Reset Your Hormones [Podcast] - PCOS Diva
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Reset Your Hormones [Podcast]

PCOS Podcast-113 - Reset Your Hormones“This is what my physiology is, and when I work with it instead of just constantly trying to change it, I am much less anxious and stressed. I’m more at peace, and also I’m not doing anything for the sake of weight loss that makes my hormones less healthy.” – Dr. Brooke Kalanick

For women trying to balance hormones with PCOS, the advice is typically to eat less and exercise more. Not only is that not particularly clear or helpful, it isn’t necessarily true. Since we struggle with both insulin resistance and inflammation, we need to be especially careful about the exercise and PCOS-friendly diet we choose. Dr. Brooke Kalanick offers practical advice on how to balance your hormones in a realistic and sustainable way. Listen in (or read the transcript) as we discuss:

  • Her favorite exercise for improving insulin sensitivity
  • How cortisol effects our hormones and the signs of it being too high or low
  • The “hormone hierarchy” to follow when choosing where to begin
  • Cautions for long-term Paleo diet
  • Role of simple electrolytes in healing

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Mentioned in this podcast:

How to Balance PCOS, Exercise & Hormones [Podcast]

PCOS Diva Revive

Full Transcript:

Amy Medling:                    Today I’m welcoming back a favorite guest on the podcast and that’s Dr. Brooke Kalanick. She is a licensed naturopath doctor and functional medicine physician, and an author of the brand new book, Hangry: 5 Simple Steps to Balance Your Hormones and Restore Your Joy. It’s a wonderful book. Congratulations, Dr. Brooke.

Brooke Kalanick:               Thank you. Yes, it is out in June.

Amy Medling:                    I think everybody needs to get a copy because there’s just so much information in here and a four-week plan to reset your hormones. It’s so applicable for women with PCOS. Before we move forward I just want listeners to know that you were on my podcast a couple years ago. It’s episode 60, How to Balance PCOS, Exercise and Hormones. I really encourage listeners to go back and listen to that episode, because you really are a wonderful expert on how to exercise with PCOS. I know you have PCOS yourself and you’ve kind of figured this out, the formula out, and we talk a lot about exercising to avoid adrenal exhaustion in that episode. Although you have a lot of fantastic information about exercise in your book and tons of how-to, there’s lots of pictures on proper form and exercises to do, we’re not going to cover that as much because there’s a lot more info that I want to dive into in your book. So, I just want to encourage listeners to go and review that information in podcast 60.

I do want to touch on one aspect of exercise that you talk about and that is walking. I wrote about in my book that when I was running so much to try to manage my weight early on when I had PCOS that I ended up with shin splints and had to start walking because I just couldn’t run anymore. I was amazed that I actually started losing weight when I started walking instead of running. You talk a lot about walking in your book. It’s part of your reset program. Can you kind of tell us why you like walking so much?

Brooke Kalanick:               Yeah. It’s funny, when we were working … I wrote the book with my business partner, my podcast cohost, Sarah Fragoso. So, she is a gym owner and a personal trainer, ex-crossfitter. So, we were kind of this blend of the clinical side and the practical side. With our program there was … We have what we call our five habits. It’s five, four, three, two, one is the structure. The fifth one is, or the one that goes with the five is five walks per week. As we were getting the book edited by someone who doesn’t really know our field or work with women the way that we do, she had so many questions about the walking. She was like, “I don’t understand why you guys are recommending this.” We were like, “Well, so many of us are a) Trying to maximize our time. Adding in a 45 minute walk tends to be something women are like, ‘I don’t know if I have time for that.'”

Like you said, when we recorded the episode in the past, we talked a lot about women with PCOS and exercise and where do we get it wrong? I think many of us … not every woman with PCOS struggles with trying to lose weight or maintain their weight. But, to some degree we typically usually struggle with both insulin resistance and inflammation. Walking is great for both of those things. So, we’ve got good research showing women with autoimmunity or inflammatory diseases do better, they feel better, and their markers of inflammation improve with more walking. It tends to be an exercise that doesn’t totally wipe us out.

Now, there is going to be like the most inflamed, adrenally exhausted, low thyroid woman that even walking for 45 minutes might be too taxing for her. But, for most people, for most women, it’s going to be a good way to move. We are bipeds. We are meant to be walking and we sit a lot. I live in New York City, so I walk quite a bit, most of us do just kind of in the run of things. But, that’s not the way most of us live, right? I still sit too much too. So, it’s a good way to kind of counteract, the sitting for sure which we know to be so detrimental for our posture and causes lots of issues.

So, it’s really great exercise that doesn’t usually perturb our hormones, so that’s a real advantage. When you and I talked before, again when we’re struggling to lose weight or we’re struggling to maintain our weight and frustrated with some of the things that happen with PCOS the advice is typically to eat less and exercise more. That can really quickly exacerbate any cortisol issues we have or create them. I think what happens when you’re a women with PCOS is you’re seen as someone that has maybe some insulin issues, definitely some estrogen and progesterone issues. But, we sometimes fail to remember that all women have all of those glands. We all have ovaries, and a thyroid, and adrenals. Just because you’re a woman with PCOS doesn’t mean we don’t need to take into account any of those other hormone issues we have and honor them, as well, with the low thyroid and low cortisol being the most delicate of those and the ones I think we have to honor first, even before we get to any of that PCOS-specific stuff like doing more exercise, getting more muscle mass, all of those things to help with the insulin resistance.

So, walking is something we recommend doing kind of as much as you can tolerate. Five walks a week is kind of the baseline. Again because it tends to really help with some of the big problems and doesn’t exacerbate some of those more delicate hormones. I think walking, as well, can be used when you do want to do a little bit more but you don’t want to run yourself into the ground like with extra cardio like the running. So, let’s say you had … You’re doing your regular walks but let’s say like, as life goes, you have a meal that’s maybe more carbohydrate, or more calories, or something that you’re like, “I know this doesn’t really work well for me.” Instead of just feeling guilty about it you could take a little walk and that is something that can put that fuel to use and not exacerbate any insulin resistance. I like to use stuff like that. When we factor in like PCOS, it is a chronic condition that we want to not be at the mercy of it, and we really want to have some tools that help us manage those things.

Let’s face it we’re not all going to be on some sort of perfect diet every day, 365 days of the year. Life happens, right? It’s your birthday, or you’re going out with your girlfriends, or you’re on vacation. Sometimes we tend to think of using exercise as a punishment for eating and that’s definitely not what this is about. It’s not like, “Oh, I went out with my girlfriends and had whatever and now I have to work it off.” It’s not that. It’s one of those like long-term things knowing that a meal that’s higher in carbs, or higher in calories, or higher in something that causes us inflammation, could be something we could really feel not good with for several days, and a little bit of exercise, like a good walk, can actually be a tool that is, I think, like a long-term PCOS strategy.

Amy Medling:                    It’s not really about calories in, calories out. It’s about taking the walk after the meal to sort of help with the insulin sensitivity, I think.

Brooke Kalanick:               Absolutely, getting those, just putting that meal to use, letting it get into your muscles. Exercise is one of our best tools with insulin resistance because it does improve insulin sensitivity. You don’t even need insulin when you’re exercising to get glucose out of your bloodstream and into a cell. So, it is a super good tool. I think so many of us that turn to exercise as a management, whether it’s stress management or managing our diet, we can overdo it and walking is one of those things that tends to keep us out of hot water with that.

Amy Medling:                    I think a lot of women with PCOS tend to be sort of that type A like really driven and do tend to overdo it. So, the other thing is with walking do you have to commit to 45 minutes or can you still derive benefits from say a 15-minute walk after lunch and maybe 15 minute after dinner?

Brooke Kalanick:               I think that with the walking as long as it’s not causing you to feel wiped out which, again, most women it’s not. It’s one of the ones you can kind of do, more is better. So, ideally getting in an hour a day, 45 minutes a day is great. I tend to do it … I take my kids to school and tend to walk fasted in the morning after taking care of my kids. That’s because that’s where my hormones are at right now. A couple years ago a fasted walk wasn’t in the cards for me, because I had more adrenal issues. But, that’s what I do now. But, if the best you can do is 20 minutes after lunch, 20 minutes after dinner or split that hour into two, it’s better than not doing it. It really is something … I think it’s a problem worth solving when it comes to your schedule. Do it when you can, as you can.

I consider those post-meal walks to be … that’s like medicine. That is literally helping your hormones put to use the fuel that you just ate, so those could be bonuses. Again, if that’s the only time you can do it, I think it’s all helpful. The biggest complaint we hear from women, well sometimes, is that they don’t think it’s going to be effective. They’re like, “Well, it’s just not hard enough. It’s not intense enough.” But, it’s kind of accomplishing a different purpose. The other argument is the time. I think it’s, again, a problem worth solving to try to find some time that that can fit into our day.

Amy Medling:                    You mentioned being low cortisol and low thyroid. I think a lot of women really struggle with knowing what their hormonal issue is. It’s hard for them to get the … They try to advocate for the testing that they need at their doctor’s office but doctors aren’t always willing to do the tests that will give us a full picture of what’s going on. In your book you had a really nice hormone quiz that could sort of indicate what might be going on with your hormones in terms of your thyroid and insulin resistance, cortisol, excess estrogen, or low progesterone. Then, you give us some sort of hacks and tips in terms of supplements and food that we can eat to sort of help bring things back into balance.

I was wondering, because I tend to have issues with serotonin. We’re going to talk about that in a minute, but cortisol. I tend to be low cortisol. I was wondering if you could talk a little bit about how cortisol, the role it plays for women with PCOS, and give us some idea of what signs are for low cortisol and what signs are for high cortisol to look for?

Brooke Kalanick:               Yeah, sure. The quizzes in the book is available at my website and at the Sarah and doctor. So, or That exact quiz is there. It’s free. Anybody can take that. Cortisol is the other blood sugar hormone. So, if you’ve got PCOS to some degree you have some issues with insulin. Obviously, some of us have that more severe than others, which I know your listeners are aware that PCOS has many faces and many hormonal imbalance faces as well.

So, women with PCOS, we struggle with blood sugar one way or the other, typically. Cortisol is the other piece of that. Even taking aside just life stress and things like that, when your blood sugar is up and down, that’s a stress and cortisol is going to get involved. Then you layer in, of course, any other biochemical stresses. Some of the biggest ones for women with PCOS are thyroid imbalances, gut infections, estrogen dominance, inflammation, essential fatty acid balance, any host of nutrient deficiencies, electrolyte imbalances. All of those things are stresses, biochemical stresses, as well. We tend to have just pretty much everything on that list that I just rattled off. Then, of course, there’s the lifestyle stress and how we’re exercising and are we getting enough sleep?

For most women with PCOS there’s usually some degree of cortisol involvement. Sometimes it’s high and sometimes it’s low. The high cortisol/insulin resistance combo is a tough one. It’s going to make all of the PCOS stuff worse. It’s going to make the insulin resistance and the inflammation worse, and we tend to see puffiness or inflammation. Cortisol is funny because acutely it’s anti-inflammatory but most of us are not dealing with acute high cortisol. We’re dealing with that chronic calling upon it way too many times a day every day for a long period of time.

So, we’ve got this chronic cortisol release and it tends to affect our sleep. We tend to not be able to fall asleep and unwind very easily. We might feel tired. Then back to the inflammation, in time that gets worse. We feel puffy, we feel sore, we feel achy. We tend to feel tired and achy in the morning and then we tend to have a hard time balancing our blood sugar through the day. We tend to crave fatty or sugary carby foods, all the stuff you know is not going to make your stress or insulin resistance any better. So, we tend to be low energy, higher cravings, and then difficulty falling asleep.

Low cortisol can either kind of come with adrenal issues or it can develop because you’re having lots of blood sugar problems because of insulin resistance and PCOS, or it could just come from going through a period of stress. So, those symptoms tend to be … What I see with women with PCOS and adrenal issues, it tends to be the hardest blood sugar problem to control. Because, you have trouble if you eat, let’s say, for low cortisol which people would tell you to eat frequently, eat more carbohydrates. That tends to exacerbate the other side of the coin, the insulin resistance. So, that tends to not work very well for that other side of it. Because, with the low cortisol you have a harder time keeping your blood sugar up. You’re going to see symptoms between meals like feeling hangry, feeling irritable, cranky, light-headed, craving lots of carbs, not able to go very long without eating, possibly more frequent waking in the night if you’re not able to keep your blood sugar up.

The low cortisol and insulin resistance combo is the toughest, because you have to honor that low cortisol first, because that’s what’s on the top of my hormone hierarchy. If we don’t deal with low cortisol and low thyroid first and just treat ourselves like we only have PCOS and nothing else is going on. That advice is low carb, keto, exercise a ton, which is the exact opposite of what someone would tell you for your low cortisol, which is eat frequently, eat plenty of carbohydrates. Don’t exercise too much, you want to do some yoga and some walking and nothing more strenuous. It’s a real conflicting bit of information for women that have this issue. But, yet, if we don’t deal with it, just doing some of the PCOS stuff can be really frustrating.

So, in this case what I recommend is we honor them both but make sure that we are really attuned to that low cortisol first. I tend to start women … It’s like maybe four meals a day, five can really exacerbate the insulin issues. You might need a teeny smattering of carbohydrate, like a little bit, a few bites at every meal versus a big serving at every meal. Whereas maybe someone with just insulin resistance can do just starch at night, or they could even do something more extreme like a keto diet or a very low carb diet. I find that that kind of making sure we honor them both, that tends to be the combo, hopefully while you are dealing with the low cortisol issue. What’s driving all that stress? What’s causing you to be so wiped out? Is it infection, lifestyle? What is it that’s going on, and hopefully heal that a little bit so, we don’t need to be on such a tightrope with your blood sugar?

Amy Medling:                    Great advice. Your book goes into much more detail onto how to treat those issues and more. One of the sections of the book that really kind of struck my interest was your discussion about GABA and serotonin. I think that a lot of women with PCOS struggle with both levels of both of those. I was hoping that you could talk a little bit more about it for our listeners.

Brooke Kalanick:               When you think about all of your neurotransmitters, we get in real quick to like, “Well, what can I take?” So, we know that tyrosine will induce dopamine and tryptophan or 5-HTP, St. John’s Wort, those things will induce serotonin. But what we want to always remember, when it comes to neurotransmitters insulin has a role in this. It helps drive the amino acids from your foods. Let’s say you ate some chicken, or some turkey, and it’s got some tryptophan in it, but you need to get that tryptophan into your nervous system, into your brain, in order to be produced into serotonin. That’s going to be driven by healthy blood sugar and by insulin balance.

If you think you have any neurotransmitter imbalances one of the first things you want to do is make sure were managing your blood sugar, which all goes back to what I talked about with insulin and cortisol. So, that’s a really important thing, I think, for women with PCOS or all women. You know we get so into exciting things like keto, or CrossFit, or whatever is like the new or Orange Theory, whatever is like the new hot trend, or now the carnivore diet. That’s the new nutrition trend. We get focused on that and we forget just the basics of what’s actually working for your physiology right now, for you to balance your blood sugar. So, we want to make sure blood sugar balances really in line anytime we’re wondering about having neurotransmitter issues. GABA and serotonin tend to be some of our calming, kind of feel-good neurotransmitters. When we don’t have enough of them we feel anxious. With serotonin we can feel depressed.

So, with GABA, again, very reliant on balanced blood sugar so do that first. If you are having symptoms of low GABA you tend to feel more anxious. You can feel almost like a sense of dread at times. This anxiety and dread doesn’t really have a reason. Like, I just actually had a super stressful phone call with my daughter’s school about registration next year, so that’s a reason for me to feel anxious. This dread with GABA deficiency tends to be, or anxiety with it, tends to be sort of for no reason. You’re sort of finding yourself feeling anxious and upset and a knot in my stomach, and I’m not really sure why. You can also feel a little bit disconnected from other people when GABA is low and certainly have a hard time sleeping.

With serotonin we tend to have some depression. It’s not so much like a dopamine depression. You didn’t really ask me about dopamine, but I’m going to talk about that one, too, because they both can make us feel depressed. So, serotonin depression is a sort of a flat affect, where you don’t go up and down a lot. You’re down. You’re not super, super down but you are down. It can worst in overcast weather. You lose appreciation for the things you used to love. Like maybe you used to love painting or biking, or whatever, and just none of it really makes you feel as happy as it used to. It can also give you some cravings for sugars. I think a lot of those things, again, are driven by your body trying to get that blood sugar balanced and boost things up. Serotonin depression, again, is kind of the blues where your down and you almost can feel guilty about it like, “My life’s pretty good. I don’t know why I don’t feel happier.”

Whereas a dopamine depression … Dopamine is one of our uppers, so it’s one of our real, it’s about focus and motivation, having to do with drive, sex drive, organization, being able to kind of like wrangle your thoughts, short-term memory. That kind of a depression when we don’t have enough dopamine can be a bit more up and down versus that flat nature of low serotonin. But, when you have your down days they’re really down. You can feel kind of hopeless like, “Nothing’s ever going to get better.” I’ve seen women with PCOS having all kinds of neurotransmitter imbalances, in part because we are dealing with blood sugar. That’s one of the biggest ones.

Inflammation is another real cross to bear when we have PCOS. It’s one of the root causes of this condition. Inflammation will always make all of our hormone imbalances worse, but definitely is not great for our brain. So, that’s going to be another factor that drives some of these neurotransmitter imbalances. Some women with PCOS have high prolactin. Prolactin and dopamine have a completely opposite relationship where when prolactin is high dopamine is going to be low. This can be at least a component like a postpartum issue, like when we’ve got high prolactin if we’re breast feeding. So, those are a couple of ways that PCOS really gets involved in our neurotransmitter imbalance. Yet another one is … So, serotonin is derived from tryptophan, but tryptophan can go down the pathway to make serotonin, or it can also go down an inflammatory pathway to make something called cyanurate. That process is turned on higher when we have a lot of estrogen dominance, which can happen with PCOS because of the low progesterone, so we have an imbalance there, an unhealthy gut.

A lot of things can drive our estrogen and progesterone to be imbalanced, and we can have poor estrogen detoxification. That can be another thing that really drives down serotonin. So, if you’re wondering like, “What do I do? I’ve got PCOS. I’ve definitely got some anxiety, depression, sleep issues?” First and foremost, tackle the blood sugar, again in a way that honors all of your hormones including your cortisol and not just the insulin issues. Tackle some inflammation. Those are going to go a long way. Then, I would look at some of those other things like possibly prolactin, possibly estrogen dominance and, of course, with mood stuff we always want to get our thyroid checked, as well. One of the main symptoms of low thyroid is a low mood.

Amy Medling:                    So, this is all really helpful information. I don’t know if you know that the statistic that 60% of women with PCOS have some mood-related disorder, whether it’s anxiety, or depression, or both. I think what you’re saying is that the cause of those issues can be different. I think you need to get to the root. Once you’ve kind of got your insulin resistance under control and your thyroid is checked, and you have some of these other what you had mentioned under control. Do you think that most functional medicine practitioners can help you fine tune?

Brooke Kalanick:               Yeah. I think … When you’ve got a condition as nuanced as this and, quite honestly, misunderstood. You hear some crazy things even from functional medicine practitioners and alternative medicine practitioners about PCOS. One of my dear friends, trusted colleague, continues to call PCOS a lifestyle issue, that we’re just going to sort by eating less carbs. As we know, this goes a lot deeper than that. Yeah, I think functional medicine is, of course, going to give you a way better, broader look at all of your hormones and a bigger picture view of, “How’s your digestion? How’s your detoxification of hormones?” We’ve got tests that can sort out the cortisol rhythm and give you even more insight versus just going off symptoms like you would do with my quiz. Finding someone who is like a little more versed in PCOS can also be, of course, really helpful because that’s someone who is going to understand more of these nuanced things.

When you can get to the cause and, again, if you’re someone new to it then you’re going to want to start with the basics of insulin and inflammation.; If you’re someone who is like, “I feel like I’ve got that dialed in,” like you said. What do I need to do next?” Then, yeah, working with someone who can help you kind of get on top of the metabolism of hormones and understanding that bigger picture of all the stuff that has to go on in that big interplay.

Amy Medling:                    So, speaking of getting dialed in. I realized recently that even though I was hydrating enough. I was drinking a lot of water during my day, but I realized that I was missing electrolytes. I started by drinking more mineral water, adding a little like Himalayan salt to my water. Then when I started using electrolytes, I really noticed a difference in kind of my energy levels for sure. I was so pleasantly surprised to see that you talk about that in your book. I was wondering if you could share more about the benefits of electrolytes for women with PCOS?

Brooke Kalanick:               Yeah, electrolytes are a game changer. It’s so simple but it’s one of those ones that so many women are like, “That …” You know, I think there’s a lot of supplements that we take that we’re like, “Yeah, I feel a little better,” or “I know I should, based on my lab work.” But, it’s not like when people take a cup of coffee and they’re like, “Okay, I feel different than that.” But, electrolytes are one of those ones that actually it’s like, “Okay, I immediately see an improvement,” and definitely notice when we don’t do it.

So, there’s a couple of reasons why. Women with PCOS we’re mineral leakers, right? We’ve got insulin issues and inflammation. We tend to be peeing out a lot of our B vitamins and our minerals. So, the more imbalanced your blood sugar is, obviously, the worse that is going to be. But, yeah, PCOS women, I think all of us, should probably be on a great electrolyte formula. The sea salt is a good place to start but that’s only going to give us the sodium. So, when you think about low adrenals and low cortisol that’s another absolute condition that absolutely needs more electrolytes.

So, if you’re someone dealing with … Amy, like you were saying, some adrenal issues and PCOS, then electrolytes are going to be like a must have supplement. Sea salts or salt in the water might be a good place to start, but it’s not going to give you, especially, the potassium which is the other mineral that we’re losing. Between the low cortisol and just having PCOS that’s no wonder that you feel so much better. I’m definitely in that same camp. There could be other reasons, you know. Whether it’s how you’re training, histamine issues can cause us to have a bit of an irritable bladder and peeing more frequently. Anything that causes us to sweat more than we were, or urinate more than we were can be a real quick way to lose some electrolytes. A good well-rounded formula, I think, is that kind of eye-opening like, “Holy smokes I feel so much better.” But sea salt, of course, is the place to start.

Amy Medling:                    I offer the electrolyte formula that I use in my store now. I call it Revive, and it has kind of like an orange/lemon taste. It’s really light, and it’s easy to drink. It also, I find, helps me with my sugar cravings, too. I don’t have them as much when I take it.

Brooke Kalanick:               It’s a real, like I said it’s kind of a life changing formula for women with PCOS. I think we can hardly ever go wrong adding more magnesium. I know there’s magnesium in your formula. So, a good well-rounded electrolyte. It’s simple. It tastes good. It gets you to drink another glass of water, right, because you’re putting that in. It’s really an important one. If you’ve got any adrenal issues it’s going to be even more important for you.

Amy Medling:                    So, I wanted you to talk a little bit about your diet plan in the book and the importance of vegetables. I think some people might be a little surprised by the amounts. You actually kind of give an amount of veggies you want people eating a day. I think that this is one of the first things that we need to do to start feeling better with PCOS. So, tell us about your veggie protocol and a little bit more about your diet plan.

Brooke Kalanick:               If you know my coauthor, Sarah Fragoso, her work. She started off as a huge advocate of paleo. She was one of the first women on the paleo scene. She had that transformation where she started training differently and going grain free, went paleo, the skies parted, she lost weight, life was amazing, of course until it wasn’t, because it’s one of those nutrition strategies that was a really great place for her to start, but there were other things she needed to address.

So, what we, and I, found as well when I first started working with women and with my own PCOS, I sort of stumbled upon the paleo diet when I was in school at Bastyr. We had a vegetarian cafeteria, like this was not really the way that I was eating with all of this meat. I didn’t dislike it, it just really wasn’t in the construct of what natural health was, especially at the time. But, I wasn’t doing great. My PCOS was definitely not great. I had a lot of stress but I was also eating foods that were really aggravating me, kind of based on this little nutrition bubble that I was in at Bastyr. I discovered paleo dieting kind of around that time, ancestral health, and it was a miracle for me, as well. There are some things that happened in time which, again, I think as women we need to …

Women with PCOS we have multiple hormone issues kind of going on at the same time. Again, we’ve usually got insulin issues and some cortisol issues. Often times a thyroid issue, some estrogen and progesterone imbalance. We might find what works for us but then something happens. You go through more stress, you get a bigger cortisol issue or it trips a thyroid issue. Or, you go through a pregnancy, or perimenopause, or some sort of new diagnosis, or just a period of high stress. So, we have to continue to be able to check in and kind of take what has always worked for us and take an honest look at it like, “Oh, this isn’t working anymore. I need to make some adjustments.” What I found when I was like a hardcore paleo person, it managed my PCOS really well because it was pretty low carb. Then, in time other stuff creeps up and it’s really easy to have that diet be a very low-vegetable, low-plant diet and just eat a lot of meat. It’s easy for that diet to be really high in animal fat. If we’re not careful we might be eating animal fat, or animal products that aren’t from a great source, and that can really wreak havoc on our estrogen balance.

So, we talk about that a lot in the book, the importance of kind of maybe that paleo base but really watching fat for women, animal fat, and making sure we do enough plant-based fat and not all bacon and cheeseburgers. I guess it wouldn’t be cheeseburgers on paleo, but bacon and higher fat cuts of meat, because those POPS, those persistent organic pollutants, that get kind of locked into fat cells, so many of them have estrogen activity or somehow disrupt our thyroid or microbiome. We really want to be careful that we do as good of a job as we can with the quality of our animal fats to lesson that burden. Also, I find most women, especially as we get a little bit older, do better with a little less animal fat and a little more plant fat. So, just to fine tune, the more estrogen dominance or estrogen/progesterone imbalances you have, the worse some of those issues can be.

Our diet, as Sarah and I worked together we sort of collaborated on what we found to work best for women we came to sort of this paleo Mediterranean hybrid. So, there was plenty of animal protein. There was some animal fat but there was a lot of plant fat, lots of olive oil, some of those things, avocado, olives, coconut and then loads of vegetables. So, we actually advocate a pound of vegetables a day, which tends to seem like a lot to some of us. Again, that’s going to be kind of the other piece of balancing estrogen because, again, many women with PCOS have some estrogen dominance issues, some estrogen metabolism issues. The fiber in vegetables is going to keep our gut bacteria healthy. It’s going to help with the estrogen and progesterone issue. It’s fiber so it’s going to help balance our blood sugar, and it’s full of all those phytonutrients which, again, just kind of fills in all the holes of the different parts of your metabolism that need all of these different, zinc and those antioxidants and those phytochemicals.

To me a paleo diet should be a plant-based diet. It shouldn’t be a vegetarian diet, but it should be a plant-based diet. So, we’re getting out a lot of immune aggravators by kind of avoiding some of the things that are commonly avoided on paleo, like dairy and grains, and legumes, and soy. But, we kind of turned it on its ear a little bit and shifted where the fat was coming from and really advocate a lot of high plant intake, high vegetable intake.

Amy Medling:                    Yeah, I think this is where you can really take back control of your hormones and you feel sort of helpless. This is something that you can do every day to really make a tremendous impact in the way that you feel just by choosing what you put on your plate. I really liked your plan, and I thought your recipes looked great. How many recipes do you have in there? There’s quite a few.

Brooke Kalanick:               Sarah is a five-time best-selling cookbook author, so she’s fabulous in the kitchen, and she knows what’s she’s doing. I think part of asking a woman to up her game with her nutrition. It takes some time, it usually takes a little more money. You might be buying organic. You might be buying grass-fed beef. Time, and especially if you’re expecting the rest of your family to eat it, and for you not to get bored and to not feel like this is just something I can do for 30 days but this is like a life transition I can make, it’s got to taste good. Yeah, we’re very lucky that I have such amazing recipes from Sarah.

A couple other things we really wanted to just do with the nutrition plan is most of us … You’re taking your time to listen to this podcast. You’re taking the time to read this book and make some of these changes. We still want it to be easy. There’s only so many hours in the day that you’re going to have to devote to your health. One of the things that we really wanted to do was have a meal that could easily go into multiple meals, so taking one recipe and turning it into four different things over the course of three days, so that you only cooked once but you got to eat several different things, and to kind of also …

So many of us are not getting enough protein at breakfast. That just sets us up for more blood sugar problems, more cravings, worse energy, harder to regulate appetite for the rest of the day. So, wanting to give women something else to do in the morning besides just eggs, or maybe a protein shake. We tend to not really get outside of that breakfast box very easily, so we have breakfast salad recipes, breakfast soup recipes, so really trying to solve some of the problems that make doing what we need to do a little bit easier.

Amy Medling:                    Another problem you address is mindset in your book. We’re kind of running out of time, but I was hoping that you could leave us with one of your favorite mindset shifts around balancing your hormones, and taking better, and restoring your joy.

Brooke Kalanick:               Well, that was kind of our goal of the book, right? We just see all these women spending so much time and money at the gym and working on their health but they’re still unhappy. Maybe they’re doing all the things. But if you’re not taking some time to express who you are, to do the things that you love, to do things just for play, just for the sake of it, like what’s the point if we’re not happy? So, we have in our book what we call the five pillars. They’re just foundational ideas about being more engaged in your life, being who you are, being your own best friend, committing to what works you, getting into that as a foundation to rest all this other stuff on. So, we teach that throughout the book.

So, as far as me, I think that there’s a couple things. Our first pillar is find and commit to what works for you. I think some of us in this journey are trying to find what works. We’re not sure if we need to be dairy free, or we’re not sure if we need to try a low-histamine diet, or a low FODMAP diet. We’re still trying to find what works for us. Some of us have done that work. We know … Like for me as a woman with PCOS I know that low carb, dairy free, gluten free, watching my stress, being committed to exercise. I know that those are things that work for me. So, what a lot of women struggle with is, “How do I stay committed to that? How do I make sure that I’m able to do that and not feel overly restricted or overly miserable?” So, for me a big mindset shift, for me with having PCOS, was in my younger years …

Like you were saying with the running, I did the same thing. It didn’t matter what I did at the gym I just wanted it to make my legs smaller and I wanted to be able to lose more weight. That caused me to do a lot of things that really worked against my PCOS physiology. The biggest shift for me that changed is to just embrace this PCOS body that I have. I put on muscle really easy, so I’m strong. I have started training in a way that kind of works with that instead of constantly trying to rail against it. Then, being able to just instead of being miserable that, “Oh, I have to be gluten free, or “I don’t do well when I have coffee.” I have to be committed to my sleep and I do need to exercise regularly.” It’s easy to stay in the unfairness of that. Well like, “My girlfriend who doesn’t have PCOS doesn’t have to do any of those things. She drinks wine every night. She looks great.”

Kind of minding my own business about, “Well, this is what my physiology is and when I work with it instead of just constantly trying to change it, I am much less anxious and stressed about it. I’m more at peace and also I’m not doing anything for the sake of weight loss that makes my hormones less healthy.”

Amy Medling:                    That’s great advice. I know you talk a little bit about that in more detail, too, in our podcast together, #60 How to Balance PCOS, Exercise, and Hormones, and your book title again is, Hangry: 5 Simple Steps to Balance Your Hormones and Restore Your Joy. It’s going to be available June 4th everywhere books are sold. I’m really encouraging everybody to pick up a copy because you not only get all of the fabulous recipes but those five pillars that you’ve just touched upon, I think, really powerful mindset shifts which is such an important part of really taking on your PCOS.

Brooke Kalanick:               For sure.

Amy Medling:                    Dr. Brooke, thank you so much for being such an advocate for women with PCOS. I know that’s something that you talk about a lot on your blog. Maybe you could just tell us where we can find out more about the work that you do?

Brooke Kalanick:               Yeah, so Hangry was not just a PCOS book but there, obviously, is a lot of information about PCOS, because it’s what I specialize in. I think it’s a unique condition that deserves some real extra care and attention. So, you can find me on Social Media at Better By Dr Brooke, Facebook and Instagram. That is also my website. I do also have the Sarah and Dr. Brooke show is my podcast with Sarah. Our new website is If you go to that website and you pre-order the book, or even after the book comes out and you order the book, there are 17 bonuses. You can get a beautiful printout of those five pillars. We’ve got more stress management tools. There are some great videos with Sarah in the kitchen, like some tips to make this easier. She does that. We have a video of that exact thing where we took one recipe and she turned into five things. So, again, cooking once, getting multiple meals.

Brooke Kalanick:               I did four webinars, and I did one entire webinar on PCOS. So, if it’s something you want to kind of learn more about the other hormones and the interconnectedness of your PCOS to your other hormones, that’s one of the free bonuses. You can get all those at

Amy Medling:                    That sounds so great. Well, thank you so much for coming on and for writing your book. Thank you, everyone, for listening. I look forward to being with you again very soon. Bye-bye.

Brooke Kalanick:               Thanks.

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