get very far. That’s kind of a lot of stuff when it comes to insulin and cortisol and exercise. Is there any part of that you want me to expand on or any more specific question to kind of dig into that a little deeper?

Amy Medling:                    I think you are just really showing us that it isn’t an issue of calories in, calories out. You take in 500 calories and then you see the little calorie meter go up on the treadmill that, “Okay, I’ve just burned 500 calories so now I just erased the doughnut that I just ate.” I mean, it just doesn’t work that way.

Dr. Brooke:                         Yeah. We’ve always been told that. We’ve kind of … I think we’re moving away from that and especially … At the end of the day, yeah, you’ve got to burn more than you take in. How do you get there isn’t as simple as well let’s subtract from here and add more time on the treadmill. We don’t work so much like a math equation. The real kind of magic of it is can you create that caloric deficit by balancing your hormones for two reasons: One, you’ve already got a hormone problem. You’re not just the average woman with … Well I don’t know if there is an average woman with no hormone problems anymore, but when you’ve got PCOS we have at least one hormone issue, likely you are also dealing with low progesterone, estrogen dominance, high or low cortisol and possibly a thyroid issue.

Many of you are dealing with oxidative stress and inflammation, food sensitivities, lots of GI disruption. There’s all sorts of … Sometimes there’s high prolactin in the mix, which really will impact insulin even further. You’ve got all this hormone stuff going on so you have to create as much balance within that as you can if you’re going to get results. Yeah, it’s never just one thing. When you look at all of those things, then we deal with something called metabolic adaptation or stagnation. It’s basically when you are putting in the effort and you’re putting in time at the gym and you’re not getting the same result, or you’re cutting calories and you’re not getting the expected result. You shave off 500 calories, either because you didn’t eat them or you thought you worked them off, and the math doesn’t work in reality.

This is thermogenesis and this is just your body’s way of getting really good at sort of, getting wise to our shenanigans when we start to do this thing. That happens to everyone. If any of us can think back to even in our earlier days we did a certain diet and at some point it just was less effective. Eventually your body kind of gets used to it. That adaptation, we’ve already got all the compromises in our metabolism and places where our metabolism already is not efficient and you’re sort of already at adaptation and stagnation so you really when you just think of it as calories, the math does not work out in our favor because we’ve got all these other shifts that are going on inside and your body is really stuck.

One of the things to think about, I think if you’re a woman with PCOS that’s looking to lose weight, the diet I think is probably the most important thing, just because it’s something we do several times a day, it can have really far-reaching consequences. It’s hard to just go back and put in time, like we said, on the elliptical and think, “Well, that’ll cancel that out.” Dialing that in and really honoring the fact that we have this carbohydrate sensitivity whereas someone who’s that leaner type that doesn’t put on as much body fat, they need to eat some carbohydrate but honor the fact that they have insulin resistance. Someone like me does better on a little bit more plant based fat, lots of lean proteins and very little carbohydrate.

We all have that spectrum where I help women try to find what is your unique carb tolerance, I call it, so it goes past this idea, “Well you have PCOS, you should be low-carb.” We all have, depending on your training as well and your stress levels, some adjustments we need to make within there.

When you look at that whole thing, dialing that in first and then like you said at the beginning, we tend to shy away from weight training and that is the most important thing for women to do, whether it’s lighter or heavier, for not only like aging and bone density but that is your sort of reserve of insulin sensitivity is your muscle mass. We have to remember too, with exercise there are these different types of proteins in muscles called glut transporters and when we exercise we actually don’t need insulin to get glucose into the cell. These little receptors rise up to the surface and take in the sugar and the fat without needing insulin. Whether you’re insulin resistant or not, exercise will always help you lower your blood sugar.

Then it’s just a question of: Are you someone who just needs to walk? Are you someone who needs to do some sort of old school standard body weight, or bodybuilding kind of training where it’s like 8 reps, or are you someone who can do a little bit more of like heavier weights and a little bit less reps and work with your cardio. Exercise to me is like one of the best pieces of medicine we can give for someone with PCOS.

Amy Medling:                    I love how you talked about finding your unique carb tolerance. In my programs I talk about it in a way of that PCOS is like this big science experiment and you have to kind of experiment with how many carbs, the types of carbs, to kind of get the right combination for you and that might change week by week, like you said, by your stress levels and such. In the article that you wrote you had this great quote, and I don’t know if I’m going to be able to find it. “Test yourself before you wreck yourself.” You talk about that in terms of exercise too and, again, it’s like this experimentation and you have to figure out what works best for your body by really getting in tune and listening to the signals and the messages that you give us.

Maybe you could talk a little bit about that idea about testing yourself before you wreck yourself. I think that’s probably what those, the women that are really wanting to train harder, what they need to hear, the message they need to hear.

Dr. Brooke:                         You’ve probably got information on your side about that. I definitely have finding your unique carb tolerance all over my website so looking through some of those and take the time to figure that out. Don’t also think that all that stuff with food sensitivities and wheat issues and dairy issues. Those are really big deals for women with PCOS and not every woman with PCOS is going to have an issue with certain, like those bigger culprits, but it’s really common, either because of the sensitivity or because those foods actually create some unique insulin responses so there’s a protein, there’s something called amylopectin in wheat and that is, some of it is just cause of a bigger insulin response and a lot more inflammation. Sometimes it’s not so much that you have celiac or gluten issues but digging in a little bit, because you may just have an exaggerated insulin response to wheat-based things.

Same thing with dairy. It behaves a little bit more like a sugar for most women, yet we’re taught eat low-fat Greek yogurt, eat low-fat cottage cheese, those are really great kinds of protein sources, and they don’t always work so well for women with PCOS. When it comes to like checking yourself and testing yourself, if you have a food that you’re questioning, the easiest thing to do with stuff like that is just take it out for a month. That might seem like a long time, but pay attention and check yourself and test yourself a little bit and see if you do better. Maybe it’s not something you can never have but maybe choosing that as one of your main foods that you have a couple of times a day or at least several times a week maybe won’t work for you as well as something else might.

When it comes to exercise, we’ve got, I think, a couple camps of people. There’s one, the women who really love to exercise, but they realize that it’s flaring their symptoms or making their PCOS worse somehow. If we’ve got someone who, like you mentioned, a marathon trainer, somebody who really loves to run a lot or train for those big events, or you’ve got someone like who’s doing a lot of CrossFit, which can just be very metabolically demanding, it’s a lot of high-intensity training. If you find that that changes your sleep, changes your appetite, changes your cravings or you’re not getting the expected results, then look to the stress of that and maybe think about adding more standard weight training, more walking and dialing down either the miles or dialing down the intensity of the workout and see if you do better.

We were talking before the show, Amy, as well that I put together finally a guide to managing your training and adjusting your training for your hormones so I’ve got all this in one spot here finally again at my website, betterbydrbrooke.com. You know when you’re doing something and you feel like you’re hitting your head against the wall, we have to listen to stuff. So anything that you love. I talk to a lot of people who, not so much the marathon runners, but I do talk to a lot of women who love things like CrossFit or they love just doing high-intensity training, and then they’re feeling achy, they’re feeling tired, they’re feeling sore and they’re just not recovering as well and they’re definitely not getting the results that they want.

We always have to remember what worked for us before may not work for us now. Like you said, time marches on, things change throughout our cycle. There might be a type of training that you do better on the first two weeks of your cycle and you have to dial it down the second two weeks because you’re dealing with adrenal fatigue and more progesterone and those more intense or longer-duration workouts affect your sleep more profoundly, let’s say, the week before your period, when you really need some resources to make progesterone. Most women with PCOS don’t have as healthy of ovulation all the time and make as much progesterone from our ovaries.

Just listen to the results that you’re getting, listening to the appetite cravings, energy and sleep and trying to just honor the fact that your body is really trying … I think we spend so much time hating our bodies and being frustrated that we have this hormone issue or that. I’ve had PCOS since I was in my teens, this is not new. It’s still annoying sometimes, but we spend so much time being upset and fighting against that. Our bodies are not trying to be so terrible. They are trying, really, to keep us going, so when they are talking it’s nice if we listen. This is why I always say, “Be your best friend.” If your best friend was saying, “Oh my gosh, I am so exhausted. My cravings are off the chart. My PMS is terrible. I’m having such a hard time falling asleep. I feel achy and tired every time I train. Do you think I should go to the gym and just really have a crazy hard work out for an hour?” You know your best friend would be like, “No. No you absolutely should not do that. You should probably take care of yourself, get some rest, maybe even get some help, but definitely today is not the day for you to push yourself.”

We are to have that own voice in our head. When our body and our hormones are giving us all these signals and we’re saying, “No, well I will deal with you next week because right now I really need to focus on this …” or “Right now I have this deadline …” or “Right now whatever …” We would never say that to our best friend, “I’ll get back to you in six months. I’m sorry that you’re suffering and falling apart, but too bad. We’ll talk later.” That can happen so easily when we’re over-training and eating inappropriately or just in some other way stressing ourselves out.

If we’ve got someone who has maybe already realized that they are not doing well with exercise, like every time they train they’re just kind of wiped out and it doesn’t feel good for them to work out harder or doesn’t feel good for them to work out regularly, we have to think too with that, is there something that needs a change in your workout? Maybe we don’t … This is hardest when women that are dealing especially with thyroid issues, they have some bad days so they don’t train, but then they have a really good day where they’re like, “I feel great …” and so they go to the gym and they do a bunch of stuff at home, and they have a great day at work and then they go back to the gym because they’re like, “I feel so good today …” and maybe they stay up too late.

When you’re someone who’s been dealing with adrenal stress or thyroid issues or Hashimoto’s, which is autoimmune hypothyroidism, when you’re doing that and you notice that you over train and you’re trying to work your way back up, especially I see women coming out of that adrenal fatigue place like, “Okay, I’m feeling good and I’m going to do more …” don’t add another 45 minutes to your training session. Add another five minutes and see how you do and maybe add another day per week, but what we do, I think, we feel … If we’ve been feeling bad it feels so good to feel good we just want to do a bunch and we set ourselves back. That’s another thing, back to the quote there Amy, is test yourself and listen. Don’t try to do a ton of something that you’re afraid is not working for you.

It can be hard when you have been in that place and you don’t want to stress yourself out or push yourself so then we get sort of scared to do anything. Especially if you’re working on losing weight, we always have to create a little bit of stress or change won’t happen. The question is always, can you give yourself a teeny bit of stress without giving yourself so much stress that you’re back to wrecking yourself.

Amy Medling:                    I loved that you brought up the idea of being good to your body and I think a lot of women approach exercise as it’s kind of this way … From like a way of punishing themselves to exercise out those calories, like we were talking about in the beginning. I really want women to think of exercise as a way to kind of love up their bodies. You want to feel good after, and if you’re feeling exhausted, like you need a nap after your workout, then you have to listen to that. I think that there’s something that’s not quite right there and try some other types of exercise. I always come back and talk about Pure Barre, but for me at 45 I can’t exercise the way that I did at 25, and I was doing Body Pump for quite a long time but then my shoulders started to get sore. I think it was too much weight, too much repetition. I started feeling kind of that exhausted afterwards, so I’ve switched it up and feel really good. I’m energized and ready to take on the day after I go to Pure Barre class and that really works for me.

I want women listening to exercise so they feel good and not so that they feel, that they’re punishing themselves or they feel burned out because that’s what’s going to make it sustainable because you keep going back for more of that feeling good feeling.

Dr. Brooke:                         Yeah, there’s the biochemistry of that that feels bad and there’s all the psycho, emotional stuff that we have about. Exercise has always been kind of thought of as a punishment. I have to go do this because I ate something bad, or I have to go do this because my body doesn’t measure up in one way or another. That’s a whole important conversation. You mentioned Girls Gone Strong. I was one of the original advisory board members for Girls Gone Strong and that’s definitely something we talk about a lot. Every body is a good body and we have to honor this body that we have. No one ever got anywhere, no one ever got happy hating it into change. If you’re someone who’s like, “You know, I’m trying to work on …” maybe you had a baby and you’re trying to work on getting stronger again and getting your body to a place where you feel more comfortable or more at home.

I’m very gentle with women when they’re post-partum. It takes a long time to put things back together, and I don’t think that post-partum ever ends. I think our bodies are … We’re forever changed by babies and we’re forever changed by decisions we make. I talk to women who maybe they don’t have children, but they’re high level executives and they’ve done great things in their career and we made compromises with our stress and our hormones. A lot of stuff can happen for women and we have to just continue to listen and continue to kind of honor the choices we’ve made and where we’re at. It doesn’t always fit sometimes with our goals in the gym or our goals to have our body look or be a certain way.

If we’re going to go about changing our body in any way, whether you want to get stronger or you want to lose body fat, going about it from a place of love is going to just be so much less miserable. You’ve still got to do the work, but it’s not … I would say nourish, not punish. Food is nourishment. Exercise is nourishment. We always have come at it from the other way so I always go back to the just simple analogy of be your best friend. What would your … I think some women they’re kind of like, “I don’t know how to do that, I don’t know how to listen.” Think about how your best friend talks to you or how you would talk to your best friend and just adopt that voice.

I think too with PCOS in particular, you mentioned earlier getting bulky. I am one of those people as well, I put on muscle really easy, I’m really quite strong. I also really love heavy strength training. It’s funny, when I used to run, I’d sort of run myself into the ground because I always just wanted my legs to be smaller. They’re smaller but not leaner because it was causing a lot of stress response for me and so it wasn’t burning body fat very effectively. Now that I’ve sort of finally appreciated the body that I have, that I do put on muscle easy and that I do get strong easy, I don’t take off body fat as easy. My sort of formula has been two-fold. One is I tolerate a little bit more like traditional cardio that everyone’s telling you is a waste of time, is going to kill you, which is not true. We have, there’s a dose for all of our kinds of exercise and we balance that dose with our own hormone analysis.

I do the best on heavy training and some intense cardio and some moderate cardio. I’ve also had to balance my metabolic issues with my mindset around the fact that I am, unless I do things that drive my hormones crazy, I am not going to be super, super skinny. I’m not going to be super small because if I keep myself healthy and keep my body fat low I train a little harder and then put on some muscle and I’ve had to sort of get my head around the fact that that’s okay. I’m going to make this body that I have the best that it can be, rather than sort of punishing it and trying to just make it something it’s not. My legs right now are probably in some ways bigger than they’ve ever been but leaner because I’ve kind of found my own formula.

I think when we move towards training, whereas if you’re someone who has just never even picked up a weight or someone who has only done really like things when you move into something heavier, but I also think something great can happen with that too where we can have a strength goal, which is I think a lot more motivating most days than a fat loss goal because some days you just don’t care so much about that, but you get to see a little progress and you’re feeling stronger.

Amy Medling:                    Yeah, I love that, embrace the body that you have and make it the best body it can be. I love the idea of the strength goals. I really encourage women to throw away the scale, and I think when you’re into body fat composition and it just really, those numbers drive you, like if the number goes up then mentally it kind of takes you out of your day. I think often it can cause a lot of self-sabotage. When the number goes down you have this kind of sense of everything’s right in the world but it’s just not driven from the right place, so I love the idea of kind of ditching those metrics and focus on the strength. I often say it’s how you feel in your clothes because your legs might be bigger but they might be leaner and they’re fitting better in the jeans anyway. I think that kind of changing the metrics around fitness and your body is the way to go as well.

Dr. Brooke:                         Remember, you get to make those decisions. You get to decide that you don’t want to lose a pound, you want to lose a pound. Those are all choices that we get to make and that if it feels good, and I feel more at home at X, Y or Z then move towards that in a way that works with your hormones for two reasons: One is you’re going to have more success and you won’t wreck yourself in the process, and probably three reasons, it’s going to be more sustainable and then if you don’t feel that way, that you just want to focus on balancing health for other reasons, then we have to remember too that we’re grown up girls and we get to decide what we want for our bodies and what we want for our lifestyle.

It’s hard to do that work and trying to keep it focused, kind of eyes on your own paper. This is what is important to me and this is how I’m going to feel about my body and how I’m going to make the choices, but when we’ve got stuff like PCOS or thyroid issues we just have I think one other layer to honor and that’s the fact that we already have a somewhat kind of deranged metabolism and so much of the popular advice is just going to blow up in our faces. It’s why even I help so many women just with this one condition because these women are super frustrated and we get it. We’ve been there.

Training with a lot of different hormones is tricky but it can be done. I think focusing on just your PCOS crux of insulin resistance and then focusing on stress and sleep and are you managing those things well and checking in with those symptoms can really give you a lot of insight into what you should be doing differently. I wanted to say, one thing you mentioned, Amy, about doing the higher repetition weight, that is such a common thing I see with women that are doing maybe a weight that is too light for them but they’re lifting it 15 times. It’s so easy to get repetitive strain injuries like that, especially if you have a thyroid condition, but that can happen with any of us. It’s something to think about if you’re taking a class like that but if you’re getting those issues then it’s really not working for you right now.

Doing what you did, it’s finding a form of exercise that seems to kind of manage your hormones and make you happy and that you enjoy showing up to do.

Amy Medling:                    This has been such great information. I think you answered all my questions, Dr. Brooke. I would love for you to just kind of tell us again how we can learn more about your work and maybe just another plug for your opt-in about the different types of exercise, I think that’s going to be helpful for a lot of women listening.

Dr. Brooke:                         Yeah. My website is betterbydrbrooke.com. If you go there now there is it talks about a lot of the things we talked about today, which is just if you’re somebody who is trying to manage your hormones and work on weight loss and you’re feeling frustrated, whether you’re going through PCOS, perimenopause, thyroid issues or all of the above. There’s a lot of good information in there that’s free. I’m putting together my e-book too with all the stuff I talked about today, so how do you modify your exercise to honor all these different hormone imbalances, whether that’s, again, menopause, PCOS, thyroid issues or stress issues. I also have a podcast as well, it’s Better Every day with Sarah and Dr. Brooke, I do that with Sarah Fragoso who is most known for being the face of Everyday Paleo, although she stepped away and now is just Sarah Fragoso. You can find me on Facebook at Better By Dr. Brooke and on Instagram, same thing, Better By Dr. Brooke there as well.

Amy Medling:                    You also work with clients one-on-one, I wanted you to just mention …


Dr. Brooke:                         Again, on the website you can fill out a … Yeah, there’s a little contact form on my website so just send me questions that you have if you’re curious about working with me, or just if I’m someone that might be able to help you. E-mailing that contact form is great or you can send an e-mail to me directly, which is drbrooke@betterbydrbrooke.com. My website is a great way to get in touch with me if you’re interested in working with me. I do work with women all over the world these days.

Amy Medling:                    Excellent. Thank you again for joining us. I want to just thank everybody for listening. I hope you enjoyed this episode, and if you liked it don’t forget to subscribe to PCOSDiva on iTunes, the podcast app, or wherever you might be listening to the show. If you have a minute, please leave me a quick review on iTunes; I love to hear from you. If you think someone else might benefit from this free podcast, please take a minute to share it with a friend or family member so she can benefit from it too. Don’t forget to sign up for my free newsletter, just enter your e-mail at pcosdiva.com to get instant access and make sure you never miss a future podcast.

This is Amy Medling wishing you good health. Until next time, bye-bye.

The post How to Balance PCOS, Exercise & Hormones [Podcast] appeared first on PCOS Diva.

Your Spring PCOS Diet Should Include… http://pcosdiva.com/2017/03/spring-pcos-diet/ http://pcosdiva.com/2017/03/spring-pcos-diet/#comments Thu, 09 Mar 2017 14:40:49 +0000 http://pcosdiva.com/?p=12201 It is time for spring cleaning! For your home, that means washing your windows to let all in all the radiant spring sunshine. For your body, it means flushing out […]

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Spring PCOS DietIt is time for spring cleaning! For your home, that means washing your windows to let all in all the radiant spring sunshine. For your body, it means flushing out all of the heavy foods that you have been enjoying all winter and refreshing with fresh foods of the season which compliment your PCOS diet.

I like to do a gentle, PCOS friendly detox or cleanse at the start of spring. It gives my body a boost as it naturally purges the heaviness of winter and sets me on the right path for the new season.

I love the feeling during a cleanse when suddenly, I am lighter, brighter, have less brain fog, and more energy. The feeling of renewal is my favorite part of spring!

The goal of a spring cleanse is to rid your body of excess fat, proteins and toxins it stored up to help get through the winter. During cold, dry weather, your body holds on to water to keep itself in balance. In the spring, it naturally begins to flush all of this extra water.

With the water, it flushes toxins that have built up. The body protects itself from these toxins by producing extra mucus.

Spring foods such as dandelion root, echinacea, chicory, watercress, mustard greens, parsley and cilantro can help break up that mucus.

All of these flushed toxins can begin to overwhelm the liver. Spring bitter roots such as dandelion are natural diuretics and liver protectors. In addition, the chlorophyll found in all of these beautiful spring greens promote the growth of healthy bacteria in your intestines that protect you from parasites, yeast and harmful bacteria.

A good cleanse or detox will support your liver and lessen its burden during this period. My Sparkle Program, for example, includes detoxifying smoothies and recipes for cleansing (but satisfying) foods as well as enzyme and nutritional support capsules. This combination is offers your system a gentle boost to its natural cleansing.PCOS Diva Sparkle Detox

Whether you “do a detox” or not this spring. Try to work some cleansing foods into your PCOS diet.

Foods to Enjoy in Abundance: 

  • sprouts of any kind
  • mustard greens
  • leafy greens
  • green beans
  • asparagus
  • kale
  • spinach
  • Swiss chard
  • dandelion greens
  • cherries
  • berries
  • onions
  • watercress
  • parsley
  • celery
  • cilantro

Foods to Reduce or Avoid:

Heavy dairy (ice cream, cheese, yogurt) – If you have PCOS, you should avoid dairy anyway. For more information, read my article about PCOS and dairy.

As you begin to prepare your body for spring, concentrate on gentle whole foods.  In order to truly cleanse and help your body rid itself of toxins, you need to have proper nourishment, lots of filtered water, and plenty of seasonal produce – especially green leafy vegetables. These easily digested foods allow us to free up energy that can be used to help rid toxins from the body. This is the way to go, especially if you have PCOS.

Also, by removing common food allergens that often cause an immune response and inflammation, you boost your nutritional uptake, support your digestive track, and support the liver in its work of neutralizing and preparing those toxins to be eliminated.

So, get out there and start enjoying the bounty of the season, from sunshine to vegetables!

I invite you to join me for the Sparkle 14-day Detox Program beginning April 2nd. Registration ends Wednesday, March 21st, so register today and get ready to feel refreshed, light and ready for the new season!

The post Your Spring PCOS Diet Should Include… appeared first on PCOS Diva.

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5 Root Causes of Low Libido [Podcast] http://pcosdiva.com/2017/03/low-libido/ Wed, 08 Mar 2017 14:00:57 +0000 http://pcosdiva.com/?p=11985 Just like we’re not a victim of our trauma, we’re not a victim of our genetics. We’re not a victim of our circumstances; we actually have the power if we […]

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PCOS Podcast - Dr KeeshaJust like we’re not a victim of our trauma, we’re not a victim of our genetics. We’re not a victim of our circumstances; we actually have the power if we put attention and consider ourselves important enough to heal.” -Dr. Keesha Ewers

Low libido is a common concern for women, maybe especially those with PCOS. Why? Dr. Keesha Ewers has researched the topic extensively and developed a theory of 5 root causes. Women with PCOS will almost certainly relate to many of them including “fighting with your body” and feeling it has betrayed you, but it goes much further. As Dr. Keesha says, “What’s in your head goes to your bed.” Listen in as we discuss:

  • PCOS, how it can affect our libidos, and what we can do about it
  • The pill and its impact on libido
  • Five root causes for low libido
  • The biology of stress causing low libido

All PCOS Diva podcasts are now itunes-button

A full transcript follows.

Dr. Keesha Ewers is a board certified Functional and advanced Ayurvedic medical practitioner as well as Doctor of Sexology, family practice ARNP (advanced registered nurse practitioner), Certified Psychotherapist and the founder and medical director of the Academy for Integrative Medicine health coach certification program. She is also the founder and a host of the Healthy YOU!
Radio network. Dr. Keesha has been in the medical field for over 30 years. After being diagnosed with rheumatoid arthritis—an incurable disease according to Western medicine—she began exploring alternative modalities, which led her to Ayurvedic and Functional Medicine and a complete reversal of her autoimmunity.
Her constant thirst for knowledge in the pursuit of finding answers to her patient’s problems has taken her around the world, learning from traditional healers and native cultures from Australia to Peru and from India to Africa, as well as from the best of the innovative thinkers and scientists our country offers.
Dr. Keesha is the best-selling author of Solving the Autoimmune Puzzle: The Woman’s Guide to Reclaiming Emotional Freedom and Vibrant Health and Your Libido Story: A workbook for women who want to find, fix, and free their sexual desire.

Full Transcript:

Amy Medling:                    Hello and welcome to the PCOS Diva podcast. My name is Amy Medling, and I’m a certified health coach and founder of PCOS Diva. My mission is to help women with PCOS find the tools and knowledge they need to take control of their PCOS so they can regain their fertility, femininity, health and happiness. If you haven’t already, please make sure to check out pcosdiva.com because there I offer tons of great free information about PCOS, and how to develop your PCOS diet and lifestyle plan so you can begin to thrive like a Diva. Look for me on iTunes, Facebook, and Instagram as well. Today I have the honor of talking with Dr. Keesha Ewers about PCOS and how it can affect our libido, and what we can do about it, so welcome to the PCOS Diva podcast, Dr. Keesha.

Dr. Keesha E.:                    Thank you. I am so glad to be here. Thank you for having me on.

Amy Medling:                    Well, let me give our listeners just a little bit of your background. You are a board certified Functional and Ayurvedic medical practitioner, as well as a doctor of sexology, family practice ARNP, and that’s an advanced registered nurse practitioner, and a certified psychotherapist, so I think as a doctor of sexology you’re certainly qualified to talk about this subject.

Dr. Keesha E.:                    Yeah. It’s a fun subject because no one is talking about it, and it needs to be talked about, so I always love opening up this conversation.

Amy Medling:                    One of the questions I definitely want to address, and maybe we’ll just jump in with this, is the pill and its impact on libido because as you know, so many women with PCOS are given the pill as a therapy, but I think of it as really more of a Band-Aid for PCOS and their PCOS symptoms. I know when I was on the pill, it certainly affected my libido, and it really took me a long time post-pill to get it back, so maybe you can talk about that for those women listening that are on the pill or have been on the pill.

Dr. Keesha E.:                    This is such a great topic that you’re bringing up. Taking the hormonal birth control pill can really mess with your testosterone levels. Most of the methods that we have releases hormones that stop ovulation, so when you’re using the pill or the ring or the patch or the shot or the implant, and you’re not actually ovulating every month, that’s great because that’s the birth control that you’re looking for, but it’s also messing with your hormones that are in charge of saying, “Oh, I want to have sex,” right? So this is a problem. The other thing that can be affect are your dopamine levels in your brain. Women have to have good, adequate levels of dopamine in order to feel desire.

The birth control pill is actually starting to affect even teenagers. We’re giving to people that are younger and younger, and they’re staying on it for a lot longer than was historically the case, and so now we have a lot of really young women walking around at a time in their lives when libido is supposed to be your natural birthright and part of life on planet earth and human as we know it, and it’s messing with it. You know, I never prescribe the birth control pill. There are other ways to do birth control, so I will usually recommend that you get fitted for a diaphragm or do a non-hormonal IUD, or if you’re finished with childbearing years and you say, “Okay, my family is here and I’m done,” then to have a tubal ligation, have your partner have a vasectomy, and just stop putting that into your body.

Amy Medling:                    Yeah. Conceivably, women with PCOS could be on the birth control from like age 15 until her early 30s when she’s ready to now get pregnant, and may not even know she has PCOS until coming off of the pill and then might be diagnosed. For someone that has been on the pill for so long, what can be done to reclaim that sense of … even it’s femininity, I think, for a lot of women with PCOS, and that certainly plays a role into feeling desirable. What do you coach your patients, or maybe you can give us some tips?

Dr. Keesha E.:                    Sure. I’d like to sort of circle back to the beginning of what libido even represents and why it’s so important. The word “desire” is a Latin word that actually means “from the stars” and so the way that I think about desire is, your desire for your whole life from the stars. It’s what’s your life purpose here on the planet. What is it that, I’m going to say use the word God, but your God given birthright and purpose for being here? That passion infuses you to do that. You know, your life work, your life path, whether it’s mothering, coaching, writing, marathon running. What is it? What’s the thing that inspires you? If you don’t have desire for that, then you’re not filled with the amount of vitality that you need to be living your life in the most juicy way that you can.

To me, libido becomes more of kind of a gage, like the gas gage on the dashboard of your car. If it’s low, it’s the same as having nothing left in your tank. If you’re driving a car and there’s nothing left in your tank, you know you have to stop pretty quickly, pull over and go to a filling station and fill up, or you’re going to be broken down on the side of the road. What we do instead of filling up, pulling over and taking care of ourselves with some self-care, we will grab dark chocolate if we’re super attuned and on the healthier track, or a pastry or a Red Bull or a coffee, and try and get our energy levels that way.

What happens is, you do break down on the side of the road, and eventually, because you’re not taking care of your tank, so for me, when I’m taking to a woman, it’s not going to just be about, obviously, the birth control pill when we start talking about level of desire. I’m saying, “If you used to have a good sex drive with your partner and liked having sex with your partner, and you know that this is an intimate connection that has brought your relationship a lot of health and joy … There are so many healthy, amazing aspects that come from having sex. If you know that you’ve been there before and it’s now gone, then we address it from one direction.” If I ask a woman, “When was the last time that you did have a sex drive that you were satisfied with?” This is usually a woman that’s coming in asking me for a bioidentical hormone replacement.

I’ll say, “When was the last time that you did have a sex drive that you wanted,” and if she says, “I never have had one” and starts crying, then I start asking questions like, “Is there a history of abuse? Did you have a fairly stressful childhood, adolescence? Was college tough for you?” Stories will come out as a result of that question that are just heartbreaking. Or, “I’ve been fighting with my weight.” A lot of times people with PCOS have been, and they use that word “fighting,” fighting with their weight, and have been somewhat at odds with their bodies from at least adolescence forward.

When I’m coaching somebody in my office around this, I’m looking at five root causes for low libido. They’re going to be anywhere from physical, like you’re on a medication that’s affecting it because another thing that’ll happen is a lot of women are put on antidepressants. Of course, the number one side effect for that is low libido. Surgeries, birth control pills, illnesses like Hashimoto’s thyroiditis or any other autoimmune disease, or hypothyroidism, all of these will affect libido level because they’re impacting your gas tank. You’re looking under physical, you’re looking in mental places. Is there a body image issue? Are you at war with your body or you’re in a collaborative relationship with your body? Do you feel safe with the opposite sex? Do you feel safe with same sex? What’s going on mentally for you with your beliefs about your sexuality? Those were created in childhood and adolescence, and so those can impact your level of desire. They can be in the emotional arena. Maybe there’s some trauma in the past.

You know, Amy, I say that every single person comes out of childhood with trauma. It’s not necessarily sexual abuse. That’s my history. When I was 10, I was sexually abused by the vice principal of my elementary school, but that’s not everybody … People will hear that and go, “Oh.” You know, that’s a huge trauma. If you had a group of friends on the playground one day and the next day they reject you, that’s trauma too, so it’s part of the process of growing up, is to go through these experiences of rejection that feel terrible, and failing. Failing a test or not being good at something, and taking on this message that “I’m not good enough.” All of these things actually impact your desire for your life.

The fourth root cause will be in the spiritual area. Sometimes people are raised in a religion where desire is a sin from the pulpit, and they hear that over and over and over again. They’re expected to repress all of that, and then get married and all of a sudden be able to turn the faucet on. That’s not really reasonable, right? There’s this kind of angel-whore complex that can happen inside of religions that say sex is bad, sex is a sin unless you do it in these certain paradigms. There’s that piece. There’s also just the cultural story that can occur too. Did you get raised in a sex positive household or a sex negative household? In other words, were you able to talk freely at the dining room table with your family about age appropriate aspects of your sexuality as you were developing? Was that just part of the family conversation or was it hush-hush?

The fifth cause will be in what I call your libido story. That’s, as you were going through your human growth and developmental stages in childhood, what were the meanings that you made up around different sensual, sexual body experiences that you then created beliefs around that you carry forward into adulthood, and get an opportunity reframe if you do it with intention? So it’s a really complex subject for women. Men, we have this whole arousal paradigm that happens.

Masters and Johnson identified it in the 1950s and ’60s in their groundbreaking research. They applied it to men and women, but it’s mostly men that run this way, where there’s desire, then there’s arousal, then there’s an orgasm, and then there’s a refractory rest period. You can see that on a man, right? The penis shows the whole thing, while with a woman it’s really different and we have all kinds of different motivations for engaging intimately with somebody. That could be emotional connection. It could be kind of like cuddles and that closeness. It could be wanting to be ravaged, and that will be one day of the month that you feel that way, and then you’ll feel all cuddle, snuggle the next day of the month. It’s very different for women because our hormonal levels, our context of our lives are so different. Our brains are wired differently than men’s are. That’s why I do this whole program for this because you can see there’s so much here, right?

Amy Medling:                    Oh, yeah. You hit upon several topics — I was writing them down — that parallel what I’m hearing from women with PCOS. I find this common thread. Certainly fighting with your body, that really resonates. You’re growing hair where you shouldn’t be growing it and you can’t lose … like you said, fighting to lose the weight. The-

Dr. Keesha E.:                    Acne.

Amy Medling:                    The hair loss.

Dr. Keesha E.:                    Yeah.

Amy Medling:                    All of it. It’s like, “Okay. I have this body that has sort of betrayed me.” Having to shift through a place. It takes a lot of work to do that, to sort of embracing your body and beginning to love it so it will love you back, so to speak. I also find that women who are really struggling with PCOS have lost their connection with creativity, and I think you described it with things that make them feel vital, and trying to rediscover that so you can experience that flow state when you’re doing something that you really love to do. There’s a real disconnection from that for a lot of women, and I can see now how that could really affect your libido, so it was great that you’ve described your five pillars.

Dr. Keesha E.:                    There’s another component to this and it’s our brains. This was a fascinating thing that came out of my research when I was going through my doctoral work. I did a research study. I called it the HURT Study, which is Healing Unresolved Trauma Study. I asked women, because I was seeing this in my office and there was nothing in the medical literature to reflect what I was seeing in my office. I asked women, “Do hurt’s emotional wounds that somebody comes along and presses on in current day, these things that happened a long time ago, impact your willingness to have sex?” As woman it seemed like, “No, duh. Yeah, of course.” If my partner forgets my birthday, I’m not going to really be in the mood to have sex with him that night, right?

There was nothing in the medical literature that actually talked about this phenomenon, and it’s all focused around hormones or this idea that there’s a pill, the pink Viagra, something that’s going to solve women’s libido by taking it every morning. I was, in my clinical work, saying, “No. Women are so complex. There’s just no way.” As I started delving through the research and looking at PET scans, PET images of brains and different studies that had been done in this arena, I found, as I mapped the brain, that the same parts of the brain that are required for women to have libido are the exact same parts of the brain that are co-opted or lit up when there’s chronic daily stress or PTSD, post-traumatic stress disorder. Same brain injury.

If you feel that you’re overwhelmed day in and day out as if you’ve had a big trauma, like in the Adverse Childhood Experiences Study that was done between 1995 and 1997, 17,000, over 17,000 people were looked at and over two thirds of them reported some form of neglect or abuse that then the researchers tied into, “Oh, this is actually causing some of the chronic illnesses that we see in adulthood.” These are linked. People with more perception of trauma get sicker in adulthood.

What I found is that they also don’t have libido and that made so much sense to me when I started thinking about what libido actually is as a measurement of your vitality. Our brains change if we think we’re stressed. Now, that was huge because you hear this all the time, the Wonder Woman Complex. Women, we have ourselves painted into a corner where we think we have to bring home the bacon, fry it up in a pan, and look hot at the same time. We’re strung out and burned out and over-scheduled, and taking our kids hither and thither and yon, and we hardly breathe.

Of course you’re not going to feel like having sex, right? You got nothing left in the tank. That was a fascinating thing to see. The great news about that is that that brain change that happens on these images, you can actually heal it. That to me is true freedom. “Oh, we have this neuroplasticity in our brains that we can actually heal this if we pull some focused intention on it.” That’s why I did this program. It’s like, “Oh, you can heal every one of these things.” That’s amazing and that’s empowering, and so then that means that just like we’re not a victim of our trauma, we’re not a victim of our genetics, we’re not a victim of our circumstances; we actually have the power if we put attention and consider ourselves important enough to heal.

Amy Medling:                    Yeah. That just fits in with my whole Diva philosophy that-

Dr. Keesha E.:                    I know.

Amy Medling:                    And it’s beautiful. I love this saying that you have, and what you just explained is so true. “What’s in your head goes to your bed.”

Dr. Keesha E.:                    Yep.

Amy Medling:                    I think if you think of us all on an evolutionary sort of animal level, that why would we want to procreate if we felt like we were being chased by the tiger, right?

Dr. Keesha E.:                    Right. It’s not only why would we want to; our bodies say, “You cannot.” If you’re a zebra being chased by a lion and you think you’re going to get eaten, it’s not even about a choice. Your body says, “I can’t keep you alive. I’m not going to reproduce” so every amount of hormone that would go towards desire, which is what’s the precursor of reproduction, goes away. It gets reallocated to your adrenal glands to keep you in survival mode, so you don’t even have a choice, and that’s the thing about running around overwhelmed all the time. Your body believes you’re getting chased by a lion.

Amy Medling:                    Yeah. As women with PCOS, we have elevated cortisol and adrenal issues. That’s why it’s so essential that we learn to take care of ourselves. I love that you brought that connection to libido. It’s not something that just magically comes back, like you said, with a pink pill.

Dr. Keesha E.:                    Right.

Amy Medling:                    For those women that are listening that are really struggling with feeling feminine, how would you coach them?

Dr. Keesha E.:                    It depends on what feelings feminine means. What do you mean by that?

Amy Medling:                    I think it goes back to that feeling like your body has betrayed you. You don’t feel like-

Dr. Keesha E.:                    Okay. Stop with that right there because that’s a huge one and I see it in my office all the time. If you have made up the meaning and have the belief that your body has betrayed you, then your behaviors that result from that belief are going to be, like I said earlier, more combative with your body and not in collaboration with, and you’ll do a lot of self-sabotaging behaviors. If you believe that, that your body has betrayed you, that’s where you heal first. That’s the part that you ask, “Is that really true? Has my body betrayed or is my body just trying to get my attention, and I haven’t been listening? And in fact, I’ve betrayed my body because I’ve tuned out from it and I’ve been doing all this self-sabotaging behavior.” Ask, “Is that really true that my body betrayed me?” Because it’s actually not possible for your body to betray you. Your body gives you feedback and it starts really early with very quiet little tugs on your skirt, like a little toddler who’s trying to get mommy’s attention.

It will be something like a coating on your tongue or constipation or dry hair or acne, it’s like these early signs. If you don’t pay attention and say, “What do you need, body?” … I always say, “Test, don’t guess.” If you don’t go get some testing done that’s actually functional medicine style testing rather than go get your TSH checked, then you won’t know what the body is trying to tell you. That’s the, I think, criminal part of our medical model, is that we’re not taught to listen to our bodies in that way. We’re actually taught to think in terms of betrayal.

Ayurvedic medicine, which is a 10,000 year old model of medicine that’s the sister science of yoga that came out of India all that long ago, actually identified that we’re not all the same way back then, which is sort of revolutionary with the science of genetics today and epigenetics or nutrigenomics. We’re saying, “Oh. We’re not all the same” but they knew this a long time ago and said, “You know, your body is giving you feedback all the time, and if you’re out of balance, all you have to do is do these small corrections, like an airplane that’s going off course. The pilot’s got to get it back on course. It’s just a tiny little correction and then you’re back in balance again.” But we don’t think that way in our model of medicine. We go by match drug to symptom, and we got so far out of balance that our plane is taking a nosedive, and is in crash and burn by the time we pay attention.

That’s part of what I teach, is how to listen to the quiet tiny voices your body is trying to do communicate with you through. Then you’re not in that, “Oh, my body has betrayed me.” You’re in that, “Oh. Body, you’re trying to get my attention. Let me listen to you. Let’s be a team. Let me figure out what you need and give that to you.” Then your body gives back this amazing strength of carrying your spirit around in your life’s path. It’s such a gift and a blessing to have a body, so when you’re in a combative relationship with it, nobody wins.

Amy Medling:                    Right. No, and it’s so true. Before we run out of time, I’d love for you to talk a little bit more about how we can work with you through your five steps to help us regain our vitality and our libido.

Dr. Keesha E.:                    Sure. I have this program called the Libido Cure. It’s seven different modules and you do it at your own pace, and you can drop into it at any time. What you get is you join this incredible vital tribe of women that are already taking it. It’s yours forever, so you can keep returning back. You’ll see in the tribe and the private group these women saying, “Okay, I’m going through it again, and this is what I learned this time.” It’s like layer upon layer because this is, you’ve heard, this is all about healing from the inside out from all these different layers of meanings and beliefs you created when you were a kid. You get that amazing support of community and then these seven modules that have videos, a bunch of tracking tools, a lot of material and lecture.

It’s just a really amazing program that goes through each of those five areas I was talking about, in addition to a lot of relationship work. I’m a psychotherapist as well as a medical provider. The number one reason for women to have low libido is actually if they have a dissatisfaction in their relationships. Women get really stressed about that, so there’s that component too, and then healing some of those old beliefs, and like we just talked about with the body betrayal piece, there are many of those, and how to rework them and reframe them and heal them, so it’s really an amazing program.

Amy Medling:                    It sounds wonderful, and I love that it really makes that mind-body connection, and touches upon all of those facets of being a Diva, so I really highly recommend those listening that are struggling with libido, that you work with an expert. Dr. Keesha has been doing this for a long time and is really, from a functional perspective and a root cause perspective, she’s somebody that I would work with for sure.

Dr. Keesha E.:                    I’m going to give your group, your tribe, Amy, just because I feel so grateful that you work with people in the way that you do … You’re doing such amazing work. I’ll give you a link that you can use with this podcast for your tribe that will give them a discount.

Amy Medling:                    Oh, excellent. Yeah, and we will post that right below the podcast recording for everyone that’s listening. Well, thank you so much.

Dr. Keesha E.:                    Sure. Thanks so much for having me on. I love talking about this and helping women become their own Diva. That’s such a great way of saying it.

Amy Medling:                    I’m so happy that you joined us. Thank you, everyone, for listening to our podcast today. I hope that you enjoyed it. If you liked the episode, please don’t forget to subscribe to PCOS Diva on iTunes or wherever you might be listening to this show. If you have a minute, please leave me a quick review on iTunes because I love to hear from you. If you think of someone else that might benefit from this free podcast, please take a minute to share it with a family member or a friend so she can benefit from it too. Don’t forget to sign up for my free newsletter. Just enter your email at pcosdiva.com to get instant access, and make sure you never miss a future podcast. This is Amy Medling wishing you good health, and I look forward to being with you again soon. Bye-bye.

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Managing Shortened Luteal Phase for Conception http://pcosdiva.com/2017/03/shortened-luteal-phase/ Tue, 07 Mar 2017 15:59:09 +0000 http://pcosdiva.com/?p=12156 You and Your Luteal Phase Guest Post by Kate Davies Many of my fertility patients come to me with concerns about their menstrual cycle and whether it is normal. The […]

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Luteal Phase

You and Your Luteal Phase

Guest Post by Kate Davies

Many of my fertility patients come to me with concerns about their menstrual cycle and whether it is normal. The most frequent problem I see is with the luteal phase of the cycle.

The luteal phase (LP) is the post ovulatory phase of your cycle which lasts until menstruation. This is when fertilization and implantation occur. It is essential that the length and quality of the LP is sufficient enough to support an implanting pregnancy, ideally being 10 days or longer in length. In general, a normal LP is between 10-16 days. A short LP can cause complications in trying to conceive, and women who regularly have a short LP may suffer from Luteal Phase Defect (LPD).

Symptoms of LPD can be:

  • A short menstrual cycle
  • Low progesterone levels
  • A disruption in Basal Body Temperature (BBT) readings post ovulation

If you are concerned that your LP is short or think you may have LPD, you should discuss this with your doctor. It is important to mention that although the diagnosis of LPD has been described convincingly in the research setting, it remains a controversial clinical entity (Bukulmez and Arici 2004, Shivapathasundram et al. 2010). As a result of the uncertainties that surround the diagnosis of LPD, medical treatment is controversial and may not be offered by your doctor.

What Causes Shortened LP?

Low progesterone levels is a common cause of a shortened LP. Good progesterone levels are crucial to support an implanting pregnancy, and low levels can be the cause of infertility or recurrent early miscarriage. It is therefore important to consult your doctor if you suspect that this may be causing you a problem, as there may be other causes for progesterone deficiency such as thyroid disorders or Polycystic Ovarian Syndrome (PCOS).

Symptoms can include:

  • breast tenderness
  • loss of libido
  • headaches that are associated with your menstrual cycle
  • acne
  • anxiety
  • irritability
  • insomnia
  • weight gain
  • PMS
  • irregular bleeding

PCOS Diva JumpstartWhat can you do to improve your cycle, progesterone levels and LP naturally?


  • I recommend that you start fertility charting to assess your hormonal health and look closely at your LP. Find out exactly how long your LP is and how often it is less than 10 days. Observe your temperature for an indication on how healthy your progesterone levels are. Your temperature is a direct indication as to what is happening with your progesterone levels. For example, after ovulation your temperature should stay raised and above the pre-ovulatory temperatures. In general, your temperature will stay raised through the LP, dropping only the day before or the day that your next bleed starts. If your temperature drops early, this can indicate low progesterone levels.


  • Ensure an adequate supply of Vitamin C in your diet – Research shows vitamin C improves hormone levels and increases fertility in some women with LPD. Foods rich in vitamin C include: papaya, bell peppers, broccoli, sprouts, strawberry and oranges.
  • Essential fatty acids – these are vital for balanced hormone production. Many women are low in omega 3. Foods rich in essential fatty acids are walnuts, salmon, sardines and scallops.
  • Green leafy vegetablesGreen vegetables are rich in vitamin B complex and are necessary for good hormonal balance.



  • Consider taking magnesium, vitamin E and evening primrose supplements.
  • For PCOS Inositol supplementation will help regulate a menstrual cycle.


  • Vitex (Chasteberry)

Research has shown this herb to effectively lengthen the LP. It helps the body to increase its own production of luteinizing hormone (promoting ovulation) boosting progesterone levels during the LP of the cycle. Consult a qualified herbalist if you are considering this treatment.


  •   Women with LPD have significantly lower levels of antioxidants. Make antioxidants part of your every day foods by enjoying blackberries, blueberries, garlic, kale, strawberries, sprouts, plums, broccoli and red peppers.

Alternative therapy

  •    Acupuncture– Randomized controlled trials in China have demonstrated benefits to the menstrual cycle and fertility (Song 2008), however caution is needed when interpreting these studies as they may not be of high quality. In the West, there is a paucity of evidence for the benefits of acupuncture on the menstrual cycle and fertility (Balen et al. 2016) and it is clear that further research is needed. However, a recent study by Stener-Victorin et al. (2016) identified a decrease in circulating androgens in women with PCOS which in turn would improve cycle regularity and the luteal phase. If you are considering acupuncture to help with cycle regulation and your luteal phase, find an acupuncturist who specializes in fertility.


Balen, A.H., Morley, L.C., Misso, M., Franks, S., Legro, R.S., Wijeyaratne, C.N., Stener-Victorin, E., Fauser, B.C.J.M., Norman, R.J. and Teede, H. (2016) ‘The management of anovulatory infertility in women with polycystic ovary syndrome: An analysis of the evidence to support the development of global WHO guidance’, Human Reproduction Update, 22(6), pp. 687–708. doi: 10.1093/humupd/dmw025.

Bukulmez, O. and Arici, A. (2004) ‘Luteal phase defect: Myth or reality’, Obstetrics and Gynecology Clinics of North America, 31(4), pp. 727–744. doi: 10.1016/j.ogc.2004.08.007.

Shivapathasundram, G., Kwik, M. and Chapman, M. (2010) ‘Luteal phase defect: Part of the infertility zeitgeist or relic from the past?’, Human Fertility, 14(1), pp. 60–63. doi: 10.3109/14647273.2010.528504.

Stener-Victorin, E., Maliqueo, M., Soligo, M., Protto, V., Manni, L., Jerlhag, E., Kokosar, M., Sazonova, A., Behre, C.J., Lind, M., Ohlsson, C., Højlund, K. and Benrick, A. (2016) ‘Changes in HbA1c and circulating and adipose tissue androgen levels in overweight-obese women with polycystic ovary syndrome in response to electroacupuncture’, Obesity Science & Practice, 2(4), pp. 426–435. doi: 10.1002/osp4.78.


Kate Davies is a fertility practitioner, fertility coach and columnist. Kate works with women wishing to optimise their ability to conceive naturally and coaches women going through a difficult fertility journey.

Kate is a registered nurse specialist and worked for over 20 years in the UK’s National Health Service as a specialist nurse in Gynaecology, Sexual and contraceptive health and fertility. Four years ago Kate, frustrated with the lack of support and high quality advice for women who were struggling to conceive, founded her private practice ‘Your Fertility Journey’. Shortly after this, she trained as a fertility coach to offer her patients much needed emotional support as well as medical advice. Kate now has a thriving practice and consults women nationally and internationally via the wonders of Skype.

Kate has a special interest in PCOS and over the years has worked with 100’s of women who suffer with this debilitating condition. To enhance her practice, Kate has recently undertaken specialist training to enable her to offer women both the specialist advice and emotional support they desperately need.

Kate loves her job and her best days are when one of her lovely ladies calls her to say she is pregnant. Often she is the second person to know – what a privilege! Kate is very proud of the Facebook Support Group she founded over two years ago. This group, full of inspirational ladies going through all sorts of fertility journeys, gives ladies a safe place in which to ask advice, find support and get virtual hugs.

As well as her natural fertility and coaching services, Kate is also passionate about Natural Contraception and teaches women internationally on how to use this effective, safe and natural method of contraception.

Facebook Support Group: https://www.facebook.com/groups/Yourfertilitysupportgroup/

Website: http://yourfertilityjourney.com

Facebook: www.facebook.com/yourfertilityjourney

Twitter: https://twitter.com/fertjourney

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Is Red Wine Good for PCOS? http://pcosdiva.com/2017/03/resveratrol-for-pcos/ Mon, 06 Mar 2017 15:09:34 +0000 http://pcosdiva.com/?p=12149 Not since the health benefits of chocolate were announced has there been such enthusiasm about research results. Scientists now say that resveratrol, a compound found in red wine, can help […]

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resveratrol for PCOS

Not since the health benefits of chocolate were announced has there been such enthusiasm about research results. Scientists now say that resveratrol, a compound found in red wine, can help alleviate symptoms of PCOS and much more.

What is resveratrol?

Resveratrol is a powerful phytoalexin found in peanuts, nuts, many berries, Japanese knotweed, the skin of red grapes, and red wine. Phytoalexins are antimicrobial compounds produced as part of a plant’s defense system against disease and in response to an invading fungus stress, injury, or infection. It also helps them withstand drought or lack of nutrients. Resveratrol specifically has noted anti-inflammatory, antioxidant, anti-aging and cardioprotective properties in humans.

How does it help with PCOS?

Women with PCOS typically produce more testosterone and other androgens than other women. This androgen excess causes many of our most common symptoms including irregular or missing periods, infertility, weight gain, hirsutism (excess body hair) and acne.

In a recent study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism, researchers found that resveratrol can lower levels of testosterone and dehydroepiandrosterone sulfate (DHEAS) which the body can convert into testosterone. In fact, the senior author of the study, Antoni J. Duleba, MD, of the University of California, San Diego, says, “This nutritional supplement can help moderate the hormone imbalance that is one of the central features of PCOS.

In fact, Duleba reports that the decline in hormone levels was greater than what they found with  , a common band-aid for PCOS symptoms. The research team is hopeful that resveratrol will help restore normal cycles and improve fertility in the long term. That’s great news for women who are trying to conceive or are concerned about the side effects or short term solution of the pill. Resveratrol may be a natural alternative.

Resveratrol and Diabetes Risk

The news gets even better. Women in the study who received resveratrol showed improvement in diabetes risk factors. Their fasting insulin levels dropped by nearly 32%, and the women became more responsive to insulin. This prompted the researchers to report that, “Resveratrol significantly reduced ovarian and adrenal androgens. This effect may be, at least in part, related to an improvement of insulin sensitivity and a decline of insulin level.”

“The findings suggest resveratrol can improve the body’s ability to use insulin and potentially lower the risk of developing diabetes. The supplement may be able to help reduce the risk of metabolic problems common in women with PCOS.” -Antoni J. Duleba, MD

This isn’t only this study that is finding hopeful results. In a 2013 study, researchers found that “resveratrol supplementation exerted strong antidiabetic effects in patients with type 2 diabetes” including significantly decreased systolic blood pressure, fasting blood glucose, hemoglobin A1c, insulin, and insulin resistance, while HDL was significantly increased. As far back as 2011, research studies were beginning to show that “resveratrol improves insulin sensitivity in humans.”

A more recent study published in the International Heart Journal, again demonstrated that resveratrol may bring some relief for patients already struggling with type II diabetes. In this study, resveratrol supplementation proved itself as a “potential strategy for mitigating arterial stiffness and reducing blood pressure and oxidative damage” in diabetes patients.

Since the early 1990s, scientists have been exploring the effects of resveratrol on health in answer to the “French Paradox.” How is it that the French eat a diet high in fat, but have a low incidence of heart disease? The answer seems to be the resveratrol in their red wine. Since women with PCOS are at increased risk of cardiovascular problems, the combined hormonal, insulin and cardiovascular benefits of resveratrol are especially promising.

What is the best way to take resveratrol?

The bad news in this research is that you can’t drink the amount of wine to equal the resveratrol supplement used in the trials. It would be about 100-200 liters a day, says Duleba. On the upside, you can take resveratrol in supplement form and still drink your favorite pinot noir (the best source of resveratrol in wine) with no risk.

To get the most benefit from resveratrol, take it in the morning with breakfast. Studies suggest you should avoid eating fatty foods at the same meal since it will reduce the effectiveness of the resveratrol. Consumption of alcohol or of quercetin (another polyphenol) does not affect absorption.

Until recently, all of the testing of resveratrol has been on mice, so the required dosage must be scaled. The amounts used in one successful mouse study were approximately 22.4 mg/kg body weight per day. Scaling this amount to human body weights could imply an equivalent human dose of 1.5 to 2.0 grams/day. However, if one compensates for the fact that humans have slower metabolic rates than mice, an equivalent human dose may be closer to 200 mg/day.

Finally, be certain that your supplement is trans-resveratrol.  This is the type of resveratrol used in the studies and proven effective.

So, go forth and drink red wine! But first, take your resveratrol supplement.


Brasnyó, P., and Et Al. “Resveratrol Improves Insulin Sensitivity, Reduces Oxidative Stress and Activates the Akt Pathway in Type 2 Diabetic Patients.” The British Journal of Nutrition. The British Journal of Nutrition., Aug. 2011.

“Effects of Resveratrol on Polycystic Ovary Syndrome: A Double-blind, Randomized, Placebo-controlled Trial.” Effects of Resveratrol on Polycystic Ovary Syndrome: A Double-blind, Randomized, Placebo-controlled Trial: The Journal of Clinical Endocrinology & Metabolism: Vol 101, No 11. The Journal of Clinical Endocrinology and Metabolism, 18 Oct. 2016.

Imamura H et al. Resveratrol Ameliorates Arterial Stiffness Assessed by Cardio-Ankle Vascular Index in Patients With Type 2 Diabetes Mellitus. Int Heart J. 13 Jul. 2017 .

LaPorte, C., N. Voduc, G. Zhang, I. Seguin, D. Tardiff, N. Singhal, and DW Cameron. “Steady-State Pharmacokinetics and Tolerability of Trans-resveratrol 2000 Mg Twice Daily with Food, Quercetin and Alcohol (ethanol) in Healthy Human Subjects.” Clinical Pharmacokinetics. Clin Pharmacokinet, July 2010.

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Food Sensitivity Testing- Your Next Step in Healing PCOS? [Podcast] http://pcosdiva.com/2017/02/food-sensitivity/ Fri, 24 Feb 2017 19:18:52 +0000 http://pcosdiva.com/?p=12001 “Food is medicine, and specific foods are medicine for specific people.” – Dr. Margrit Mikulis As you might expect, I am very careful about the foods I choose. I am […]

The post Food Sensitivity Testing- Your Next Step in Healing PCOS? [Podcast] appeared first on PCOS Diva.


PCOS Podcast - Food Sensitivity - Mikulis-58“Food is medicine, and specific foods are medicine for specific people.” – Dr. Margrit Mikulis

As you might expect, I am very careful about the foods I choose. I am living proof that food is medicine. Eliminating inflammatory foods like gluten and dairy made all the difference in healing my PCOS. Inflammation is at the root of many of our PCOS symptoms, and eliminating common irritants can, in some cases, yield almost immediate relief. This summer, I took a food sensitivity test that examined my reaction to 132 foods. The results were surprising, and when I acted upon them, I felt even better! My naturopath, Dr. Margrit Mikulis, understands the link between PCOS, inflammation and diet. Listen as she explains:

  • How food sensitivities increase inflammation in women with PCOS
  • The difference between food sensitivity testing and food allergy testing
  • The correlation between cardiovascular health, gut health and inflammation
  • The difference between food allergies, food sensitivities and food intolerances
  • How to get tested for food sensitivity

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A full transcript follows.

Dr. Margrit Mikulis is the owner of Living Natural Inc., which is an established center for natural healthcare and Family Medical Practice in Nashua New Hampshire. She is a Naturopathic Doctor and an Ayurvedic Practitioner and has been in practice for over a decade.   
For seven years she has served as a clinical faculty member at the Kripalu Institute for the Kripalu School of Ayurveda, in Lenox Mass.  
Dr. Mikulis is known and loved for her dynamic integrative approach to healthcare.She utilizes naturopathy, ayurveda, classical homeopathy and the European traditions of anthroposophical medicine, supporting the health needs of families throughout the USA.    She has treated an array of diseases and maintains specialties within the fields of vector borne illness, infectious and autoimmune disease, cancer, food and environmental allergies, and nutritional deficiencies. 
 She currently serves as the corporate Secretary and is on the Board of Directors of The National Ayurvedic Medical Association. For several years Dr. Mikulis has been a leader in the field of Ayurvedic medicine in the United States dedicating her time to the forward movement and preservation of this ancient healing medical system.  Her hope is to help others learn about this individualistic approach to health as she believes that Ayurveda is the key to promoting optimal wellness.  She teaches her clients that at the heart of Ayurveda is a foundational understanding that eating pure food and prioritizing your digestive health are the most important components, if you want to live a healthy life.
Because of this she has developed and will soon be launching her Food First Project which is a program that will teach people how to simplify their approach to food and give them an opportunity to do a very sensitive and specific test.  Her innovate approach allows her clients to make radical, positive and permanent changes in their health, and she hopes the Food First Project will become an oasis for anyone who suffers from not knowing how or what to eat.
Dr. Mikulis can be reached at 
22 Concord Street 
Nashua New Hampshire
Full Transcript: 

Amy Medling:                    Awesome. Hello and welcome to the PCOS Diva Podcast. My name is Amy Medling. I’m a certified health coach and the founder of PCOS Diva. My mission is to help women with PCOS find the tools and knowledge they need to take control of their PCOS, so they can regain their fertility, femininity, health, and happiness. Today I have the special privilege of introducing you to my Naturopath doctor, Dr. Margrit Mikulis. She is the owner of Living Natural Inc, which is an established center for natural healthcare and family medical practice in Nashua, New Hampshire. She’s a Naturopathic doctor and an Ayurvedic practitioner, and she has been in practice for over a decade.

Welcome, very warm welcome to the PCOS Diva Podcast, Dr. Mikulis.

Dr. Mikulis:                         Oh, thank you so much for having me, Amy. I’m really looking forward to talking with you today.

Amy Medling:                    I wanted Dr. Margrit to talk to us about PCOS and food sensitivities, and how that can really sort of stir up the flames of inflammation in women with PCOS. I know if you’ve been following me you know that I really advocate a gluten free, processed soy free and low dairy, dairy free diet. Those are all common food sensitivities I think for women with PCOS. We’re really just scratching the surface on those food sensitivities. That’s why I wanted Dr. Margrit to sort of speak to food sensitivities and fool allergy testing, which my husband and I just did her awesome food allergy test. I’ll tell you a little bit about how that has been life changing for us. Why don’t we just start, Dr. Margrit, with how you think food plays a role in helping us manage our PCOS symptoms.

Dr. Mikulis:                         Absolutely. Thank you so much, Amy. First of all I want to say that I’m so grateful to be here and to be talking to your audience. Food sensitivities as a whole effect over 100,000,000 people worldwide. I really appreciate the work that you’re doing for the folks that are suffering with PCOS. I love your perspective in regards to thinking about food as medicine. When we talk a little bit more about the testing that I do, I’ll get into a little bit more of the guts of why specific testing in my opinion is really important, which really sort of interplays with some of the other suggestions that you obviously make.

You kind of hit on something right off the bat here in understanding that yes we know with PCOS that there’s some commonalities with having sensitivities or frank allergies to certain foods, but scratching the surface is just the basic. I would say yes with PCOS and yes with just food sensitivities in general, you can really respond to anything. We might say folks with PCOS are suffering from having a sensitivity to gluten or maybe sugar, maybe diary, but in the realm of really understanding all the food categories and potential cross reactions, the truth of the matter is there can be other culprits.

We’ve drawn some really good correlations with understanding specifics about those foods that we know can generally cause more inflammation in the body, but really every person is an individual. That’s why not every single PCOS client that you have looks the same. Food is medicine like you say on your website, and it’s really true. Food is medicine, and specific foods are medicine for specific people. Where I find food playing a role as far as having some sort of a pathology or having a syndrome like PCOS, you truthfully have to understand what’s going on with the person and what do they look like, what is their constitution so that you can really understand which foods are best for them.

You can do that from the standpoint of looking at a disease, let’s say. Somebody has insulin resistance. We’ll probably say, “Okay, well we don’t want to consume the foods that create more insulin resistance.” We do know what some of those foods are, but we don’t know what all of those foods are in reference to a specific individual. Does that answer your question?

Amy Medling:                    Yeah, and it’s funny because I think that you really hit the nail in the head, that there is really no one size fits all approach, that we’re all bio-individuals and kind of what food might make me thrive may make another woman with PCOS feel much more inflamed. I think that we have to sort of approach food not looking at it that it’s this across the board hard and fast rule.

Dr. Mikulis:                         Absolutely. I think you and I can have a big chuckle and a long conversation about wheat and gluten. We know that those are really common foods, but maybe perhaps not every single person that is suffering with PCOS is going to necessarily have an issue with wheat and gluten. This is why it’s … In the realm of understanding why somebody has a condition, what are the components? We’re really trying to look at what’s the underlying cause. It’s not enough to know that the person has an issue with gluten. It’s usually, and I think you’ll agree with this and I bet a lot of the folks in your audience will say the same thing, it’s not always going to be very clear as to, “Okay, this person is going to have this problem across the board because they have this, this and this going on. They have hypothyroid, they have insulin resistance, they have issues with androgens.” It’s not always going to be that clear. If we can take step back and really look at the individual and try to figure out what the cause is, we’re going to get closer and in some cases simplify treatment.

If a person that really could consume gluten … Now a lot of people probably with PCOS, and we can get into the reasons why, I think, beyond what we know about gluten sensitivities or frank celiac disease, a lot of the reason why people have issues with gluten is because gluten is an inflammatory food. Right? Sugar is inflammatory. When we start to connect the dots, we can really see, “Wow, okay well this is inflammatory and this is inflammatory” and the person is dealing with inflammation. Let’s say they don’t have a sensitivity. You’re going to generally get, you can kind of hit it in lots of ways by decreasing inflammation, which is probably what a lot of the folks that you’ve worked with have had some good experiences just decreasing inflammation.

Where you can take it to the next level is by looking at specifically what is the cause of the inflammation. If it’s not just gluten, if it’s something else, we want to figure out what that is. That can be anything. That could be food. It could be some sort of a toxic related scenario. There could be some sort of impact that the person is dealing with. Then of course we get into some of the more esoteric components of the spiritual realm and all of these other things that might potentially be influencing it. There’s many things, I think, at the end of the day. I think the more we can familiarize ourselves with what the components are and what are the cause, then we’ll be able to be in a better position to get somebody back to optimal health and have success.

Amy Medling:                    Yeah, and I think that once you get to that feeling good feeling, and that’s what I help women do with the Jumpstart program, which we’re kind of eliminating those major inflammatory foods and adding in lots of anti-inflammatory foods. You get to a point where you feel really good and you kind of understand the concept of nothing tastes as good as feeling good feels.

Dr. Mikulis:                         Yeah.

Amy Medling:                    Then my Sparkle program, we take that even a step further where it’s a 14 day detoxification program. You’re really cutting out even more foods because you’re having two of the Sparkle shakes a day and then the rest of your food comes from clean animal protein or fruits and vegetables and really not a lot of grains. You’re taking that even further. Then you get to the point after the Sparkle and you’re like, “Wow, I feel really good. Now I’m kind of afraid of eating regularly again. I don’t want to lose that good feeling. I’m not really sure what I should be eliminating from my diet.” It ends up being kind of like an experiment. You might add corn back in and see how you feel with corn. You might add eggs back in for a couple days and see how you feel. You have a tool that kind of fast tracks all of that for us.

Dr. Mikulis:                         Yeah.

Amy Medling:                    I would love for you to tell us about it. I did your test that you’re going to talk about over the summer. It has had a huge impact in my life. I’m excited to tell everybody about it too.

Dr. Mikulis:                         It’s so great. I think your Jumpstart and your Sparkle programs are so amazing. It’s like to get somebody to that level to then cross over to have, it’s like it’s coming out of a cave. All the sudden the light is starting to shine and you’re starting to feel better and get back to yourself. Certainly for many women this is just really the icing on the cake in so many ways, because they haven’t been feeling good. They’ve been struggling possibly with weight gain and other problems that are related, hyper functioning endocrine system and other things that are related to their syndrome and all of the sudden they’ve made some changes that they have had a direct impact on. They’re doing the work ultimately, so they’ve made this direct impact in their life and they’re feeling better. Then they get to that place where it’s like, “Okay, I am a little bit tentative about bringing some foods back in.”

What I can say about that is that this next level … We say, okay the Sparkle program. Then what’s the other option for you to get closer and to be able to take the … Your foundational programs, the Jumpstart and the Sparkle program, as far as I’m concerned those are really amazing foundational programs that start people off in the right foot and send them soaring in the direction towards health. If we could just add another component to that, in my opinion, which is to be able to look at what are the specific foods that could be also aggravating you. When we have inflammation and we know that there’s certain foods that are going to cause inflammation, inflammation plus inflammation equals inflammation. If there’s a food that’s there, like I said before, that we don’t know that’s necessarily also contributing, we’re still going to be targeting the immune system and the endocrine system in a negative way.

What the food inflammation test does is it really looks closely in a very specific and sensitive way to 132 foods so that you can actually get closer to understanding. I can promise you, there’s always a surprise. I don’t have your test results in front of me, and I don’t know if you want to get into any of this detail, but usually with most of my clients there’s some sort of surprise event from doing their food sensitivity testing. They come out of it saying, “Wow, I had no idea that this was also part of the picture. I’m consuming those foods. By the way, this is a really good food.” This is what I hear a lot of, Amy. “This is a really good food. I had no idea that it could be causing me any problems.”

Lo and behold, they’re having such a strong immune response to that particular food, and maybe it’s not even within the category of what we know is commonly known inflammatory foods, but how that person is responding is in an inflammatory way. We can argue that even with taking out some of the more inflammatory foods that are notorious for causing additional inflammation, we can argue that that individual who is eating the foods that they’re sensitive to, they’re inspiring more inflammation because of the fact that they’re sensitive.

The truth of the matter is it gives you another basis for saying, “Okay, well if you knew that corn was on your list and you are having a strong reaction to corn, you wouldn’t bring it back into your diet after the Sparkle program. In fact, you would want to take it out even longer so that you would have another opportunity to really improve gut permeability and to take time to calm down the immune system.” Really, when we talk about inflammation it’s just a dance. Inflammation is just a dance between you and your immune system. Okay? Every time you have a food that’s playing a role in that dance, it’s the orchestration to that dance, it’s the collective effects.

This is why when we look at food being important, exercise is important, making sure that you’re doing self-care, and within all of those aspects of treating a syndrome like PCOS just like looking at inflammation in a big picture and saying, “What are all the contributing factors”, we can actually make more progress. For me, in my clinical practice with all of my clients, I’m really looking to do sensitivity testing because I want them to get closer and to have more success with things like your foundational programs with Jumpstart and Sparkle, so that then they could have longer lasting and in many cases reverse the damage that’s done, which is what we’re aiming for.

Amy Medling:                    I love that visualization of the dance of inflammation. It kind of pushes you into that autoimmune place where you’re susceptible to more autoimmune issues. Women with PCOS are like Hashimoto’s and celiac and other autoimmune disorders. The question that I have is the food allergy panel that I did and my husband did, and I do want to share about my results, but how does that differ? It was just a pinprick on my finger where you just blotted a little bit of blood on a piece of paper, how does that differ from going to an allergist and having all of those pinpricks on your back? I know I’ve taken my kids to the allergist. This is a very different kind of test. Maybe you could just explain how …

Dr. Mikulis:                         Absolutely, yeah. What your kids did is really looking for food allergies and a particular immune response, which is known as an IgE type one hyper-sensitivity. That’s not the food sensitivity test that you did in my office where we did a finger stick and put your blood sample on blots and then we sent it to the lab. That’s what’s called an IgG delayed hypersensitivity. There’s a lot of information about the differences from an immune standpoint. What I can tell you is we really have a division here of food allergies, food sensitivities and food intolerances. Food allergies seem pretty clear. Usually in most cases I would say, and this is from my clinical practice. Now an allergist may have more information to add to this. There are people that are allergic type one hypersensitivity, and I often use the case of anaphylaxis as a really clear cut case, like peanut anaphylaxis.

What happens when that person comes in and sometimes if they really are allergic, there’s still levels of allergies. Not every person that has an allergy to peanuts has anaphylaxis. Somebody who does, they could come in a room and if peanuts were airborne they could have an anaphylaxis response, which airways could be shut off, they need intervention very quickly. That’s a very quick response. Okay? That happens very fast.

Where food sensitivities come in, and I like to look at this in a different way. From the standpoint of the immune system, there’s a lot happening there. Because so much is happening there it’s less of a quick response. Certain cells are talking to certain cells, and it’s typically within a 12 hour period where you’re going to see a response. Now that’s sort of interesting because I can say there’s definitely outliers. Our immune system is so dynamic. When I give time or response rates or anything, it’s really also based on the individual. I have patients that say, “If I consume gluten I won’t have a response for two days.” Then I have other patients who say, “I know really soon, like within a couple hours if I’ve had gluten because my fingers start to get inflamed or I get really thirsty or I wake up in the middle of the night.” 12 hours isn’t the magic number, but it’s a delayed response.

The difference between that and a type one hypersensitivity is really in many ways time. A food intolerance is a condition where the body reacts to food because there’s a lack of an enzyme and then damage to the gut lining from a disease or antibiotics, but it’s not necessarily that aspect. There can be a genetic component that predisposes the person to a food intolerance, but the reality is it’s not necessarily the same response that you would see in a delayed hypersensitivity or in a type one hypersensitivity, which is what we talked about in the very beginning of this conversation in regards to what your kids experienced when they went to the allergist. They had that skin test that was done, and then they were watching a response at the level of the skin. A type one hypersensitivity response, IgE mediated.

The interesting thing about that, I just want to make one other point, is yes people can be allergic IgE to many, many things. Often times it’s fairly clear. The person might eat something and they get in itchiness in their mouth or their throat or they develop hives or something like that. I typically see with IgG, so that’s the food sensitivity you did in my office, I typically see in those cases, and this is my theory, that over time as the person consumes foods that they’re sensitive to, that’s where the gut begins to break down. Our GI tract has the ability every time we consume food, our body is presented with food antigens and the body is saying, “Can I assimilate this or can I not assimilate it?” If the body can’t assimilate it it’s going to eventually bind and make these complexes that end up breaking down, if you are sensitive to the food they will end up over time breaking down the lining of the GI tract.

That’s when we begin to see immune responses at the level certainly of the GI tract no doubt, but then at the level of the systemic immune system. Now they’re beginning to really correlate that there’s some really clear understanding that food sensitivities can lead to bigger pathologies. There’s so many articles that are coming out right now that people are sending to me saying, “Oh, look at this work this doctor is doing.” There’s a pediatric doctor I think in California who has really drawn a correlation between Crohn’s and food sensitivities and doing specific diets to really decrease inflammation. I look at a food sensitivity as that slower insidious problem that doesn’t become a problem until it really becomes a problem. It’s wreaking havoc on your body until you start to become symptomatic.

Again, this all starts at the level of the digestive tract, specifically also for PCOS. In my opinion, when you look at the bigger problems as to why a person might be having, if it’s not a toxic related issue, ultimately in my opinion from the standpoint of PCOS, the truth of the matter is it starts with the GI tract and then things to askew from there. That’s a bigger topic of conversation. At the end of the day we can really look at food allergies as more of that type one hypersensitivity IgE mediated, food sensitivities type two and type three is delayed hypersensitivity and then food intolerance being enzyme deficiency, problems with food additives, damage to the gut lining from chemicals and toxins. I hope that answers your question. It seems a little bit confusing because we kind of use those terms loosely. The food test that we did is really, in my opinion, looking at how your body is responding from an inflammatory standpoint, IgG mediated.

Amy Medling:                    Yeah, and didn’t Hypocrites say all disease begins in the gut?

Dr. Mikulis:                         Yeah, and Hypocrites wasn’t the first to say that by the way. When you start reading the classical ancient text of Ayurveda, going back deep into that vedic knowledge, all of it comes back to the GI tract. I look forward to someday perhaps having a conversation about the bigger aha moments that Ayurveda really talks about as to why something like food would affect and cause a syndrome like PCOS.

Amy Medling:                    I cannot wait for that conversation. When we’ve talked about this, how much I love Ayurveda and how much balancing my dosha has really helped me manage my PCOS. We will have you on soon, Dr. Margrit to talk about Ayurveda and PCOS.

Dr. Mikulis:                         That’s great. I look forward to it.

Amy Medling:                    I also just wanted to direct listeners to posts and podcasts on my site. Dr. Felice Gersh has talked a lot about gut and PCOS and inflammation. They all tie together. I believe that learning your food sensitivities and getting to know them and start eliminating those foods can make a tremendous difference in your health. I’ve seen it in myself over the last six months since I’ve gotten my food allergy panel done by Dr. Margrit, and my husband as well. I have to tell you that I probably ate eggs two to three times a week, either for lunch or on the weekend for breakfast, and certainly in a lot of different paleo muffins and things that I was creating. I ate a lot of eggs. I was floored to find out that on a scale of 0 to 5, 5 being the highest level of intolerance that egg whites is basically up at the 5 line for me and egg yolks is about 4 1/2.

I have removed eggs from my diet and I can tell you that I’ve noticed more energy. I don’t feel so fatigued. I used to chalk that up to the grains, like in a muffin or something like that, but I really think it’s the eggs.

Dr. Mikulis:                         Wow, that’s amazing. How long have you had them out so far, just out of curiosity? We’re going to turn it real quick into a visit.

Amy Medling:                    Well let’s see. I did this in July, so I don’t know if it’s quite six months. July, August, September … Yeah it’s about six months. I’ll tell you, it wasn’t easy through the holidays trying to find vegan substitutes for baked goods…

Dr. Mikulis:                         Oh yeah. You had egg yolk and egg white.

Amy Medling:                    Yeah, like four plus. Maybe you can just explain the different level of reactions and how the report sort of comes out.

Dr. Mikulis:                         Sure.

Amy Medling:                    I can pull up a picture of mine if people are interested.

Dr. Mikulis:                         I just happened to be in front of my computer, and I pulled your results up from my secured site. Yeah, you had egg yolk and egg white, which was a four plus reaction class. There’s typically five reaction class. There’s four plus, which is severe, three plus which is high, two plus which is moderate, one plus which is mild and then no reaction.

Some people are curious about, “Okay, well what do you mean she had egg yolk and egg white?” One of the cool things about this test is that it’s looking at yolk and it’s looking at white. Now in truth we can’t really separate the yolk and the white. Typically, some people get excited because they only have egg yolk. I have to give them the bad news that it’s really all egg, it’s just that we’re trying to look at the whole versus the part. Sometimes it’s actually really helpful for us to understand like in the case of wheat and gluten. If somebody is having a really strong response to gluten, well that’s really, really clear to me that gluten grains really need to be removed.

Egg yolk and egg white were in your four plus reaction class and you are having a severe response. I don’t think you and I ended up … I don’t know how much we discussed that link, but I typically tell people that anything in the four plus and the three plus reaction class, and frankly anything two plus, three plus and four plus, you have to really look at this is really causing a big problem in the GI tract. A lot of these tests, ultimately, what they’re really pointing to is that there is some sort of issue from a gut immunology standpoint where the inflammation and the permeability and the problems with you dealing with food antigens, it’s not a happy experience for your gut.

When I see these things, basically what I tell people is, “Look, we’re trying to find what the obstacle to cure is.” Once we see what that is in the food, we need to pull it out and we have to take a period of time away from it to one, decrease inflammation and two, calm down the immune system. Sometimes that takes longer in people than in other people, and then sometimes a two plus reaction class … It’s not like you have a four plus, you’re necessarily going to be on the floor keeled over, but sometimes you are, actually. It’s really based on the individual.

Often times people are like, “Well, you have these treatment guidelines, but why do I have to follow this if I don’t feel like I’m having that strong of a response?” Well if you’re not having that strong of a response do you want to wait until you are having that strong of a response, or do you kind of want to nip it in the bud and calm things down so that maybe perhaps you can bring the food back into rotation and have it from time to time without having a really big issue? That’s one scenario.

The other scenario is if you have a lot of pathology and a lot of inflammation. We’re talking to an audience who has PCOS already. PCOS, and I think probably you’ll agree with me, if we wanted to really just, “Okay, what’s one word that we could break down and say”, we could say PCOS is inflammation. Okay? If we have inflammation in the body already, because we have PCOS, we want to stop that. If you’re having a strong immune response and you’re eating foods that are causing more inflammation, you really want to stop that. Taking the food out for a specific period of time, it’s kind of like what you were saying with your Jumpstart and your Sparkle, it’s like, “Okay, well what next?” What next is we want to have a cure.

The body doesn’t cure overnight, as you know Amy, right, and as your listeners know. It takes time. All of the things that happen with PCOS, so the hypothyroid, the androgen issues, the acne, the obesity, the anovulation, menstrual irregularity, all of those things that are happening, one thing I think we can really all agree on is that it’s multisystem. It’s not just the reproductive system, right? The fat is involved, the endocrine system is involved. It becomes this multisystem problem that you need to address. If you’re not addressing it from the root cause of inflammation you’re not going to get there.

That’s why a lot of people that struggle don’t end up making the process they want to make because they think that there’s necessarily a time limit on it. What your site offers and what your programs offer is a way of life, to change so that you can actually get better and cross over. That’s really why I think food sensitivity testing is important, because it’s giving you an additional tool to say, “Okay, now I know. Now I know really a fuller picture of what could be causing a problem in my diet that can be contributing to the inflammatory process that I’m already dealing with.”

Amy Medling:                    Yeah, and I think that’s what I loved about it. For my husband he was dealing with atrial fibrillation and couldn’t really figure out what would trigger an episode for him. He had his food allergy panel done, found out that he was number four plus reactive for baker’s yeast and brewer’s yeast. Boy, that’s a tough one to be allergic to yeast, because it’s in like everything. Vinegars are difficult. Any kind of sauces.

Dr. Mikulis:                         Yeah, that is a really hard one.

Amy Medling:                    Yeah. It was interesting because if it kind of snuck in I felt like I was poisoning the poor guy. If somehow it snuck in, and I didn’t realize it, he would inevitably have another palpitation.

Dr. Mikulis:                         Absolutely.

Amy Medling:                    You know, another episode. It is, it’s that inflammation and that’s really what was causing the heart to kind of an electrical malfunction was inflammation. I think his …

Dr. Mikulis:                         Can I just interject? I’m so sorry. Go ahead.

Dr. Mikulis:                         I just wanted to say one quick thing when we were talking before about the differences between food allergies and food sensitivities and intolerances. The truth of the matter is with food sensitivities, they can affect any organ system. Typically, with food allergies, they’re usually limited to airways, skin and the GI tract, and then food intolerances, same thing, they can affect any organ system. The truth of the matter is that because of that, and this is probably one of the things that I’m sure I said to you and to your husband when we got his results back, I’ve seen every organ system effected.

I remember over in the winter time I was having a conversation with a cardiologist about another cardiac patient that I had that we did food sensitivity testing with. They had a really amazing resolution. One of the things that they’re really drawing a very strong correlation with cardiovascular health is this inflammation component. Again, it’s nothing different than what we’re talking about today with PCOS. With food sensitivities, because they can affect any organ, you have to really take them seriously. Again, it’s going back to it’s not just happening at the level of the GI tract. These food complexes are forming in the GI tract and then somehow they’re getting out into the systemic body.

Once that cascade of events starts happening, that’s when you start seeing problems in wreaking havoc in other aspects of the body that effect all the other systems or can effect all the other systems.

Amy Medling:                    Yeah. Anyone listening that is really looking to solve another piece of the PCOS puzzle and to have as Dr. Margrit said another tool, I would highly recommend this food allergy panel and work with Dr. Margrit. She will tell you how you can do that. I do want to just say, one of the surprises for me on my panel was pineapple. As a health coach I was like, “I’m going to have some pineapple after meals because of the bromelain and how it helps digestive enzyme.” I thought this is something that I’m doing good, just a couple pieces after meals, and it was something that I enjoyed. It was kind of like a little dessert, but little did I know that that was kind of adding to my inflammation.

Dr. Mikulis:                         Absolutely, I know. Again, that kind of goes back to what I was saying before about how some people think that “Yeah, well I’m eating this food because it’s good”, and it is good. Pineapple is not a bad food, it’s just that your immune system responds to it very differently than somebody else like me. I don’t have a sensitivity to pineapple. If we can get closer to understanding which foods and being … This is where individualized medicine really sort of becomes an art form. Right? It’s like all the sudden that person with PCOS who is getting success can take it to another level and really understand what are the other additional components that are really playing a role. I’m looking forward to maybe people getting more and more exposed to this.

Food sensitivities aren’t going anywhere. Unfortunately, it’s just there on the rise. There’s so many factors. That’s a whole other show in itself too, Amy. Ultimately I think if we can really dial it back and use food as medicine then we’re going to get better across the board. You’ve got to treat the gut. It’s foundational medicine, and then you’ll have success. There’s no doubt.

Amy Medling:                    Yeah. I mean getting to the root cause, and I think this is one way to get to that root cause.

Dr. Mikulis:                         Absolutely.

Amy Medling:                    Dr. Margrit, why don’t you tell us how we could reach out to you about the food allergies and maybe get one of these tests done for ourselves?

Dr. Mikulis:                         Absolutely. As you know, Amy, we’re launching the Food First project. That information will hopefully be ready to access when you launch your Sparkle program. In the meantime if somebody does want to get in touch with me they can certainly call me and reach me at my office, 603-594-0002 or they could send an email at info@livingnaturalinc.com. That’s info@livingnaturalinc.com, the inc. is incorporated. If anyone in your audience is interested in doing any testing with me, if they mention the coupon code called “food diva“, we’ll give them 10% off of their test and be happy to serve your community.

Amy Medling:                    Oh, that’s fantastic. Thank you so much for that.

Dr. Mikulis:                         Oh, wonderful. Yes, definitely.

Amy Medling:                    Yeah, and thank you for joining us today and kind of getting this information out about this fabulous test and how it can really help women with PCOS kind of fine tune their own bodies and their care plan.

Dr. Mikulis:                         Well, thank you so much. I’m so impressed with your work. I’m really looking forward to doing some collaboration. I’m hopeful that all of your clients and audience can really find some great benefit through your programs and perhaps through something I offer down the road.

Amy Medling:                    Awesome. Yeah, I cannot wait for you to come back to talk about Ayurveda. For those listening, Dr. Margrit is an educator at Kripalu, which I still have not gotten there. It’s on my bucket list. One day I will.

Dr. Mikulis:                         Well hopefully one of these days I’ll be here with you.

Amy Medling:                    Okay, sounds good. Well that wraps up our podcast today. Thank you so much for joining us on the PCOS Diva Podcast. I hope you enjoyed it. If you liked this episode, don’t forget to subscribe to PCOS Diva on iTunes or wherever else you might be listening to this show. If you have a minute please leave me a quick review on iTunes, because I’d really love to hear from you. Don’t forget to sign up for my free newsletter. Just enter your email at pcosdiva.com to get instant access, and make sure that you never miss out on a future podcast. This is Amy Medling, and I’m wishing you good health. I look forward to being with you again soon. Bye-bye.

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Top 5 Essential Oils for PCOS [Infographic] http://pcosdiva.com/2017/02/top-5-essential-oils-for-pcos-infographic/ Wed, 15 Feb 2017 17:08:12 +0000 http://pcosdiva.com/?p=11768 Essential oils are a powerful tool in your PCOS toolbox. While upgraded diet, lifestyle and mindset are the pillars of thriving with PCOS, essential oils can help to alleviate individual symptoms. If […]

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Essential oils are a powerful tool in your PCOS toolbox. While upgraded diet, lifestyle and mindset are the pillars of thriving with PCOS, essential oils can help to alleviate individual symptoms. If used correctly, they are safe to use every day to help reset abnormal patterns, and they are especially beneficial when trying to balance hormones and insulin levels.

Completely natural remedies for PCOS are always my first choice. I have used them for many years with fantastic results, especially in stress relief and insulin balance.

Plants (and oils derived from plants) are powerful healers. Aside from the medicinal applications of plant compounds, their essential oils can have a strong effect on the limbic system. In this way, they help to restore hormonal balance, release emotional stress and impart the feeling of relaxation and well-being. In addition, essential oils can ease other common PCOS symptoms such as acne, hirsutism, hair growth, infertility, and insulin imbalance.

Finally, women with PCOS are particularly sensitive to endocrine disrupting chemicals. These EDCs are present in many medications, household products, make-up, our food, water, and the list goes on. Any opportunity we have to avoid these hormone disruptors should be taken. Essential oils make terrific natural replacements for endocrine disrupting chemicals in many household products. For more information about EDCs and PCOS, read “Endocrine Disrupting Chemicals & PCOS: What’s the Connection?

For more information about what essential oils work for women with PCOS and how to use the safely and effectively, listen to my podcast, Essential Oils for PCOS: How and What to Use, and check out my mini-course Essential Oils for PCOS for a symptom-by symptom guide to healing with essential oils.

Essential Oils Mini-course

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PCOS Diet Friendly Valentine’s Dinner Menu – Shrimp Scampi http://pcosdiva.com/2017/02/pcos-diet-shrimp/ Sun, 12 Feb 2017 23:18:31 +0000 http://pcosdiva.com/?p=11946 PCOS Diet Friendly Shrimp Scampi from Amy Medling, PCOSDiva.com My sweetheart loves shrimp.  He is from the South and grew up vacationing in St. Simons on the coast of Georgia where […]

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PCOS Diet ShrimpPCOS Diet Friendly Shrimp Scampi

from Amy Medling, PCOSDiva.com

My sweetheart loves shrimp.  He is from the South and grew up vacationing in St. Simons on the coast of Georgia where shrimp abounds.  He loves them fried, baked and broiled, but for this Valentine’s Day, I thought I would make my special Shrimp Scampi.  It is a healthy and festive dish, perfect for the holiday.  Serve with spaghetti squash or spiralized zucchini to make it very PCOS Diva friendly. Add a side salad with my Dressed up Vinaigrette and a slice of my Flourless Chocolate Cake for dessert to make the dinner complete.

Shrimp Scampi

1 lb. medium shrimp, peeled and deveined

2 tablespoons olive oil

4 garlic cloves, minced

1/4 cup shallots, minced

1/2 cup white wine

4 cups shredded kale or spinach

3 tablespoons butter

1/4 cup parsley chopped

1 lemon, juiced and zested

sea salt and ground pepper to taste

1 cup chopped and seeded fresh tomatoes

Heat a skillet over medium-high heat.  Add olive oil and shrimp and sauté until shrimp are cooked through. Remove to a plate.  Add the garlic and shallots to the skillet and sauté until both are fragrant, about 1 minute.  Add the lemon juice, white wine and greens and raise the heat to high.  Let the liquid reduce and greens wilt for 2 minutes. Whisk in the butter and return the shrimp to the pan.  Mix in the zest and parsley and season with salt and pepper.  Garnish with chopped tomatoes.


If you enjoyed this dish, you will love my seasonal menus. Check them out!PCOS Meal Plans


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