Dr. Asprey’s PCOS Protocol [Podcast]
- Her battle with PCOS and candida
- Liver and gut health and their effect on hormones and estrogen dominance
- Endocrine disruptors, their impact, and the unexpected sources
- Recommended tests
- Epigenetics and using lifestyle to control those factors that might influence our offspring
All PCOS Diva podcasts are now 
A full transcript follows.
About Dr. Asprey:
Dr. Lana Asprey is a medical doctor who trained at the Karolinska Institute in Stockholm, Sweden. The Karolinska Institute is recognized as one of the top medical schools in the world. It is also home to the Nobel Prize in Medicine selection committee. After completing her MD at Karolinska, Lana practiced family medicine and internal medicine in Stockholm. Lana is also the former CEO of a U.S.-based medical testing company that detects hard-to-spot allergies to metals and environmental toxins. Pediatricians and family physicians who care for children with autism use the company’s tests to determine if environmental toxins or food preservatives are contributing factors. Through the daily contact she had with people who were searching to regain their health, energy, or fertility, Lana gathered a deep understanding of the link that exists between environment, diet, and health. Lana also holds an MS from the Stockholm School of Economics. When Dr. Asprey and her husband were ready to start their family, they decided to combine their knowledge to figure out how to have the healthiest, brightest baby they could while reducing the risk of autism as much as possible.
Full Transcript:
| Amy: | Hello and welcome to another addition of the PCOS Diva podcast. This is your host Amy Medling. I’m the founder of PCOS Diva. In a recent survey, I asked Divas who they would like me to invite as a guest on the PCOS Diva podcast. A listener-favorite request was Dr. Lana Asprey. Dr. Lana, if you’re not familiar with her work, she is a Karolinska Institute trained medical doctor. She’s the author of The Better Baby Book, which she co-wrote with her husband Dave Asprey, who is the founder of Bulletproof and the author of The Bulletproof Diet book. I am so thrilled that she said yes to my invitation and she is here with me today. Welcome Dr. Lana.
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| Lana: | Thank you so much Amy. It’s a pleasure and an honor to be on the podcast.
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| Amy: | I think one of the big reasons why women really wanted to hear from you is that you’ve shared, as you’ve gone on different interviews, podcasts and such, that you are a diva and you have PCOS. It’s been something that you’ve had to work through especially as you were looking to conceive later in life. Maybe you can share that in your own words with our audience.
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| Lana: | Yes, I’d be happy to. I didn’t even know that I had PCOS because as I had mentioned in early interviews, I didn’t really have a lot of the physical or typical clinical symptoms in terms of hair loss, a mid of a mid-line padding, maybe somewhat more acne and so on, so no one ever thought to put 2 and 2 together, even though I had incredibly heavy, painful periods and they were all over the place. They were so irregular. Somehow this also runs in my mother’s family and incidentally my mother is a doctor as well, but she also didn’t think about that possibly there could be an explanation behind this.
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| Off I went to medical school. Eventually I just happened to go for a routine checkup, and my OB/GYN, who was also a professor of gynecology at the Karolinska Institute with 5 daughters and a 35 years of gynecology under his belt, is doing an ultrasound of my ovaries and finally says, “Oh look at that. Good god.” I said, “Oh dear.” Of course, the first thing I thought of immediately was, “I must have a tumor.” I didn’t. I had a big ovarian cyst and worse than that, my ovaries had that classic pearl appearance, both of them.
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| He turned the screen around and he said, “You need to look at this. You know what that means.” I studied that and I said, “Oh, this is not good.” He said, “No.” Then he ran some tests and my testosterone was almost as high as you would expect in a lower level for men. He said, “Well, with these hormones and with these ovaries, I don’t think you’ll ever be able to have children. IVF is your only option. Don’t hold your breath. Not even that might work.” At the time I was 30 and I was not even married yet. I was just devastating.
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| Amy: | I know that so many women listening can absolutely relate to your story. I know I was 18 in my college clinic when the doctor told me that they would have to jump through hoops one day if I ever wanted to get pregnant. That news can be so devastating, but that wasn’t the case for you. What did you do when you found out that you had PCOS to start treating your symptoms, your condition?
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| Lana: | First of all, I was terribly upset. I was upset for a good long time. Then I went back to my OB/GYN, whom I actually really liked, and I said, “There must be something that one can do.” He said, “When you find someone you want to actually have children with, we could treat you with some diflucan. We could do this. We could do that.” I said, “No, no, no. I mean something I can do now, see if I can reverse the condition, at least improve it somewhat.” Knowledgeable as he was, Dr. [Gusterson 00:05:17] was a very traditionally trained physician. He had never considered diet, supplements and so on, herbal remedies, acupuncture. He said, “No, not really.” Then of course I went off and started doing my own research. I actually came across Donna Gates’ book The Body Ecology Diet. I began to incorporate the principles in her book. Are you familiar with Donna Gates?
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| Amy: | Yes.
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| Lana: | Isn’t her book amazing?
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| Amy: | She is, and I think for those women that are listening, I think that so many women with PCOS have candida and her protocol I think is the top anti-candida protocol.
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| Lana: | I would absolutely agree with that. I’d say it saved my sanity because of course on top of all of that I did have horrible candida infections. Again, Dr. Gusterson, he said, “Don’t we just need to put you on higher and higher doses of diflucan?” I said, “What does diflucan do to my liver?” I’m eating 400 milligrams twice a day. This is what you treat AIDS patients with when they get those opportunistic terrible yeast infections. I said, “I can’t be doing this to my body.” I followed Donna Gates’ principles and my condition was so severe that for the first 6 months, I could barely notice a difference. I stuck with it and after a year … This is how long it can take when your hormones and your own biome is just so out of balance. It can take up to a year before you start seeing any kind of improvement, but then I did.
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| I cut out all the wheat, all the dairy, and that was really just about it. I wouldn’t have even a little bit of butter in a sauce or even a splash of milk in coffee. Nothing. Completely wheat free. completely diary free. I did not cut out soy because at the time, soy was still considered as healthful to female hormones. It’s only been later that we’ve started to realize that it actually disrupts your own biology in terms of hormonal balance. I went on all fresh produce, mostly organic as much as I could afford. Bear in mind I was in medical school so money was in short supply. I got much, much better and my periods started to become more regular and they were not as painful. I still went back to Dr. Gusterson, and he said, “Yeah, but your ovaries still look as bad. They’re improving a little bit, but … ” He was still very pessimistic.
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| Fast forward 7 years, and I met my husband, Dave Aspery. When we discussed this … It’s one of the first things we talked about when we started dating. I said, “If you want children, I’m not sure that I can actually ever carry a pregnancy to term. I might not possibly even be able to get pregnant.” He looked at me and he said, “We’ll just need to do some serious biohacking.” That is his approach to everything. It’s like, “There cannot be a problem that does not have a solution. We just don’t know what it is yet so let’s do it.”
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| We cut of course out all soy zero [inaudible 00:09:15] I had to say goodbye to a lot of things that I liked, including Italian salami, but anyhow it was a small price to pay. He and I did much more research. We put together a protocol which we talk about in The Better Baby Book in terms of supplements. I did go on very high doses of vitamin C prior to pregnancy because vitamin C is incredible in terms of healing your gut. As I’m sure you know, but if you can heal your gut and that functions well and you have a good biome, it absolutely helps with your hormonal balance. It is healing.
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| Amy: | I think it helps with progesterone too and that’s something that people with PCOS, we deal with low progesterone. It’s a nice … Those higher doses of vitamin C I think boost your progesterone.
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| Lana: | They boost your progesterone. That’s the other thing that they do when they heal your gut is that your estrogen does not get recycled. See that’s one of the problems. If your gut does not function well, then it doesn’t have the ability to … Your liver doesn’t have the ability to properly metabolize because of all of these toxins basically, your endotoxins that keep floating around in your body because the digestion isn’t what it should be. The liver gets overloaded. Then the liver cannot properly recycle the estrogen, break it down so the estrogen isn’t broken down properly and it goes in for round 2 or 3 or 4, so you might not be producing massive amounts of estrogen, but because it’s not being broken down and shifted out of your system, you have lots of it. Do you know what I mean? Lots of it actually in your system.
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| Amy: | The dominance.
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| Lana: | That’s right. Once you heal your gut and your liver has an ability also to heal itself and do all the detoxifications and the proper metabolism, not just of food, but of your own hormones … People don’t really talk much about that either, how important it is for the liver to be able to process your own hormones right … Then your hormones stabilize quite a bit. When all of that happened, within 7 months on this program, I for the first time ever had a regular cycle. I could not believe it because at the time, I was 38. It was like a miracle to have a regular cycle, to know that, “Aha, this is now day 27 and tomorrow my flow will start.” It did. It did the same thing next month and the month after because I had lived with this irregularity my entire life. I also felt fairly bad. I had horrible PMS as most women with PCOS can relate to.
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| Amy: | I think you’re just another testament that so much can be done to help women’s PCOS symptoms through these lifestyle changes. In your book, you talk about the importance of diet. You mentioned about the foods that you eliminated and added in to crowd out what was inflammatory or not good for our guts. Then supplements played a key role. You talked about vitamin C. Then in your book, you also talk about the importance of detoxification, you mentioning about the liver. I think women with PCOS, it’s been shown that we have higher levels of non fatty alcoholic liver disease too so our livers are compromised. We’re bombarded with so many endocrine-disrupting toxins on a daily basis. Maybe you can talk a little bit too about what role did detoxification play in your journey.
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| Lana: | Absolutely. It was absolutely one of the pillars. It was just as important as the diet and the supplements because if you clean up your diet and you get on the right supplement regiment, that’s good, but if you keep surrounding yourself with toxins in your home or workplace, then that is still going to undermine you. It will. Often times, we’re not even aware of what could be endocrine disruptors. For instance, you go with a friend out for a day to do some shopping or what have you. She has one of these scented little trees in her car because it smells good. You’re sitting there for several hours while driving in, breathing in this very harsh chemical really. That’s a classic endocrine disruptor, but is it something that people even think about it? Is it something you would even consider as, “Oh my gosh, this is so bad for my liver”? Most of the times not. It seems so small and innocuous.
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| You use whatever cleaning products you’ve always used because they smell good and they do a good job. Then you started educating yourself and you read the labels and you realize, “Oh goodness, look at that. I wipe this on my counters every day when I clean my kitchen, and there it stays and then I breathe it.” I wash my sheets in this and then I lie and sleep in bed for 8 hours breathing this in. One of the biggest culprits, all the first retardants in our mattresses, there are studies that show that these fire retardants are such potent chemicals that they break down very slowly over the course of 10 years. 10 years, imagine. 8 hours a night for 10 years.
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| Amy: | What can we do if we’re bombarded with all of these chemicals on a daily basis? What can we do?
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| Lana: | There’s a lot that you can do, and some of it doesn’t even have to be terribly expensive. Now, for instance, a natural latex mattress with no chemicals … Natural latex doesn’t need any fire retardants. It practically doesn’t burn. You don’t need to be concerned about that particular aspect. A natural latex mattress is no more expensive than a mid-range, regular mattress with box spring. Change out your mattress. That would be one of the absolute top things to do so that when you sleep you’re not breathing in any chemicals. Switch out to laundry detergents and cleaners that are also mostly chemical and fragrance free. There are some really good ones. We talk about Seventh Generation.
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| I also want to say, just so it’s clear, we have not been paid or sponsored by any of these brands that we discuss. The only reason we discussed them is because we have done the research, we’ve read all the labels and these are the ones that we found that have the best components, that are the least chemically disruptive. You don’t need to use those dryer sheets to make your laundry smell good for instance because they’re also very full of chemicals. We should never use those. It’s a big disruptor. That doesn’t cost anything. It’s just eliminating a product. Cleaners in your home, to be sure that your cleaning products are as clean as possible, as few disruptive as possible. Same goes for any kind of personal hygiene: soaps, toothpaste, body lotion, shampoos. Your mattress, as I already mentioned.
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| Amy: | Getting rid of the toxins and detoxificating, what tips do you have for women to … Do you like cleanses periodically? What should a woman with PCOS be doing to proactively detoxify and cleanse after she’s gotten rid of the items to avoid retox?
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| Lana: | I often go back because I’m very interested in medical anthropology. I often go back to how did we develop? What is it that our bodies learned through thousands and thousands of years of evolution? When you look at most cultures, they would have a spring ritual and a fall ritual. Mostly they would start eating certain foods in spring and take certain herbs and then the same in the fall, preparing for winter because those are the big shifts. I think to have a spring detox that cleanses your liver and your gut is an excellent idea and do the same preparing for winter.
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| There’s no such thing as one size fits all because some people will respond very well to certain herbs or supplements and others won’t. It also depends on what your load is. If you have quite a lot of toxins accumulated over a long period of time, you want to go very gently on yourself. You do not want to go into a very harsh aggressive cleanse because you could release a lot of toxins into your system very quickly, which could overwhelm your liver and which could make you quite sick.
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| My suggestion there would be to work with a naturopath or a holistic or integrative physician and get a full history. When you have that, they should recommend a cleanse that should be good for you. You should also do some testing, get a hair analysis to see what kind of heavy metals you might have in your body. You could do some blood work. You could do a gut biome check just to see whether there is any big disruption in your blood. This may sound a bit complicated, but it’s actually not. A lot of these tests what used to be hundreds and hundreds of dollars, they’ve come down in price so much during the last 5 years.
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| Amy: | I know my husband is doing the Genova Gut Test. I forget the exact cost.
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| Lana: | Exactly.
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| Amy: | $150 I think we’re paying out of pocket for it. I feel like that’s worth it to find out what’s going on for sure.
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| Lana: | Definitely. It’s not like you need to do it every few months. You do it once and change your diet around and your supplements and then you can do a new one if you’d like 6 months later, but if you’re feeling much better, then there’s not really even a reason to retest unless you’re just interested in the results because you can tell. Your skin is better. You feel better. You have more energy. Your sleep improves and so on. [crosstalk 00:21:08]
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| Amy: | I was just going to say I got you off track a little bit. We were talking about the supplements and then I added the detoxification piece. You were on vitamin C. I want to bring it back to your story so we can finish with the happy ending.
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| Lana: | Of course.
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| Amy: | Finish your story for us.
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| Lana: | It wasn’t just the vitamin C. In The Better Baby Book, there’s a whole protocol that’s described. Vitamin C plus NAC is a good combination in order to boost the glutathione production in your liver. You can also take glutathione, but that is of course quite a bit more expensive. I did take glutathione. I guzzled it probably 2 tablespoons a day. It was amazing. It was amazing. I was on vitamin E. I did take chlorella. I drank stinging nettle tea. I was on a good multivitamin. I had extra zinc balanced with copper … Again, this is one of the reasons why it’s important to before you set out on a new vitamin or supplement regimen to have testing done so you actually know what you already have so that you’re not taking too much of something.
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| I think for a while there I was religiously … For quite a long time, I was religiously taking vitamins morning, lunch and dinner. Like I said, within 7 months my skin was beautiful. I slept well. I had energy. I had regular cycles and then we said, “Okay, let’s do a hormonal panel.” We did and my hormones were actually very well balanced. I no longer had an estrogen dominance. I had progesterone, which was about middle of the range. It wasn’t particularly high, but it wasn’t low. Vitamin D is another thing that I must mention, so important. vitamin D is actually not a vitamin. It’s a hormonal precursor, actively vital in order to produce any of our hormones.
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| Even though at the time we were living in California, a lot of people still are vitamin D deficient even in those sunny climates because people put on sunscreen, long sleeves, a hat when they go out. Suddenly your vitamin D exposure is reduced to practically nothing. I did take lots of vitamin D. All the hormones were very good and the testosterone had come down. One of my ovaries had completely lost the PCOS pearly look if you know what I mean.
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| Amy: | Wow. That’s wonderful.
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| Lana: | It looked like a normal ovary. Of course I had [all those 00:24:19] pictures done, sent to Dr. Gusterson. I said, “Look what I’ve done.” It wasn’t just because “told you so.” I was very happy of course, but I sent it to him because I wanted him to know … Because he had been there and diagnosed me in the beginning. I wanted him to know, “Look what can be done. Please share this with other patients of yours who also suffer from this.” There’s no guarantee that everyone will have such spectacular results, but the chances are that if you do follow these protocols and do make these lifestyle changes, that it will actually dramatically affect your health and your PCOS as you yourself know because you have 3 children.
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| Amy: | Right. Right now my lab … Nobody would know that I had PCOS, but I think it is important to say that if we were to go back to our old lifestyle, all of those symptoms would rear their ugly head again. You’re not cured, but everything is at bay. That is the good news that you don’t need heavy duty pharmaceutical drugs that have a lot of side effects. A lot of these supplements and lifestyle changes, there’s really no side effect to it.
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| Lana: | No, it’s about balancing your hormones and balancing your gut. I’m absolutely convinced about that. The happy ending for me there was when we did this testing, the hormones looked all good so we said, “All right, now let’s try for a baby.” It was really, really time. I was 39 at the time. Even though a lot of women feel, “Oh that’s no age,” really you still feel so young, but biologically, the clock is still ticking. Yes, you can slow the clock down a bit, but you can only slow it down so much. We went ahead and I was still even despite all these amazing positive changes, I thought to myself, “I wonder if this will work? How long will it take?” As I was mentally preparing myself a little bit because I didn’t want to be terribly disappointed, but maybe I wouldn’t get pregnant or it would take us a long time. Maybe we might need some fertility treatment.
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| When my period didn’t arrive punctually, I just told myself, “It’s because I’m nervous. I’m so nervous now about this that of course it’s late.” Then my husband Dave, he looked at me and he said, “Are you pregnant?” I said, “No, I don’t think so.” He says, “Well, you’re eating like you’re pregnant.” Apparently without noticing, I had started finishing off his dessert before he had even chance to touch it. He said, “Yeah, I think you should go take a pregnancy test.” I said, “No, no, no. It’s too soon. It’s only been one cycle.” He said, “Just go take a pregnancy test.” I did and there it was positive.
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| Amy: | Fantastic.
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| Lana: | It was unbelievable. I sat and I cried and I cried. I just hadn’t realized up until that day, despite all this work and all these changes, how traumatized I actually was by that one morning in that doctor’s office when the screen was turned. I saw those pictures. The experienced gynecologist said, “Wow, look at that. I don’t think you’ll ever be able to get pregnant.”
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| Amy: | Your story provides-
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| Lana: | [crosstalk 00:28:13]
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| Amy: | It provides so much hope. When I hear some women that have the same experience, I encourage them to … This is something that I did that that, “What that doctor said, that isn’t my truth.” Women that are listening, if you’ve been given that kind of diagnosis, that doesn’t have to be your truth. There’s so many of us. Dr. Lana, myself and hundreds of other women that I’ve heard from that when making appropriate lifestyle changes … Please get a copy of Dr. Lana’s book, The Better Baby Book. She does outline her whole protocol in there. You can get pregnant. Dr. Lana, you went onto have another healthy pregnancy. At what age?
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| Lana: | Yes, indeed. Absolutely. The first one was, like I said, I could barely believe it. As I said, “Oh my God, we’ve been so blessed and so lucky. Thank you God. Let’s just be satisfied with that,” but we wanted at least one more child so we stuck with the protocol and then it was time again. Like I said, went equally smoothly. Second healthy pregnancy. Throughout the pregnancy, I felt so well. In fact, I don’t know if we shared that in the first edition of our book. It may be only in the second edition I think we printed. During that second pregnancy, we did the blood work, and we had a midwife and an OB/GYN we were working with. The lab called back to our midwife and said, “Can you go over the birth date of this lady because here it says that she’s 42, but that doesn’t compute.” Our midwife, Ronnie Falcao, who is amazing, amazing woman, she said, “No, no, no, yeah, Lana is about to turn 42.” They said, “These blood levels, these test levels they’re the same as somebody who is in their mid 20s. What is she doing?”
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| Amy: | Wow.
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| Lana: | Exactly, oh wow. Your mid 20s actually from a physiological point of view and hormonal point of view are the prime child bearing years. That’s when the female body is, if it’s healthy, is at its peak. Its fertility peak is the mid 20s. I was so happy. As soon as Dave come home from work I said, “Look a this. Look at this. I told you so. I told you we could have this.”
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| Amy: | It’s interesting because science is showing … There’s studies that women with PCOS … This I think is hopeful news … That we remain fertile longer. It isn’t really unheard of, certainly when you have making the lifestyle changes like you did, to remain fertile well into your 40s. That’s a really great piece of news for women that are trying to conceive, that feel like the clock is ticking, listening today. Before I’d like-
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| Lana: | [crosstalk 00:31:55] improve your fertility … Like I said, you can slow the clock down, but in my experience and from my practice, what I see from my clients, predominantly my clients are older … That’s one of the reasons they often times seek me out is because I was an older mother. It is true that once you get to age 45, even with the best supplements and lifestyle and everything, your fertility stuff starts slowing down. It really does. That is simply because it is encoded in our genes for now that you must have enough time to care for your offspring.
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| Amy: | Before we have to go, I just wanted to ask you about this. You’re speaking about offspring, we both have daughters. PCOS, I know in my case, my grandmother had … I could pretty much bet she did. I know my mother did. Passing those genetics onto my daughter. I’ve been working really hard to make sure she has a healthy diet without a lot of inflammatory foods that might trigger the genetics and trying to detoxify our home, like you had mentioned. Maybe you could just speak briefly … You talk about this in your book, the idea of epigenetics and using lifestyle to control those factors that might influence our offspring.
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| Lana: | I’d be happy to. Epigenetics for the listeners who are not so familiar with that, it’s basically the science that shows how our genes are modified by the environment, whether it’s our internal environment or external environment. The fact that you have a certain gene doesn’t necessarily mean that it will express itself. It can express itself if it’s triggered. Quite a few of the, shall we say, negative outcomes can often be turned on by inflammation for instance. Inflammation is one of the biggest, biggest culprits in disease because an inflamed body produces toxins which then overwhelm the liver and the kidney and the gut, also the brain.
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| If you avoid certain foods and instead add other foods that are more likely to reduce inflammation and keep you healthy, remove the hormonal and endocrine disruptors from your environment as much as is possible and you take good probiotics and good care of your gut, then the likelihood is that those genes may remain dormant, that they will never express themselves.
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| Amy: | I think that’s what we hope for those of us listening that have daughters and we’re concerned about them carrying the PCOS gene, that hopefully … This hasn’t been proven yet with women with PCOS, but we can only hope that we do our best to reduce exposure to things that can trigger … We didn’t have time to talk about stress today, but maybe you can come back on and we can talk about stress and how that impacts fertility in a future podcast, but certainly-
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| Lana: | I would love to do that because that is a very, very big subject especially in this day and age, where women are accomplishing so much, but it often leads to the fact that we are juggling too many things, then as you write … I’ve seen on your website many times and listened to this podcast … It is one of the things that be a diva, take time for yourself, care for your [inaudible 00:36:13]. Manage your stress absolutely. Stress produces cortisol. Cortisol steals the good building blocks for hormones. When this happens, you don’t have a proper hormonal balance. It’s true.
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| Amy: | It really wreaks havoc on-
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| Lana: | Yes, it does.
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| Amy: | I want to thank you for saying yes and coming onto talk to us about your PCOS journey and your really wonderful resource, The Better Baby Book. I just think that women who are listening who are trying to conceive, this book is just a really great guidebook to help you have the healthiest pregnancy possible. I know I had some horrible morning sickness and boy, I wish I had this when I was pregnant with my kids. I know you talk about how women in your family had a lot of morning sickness and this is not something that you experienced.
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| Lana: | My sister, with both her babies, she had morning sickness until she was 6 months pregnant. Her morning sickness lasted from the moment she woke up until 5:00 in the afternoon. It was a nightmare.
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| Amy: | That was me.
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| Lana: | I can’t imagine.
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| Amy: | It’s a great resource and you have a really great website. We’ll post the link to that as well underneath the podcast. The podcast will be transcribed for those who want to read through. Then Dr. Lana, if somebody was interested … They were trying to conceive. They’ve gotten to lots of doctors and just with really no results, how could somebody work with you?
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| Lana: | The first thing to do would be to go to my website and then send an email to my assistant. I only take on a small number of clients because I find that it’s really important to just focus on a small number of women so you can really provide the level of care, but I am going to start a waiting list. I have not been accepting new clients, but I will start a wait list now. You would send an email to my assistant and describe what it is that you are looking for, what it is you would hope to accomplish and go from there.
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| Amy: | Great. Again, thank you. I’m going to take you up on having you back on and we’re going to talk about stress and PCOS.
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| Lana: | I’d be delighted Amy.
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| Amy: | Thank you.
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| Lana: | Absolutely.
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| Amy: | Thank you everyone for listening. I look forward to being with you again soon. Bye-bye.
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