8 Steps to Reverse Your PCOS [Podcast] - PCOS Diva

8 Steps to Reverse Your PCOS [Podcast]

PCOS Podcast Dr. Fiona McCullochThere is no pill that can cure PCOS. Why not? PCOS is a very complex metabolic condition. No two women have exactly the same PCOS symptoms, though there are a few common factors we all share. Dr. Fiona McCulloch, one of my favorite PCOS physicians and thought leaders, has written a new book outlining 8 factors to consider and address in order to best treat your PCOS. Listen in as she explains:

  • the single most important factor in healing PCOS
  • exactly why extremely restrictive diets can never work for women with PCOS
  • what the Insulin Index is and why is it more helpful than the Glycemic Index
  • why women with PCOS are better off without dairy
  • the right way to snack and structure meals & a snack combination to absolutely avoid
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A full transcript follows.

Fiona Headshot 1Dr. Fiona McCulloch, is the founder and owner of White Lotus Integrative Medicine, one of the longest established integrative medicine clinics in Toronto Canada. Fiona has worked with thousands of people seeking better health over the past 16 years of her practice. She is also committed to health education  and to sharing the most current information on health topics, nutrition and natural medicine with patients and other practitioners.

Fiona has published many articles and is a regular contributor to NDNR, one of the leading journals for naturopathic doctors as well as other publications for health professionals. Her first book “8 Steps To Reverse Your PCOS” will be published on September 21st, 2016 for PCOS Awareness Month.

As a woman with PCOS herself, who struggled for many years with irregular cycles, cystic acne and metabolic issues, she’s passionate about health education and advocacy  for women with PCOS, and serves on the medical advisory committee of the PCOS Awareness Association and as an expert on IVF.ca. She is also a medical advisor to The Open Source Health Precision Medicine PCOS Project which integrates genetic and molecular testing, and evidence-based integrative medicine and cloud-based technology to help the growing community of women with PCOS.

Fiona also frequently lectures to patient groups as well professionalsm including naturopathic doctors and integrative medicine clinicians and also to students at the Canadian College of Naturopathic Medicine.

Fiona is a graduate of the Canadian College of Naturopathic Medicine (2001) and the University of Guelph (Biological Science/Molecular Biology and Genetics).

Full Transcript:

Amy Medling: Hello and welcome to the PCOS Diva podcast. This is your host, Amy Medling. I’m a certified health coach, and I’m the founder of PCOS Diva. I was diagnosed with PCOS, gosh, 15 years ago now. Back then, we didn’t have a lot of resources online to kind of educate ourselves about PCOS, so I went to the bookstore and found 2 really fantastic books, “PCOS: The Hidden Epidemic,” by Dr. Samuel Thatcher, and “The Patient’s Guide to PCOS,” by Dr. Walter Futterweit. Gosh, that was like 15 years ago, and those 2 books really helped me educate and empower myself, so that I could advocate for myself at the doctor’s office. I’m really pleased to have on our show today … I really think of her as sort of the next generation of PCOS educators, because she is coming out with a fantastic book. I’m one of the lucky ones that got a preview copy, and her book is going to really help to empower you, so that you can educate and advocate for yourself at the doctor’s office. Welcome, Dr. Fiona McCulloch. Thank you for being here.


Dr. Fiona: Thank you so much, Amy. I really am so thankful just to be on this podcast. I know we’ve known each for a little while, and you’ve always been such a great supporter of my work, so thank you so much for having me.


Amy Medling: Oh, gosh. Thank you for being here. I’m going to just give our listeners a little overview, and if you want to read Dr. Fiona’s full bio, it’ll be at the bottom of this podcast. She is the founder and owner of White Lotus Integrative Medicine. It’s one of the longest established integrative medicine clinics in Toronto, Canada. Fiona has worked with thousands of people seeking better health over the past 16 years of her practice. Her first book, like I mentioned, it’s called “8 Steps to Reverse Your PCOS,” and it’s going to be published on September 21, so not very far away. It’s perfect timing, because September is PCOS Awareness Month. Dr. Fiona also has PCOS, and she understands the struggle. She struggled for many years with irregular cycles, cystic acne, metabolic issues, and she’s very passionate about health education, and advocacy for women with PCOS.


She served on the Medical Advisory Committee of the PCOS Awareness Association, and she’s also a medical advisor to the Open Source Health Precision Medicine PCOS Project, which we actually did a podcast about that with Sonya Satveit. You can check that one out. It’s really interesting. This project, and maybe you can talk a little bit more about it, Fiona, but it integrates genetic and molecular testing, evidence-based integrative medicine, and cloud-based technology to help the growing community of women with PCOS. Lots of good stuff going on.


Dr. Fiona: Yeah. It’s a really exciting time right now. That project, the Open Source Health PCOS Project is one of the most exciting things, I think, that could help so many women with PCOS, because it’s basically a cloud-based technology platform that’s basically gathering a lot of data on women with PCOS, and their responses to different interventions with respect to supplements, dietary changes, and exercise. It has the potential to actually change the way that we treat PCOS on a very large scale.


Amy Medling: Yeah, and that individual medicine, I think, I just such a great approach because, and we can talk about this, that not everyone experiences PCOS the same way. There really is no one size fits all approach, so this is just a great way to sort of collect data on the different types of PCOS and how different treatment plans might work for those different groups.


Dr. Fiona: Absolutely, yeah. It’s such a variable condition. There’s just so many different ways it can express in different women, and there’s different treatments that work well for certain aspects of the condition. This really allows you to, or us, to really see and understand each one woman’s unique physiology, and just understand which treatments would suit her best.


Amy Medling: Let’s step back a little bit to talk about the inspiration for your book. I know you are a woman with PCOS. You’ve worked 16 years in a practice, I’m sure treating lots of women with hormonal disorders. What inspired you to write the book, and why now?


Dr. Fiona: Definitely my own experience with having PCOS. I mean, I had it for so long, and I had no idea that this was what I had, and this was what was causing a lot of my issues. I just felt very interested in learning more about the condition. I’m really, really, fascinated with, in particular, hormones, I’ve always been very interested in the hormonal system, and the metabolic system, and the brain, and all of these are so important when you’re looking at PCOS, because it truly is a condition that effects the whole body. I just became really interested in understanding more about it. I love research, and so as I was researching, I would write a lot of articles on it and I discovered I love writing.


It’s so interesting, as a child, I was going through some of my things because I was moving house and I found this paper that I wrote when I was little girl and I said on there that I wanted to be an author, and that I was going to write a book, and I was going to live in a white house. It was so interesting because I found that piece of paper as I was moving into my new house, which is white, and my book was coming out, and it was just so cool. Yeah, I think I’ve always kind of wanted to write a book. I just love writing. I guess, I just started writing it. One day, I was like, “You know what, I’m just going to do this. I’m going to write this book.” I started writing it, and it took a while, but it’s finally finished. I might like to write more books, actually. I really enjoyed the whole process.


Amy Medling: I love that story. You know, working with women with PCOS, I find that those who are suffering the most, don’t have a creative outlet. I find that women with PCOS are highly creative, and they need to express that creativity. Writing is just a fantastic outlet for that. I often find that you have to kind of get back to what you enjoyed doing as a child, and so I love that you kind of made that connection, and so I really encourage women listening, think back to what you liked doing as a kid, and maybe you need to tap into that a little bit more.


Dr. Fiona: Oh, yeah.


Amy Medling: I wanted to, I guess, go over your 8 steps. The title of the book is “8 Steps to Reverse Your PCOS.” I know we won’t have time to talk about them all in the podcast, but maybe you could just kind of give a overview for listeners.


Dr. Fiona: Sure. Absolutely. Basically, what I learned through practice and also, of course, from my self is that women with PCOS are very different, each and every one actually. There’s just so much variability. There are certain things that work for some, but don’t work for others. What I determined is that there are 8 different things to look at, and to understand if this is a factor for you, and your health, and your PCOS, and then to address them. I can go through what those are. I find that many women with PCOS have several of these different 8 factors that will make a significant impact on their health, but you may not have all of them.


The first one is inflammation, and that is present, really in all women with PCOS. It’s actually thought to be one of the central underlying causes of PCOS, so that’s very important. In the book I talk about how to determine if this is a key factor in your case, or how strong it is. There’s some quizzes in there, which can help you understand more about that.


The next one is insulin resistance. This was actually something that is present in most women with PCOS to some degree, but how much is there really varies from woman to woman, so how much to address that really depends on how much is present. That relates, really, to secretion of a lot of insulin after eating, and that high amount of insulin actually makes it difficult to lose weight, for one thing, because it blocks fat burning. The other thing it does is it causes us to make testosterone from our ovaries, and it causes inflammation, so the insulin resistance is really important, especially if it’s a significant factor in your case. You can tell if you have that through testing, or if you’re gaining weight on your stomach, or if you have some of the skin symptoms like acanthosis nigricans, which is like a pigmentation of the skin. There is quite a few ways that you can tell if this is a factor in your case.


The third one is the adrenals. In PCOS, the adrenals are a little different than how we would normally think of adrenal health. You may have heard of adrenal fatigue, and this is really related to stress. In PCOS, the adrenals, in many women actually, can secrete androgen. This actually really exacerbates the entire condition, but it’s completely different from the insulin resistance aspect, so it has to be addressed sort of separately. Stress does play a role in this, too. I can talk more about that, but I find that’s a very interesting topic. I have actually have this myself, and so it was really interesting to me, when I learned about that.


The next one is the androgens. Androgens are present in most women with PCOS to some degree. The testing for androgens is not very good, actually, because it really depends on which type they’re doing when they’re looking at testosterone. It also depends on the age of the woman. A lot of women with PCOS, they’ll run their testosterone levels and they’ll look normal, and there’s different reasons for that, but they can still have high androgens and that presents with the symptoms of acne, and hirsutism, and hair loss.


The next one is the female hormonal imbalances. Some women actually don’t have a lot of issues with their ovulatory patterns, whereas others do, and there are connections with the pituitary hormones and the way that those communicate with the ovaries, so the way that the brain and the ovaries communicate with each other. That’s a factor that’s present in many, many, women, so you’ll see that that expresses with high LH levels, or delays in ovulation, so that’s a factor that, you know, some women are ovulatory who have PCOS, but many women are not, or ovulate very late.


The next one is thyroid. I include this because it’s so common in women with PCOS, and it’s such a huge blocker to improvement. If you have a thyroid condition, and you have PCOS, there’s only so far you can get until you really treat that thyroid condition. There’s an increase in Hashimoto’s. Although it’s not a part of PCOS to have a thyroid condition, it’s just such a blocker and it’s so common, that I included it as a step to definitely look at and understand if that effects you.


The next one is the environment. I think we may heard a lot about this. The toxicity of different kinds of plastics and pesticides in our environment has been linked to PCOS. It’s actually been found that, you know, an exposure to a female fetus in the womb to Bisphenol A can actually induce PCOS for 2 future generations. It’s quite certainly an aggravating factor in PCOS, but also in us passing it on to future generations.


The next one really relates to everything, and it’s really one of the most important factors. It’s diet. Diet is the single best way that you can improve your PCOS. Everything else is secondary to diet changes. This can actually transform your entire life and your hormones entirely, so I have a whole section just on diet. It’s a very specific kind of diet, and I can talk more about that, but it’s related to actually, specifically, reducing insulin secretion or controlling insulin secretion after we eat.


Amy Medling: I love that you really emphasize the lifestyle change, the diet and exercise, in your book. I think so many women with PCOS are looking for a magic pill, whether that be a pharmaceutical drug or a supplement, that’s just going to cure their PCOS. I’m going to read this from your book, you say, “No supplement or medication listed here will ever come close to bringing you the benefits you’ll get from making those simple lifestyle changes.” That was really about changing the foods that you eat, and exercising. I appreciate that you really hit that message home in your book. I think it’s so important.


Dr. Fiona: Oh, yeah, I couldn’t tell you just the number of women who I’ve seen make changes to their diet and the level of improvement is amazing. It’s just very empowering, because it’s something you can actually do, and you can succeed at it. There really is no magic pill, because it’s not really a simple thing. It’s a complex condition, and it’s really a metabolic condition.


Amy Medling: Yeah. I like, also, that you, you know, you’re not really talking about a … When we say diet, it doesn’t mean going on this crazy low-carb diet. I’m just going to read a little excerpt here that I starred several times, “You can achieve your personal best health at any size. It’s far better to achieve a healthy natural and stable weight, based on a foundation of good nutrition, than it is to swing back and forth between high and low weights. Putting women through diets that ultimately do more harm than good cause more weight gain. In the end, it just doesn’t make sense. In addition, all this dieting, can trigger binging and other eating disorders, which women with PCOS are already prone to. They also cause you to ignore your natural hunger and fullness cues,” which, gosh, I think that’s so important. “When you are trying to cultivate good responses between the brain and metabolic hormones, restrictive dieting only takes us further away from our ultimate goals.”


Dr. Fiona: Yep. Yeah. I just feel that so strongly. Most women I see with PCOS have tried so many diets and in the end, they don’t work. We all know that. Like, none of these diets work at all, for most people. Most people just gain the weight back, and then you feel bad, because you didn’t succeed, or this and that, right? It’s really just about, and I love how you always talk about self-care, but it’s just like that. It’s like learning about how food effects your body, what it actually does to our hormones, and we do need to eat it differently than women without PCOS, but also looking at food as nourishment and caring for ourselves rather than hurting ourselves with restricting, you know, punishing ourselves when we’re not perfect.


The food plan I have here is really … It’s one plan that can work, but there are many different healthy ways to eat that can work for PCOS. It’s not the only way, but this is a very, kind of forgiving, moderate, kind of eating plan, but it’s really aimed at addressing the insulin secretion very specifically. You can’t fail at it. It’s not a diet, really. It’s just nutrition.


Amy Medling: Yeah. For women with PCOS this is a lifestyle that we have to sustain over our lifespan. It isn’t something that we just kind of go on in order to get pregnant, because PCOS doesn’t go away after our reproductive years, and I think that’s an important message. I just wanted to say one more thing here, is that if you have a doctor that’s telling you, and I hear this from women all the time, “You need to go on the HCG Diet, and consume 500 calories a day,” or these really crazy calorically restrictive diets, or no carb type diets, you need to push back. Read Dr. Fiona’s book, and she talks about how that messes with your metabolic hormones, and push back and find another doctor that has a different approach.


Dr. Fiona: Yeah. I agree. Those really low calorie diets, I mean, all the research just show it causes something where our metabolism actually slows down because our brain thinks we’re starving to death, and this is actually the problem that we already have in PCOS. This brain-hormone connection, metabolic connection with the brain and the fat, is actually one of the underlying primary causes of PCOS. When we’re doing those really restrictive diets, we’re kind of damaging that even more. We really just want to learn to like nourish our body, and most women actually who have a lot of metabolic issues, don’t really feel those normal patterns of hunger and fullness, and that’s what we want to really get back, and that’s a sign that we’re getting better with that connection.


Amy Medling: Yeah, and I think another thing to point out too, that it isn’t really, you can’t think of it as a matter of willpower, because when you’re not getting those satiety cues, and your insulin’s kind out of control … I remember thinking to myself, at one point, that you know, “I’m such a smart, successful, woman, but why can I not control the food that I put in my mouth and eat?” … Once you can realize the underlying issues, and your book does a great job explaining that, then you kind of have these “Aha” moments. It starts to make sense and you don’t feel so bad about you, that it’s not a willpower issue.


Dr. Fiona: No, it’s not. It’s actually a lot harder to lose weight if you have PCOS, and it’s a lot harder to … Like, because in our society we grow up eating certain foods that in particular are going to cause those problems for us a lot more than for other people, because with PCOS, we’re metabolic conservers. We’re really good at storing fat, so that’s a benefit in times where there is famine, but when we’re eating foods that spike our insulin a lot, then we’re really good at storing all of that as fat, and that just actually sets off all these patterns. If you go to a doctor, and they’re like, “Well, you just need to lose like 30 pounds,” but that’s not easy to do, and it’s certainly much harder when you have PCOS because once you’ve gained the weight, it just gets harder and harder to lose it.


The solution there is really just to understand more about the actual kind of metrics of food and how they stimulate insulin release, and how to find the right pattern of eating that works for us, and then those kinds of cues start coming back. You start getting those more natural hunger responses and fullness responses. That, I think, is really important to understand, and definitely don’t blame yourself. It is really, really, hard to lose weight when you have PCOS. The whole nutrition thing is challenging.


Amy Medling: Yeah. I mean, don’t shame yourself, or don’t let doctors shame you, is so important.


Dr. Fiona: Oh, yeah. Too much of that going on.


Amy Medling: Yes. One of the things that I wanted to talk about, and you kind of mentioned it when you were talking about the adrenal step, is the adrenal/androgen excess. You mentioned you thought that was something that was kind of what you were dealing with, and after reading your book, it’s definitely kind of the adrenal/androgen issues that I’ve experienced in my life. I think it was an “Aha” moment for me, and I hear from a lot of women that I think also have this kind of type of androgen excess. Could you go into a little bit more detail about what that is, and how you can kind of figure out whether that is something that you’re dealing with, and then what can you do about it?


Dr. Fiona: Oh, absolutely. I can first start with a little background on what happens with our adrenals as we develop. The adrenals and the ovaries develop from similar tissues when we’re fetuses, so they do have commonalities with some of these hormones, especially androgen. As we develop and we go through puberty, our adrenal glands kick in before our ovaries, and the reason they do that is to make us insulin resistant, actually, so that we can gain weight and reproduce. This is a normal thing, and all teen girls go through this, and that’s why teens, they tend to gain a good amount of weight around their tummies at that age before they go through puberty and get their first period. Part of what happens there is, too, is that the androgens also turn on in the females at the same time, and so, you know, you’ll see a lot of teens have acne, and a lot of this is actually coming from the androgen. When we’re teenagers, our adrenals are extremely, they secrete a lot of androgen, more than at any other time in our life. All teenagers have this.


As we get older, the adrenals secrete less and less and less with age, and there’s one androgen that we see that decreases with age, which is called DHEA-S, so you can actually test for that. It should be quite high when we’re young, and then it should be quite low when we’re older. By the time you’re 40, 45, your DHEA-S should be pretty low. What should happen then when you first get your period is that estrogen starts taking over, and it overpowers the testosterone that’s coming from the adrenals, and then this is when the cycles can start. This DHEA-S, some women secrete a lot more, and it actually turns into testosterone, and it can interfere with ovulation, and delay ovulation. This actually is, almost a different kind of PCOS, but actually, it coexists with all of the other factors in many women. Some women only have this coming from their adrenals, but most women have that plus some of the ovarian androgens, and the insulin resistance, and all of these other factors as well. It’s quite individual, but it’s very, very, interesting.


The way to test for it is really to check this DHEA-S level. However, it really depends on your age. If you check that when you’re 35 or 40 it’s going to be within that normal reference range, so you really want to look at what’s typical for your age. I do have some info in the book about that, but you really need to look at that. What could be a very normal number for somebody who’s 19 years old would be very high at a different age, so it really depends on your age. For example, at 40 years old, if you had a DHEA-S level of 8, that’s pretty unusual, whereas that would be very common to see in somebody who’s 22 years old. That’s where I think a lot of the missed diagnosis, or the missed adrenal PCOS happens, because women who have this, stress triggers the secretion of DHEA-S.


If stress is a really big issue, it actually really aggravates women who have this much more than the other types of PCOS. It aggravates all of us, for sure, but for the adrenal types, it aggravates them so much, and it causes them … You’ll see that their DHEA-S goes up and down all the time, whereas for other women, it doesn’t do that. It just sort of decreases with age.


Amy Medling: What are some of your favorite ways to reduce stress, if those of us, I mean, all women with PCOS need to reduce stress, but especially those of us with the adrenal issues?


Dr. Fiona: Oh, there’s so many ways. My personal favorites are meditation. I’ve meditated for a really long time, since I was … I started about at age 16, and I did a lot of different types of meditation throughout my life. I found for me, that’s a very grounding way of relaxing, and it’s something that I can do anywhere, anytime, and I love it. There’s so many ways that you can do that now. There’s lots and lots of online courses that you can get, visualizations. There’s the Muse, which we’re actually using in the Precision Medicine Project. It’s interesting. It’s a device you place on your head, and it actually monitors your brain waves, and it has an app, and it helps you learn how to get your mind relaxed, which is really, really, interesting. There’s these kind of technologies you can use now to help relax. There’s Yoga. There’s prayer. There’s just so many different ways that you can relax.


The other thing is, I know we talked about this, but creativity is so important. I think that’s very healing for us, with our stress. Finding your own creative outlet, what you really love to do, spending some time nurturing that aspect of yourself, and really like finding that joy in making something.


Amy Medling: Yeah. I haven’t tried Muse yet, but I have Spire. Have you ever heard of that? S-p-i-r-e?


Dr. Fiona: No, I haven’t.


Amy Medling: It monitors your breath, and you have an app with your phone, so if your breathing is like short and shallow, it kind of senses that you might be stressed and sort of reminds you to take some deep breaths. That has helped me. I also recently did the Ziva Meditation, Z-I-V-A Meditation.com course, and I’ve invited Emily Fletcher, who runs it, she’s going to come on the podcast. She has a nice online course that people can check out, and it doesn’t make, what’s our quote, “You don’t meditate to get good at meditation. You meditate to get good at life,” which, you know, I love that.


Dr. Fiona: That’s beautiful.


Amy Medling: Yeah, I’ll definitely check out that Muse app. I’m really curious how that all works.


Dr. Fiona: Yeah, my husband is a techie, so of course he had to get it right away. It’s really cool. To me, it’s just so cool that it can measure your brain waves. It’s really interesting.


Amy Medling: One more thing, before we run out of time here, tell us more about the insulin index, kind of, counting system that you describe in your book. It’s kind of your dietary approach for women with PCOS.


Dr. Fiona: Oh, sure. This to me is super-exciting. I think we all know about the glycemic index, which is basically like how much a certain amount carbohydrate raises your blood sugar after you eat it. The researchers who’ve done most of the work on that are at the University of Sydney. They have done so many studies on the glycemic index, and they’re just brilliant. They also recently have been developing more information, or research, on something called the insulin index. In 1997 they did the first study, which looked at how much foods actually cause you to secrete insulin, so not glucose, which is the glycemic index, but actually insulin. When you have PCOS, your glucose responses aren’t really usually the problem. It’s actually a condition of hyperinsulinemia, meaning that most women with PCOS, when we eat, we secrete a lot more insulin than other women, so even if we eat that same food, we’ll secrete a lot more insulin. Our insulin stays higher for a lot longer in between our meals, and it stays higher at night-time. The insulin being high makes it very much difficult to lose weight.


Insulin’s role, we often think of is that it when we eat our blood sugar goes up, then insulin takes that blood sugar and moves it into the cells to be stored as fat, and we move some into the liver also, to be stored as glycogen. The more important role, one of the most important roles of insulin that we don’t think about, is it blocks us from breaking down fat. The reason it does that is that if we have just eaten, we’re not going to be breaking down fat for fuel, so having high insulin all the time basically blocks you from burning fat. It’s a real issue, plus all of the other things that are causes for PCOS, like it makes us make testosterone from our ovaries, which is a big problem also.


This insulin index of food, it includes more than carbohydrates, which is great because the glycemic index only includes carbohydrates. What the researchers found is that, for the diabetics, which is their area of research, that using carbohydrates alone wasn’t enough for them to estimate how much insulin they needed to inject after a meal. What they found was that certain proteins cause us to release a lot of insulin, and it’s actually related to certain amino acids in the proteins, which are called the branched-chain amino acids. These amino acids actually stimulate large amounts of insulin release, and can be a big problem.


One of the most interesting things is that dairy contains these amino acids, and this is probably why so many women with PCOS do so much better without dairy, and it’s actually … For example, yogurt has a higher insulin index than white bread, so if you were to have 2 pieces of white bread, you would secrete as much insulin as you would if you ate a small tub of yogurt. That’s pretty shocking for a lot of people, because we’ve often been taught, you know, eat dairy. I mean, I know that you and I don’t follow that, but in conventional nutrition, we’re taught that dairy is something that’s healthy, but it actually causes us to secrete a lot of insulin.


This system basically, it’s based off of what they call the food insulin demand. The insulin index is how much insulin you’ll secrete when you eat 239 calories of food. As you can imagine, 239 calories of broccoli is so much different than 239 calories of chocolate, right? We want to really know about like quantities. The food insulin demand, it relates to the actual quantity that we consume. They’ve been doing research on this, and they’ve done some research on Type 2 Diabetes, and found that it’s much more successful than carbohydrate counting, which is based on the glycemic index. My system is based on this food insulin demand system that’s been created at the University of Sydney, but it’s really for PCOS.


It follows a certain structure, where you get a certain amount of insulin points from protein, because protein is really good. We don’t want to eat low protein, because protein has a lot of benefits for us, as well. It’s really satisfying. The amino acids that are in protein are needed for our brain, and it’s been associated repeatedly with weight loss. We do want to have a certain amount of protein. The next part of it is to get a certain number of points from vegetables, and then from healthy fats, so there’s a significant amount of healthy fats. There’s a more specific count of insulin from healthy carbs, so those include things like root vegetables, so like squash, sweet potatoes. It really teaches you about how much to eat and how to structure your plate, and that I think is really, really, important. Just having that good meal structure really helps us to know that we’re going to secrete sort of around this much insulin after we eat.


The next thing I often recommend is don’t snack unless you’re really hungry, because we’re trying to get back those insulin signals, and what we want is for in between our meals for the insulin to go down, because when the insulin goes down, then we are starting to have a more normal kind of metabolic response to food, but if we eat frequently, and I know we’ve all been taught to eat frequently, we do secrete insulin every time that we eat. This is just my method that does work for a lot of my patients, but they actually start to get hungry again when it’s time to eat their next meal, and then they start to feel full.


The snacking is really more about, it’s when you need to, and it’s also very specific types of snacks, so not eating carbohydrate alone because that’ll increase insulin. The other thing is avoiding eating carbohydrate and fat alone together, because that causes a lot insulin. In fact, it’s the most powerful combination for secreting insulin. These are very specific sort of structures, and it teaches you sort of about which categories are best to follow, and which proportions to structure your meals.


Amy Medling: Yeah, that’s probably why potato chips are my kryptonite, the fat and the carbohydrate together. It’s just really a disaster.


Dr. Fiona: Oh, my gosh, yeah. The study at the University of Sydney they did on McDonald’s fries, like a small one, and again like fat and carbohydrate and the amount of insulin secreted, it’s insane actually. It’s really shocking. It’s quite motivating actually to avoid those things.


Amy Medling: Yeah, a really interesting way of looking at your diet, and you have all that information in your book. I think it’s a new approach and it can be somewhat confusing, but I think you’ve done a really great job in laying that out, so another reason to get the book, to try that approach. You’ve seen a lot of success in your practice with women with PCOS following this approach?


Dr. Fiona: Oh, yeah. Lots of women have been … It’s actually a very easy approach to follow. Like, women find it really simple, because it’s very flexible. Like, you can create your own meals. Their insulin’s going down. Like, we’re measuring it, and it’s going down, and that’s so great, because just the benefits of that are so profound for overall health. Yeah, we’re getting great responses. It’s basically, it’s evolved into sort of almost like a points system that we’re using at the clinic, but it’s really based on insulin. I hope to write another book with more details about that, too, just about the kind of points system. There is a very good amount of information in this book about doing that.


Amy Medling: Tell us a little bit more about how women can get your book. I know it’s coming out shortly. Where can they get a reserved copy? Tell us how we can get it.


Dr. Fiona: Oh, yeah. It’s coming out on September 21st. You can get advance order it on Amazon right now. You’ll be able to get it brick and mortar bookstores, like Barnes and Noble, Walmart. If you have a smaller bookstore, you can ask them to order it for you, and they can get it in. It’s through all the major distribution channels, so it should be really easy to get, and it’s available internationally as well.


Amy Medling: Is there a Kindle version?


Dr. Fiona: Yes, there is.


Amy Medling: Okay. Great. I really recommend everybody listening to get a copy of Dr. Fiona’s book, and use it the way that I used books early in my PCOS journey. Take it with you to the doctor’s office, and if the doctor doesn’t agree with a supplement that you want to take, flip to the back of her book because she has all the pub med studies laid out, and that’s when you can start speaking the doctor’s language. When they see the studies, and the results, they’re going to be much more receptive to working with you on making changes that you want to try. Do you want to speak to anything in there, Dr. Fiona?


Dr. Fiona: Oh, yeah. I agree that this book actually has a lot of information, and I tried to make it really thorough, so there might be even too much information for a lot of people in there. If you find that that’s too much, you can just skip past it, but really it’s meant to be an encyclopedia for you to use at different points in your life, and to really use those studies. I know a lot of the supplements you have on your website, Amy, there’s so much great evidence for them. You can find that in the reference section, and yeah, bring it in, and talk to your doctor about things in the book. There’s even, you know, there’s sections on menopause, and you know, preventative medicine. All of the evidence is there for you, so yeah I just encourage you to use it however suits you best. I know each woman will use it a little bit differently.


Amy Medling: Thank you so much for coming on and sharing your knowledge with us. If you enjoyed Dr. Fiona, check out … She has a great blog with lots of new content coming out. She’s also written some guest posts on PCOS Diva, and we’ve done another podcast together, so you can find that on iTunes as well. Thank you everyone for listening, and I look forward to being with you again soon. Bye-bye.


Dr. Fiona: Thank you.


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