The Surprising Connection Between Uric Acid and PCOS [Podcast with Dr. David Perlmutter] - PCOS Diva
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The Surprising Connection Between Uric Acid and PCOS [Podcast with Dr. David Perlmutter]

“Bringing uric acid levels down in women diagnosed with PCOS helps them to gain better control over their blood sugar, their blood pressure, and certainly their predilection for making increased levels of fat
and storing the fat that they do make.”

On today’s podcast, I am honored to interview Dr. David Perlmutter, MD, FACN, a board-certified neurologist, Fellow of the American College of Nutrition, and five-time New York Times bestselling author. He is recognized internationally as a leader in the field of nutritional influences in neurological disorders.

His most recent book- Drop Acid – explores the fascinating correlation between high levels of uric acid & an increase, or even a possible cause, in PCOS symptoms.

He explains that the elevation of uric acid is not just related to things like weight gain, increased blood sugar, and increased blood pressure, but is actually playing a causative role. This is a major breakthrough in the field of PCOS research.

Listen in as we discuss:

  • What is uric acid & why does your body create it
  • How high uric acid can cause PCOS symptoms
  • How to test your uric acid levels and what is a healthy rate
  • How to fix elevated uric acid level: important lifestyle and supplement additions

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Resources mentioned:

PCOS and the Role of Uric Acid
Dr. Perlmutter

Transcript:

Amy:

On March 4th of this year, Dr. David Perlmutter dropped a blog post on his website called PCOS and The Role of Uric Acid. He said in the post that uric acid serves as a central player in metabolic issues. And this makes it reasonable to wonder if uric acid is elevated in PCOS, and whether it’s playing a role in the common metabolic issues associated with this condition.

Amy:

Well when this blog post dropped, it really created quite a stir in PCOS Diva community. Lots of questions. What is uric acid? And what does this really mean for women with PCOS? So I was thrilled when I reached out to Dr. Perlmutter to see if he would be willing to come on and discuss his findings on the PCOS Diva podcast. So I’m really honored that he said yes. So welcome Dr. Perlmutter.

Dr. David Perlmutter:

I am very delighted to be with you today. Thank you for having me.

Amy:

Well, let me just give my listeners a little bit of your background. If they’re not familiar with your work, you are a board certified neurologist and a five time New York Times bestselling author. Dr. Perlmutter serves on the board of directors and is a fellow of the American College of Nutrition. Dr. Perlmutter’s books have been published in 32 languages and include the number one New York Times bestseller Grain Brain: The Surprising Truth about Wheat, Carbs, and Sugar with over 1 million copies in print. And his latest book Drop Acid focuses on the pivotal role of uric acid in metabolic diseases. And it was just published in February. And I picked up my copy right after are reading that blog post. And I have to say thank you for writing Grain Brain. I early on in my PCOS journey realized that I was sensitive to gluten and felt so much better when I removed it from my diet. But knowledge is power. And when you continue to read about what food does to your body both good and bad, it really empowers you to make better choices for yourself. So thank you for that, and thank you for this new book. So let’s just jump right in. Tell us what is uric acid.

Dr. David Perlmutter:

Well Amy, again, thank you for having me. And I think just to take a brief step back, I would say that it was very and remains very important for me to call attention to this issue of PCOS representing really a global concern. Not just how it affects the ability of women to become pregnant, but because of the profound associated metabolic issues that it is seen to run with.

Dr. David Perlmutter:

And I think that it’s one thing for people to have discussions about the androgenic sorts of issues that women have when they’re suffering from PCOS. But it’s really these metabolic problems that become really in the long run, far more important in that as you know, with PCOS has increased with obesity, of diabetes, of hypertension, of stroke. And having said, that these are the harbingers to the chronic degenerative conditions that the World Health Organization characterizes right now as we have this conversation as being the number one cause of death on our planet. Not a virus, not war, not trauma. It is the chronic degenerative condition.

Dr. David Perlmutter:

So what I’m trying to establish here is that it’s so important that we recognize that PCOS is a far more important issue then simply weight gain, and facial hair, and loss of menstruation, and infertility. That this is ultimately setting the stage because of its metabolic consequences for some really serious issues down the line. And that’s the reason I wrote that blog, because the book Drop Acid was written because we now understand that elevation of uric acid is not just related to things like weight gain, increased blood sugar, increased blood pressure. But is actually playing a causative role. And that’s a big step for people of my generation who in medical school were told that, “Hey, elevation of uric acid only is important in the context of gout or kidney stones. Otherwise people, they don’t need to consider it.

Dr. David Perlmutter:

Well that’s kind of your grandfather’s uric acid. We now know that uric acid is mechanistically, it’s playing a causal role in elevation of blood pressure, in elevation of our blood sugar in causing the body to make higher levels of fat and store that fat. All as a survival mechanism so that our ancestors with their elevation of uric acid would have a better chance at surviving. By making a little more fat, they would survive during times of food scarcity. By raising their blood sugar would be able to power their brains when they couldn’t eat. And raising their blood pressure would still allow them to supply blood to their vital organs, even if they couldn’t find water.

Dr. David Perlmutter:

It’s only in the context of our modern world that these issues now are associated with threats again as I mentioned earlier of these chronic degenerative conditions that are the number one cause of death on our planet. So it was very intriguing to review the literature that shows that as an average, women with diagnosed PCOS have at least an 8% increase of their uric acid. This connects some really important dots. Because again, in the context of the metabolic issues that women with PCOS are at risk for, which are serious, and the fact that their uric acid levels are elevated, and the fact that uric acid elevation brings these situations on. I said to myself it’s time to write a blog about this because it’s very important.

Amy:

It’s so interesting how you framed the higher levels of uric acid as kind of survival mechanism. And I know it’s been suggested that women with PCOS have sort of survival genetics, that our higher levels of insulin resistance helped us in times of famine. So it does sort of make sense that-

Dr. David Perlmutter:

Good for you. I mean, that not everybody gets their arms around that right off the bat. That’s great.

Amy:

Yeah. So it kind of makes sense that these elevated levels of uric acid would happen in women with PCOS. And I know in your article, you had referenced a study that showed that it was independent of BMI. And there’s a lot of women that have the thin phenotype of PCOS, and that’s myself included. That we still, even though we’re thin PCOS, we still have levels of insulin resistance.

Dr. David Perlmutter:

That’s right. And that’s an interesting concept right there, because we see this far beyond PCOS. We see this in men and women without the hormonal issues, suggestive of PCOS. And we call this tofi T-O-F-I meaning thin on the outside, fat on the inside. Meaning that although you have a normal body mass index and you don’t look necessarily overweight, nonetheless, there are accumulations of fat in the viscera within the body, in the liver for example, that do present a health risk. And this is precisely what uric acid does when it is elevated. It increases the amount of fat stored within the liver, leading to what we call non-alcoholic fatty liver disease. And that is certainly quite threatening. So it’s a very good point that you make.

Amy:

So could we back up again? For so many women that are listening, they may have heard as you mentioned, the correlation between uric acid and gout, but don’t really know what uric acid is.

Dr. David Perlmutter:

So let me start by saying that uric acid is an alarm signal in the body. It’s screaming to the body that winter is coming. It’s saying that we are not going to have food over the next several months. We had better make fat as an energy resource. We better store our fat and not use it for now, because we’re going to need eat it. We need to ratchet down the energy in this body, because we need to not burn as many calories. We need to raise the blood sugar so that we can keep our brain’s power so we can find food and avoid being eaten by another animal. So we need to be clever. And we need to raise the blood pressure. That’s what uric acid does. It serves as a survival know in the body to prepare for winter. And our hunter gatherer ancestors would increase their uric acid by eating fruit only at a very small window of the year in the late summer, early fall when they would stumble upon some wild blueberries or whatever, and eat as much of them as they could. Not of course understanding this was going on in their physiology, but eating it because it was sweet.

Dr. David Perlmutter:

And that takes us to the place of why we like sweet. We are hardwired to love sweet, because it’s instructing our body to prepare for winter. And it’s telling us that that food is safe to eat. Because in nature, by and large foods that are toxic are not sweet. Sweet is an indication that the food is safe to eat.

Dr. David Perlmutter:

So our ancestors would stumble on the blueberries or other types of fruit, and eat as much of it as they could. And that was a powerful superpower if you will, to allow them to survive.

Dr. David Perlmutter:

And nowadays, what’s happening is we are targeting that mechanism 365 days a year for the winter that will never come. We’re not going to hibernate or we’re not going to likely be cut off from any food for the next four to six months. So there’s no reason that we need to raise our blood sugar, blood pressure, and make more body fat. And that’s exactly what’s going on.

Dr. David Perlmutter:

So as it relates to PCOS, here is a syndrome in which we see all of these metabolic issues. The elevated blood pressure, the increased risk for stroke, heart disease, gestational diabetes and even type 2 diabetes in and of itself, obviously without pregnancy. These are all issues that are the downstream consequence in even non PCOS individuals when their uric acid levels are elevated.

Dr. David Perlmutter:

So this becomes a very interesting I think new tool in the toolbox for everyone who is suffering from metabolic issues. And let’s call it like it is. Here in America, 88% of adults, men and women have at least one component of what we call the metabolic syndrome. That means only one in eight American adults. Again, both genders, is metabolically intact. So we live in a country where a third of our adult population is not just overweight, but obese. And that number is predicted in the distant future in the year 2030. That’s a long way away, right? Eight years from now. That number will be 50%. One in two adults will not just be overweight, but will be clinically obese.

Dr. David Perlmutter:

So it’s in our interest to look for reasons why we are having this incredible degree of metabolic mayhem, if you will. And now that uric acid has been determined not just to be on the sidelines. There was actually a report published in 2016, collaborative report from Turkish and Japanese researchers. And it was entitled, the title says everything. Uric acid in metabolic syndrome: From an innocent bystander to a central player. Meaning yeah, we’ve seen elevation of uric acid correlated with obesity, with hypertension, with elevated blood sugar for a long time. But these authors made it very clear that it doesn’t just happen to be elevated. It’s playing a role in causing these issues.

Dr. David Perlmutter:

And now that we see this elevation of uric acid characterizing women with diagnosed PCOS, and understand that they have significant metabolic issues, then it sure makes sense in giving us a powerful new tool to target their uric acid and bring it down to gain better control over their blood sugar, their blood pressure, and certainly their predilection for making increased levels of fat and storing that fat that they do make.

Amy:

I love that viewing it as a tool or a metric. I know in your book, you’re a fan of the continuous glucose monitor as am I, because I think it’s a great way to see how the lifestyle changes you make is impacting your physiology.

Dr. David Perlmutter:

That’s for sure.

Amy:

Yeah. So is there a test that a consumer can get to measure your uric acid levels?

Dr. David Perlmutter:

Oh, it’s very, very easy. Any doctor can order it at the lab, at their office. But you can go online and go to Amazon and get a home uric acid monitor. You put a drop of your blood on a test strip, just like we used to do with blood sugar before we had CGM, continuous glucose monitors. And you’ll know your uric acid level in about five seconds. So we talk about that in drop acid. How to measure, when to measure.

Dr. David Perlmutter:

And then importantly, I think the take home message for our time together today is why is my uric acid level elevated, and what do I do to fix it? And the good news is that understanding part one and acting on part two are both very, very simple.

Dr. David Perlmutter:

So part one, where does it come from? In our modern world by and large, it is from the sugar fructose. Fructose is added to more than 60% of the package foods sold in America’s grocery stores. And fructose is directly metabolized in the human body to uric acid, setting off the alarm signal that winter’s coming. Make fat, raise blood sugar, raise blood pressure. It is that straightforward.

Dr. David Perlmutter:

Where do we get fructose? Well, the name fructose is derived from fruit sugar. So fructose is naturally found in fruits and in vegetables. But as it turns out, the fructose content in an apple or in fruits and vegetables in general is not really that high. It’s not really to the point that eating some fruit is going to raise your uric acid level. Fruit juice on the other hand bombards your body with up to 32 grams and a glass of juice with sugar. And a lot of that sugar is fructose.

Dr. David Perlmutter:

So what I’m saying is I know your listeners right now are scratching their head. “To me, he just said we shouldn’t drink fructose. We shouldn’t drink fruit juice.” The answer is that is exactly what I’m saying. The amount of fructose that you get in a glass of apple juice is about the same as you get in drinking a glass of soda. So it’s an incredible large amount of fructose that overwhelms your body’s ability to deal with it. And low and behold, uric acid love will spike and tell your body winter is coming. Make fat, store fat, become insulin resistant. That’s what happens when we drink organic wonderful apple juice that was made by elves or whatever. It’s the best apple juice in the world. It’s got so much fructose. There’s nothing natural about that. I can assure you that our hunter gatherer forebears didn’t stumble upon trees laden with cartons of apple juice or orange juice. Nothing natural about that, as opposed to eating an apple that might contain five grams, which is a low amount of fructose with fiber to slow its absorption. With vitamin C, to aid in its excretion and therefore lower the uric acid value ultimately. And also with things like quercetin that help the body reduce its pretty reduction of uric acid.

Dr. David Perlmutter:

So fructose and its hidden sources in our sauces, and condiments, and what have you is the issue of the day. Other issues are of course, foods that are high in the chemical called purines, a class of chemicals. And these are the organ meats like liver and kidney. And certainly some types of alcohol dramatically increase uric acid. And these are things like hard alcohol and beer. Beer is a double whammy because it has alcohol, but it also is rich in what I just mentioned, purines. Because it’s made from yeast, and yeast has a lot of purine. Wine isn’t really an issue in moderation. Wine consumption actually in women is associated with a slight lowering of the uric acid. In men, it seems to be about neutral.

Dr. David Perlmutter:

So those are the dietary things to be aware of. We do know that a specific nutritional supplement or actually a suite of supplements are really helpful in bringing that uric acid under control. And I’ll explain what that means in just a moment. These include quercetin, available at the health food store. Quercetin, 500 milligrams a day. Vitamin C, 500 milligrams a day. And something called luteolin L-U-T-E-O-L-I-N 100 milligrams a day. Buy them online, buy them at the health food store. But these are actually very straightforward, easy to come by nutritional supplements. And then you can know what kind of progress you’re making if for example, you get a home you’re acid monitor and are able to monitor your level.

Dr. David Perlmutter:

Now, here is a point that is really fundamentally important. And that is if you go to a blood lab or to a doctor’s office, you will learn that the normal level of uric acid is seven milligrams pre deciliter or lower. So if you call your doctor’s office a couple days later after you had your blood work and she or he says, “Well, you’re in the normal range.” And you press it and you say, “Well, I appreciate that. That’s great, but what’s the number?” And they say, “Well, it’s under seven. You’re good to go.”

Dr. David Perlmutter:

Please understand that number of under seven only relates to gout risk. It has nothing to do with these metabolic issues. The blood pressure, the increased fat production, the increased insulin resistance, the metabolic issues that begin to happen at a level of 5.5 or above. So that’s Amy, a very important take home message for all of the listeners right now. Is that the level that your doctor says is cool, don’t worry about it. You don’t have gout under seven. That’s not good enough for the listeners of your podcast. They want to get their uric acid level at 5.5 or lower, because that’s when you begin to see the real, profound metabolic advantage offered by getting your uric acid level lowered.

Amy:

So you had mentioned quercetin, which I just thought was interesting because a couple years ago, quercetin kind of became the breakthrough supplement for PCOS, because it helped with inflammation. It helped with testosterone balance. And it helped with insulin resistance and obesity. And now I’m wondering if really, the reason is it was helping with lowering your uric acid. And in your article about PCOS, you found research that showed there was a strong relationship between testosterone levels that were elevated and uric acid levels.

Dr. David Perlmutter:

Right. And in fact in that research, that was the only hormone that seemed to show this relationship. But I think quercetin is a really top tier nutritional supplement. I take it every day myself. And you are correct that not only does it target the important enzyme in the production of uric acid called xanthine oxidase, which is actually where the gout drugs work. And it does it almost as well as prescription drugs. But it does other things that in the context of PCOS would be very, very helpful. Quercetin turns on something called AMPK. Now that sounds kind of challenging, but I would bet that some of the people on your podcast have talked about this before. AMPK is a signal to the body that the hunting is good. And what I mean by that, it tells the body don’t need to make fat. Don’t need to store fat. Increase energy utilization. And most importantly as you just alluded, it tells the body to stop making sugar, stop making glucose. Working directly in the liver to turn down a process called gluconeogenesis, the making of glucose de novo.

Dr. David Perlmutter:

So that’s what happens when we stimulate this pathway called AMPK, AMP kinase. That’s why we want that pathway to be lit up. One of the best things we can do to activate AMPK is physical exercise. We can activate it with quercetin. We can also take a drug that is very commonly used in the PCOS world called metformin. Metformin acts by activating AMP kinase, because we see that AMP kinase seems to be less active in PCOS women.

Dr. David Perlmutter:

Interestingly, one of the main detrimental issues related to uric acid is it shuts down AMP kinase. And actually, what it does is it activates the evil twin of AMP kinase. AMP kinase has an evil twin in the body called AMP deaminase. So when AMP deaminase is active, then it tells the body that’s the signaling mechanism. Make fat, store fat, make more blood sugar through the liver. All the things that we’re trying to avoid, not just women with PCOS, but anybody who wants to achieve metabolic wellness. So uric acid, the signaling mechanism by which it works, works directly against what your fundamental goal is with PCOS. And that is activating this AMPK pathway.

Amy:

A lot of women with PCOS, they’re looking for the magic pill. So you had mentioned metformin. And then some of these great supplements. But in my viewpoint, you really can’t out supplement a bad diet and lifestyle. And I know the answer to this because I’ve read your book. But there’s more to this than just some supplements. Correct?

Dr. David Perlmutter:

You’re right. And by definition, supplements are supplemental. They are tagged on or added to. And you can’t out supplement a crappy diet. You can’t out exercise a crappy diet. You’re exactly right. It all begins really with the food that we eat that will help keep uric acid in check, that will help keep the microbiome healthy, which is also disturbed in PCOS. That will help keep our blood sugar in check. You are 100% correct.

Dr. David Perlmutter:

Now having said that, I don’t know that there’s anybody I would not recommend taking a few key supplements. Because the diet would work if we lived in the world of our hunter gather forebears. But we don’t. So we’re challenged by various types of stress, by various types of toxins. And our diets though we try don’t perfectly emulate the diets of our hunter gatherer forebears. That said, I strongly believe that there is a place for a core set of supplements. I take quercetin every day along with extra vitamin C and vitamin D. I take what’s called an NAD precursor, and certainly I take a probiotic. So I take all things, DHA as well.

Dr. David Perlmutter:

But quercetin is right there in the core group of supplements that I think are important. And in terms of PCOS and the goal in PCOS of targeting and activating this AMP kinase, and offsetting the damage to AMP kinase done by elevation of uric acid which is ever so common in association with PCOS, I think quercetin might well be something that people with PCOS consider.

Amy:

Yeah. It’s something that I’ve been taking. I take it in my Diva Defense formula. It’s like an immune support with vitamin C, and quercetin, and D. But I think I’ll be adding it rather than just in that wintertime period where you want that extra immune support, to more than all year round after reading your book. There was a couple other ways that I think PCOS Divas would be interested in how you can lower your uric acid. And you mentioned coffee. So many of us love coffee. And maybe you could just-

Dr. David Perlmutter:

I am there. I mean, people who know me would say, “Well, you only put it in the book because it’s self-serving.” And I’m the first to admit that. Let me tell you. I love my morning coffee. It’s a great thing. But interestingly, we know that there are certain drugs that elevate uric acid, and commonly used drugs like aspirin, like the proton pump inhibiting acid blocking drugs used by 15 million Americans. Diuretic drugs to help lose water, help lower the blood pressure.

Amy:

Like spironolactone that a lot of women with PCOS are on?

Dr. David Perlmutter:

Well, let me tell you something that’s even more interesting. And that is that uric acid is elevated by supplemental testosterone. Now, what does that mean in terms of women who have higher levels of testosterone by virtue of their PCOS? I don’t know the answer to that. I think it’s certainly worth exploring. But testosterone administration is associated with increased uric acid. So something to think about.

Amy:

You also had mentioned tart cherry juice, which we think of as helping with increasing melatonin and sleep. And I was actually looking at it. You have a resource to get an extract to make a mocktail. You have some great recipes in your book, but that’s one that looks interesting to me.

Dr. David Perlmutter:

Sure. And we call them the love diet, LUV lower uric values. But if people do see, I don’t know if you’re going to have a graphic with this podcast. But Drop Acid, the cover of the book, the O is a cherry falling down. And that’s the reason we did that, because cherries have been, tart cherries and the extracts have been used as gout therapy for decades, because there’s science behind them indicating that they seem to dramatically lower uric acid. Probably because they are sources of certain bioflavonoids that target that enzyme that help lower uric acid, like quercetin and luteolin do.

Dr. David Perlmutter:

Again, quercetin has been shown in one study of young men with elevated uric acid, even mild elevation of uric acid that just five 500 milligrams a day over about an eight week period dropped their uric acid by an 8% reduction. That’s huge. That is right there with what you’d expect from taking a drug. So when we consider all the other upsides of quercetin, quercetin again, it’s a supplement. And I wish we could do everything by changing our diets and targeting our gut bacteria, etc. But I think that many of your listeners are now going to get their uric acid level checked. And we’ll see that in fact, it’s above where it needs to be. Again, that number 5.5, not what the doctor may say is seven. Seven is interest. As above seven, that’s when the uric acid starts to precipitate in the blood as form crystals. But long before that, it’s screaming to the body winter is coming, and we need to make the body fatter and raise the blood pressure. All of these metabolic issues that are such important components of PCOS, even in PCOS males.

Dr. David Perlmutter:

Now that may be an eyebrow raiser. How could males have polycystic ovarian syndrome? Well, they don’t have polycystic ovaries obviously. But there are males who have the elevation of the androgens and experience this whole panorama of metabolic issues. And for all in intents and purposes, aside from the fertility issues and the ovarian issues ,have basically what would be considered PCOS in males. And truthfully in women, they don’t have to necessarily … as you well know, your listeners know don’t have to have cysts in the ovaries per se to have these issues, these metabolic issues, and the androgen elevation that characterizes this whole syndrome.

Amy:

Right. PCOS has such a strong genetic component. And we’ve heard from on the podcast, ask Dr. Andrea Dunaif, who’s a big PCOS researcher. And she talks about that male genetic form of PCOS. So if you’re interested in hearing-

Dr. David Perlmutter:

Let’s just say that if PCOS were purely a genetic issue, then we wouldn’t expect to see such a dramatic change in its prevalence with time. And yet as you well know, it’s increasing dramatically. That doesn’t speak to it being a genetic disorder.

Dr. David Perlmutter:

Now there is a genetic predisposition or risk factor clearly associated with it. We see that there are some familial issues. But the fact that it’s increasing in its prevalence so dramatically speaks to something extrinsic, something environmental. And I would say mostly, this focuses on hormone mimicking chemicals in the environment. But I’d say mostly diet and changes in the microbiome are at play.

Amy:

Before I let you go, I would love for you to just speak on this topic. So I had a wonderful couple, they run the social media pages of seed oil rebellion. And they were on talking about the dangers of vegetable oils and seed oils that are kind of masqueraded nowadays as healthy. Think about all of those organic, non-GMO packaged products that use sunflower oil. Or organic canola oil. And in your book, you mentioned vegetable oils and seed oils. And I’d love for you to just sort of share your viewpoint on those oils for us.

Dr. David Perlmutter:

Sure. And I would say that the easiest thing to consider in terms of making your selection about what dreaded fat you consume, and I say that tongue in cheek. Because in my earlier years in medical school and early in my practice, fat in any form was dreaded because if you ate a high fat diet, your children would be born naked or some terrible thing would happen.

Dr. David Perlmutter:

But I think that to make a global statement that nowadays, we believe that fat is a good choice is unfair, because there are good and bad fats. Certainly, there is very much concern about the highly modified vegetable oils that line the grocery store shelves and are available in clear plastic bottles where they’re exposed to light and therefore heat, and can really set the stage for dramatic increase not only of inflammation in the body, but in building cells whose cell membranes are made from inferior components. The membrane lining every cell in the body including the immune cells and the neurons, which are the brain cells, are made of fat. And they’re made from the fat that is available to our bodies. And that’s the fat that we consume. So we’ve got to be really super specific about the fats that we consume.

Dr. David Perlmutter:

And I think the easiest thing would be to ask yourself, what were the fats that our hunter gatherer forebears could conceivably have consumed? And they would not have been refined vegetable oils, corn oil, sunflower oil, and certainly a manufactured oil called canola oil that was originally developed as an industrial lubricant, and somehow has now found its way into the human diet. The reason is that these high omega six oils are pro-inflammatory. That would be about the last thing in the world anyone should want to consume much less an individual who has a situation like PCOS in which there are multiple factors that are already increasing this process called inflammation. Setting the stage for chronic degenerative diseases like Alzheimer’s, coronary artery disease, diabetes, and even certain forms of cancer.

Dr. David Perlmutter:

So what might our hunter gatherer forebears have stumbled upon? Well, any type of oil that would be found in a fruit or vegetable, mostly a vegetable that you would find during your hunting and gathering. And I think we could consider that they may have stumbled upon things like avocados and coconuts. Certainly, eating meat would give some fat into the diet. Butter would be something that would be derived from utilization of dairy products. And certainly eating olives and olive oil therefore, one of the strongest, most influential components I believe of the Mediterranean diet, although there are others.

Dr. David Perlmutter:

These are important oils. Certainly animal derived types of things as well, like the oil we would get from eating fatty fish. All positive, higher in the omega-3s. Good for the brain. Good for inflammation. Good for insulin sensitivity. All of which would certainly pose clear benefit for an individual with PCOS.

Dr. David Perlmutter:

So as it relates to the seed oil rebellion, I’m pretty much dialed in with exactly what it is that they’re talking about, and how important it is not just to welcome fat back to the table, but to recognize the salubrious nature of the good fats that we consume in terms of every organ system in the body from the outside, from the skin, to the gut, to the heart, and brain. So fat is back.

Amy:

Well, thank you. That was a great way to kind of put an exclamation point on this podcast. And thank you for writing this book and writing your specific PCOS and uric acid article. I think that really opened a lot of our eyes to this important topic.

Dr. David Perlmutter:

You know, I had a feeling that it would. And I have a feeling that amongst my integrative functional types of doctors, there is I think, I don’t know how to say this politically correct. Let’s just say more of a sense of wanting to embrace the PCOS community, as opposed to mainstream medicine, which kind of says basically, “Well, take your metformin and be on your way.” Because it’s a multifactorial kind of issue. There are many roads that led to the PCOS in the first place. And there are many approaches that need to be leveraged to help women. And as we mentioned, men as well get through it. It’s not just take a prescription medication and hope for the best.

Dr. David Perlmutter:

And this is when I think people in general need to think about being their own health advocates and charting their own health destiny. And the way to do that is to become empowered with information. And I have to say that’s the kind of thing that you do Amy on this podcast. And I just think it’s so wonderful that you do it. You take the time, you do the research, and you bring out this information for anyone who’s going to listen. And hopefully, that will be a lot of people.

Amy:

Well, thank you for that. And I could tell you that it is the integrative functional medical community that is really making the difference for women with PCOS. There’s so much frustration with mainstream medical that we’re so grateful for folks like yourself. I’m glad to give you all a platform here on, I’ve been doing it since 2014. I think this is maybe my 180th episode, which it’s been a labor of love. But I’m so glad that you said yes. And I know that we’ve really enlightened a lot of women today. So pick up a copy of Drop Acid. I know I got mine on Amazon. I’m assuming it’s in all the major book retailers as well.

Dr. David Perlmutter:

Oh, it is around the world now, which is a great thing.

Amy:

And then check out Dr. Perlmutter’s website and social media. Could you just give us your handle there?

Dr. David Perlmutter:

Sure. I think the best place, the clearinghouse would be drperlmutter.com. Drperlmutter.com. That’s where everything kind of begins from there. There are links to my podcast, the empowering neurologist, and all the information. We have a huge database of searchable information. So every study like the one you mentioned the correlation between elevation of uric acid and PCOS, the actual full PDFs are available there. And as well as the blogs that I write based upon these literature citations. So that’s the best place to start.

Amy:

Perfect. And I will put those links and the link to that blog post that I was talking about in the show notes at pcosdiva.com. And thank you again, and thank you to everyone who’s listening. I look forward to being with you again very soon.

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