Master Your PCOS Genetics [Podcast]
“Our genetics are definitely not defined and permanent, and there’s just so many things we can do that make a huge impact for our health and for our children’s health.”
– Dr. Fiona McCulloch
There is, without a doubt, a genetic component of Polycystic Ovary Syndrome (PCOS). But did you know that the latest research says there is something we can do about it? The field of epigenetics is growing fast, and we are learning to control how genetics behave and even how things are transmitted from generation to generation. Listen in (or read the transcript) as Dr. Fiona McCulloch and I discuss:
- What is epigenetics?
- Tips for changing how your genes are expressed
- The profound impact of a father’s genetics & health on a child’s health
- Why the 1 year before trying to conceive is a critical time
- Importance of sleep and circadian rhythm, especially for women with PCOS
- How late shift work impacts PCOS
All PCOS Diva podcasts are available on
Mentioned in this podcast:
Previous PCOS Diva Podcasts with Dr. Fiona:
- Positive PCOS Research
- 8 Steps to Reverse Your PCOS [Podcast]
- The Latest PCOS Research and Hot Topics [Podcast]
Amy: Today, I’m welcoming back I think one of my most popular guests on the PCOS Diva podcast, and that’s Dr. Fiona McCulloch. Dr. Fiona is a certified naturopathic doctor. She has a clinic in Toronto, Canada, and she’s written a wonderful book called the 8 Steps to Reverse Your PCOS. And if you have not read that, I highly advise you to get a copy because it’s becoming one of the sort of the main resource books for PCOS. And she has been on-
Dr. Fiona: Thank you.
Amy: You’re very welcome. She’s been on the PCOS Diva podcast several times now, so check out some of those other episodes. I’ll link those in the show notes, but I just want to welcome you back. Thanks for coming back on Fiona.
Dr. Fiona: Thank you so much, Amy. It’s always such a pleasure to be on your podcast and you have such great content, and you’re always delivering the newest information to so many of the Divas who follow you. So, thanks for having me again.
Amy: Oh gosh. Well, and speaking of great contents, I really begged you to come back on the podcast to share the information that you provided to us at the 2019 PCOS Challenge Symposium. I was lucky enough to attend your session where you talked about epigenetics and PCOS, and what we can do to actually help to change our gene expression. I left your talk feeling so empowered and being a mother of a daughter who I don’t know if she has PCOS yet. She’s 10 going on 11 and I could tell you we’re starting to see some hormonal mood swings.
Dr. Fiona: Yeah.
Amy: But still not sure if she’s going to have PCOS, but so many of the things that you said at the symposium, in your talk I shared with Lila so that she can feel empowered to kind of take on her health. So, I am excited that you’re here to share that information with us today.
Dr. Fiona: That’s amazing. I know that, you know, I was always a little worried about presenting on genetics because it’s something we’ve always been taught that is permanent and final. And so what I really wanted to convey in my talk was that we actually have a lot of control over how our genetics behave and even how things are transmitted from generation to generation. So we’ve just learned so much about genetics in recent years. My undergraduate degree was focused on that. And when I think about what I learned back then compared to what we know now, we know so much more, and there is so much that we can do. Our genetics are definitely not defined and permanent and that’s really cool, and there’s just so many things we can do that make a huge impact for our health and for our children’s health.
Amy: Well, let’s start with the definition of epigenetics and for some listening, it might be the first time they have heard that word. Could you sort of explain what that means?
Dr. Fiona: Absolutely. So genetics, as we know, are basically the way that we describe the transmission of material from generation to generation. And genetics include DNA, chromosomes. So we all have 22 pairs of chromosomes. We have one pair from our mom and one from our dad, and one sex chromosome from each parent, so we have XX and XY. And genetics, these genes actually carry information. So, they can carry things such as traits like eye color or hair color. So, a lot of different variation that we’ll see is in our actual genes. There is also another part of genetics, which these are called snips. So these are just small differences in our genes from person to person. And these are not typically related to diseases, although they can be, but they’re more related to variation. So, the genes in our body can contain instruction manuals and basically our genes can tell our body for example, to make a hormone when that gene is activated.
The way that our genes actually function, because they are sort of instruction manuals, is that our body has to turn the genes on and off. And this is something that is very, very interesting. So this is the way that our genes function and this means that we can change our genes in a way basically in affecting how they function.
Epigenetics is all about the study of how our genes change their function. And so many different things can change that, including things like diet, exercise, sleep, hormones, medications, inflammation, toxins, pollutants. And this all happens primarily through something called methylation. A lot of people may have heard of this and just to sort of simplify what this is, it’s the addition of a chemical group called the methyl group to a gene. This is something that can be turned on and off, and this causes the gene to be quiet. And so this is really the center of epigenetics.
Amy: One of the things that I thought was kind of interesting, and I’m pulling out my notes from your session. I think a lot of women put so much pressure on themselves when you’re trying to conceive, that you as the mother have to get yourself into optimal health and your partner might feel a little bit off the hook, but dads have a profound impact on child’s health based upon their own health and their own genetics before conception. I kind of wanted to put that out there because it’s just as important for your partners to think about what you’re going to be talking about and the tips that you’re sharing as we women with PCOS.
Dr. Fiona: Yes. This is so interesting because I think we’ve always thought, in the past, in science, that much of the DNA and what’s passed on is passed on from the mother because the egg actually contains a lot more material. It contains the mitochondria and then the baby develops inside the mother. But what we’re learning actually is that the sperm doesn’t just pass on that DNA. Not just the chromosomes, but the sperm can pass on epigenetics, which is really interesting. Basically changes in the father’s body; health, diet, sleep stress, that influences the sperm in an epigenetic way that can be passed on to the child. This can actually pass on generation after generation. So just like the eggs, the sperm contain DNA methylation marks, and those can be influenced so, so much by lifestyle and diet. So the dad’s health is very important actually.
Amy: I think that that’s such a key point to kind of share with your partners because it’s important to have the support to kind of be in these lifestyle changes together. And that’s something that I know my husband was wonderful, being very supportive of me when I had to change my lifestyle and he kind of jumped in right along with me. So, I think this is a good sort of point to bring up that men need to get onboard as well.
Dr. Fiona: Oh, my goodness, yes. For so many reasons. I always love that your husband was so supportive to you because I really … The self-care message that you provide is so important because if you don’t take care of yourself and you don’t have the support of your partner, PCOS can be so much worse. Just having that supportive partner, especially if they’re doing the changes along with you, it just makes it so much easier to stick with things that you’re doing and the things you’re putting effort into.
Amy: Absolutely, yeah, I feel very blessed. And it’s a blessing too to then pass on what we’ve learned in our journey along to our kids to give them a great beginning. I know in your talk, you talked about different phases in life where it’s really important to look at these lifestyle changes because they really do affect your genes, and puberty was one of them. I would love for you to kind of talk about the different places in life where you can really make a difference in the way your genes are expressing.
Dr. Fiona: Yeah. I find this so interesting. If we think about the way humans develop, when we’re developing as an embryo or fetus in the womb, our body goes through very specific phases and timings of development that happen. There are certain times that the ovary develops, for example, and that the eggs are actually developing in the ovary for the entire lifetime of a female, for example. Those are very important events. And if something happens at that time or there’s an exposure, say for example, to a plastic and it happens during that window, that baby that’s developing can develop a change in the ovary that may be persistent and may last their entire life. And we know that this can be how PCOS can develop because they can actually induce PCOS in the offspring of animals by exposing them during this one little window to a plastic like Bisphenol A, and that can last several generations. So the prenatal timing is really important.
This is also a part of why women with PCOS, they often have daughters with PCOS because the higher levels of testosterone that are happening in pregnancy can predispose.
A second time that things activate and change is at puberty. Everything’s quite quiet in childhood with respect to the hormones. With PCOS, you might see little signs of insulin resistance in children, some youth do and others you don’t so much. But it’s when puberty starts and the hormones are added in that then you actually see the conditions starting to activate. And if there’s another kind of disruption at that time, for example, a lot of stress, or poor diet, or not getting enough sleep, something like this can become more entrenched in the way that the ovary functions and the hormones function. So those times are really key.
And then the other time really is any time in a woman’s life before she has children. You have that opportunity to influence future children that you may have because your eggs are in your ovary. Especially as you get closer to about a year before having a baby, this is the time that you really want to dial it in with your diet, your nutrition, make sure you’re not deficient in any key nutrients, make sure that you’re eating healthfully and avoiding inflammatory foods, exercising. All of that will reap so many benefits for your future baby because the eggs actually go through about a year of development before you’re ready to ovulate that egg. And so you actually have a lot of opportunity at those different times in life to influence your health long term.
Amy: You had talked about some lifestyle changes that can really make a big impact on epigenetics. I put a big star in my notes next to sleep that you mentioned that it makes a major impact. I think that we really under estimate or undervalue the importance of sleep in managing PCOS, and now we know that it really makes a big impact on our gene expression too. So tell us more about sleep and how that is important.
Dr. Fiona: Sleep is huge. For myself, I was very interested in this because I’m a bit of a night owl and for me it’s something I’ve always had a little bit of trouble getting enough sleep because I feel like, oh, I have all these things to do. And the more I started learning and reading about how important this really is, I made a lot of changes with my own sleep and I started to really prioritize that. I feel so much better, but if you think about it, really there are key times in our body that certain things are supposed to happen. And many of those things are actually supposed to happen when we’re sleeping, and they don’t happen when we’re awake. And when we’re sleeping, we’re also fasting. And these two things should really correlate with each other in the way that our body is naturally meant to work.
When we’re sleeping, we see certain changes. Our fat actually burns while we sleep. It’s supposed to be burning and we’re secreting more leptin when we sleep. Our liver is going through different processes like gluconeogenesis and glycogenolysis. So just keeping blood sugar stable. This is all happening through the liver. We also see glucagon getting secreted by the pancreas. We see different metabolic things happening within the muscle. We see a lot of antioxidant actions happening inside the cells during sleep as well. So lots of these things and repair mechanisms happen during sleep. So really it’s sort of like traffic lights, red and green. And if we don’t have the red light on, we’re missing out on all these great things that should be happening. And we could easily get into a traffic jam, if you can imagine, if we don’t have red lights. And when we’re awake, we have completely different processes that are happening.
So our bodies are really meant to have sleep and meant to have a certain amount of it. In order just to function well, this is very important. And these important mechanisms really impact our epigenetics. There are certain changes that happen during sleep and certain ones during waking hours. And so these marks are epigenetic changes that are say, for a sleep deprived, our body will try to compensate for that by making a whole bunch of changes and those changes, it can be passed onto future generations and also can negatively affect our health too. So it’s quite profound to think about all the different things that happen during these different times.
Amy: You’re talking a lot about cycles and rhythms. You know, you have like a cycle of sleep and then you’re awake, and you don’t want to disrupt that cycle by staying up really late at night and eating because then you disrupt that whole rhythm. And I’m hearing so much more about circadian cycles and rhythm. I just interviewed Dr. Dian Ginsberg that wrote a great new book about PCOS and how the circadian cycle and rhythm plays such a huge part of healing PCOS when you can kind of get those cycles and rhythms back on track. And I know you’ve talked about that as well. Tell us a little bit more about how circadian rhythm kind of comes into play. You sort of touched about on it with sleep and a little bit about eating, but kind of give us more information about that.
Dr. Fiona: Yeah. It’s quite interesting because as they’re looking further and further, what they’re finding is that most of our cells actually have a clock inside of them. And different things happen at different times. So when it comes to PCOS in particular, a lot of those rhythms that are problematic are related to metabolism and fat cell function. And we know that a lot of the problems with PCOS come from the inflammation that really comes from our fat. When you look at the fat cells, even recently discovered that fat cells themselves have a circadian rhythm. So your fat cells do things in the day and they do other things at night. And a lot of the antioxidant functions for the fat cells actually happen when you’re sleeping. And this is how inflammation is really controlled inside tissues.
So if you’re not getting enough sleep, you’re going to be having much more of this fatty inflammation that’s very problematic for PCOS. I think we all know inflammation is a huge problem for this condition, and the liver fat accumulation. All of these things, when we get enough sleep, all of these metabolic elements that are happening during sleep, that will just optimize us. Because with PCOS we have a lot more likelihood of having metabolic issues, so for us it’s much more important than it is for other people to get our sleep.
Amy: And I have found that in my coaching practice, it’s so difficult for women who do shift work and are working all nights and kind of sleeping during the day the best they can while they’re caring for families and you’re doing all the other things that we do during the day.
Dr. Fiona: Yes.
Amy: That it’s very, very hard for them to manage their PCOS and now the science is kind of catching up so that we understand why that is.
Dr. Fiona: Oh yeah, absolutely. I think shift workers, since I started my practice, we’ve done a lot of cortisol testing for patients, and shift workers have the most completely off levels of cortisol that you’ll ever see. So they’re really presented with a big challenge. And of course, our shift workers are some of the most important workers. They’re our healthcare workers, and people who keep things running all days and all times of the day, our emergency workers. So their health is really important, but they really have a unique challenge in that. This probably contributes to a lot of the increased types of diseases that we’ll see in shift workers, some metabolic conditions.
For the patients that are doing this, I’m always just helping to support them really to get enough hours of sleep. They can do supplementation of melatonin before their sleep hours, whether that be day or night and they can make sure that they keep their light and dark really as well controlled as they can. So making sure when they’re sleeping during the day that they are having their room really nice and dark and blackout curtains and that they are getting some light or during their waking hours too. So using a happy light. And these types of changes can really help them quite a bit.
Amy: I have found that exposing my eyes to light has made such a tremendous difference in my sleep quality and the way that I feel. When I get up in the morning, I have my tea or warm water and lemon like in front of my window where the sun rises and I just sort of stare at the skyline and kind of get that sun in my eyes. When it’s warm out, I’ll sit on my front step and do that. And then I try to get out at noon time, even if it’s just a quick walk to the mailbox just to expose my eyes to that light. And then again, usually in the evening, as the sun is setting, I try to get outside as well just to get some of that evening light.
I can tell you that it’s such an easy thing to do. You might have to set your phone reminders or alarms to remind you to do that, but it’s really painless and really actually very pleasant to do. And I have found that it makes a profound difference in my sleep. I think it’s because it’s sort of helping to set that circadian cycle. What do you think?
Dr. Fiona: It just sounds wonderful to do that in the first place, to have that kind of mindfulness to the beginning of your day and just connecting with nature that way and looking at the sun rising, it’s just beautiful. But I think, absolutely, that’s got to be very helpful because there is receptors in our eye called melanopsin receptors, and basically that’s the only way your brain knows if it’s day or night is whether a light goes in your eyes or not. The blue lights that we’re all looking at all day on computers, tell her our body and our brain, it’s daytime. And a lot of times, we’re looking at this in the night. So I love that you’re actually connecting with the real light of nature. As an naturopathic doctor, this is sort of what our elders always hold us back in school. And the more we learn about science, the more they are absolutely right.
I noticed the same for myself. I definitely try to get some bright light in my eyes. When I’m going in my clinic, we actually moved to a clinic that has many more windows, so I have a lot of light coming in my eyes. And the other thing that I do is when I go home at night, we have some light bulbs in our house, they turn the lights red as the evening comes, so you can do orange or red. And then we have apps on our phones and computers to get rid of that blue tinge and everything turns more orange and red. I’m fine with that. And then I get off my device earlier and off my computer earlier. I sleep so much better. I get sleepier earlier, which I didn’t before. I was more towards being a night owl. And I find that I’m actually reverting a little bit out of that, which is amazing to me.
Another interesting thing that I do is when I drive home from work, I find, now I noticed this and I didn’t before, but even like the streetlights and the headlights, they really are bright and very blue-tinged, and I started wearing the blue blocker glasses. They have some newer versions of these that are more stylish looking. I wear those when I drive home. I’ve had migraines in the past and they’ve really helped me with just my eyes.
Amy: That’s interesting.
Dr. Fiona: Yeah. Because I would find sometimes I would start triggering into a migraine, driving home with these bright lights, and these glasses have made a huge difference. So I think it’s incredibly powerful even though it’s so simple.
Amy: Yeah. I have those glasses as well. And I do think you’re right, it makes you sleepy earlier. And I think for a lot of women listening, that’s part of the problem is you don’t get sleepy till late at night. So try some of these techniques. I know for me right now, where I’m recording this video right after we’ve changed clocks, I could tell you that I’m like ready for bed at 8:00 PM. I’ve got my PJ’s on and it’s just so dark. And I try to honor that. I’m usually in bed with my eyes closed by 9:00, once I get the kiddos situated for the evening. But that’s okay, that’s what I need to do to feel good.
I just want everybody to know too, that Dr. Fiona does have PCOS. So I think that makes you extra special, Dr. Fiona. You understand what it’s like to live with PCOS and thrive.
Dr. Fiona: Yeah. And you know, I, just like yourself, went through many years of struggles and it’s always so satisfying to me to be able to help people not go through that, and get help earlier. Yeah, all of these topics are so interesting to me because I have PCOS, but it’s just so fulfilling to be able to send out these this information that anyone can do. They can really make your life so much better.
Amy: The other thing that you had mentioned in your talk that was so profound and powerful is that the choices that you make really affect many future generations possibly.
Dr. Fiona: Yes.
Amy: I think for me, it’s such an impetus to eat well and to live well. And so the choices that you make and the food that you eat, whether you exercise or not, and the food that you … Whether you’re eating things that have a lot of pesticides and toxins, you’re not only impacting you, but the future generations to come. So I was wondering if you could comment on that.
Dr. Fiona: I know, and it’s quite astounding to really think of it. So I always go back to this study with the pregnant female rat. If you think about a pregnant rat, that rat got a baby inside of them and this baby rat has all of their eggs in there. And if you can imagine those eggs inside will turn into the next generation from the babies. So it’s almost like daughter and granddaughter. What they found was that one exposure of this toxin could induce PCOS in the daughter and the granddaughter. But then the interesting part of this was that even in the great-granddaughter, that great-granddaughter wasn’t even in the ovary, like this was the next generation, that had the most intense PCOS. So you can influence many future generations by these changes that you’re making.
We know that epigenetics are impacted by many things. But say for example, let’s just take one like exercise. So exercise can alter a lot of the expression of so many genes that relate to our metabolic health. The way our liver functions, the way we are sensitive to insulin. In fact, our lower leg, our leg muscles have a huge impact on our insulin sensitivity. And exercise, if you’re a female who hasn’t had children yet, those changes that you’re inducing in your body from exercise will be passed on to your next generation and even to your granddaughter and probably great granddaughters. And the same goes for food and the same goals for avoiding things like plastic endocrine disruptors. So not heating your food in plastic containers, using glass or ceramic instead. Because these are all endocrine disruptors. Avoiding pesticides. So if you’re looking at which foods to buy organic, there is the Dirty Dozen Foods List from Environmental Working Group.
In 2009, the number one most heavily sprayed was strawberries. So buying organic strawberries instead of conventional strawberries. This makes a big difference for yourself, but also many future generations. And not only that, you’re adding less pesticide into environment because these pesticides persist actually in our environment forever. This is really probably a big part of why we’re seeing so much more PCOS and other kinds of diseases in our population. So everything that you do, it has so much effect and it’s so incredibly powerful and it’s mind boggling to me to even think about that.
Amy: Yeah. In my book, Healing PCOS and in my program like Jumpstart, I talk about developing your big why, like really fine tuning why you want to get healthy, and it has to be more than you just want to lose weight and there has to be a deeper meaning behind it. I think protecting your own health and that of your family and future generations, I mean that is a huge big why and a reason to get up every day and recommit to living a healthy lifestyle and making these changes that we’ve talked about on the podcast today.
Dr. Fiona: It really is. And even for women, if you’re not having children, just making these changes, it improves the environment when people are not buying the most heavily sprayed fruits and vegetables. When they’re buying organic, it makes more demand for those kinds of products. So it’s helping everyone in the whole world actually. But you know, I think also we women are very interesting in that we give so much to other people in society. We’re always giving back and we rarely receive, and these types of things that optimize our epigenetics make us healthier, stronger, and happier. And so we can give more to the world too.
Amy: Yeah. I mean, and that’s what this is really all about I feel like is moving beyond the pain and struggle of PCOS to live the life that we were meant to live without PCOS holding us back, and to do the work that we’re all meant to do in this world to make it a better place. I mean it’s hard to do when you’re sick and tired and feeling way too young to feel so old.
Dr. Fiona: Yes, absolutely.
Amy: Thank you Dr. Fiona for the work that you’ve done to kind of help support women with PCOS. As I mentioned, you have a wonderful book, the 8 Steps to Reverse Your PCOS, and you have a private practice in Toronto. Can you just let women know if they want to work with you in a greater way, how can they do that?
Dr. Fiona: Absolutely. So yeah, I have a clinic in Toronto. We established ourselves in 2001 so we’ve been here for quite a while, and we are really focus on hormonal conditions primarily in women, so we treat a lot of PCOS. My clinic is called whitelotusclinic.ca, that’s the website and you can give us a call or send us a contact form and see if it would work to work with us. I also have my book, 8 Steps to Reverse Your PCOS, which is available on Amazon. So I always encourage people to read that because there’s just so much information in there you can use. And finally as well, I have a Facebook page and an Instagram, so I’m always posting new articles to my blog and newsletter. So if you just want to keep on top of new research, I’m pretty geeky in my contents. I’m always writing about the newest science. And so if that’s your cup of tea, maybe give me a follow and you might enjoy some of the content.
Amy: Oh, you absolutely put out great content, and I do encourage everybody to give Dr. Fiona a follow and read her book and listen to other podcasts. We’ve recorded some other great podcasts as well. So thanks again for coming on and sharing this really valuable information.
Dr. Fiona: Thank you so much, Amy. I am so grateful to be here and just to speak to all the Divas again. Thank you so much for everything you do.
Amy: Oh gosh, it’s really my pleasure. And thank you everyone for tuning in and listening. I look forward to being with you again very soon. Buh-bye.