What Your Doctors Never Told You About PCOS, Losing Weight, Fertility

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Transcript

Setting The PCOS Agenda

SPEAKER_00 0:00

Hello guys and welcome back to Heart Heart with Hads. This episode, I'm gonna be covering all things PCOS and kind of like the functional, functional approach to PCOS. So let's just dive in. We're gonna talk about the different types of PCOS, we're gonna talk about supplements to take, we're gonna talk about the symptoms associated with the different types of PCOS and just deep diving in, some cues, some labs to run, and all the things you can do to help get your PCOS regulated, because I do think it is something that you can manage symptoms and almost heal from the root.

Busting Pregnancy And Weight Myths

SPEAKER_00 0:39

And also just unpacking some myths about PCOS. The first one being that if you have PCOS, you can get pregnant, and that is not true at all. If you can support ovulation, which you can, if you can support ovulation and have an ovulate, then you can get pregnant. All you need for getting pregnant is ovulation and then a progesterone rise and obviously implantation. So we're gonna dive deep into that. And then also another myth is that you can't lose weight with PCOS and you have chronic insulin issues, and again, you can resolve these issues. So we are going to just dive right in.

What PCOS Does To Hormones

SPEAKER_00 1:17

So first thing to know about PCOS is it does cause chronic inovulation, meaning no ovulation. And if there's no ovulation, there's no progesterone, and then your endometrium tissue is at risk. So another thing that it does is it suppresses your sex hormone binding globulin, which increases the free testosterone, which that's how some women with PCOS have more acne.

The Four Functional PCOS Types

SPEAKER_00 1:47

So there are four functional PCOS kind of types. First one being insulin resistant. And so this you can see with this weight gain, fatigue, cravings. Second one being post-pill PCOS. This is when androgens, so testosterone is high, DHEA is really high, SHPG is low, the sex hormone binding globulin, like I said, when that's low, free testosterone tends to be higher. This is where you have the acne, the hair loss. This can happen a lot post-oral contraceptives. So different types of oral contraceptives, hormonal birth control can cause, can cause SHPG to go down, which brings androgens up. So post-pill PCOS is what we're talking about with that one. And then inflammatory PCOS. So this is where your immune system gets activated. You have some GI and liver issues. Maybe you have high CRP on your labs, C-reactive protein, and then a lot of GI issues, like I said. So pain, um, pain heavy periods as well. And then the fourth one is adrenal PCOS. And so this is when your HPA access is dysregulated. You have super high DHES, your testosterone, a little bit normal. Maybe you're a little bit more on the leaner side, you're not overweight, and you have some anxiety and insomnia going on. So just because you have PCOS does not always mean that you are going to be overweight, carry fat in the midsection. There's four different types, like I said. And so knowing which one best kind of suits you can help you tailor your own your own lifestyle changes to that. So we're going to dive deep into what you can do to help with each of these.

Estrogen Detox And Core Supplements

SPEAKER_00 3:35

But the first thing that I want to say in PCOS is that you need to support estrogen detox because typically estrogen is you're going to have some estrogen dominance going on since you're not ovulating, your progesterone's going to be fairly low. And so you are going to have more estrogen in relation to progesterone. So to support estrogen dominance, eating, eating a lot of cruciferous vegetables, so broccoli, Brussels sprouts, kale, things that are going to help, things that are higher in um dim to help detox more. And then also good supplements to help with that is myonocetal, magnesium glycinate, omega-3, and chasberry. And then calcium deglucrate is also a good one, but also just taking your methylated B12 vitamin folate B6. So one of my favorite supplements actually for hormonal support is magnesium, zinc, and B6. There's a good supplement that combines all of these on Amazon. I don't remember what it's called, but I have it maybe like every day or well, it's like blue and white and black. Uh, I I recommend that to all my clients. Doesn't matter what they're going through, whatever. I think that it supports hormones and all facets.

Gut Health, IBS, And Estrogen Recirculation

SPEAKER_00 5:00

So another thing too with PCOS is you want to address any underlying gut issues. So a lot of people with PCOS get diagnosed with IBS, which IBS we know is just a blanket statement or diagnosis for something underlying going on. And so highly recommend a GI map, or like if you have SIBO, which is small intestinal bacterial overgrowth, uh, that can cause a lot of issues, which can make you constipated. Then you're not excreting, getting out that excess estrogen. And so it's just building up inside of your body, causing all of these hormonal symptoms, the heavy period, the painful, swollen breast, the constipation, pooping like a rabbit, all the things. So GI MAP is definitely something if you do suspect that your PCOS is uh has a little bit of gut related. And as I'm going through these, you might be like, I think I have all of these. I think I have insulin resistant, I think I have post-pill, I think I have inflammatory, and that may be true. And so it's kind of just like designing and figuring out what you need to do for your specific phenotype. And so this is why it's really important to actually have a coach that can help you with this. And I'm not just saying that just because that's what I do, but like you don't just want to be guess guessing, guessworking around everything. So let's see here. I'm just getting into my notes that I just want to talk about.

Conventional vs Functional Diagnosis

SPEAKER_00 6:26

But the oh, I wanted to compare the like conventional definition of PCOS, which PCOS is polycystic ovarian syndrome. So conventional definition versus the functional consideration. So conventional definition definition is must meet two of these three. So anovulation, clinical or biochemical hyper hyperandrogenism, which is testosterone being elevated. And then um PCOS morphology. So like if they go in and they can see inside your ovair, like ovaries, and see that you have less than 12 follicles or your ovarian volume is greater than 10 uml. So those are like that's a conventional definition. Now, the functional consideration is the one that I had just kind of talked about in the functional consideration, accounts more for metabolic drivers. So a lot of PCOS clients are misdiagnosed due to the oversimplified diagnostics, like I mentioned, the conventional definition. So functional PCOS takes a look at your endocrine system, metabolic, inflammatory GI, and environmental dysregulation. So excuse me. So endocrine-wise, if your LH is high, your LH to FSH ratio is high, this can mean androgen excess. And then if you have insulin resistance, this leads to hyper, hyperinsulemia, androgens increased, like I talked about, free testosterone high, and then your sex hormone binding globulin low. And then obviously reproductive-wise, it affects you because you're not ovulating the low progesterone, and then too much estrogen related to that, which also which when you don't have progesterone, this causes low-grade inflammation. So this can worsen your insulin resistance. So as you can see, it's kind of all like a cascade effect. And then your GI and liver, if which you're not gonna know what this is, but your beta glucuronidase, if this is elevated, this means more risk for dysbiosis. And then the estrogen, like I'd mentioned, is recirculating your body because it's not

Endocrine, Metabolic, GI, Environmental Drivers

SPEAKER_00 8:35

being excreted through bowels. And then environmental, obviously, there's so many environmental toxins, the things that we put on our body, what we store our food in, this the chemicals in the air, the fertilizer, the food that's covered in pesticides, all the things. This can this can slow down or like over, what's the word I'm looking for? Can be overbearing on your like your detoxification system. So really focusing on making sure that you're minimizing all the things that you can with environmental toxins, like xenoestrogens, like I said. So these things can be like plastic, especially cooking food and plastic, highly recommend you get glass pepperware ASAP. Anyways, let's get into um insulin. Wait, I want to mention too that the reason that the personal care products and the xenoestrogens and things cause issues is because they bind to your estrogen receptors. So making estrogen increase even more and exacerbate the symptoms that are already there. This disrupts your detox enzymes for you to be able to properly detox. So that's why it is important to really make sure that you're focusing on all of these things. So let's get into the type of PCOS and what we can do to help minimize these symptoms. So wait, first I

Xenoestrogens And Everyday Toxin Load

SPEAKER_00 10:00

want to go into I need to find this on my computer first. I want to go into where did I do with that? I want to go into the let's see, can't find it. Give me one quick second. I wanted to find the like symptom thing and go through the symptoms with you. So just give me one second so I can pull this up. Do to do to do to do to do to do to do. Where is she? I don't know where she's at. Okay, there she is. Okay, so this is like your phenotype quiz. So section one, and you can just mark off all that apply to you. So the section one is insulin-resistant PCOS. So first one being I have strong sugar or carb cravings, especially in the afternoon. I gain weight easily around my belly, even with exercise. I feel tired or sleepy after meals. I have darkened skin patches or skin tags. I've been told I have prediabetes or elevated insulin. My fasting insulin or glucose has been abnormal. I experience energy crashes or shakiness between meals. Blood work showed low SHBG or high free testosterone. My triglyceride to HDL ratio was greater than two on labs. So total up your section for that, and that will be section one insulin-resistant PCOS. Now

Phenotype Quiz Setup

SPEAKER_00 11:20

we're into section two, which is post-pill PCOS. So you can check all that apply. My periods were regular before I started hormonal birth control. My PCOS symptoms began or worsened after stopping birth control. I had a long period of no periods after stopping the pill. I experienced acne flare-ups or hair loss after stopping the pill. I've taken the pill for over three years or started in my teens. My SHBG is very low and androgens are elevated. I was diagnosed with PCOS within six to 12 months of stopping the pill. Last one, I had no symptoms of PCOS before birth control use. So total that up, and that will be for the post-pill PCOS phenotype. Next one,

Insulin-Resistant Phenotype Checklist

SPEAKER_00 12:00

this is inflammatory PCOS. So check all that apply. I have bloating, gas, or digestive symptoms frequently. I had food sensitivities or histamine issues. Example, wine, avocados, aged cheese, things like that kind of make you have heart palpitations or just flare up like your gut is sensitive to those. I've been diagnosed with IBS, leaky gut, or SIBO. I have joint pain, skin rashes or eczema. I have had chronic fatigue or postviral symptoms. My CRP or other inflammatory markers were elevated. I have autoimmune conditions or strong family history of them. I get acne or skin flares after eating certain foods. I've had recurrent yeast or urinary tract infections. Total for that section. Remember that one's the inflammatory PCOS. Shoot. What just happened? They all just went out. Just went out again. All right, section four. This is the last one. I am naturally lean but still have PCOS symptoms. I wake up in the middle of the night and can't fall back asleep. I feel wired but tired, especially in the evening. I experience anxiety, irritability, or restlessness often. I have been told I have quote unquote normal labs, but I still don't feel normal. My DHES was elevated, but testosterone was

Post-Pill Phenotype Checklist

SPEAKER_00 13:15

normal. I crash after stress or intense exercise. I can't handle fasting. It makes me jittery or dizzy. My cortisol or adrenal rhythm was abnormal on a Dutch or salivary test. So total total for that section. And then you can add all these up. Obviously, if section one was the highest scoring section, is likely your primary PCOS driver, but it's common to have like a secondary overlap, for example, insulin plus inflammatory. So identify your dominant one, and then that will kind of help lead lead you to where you need to start. So if you're if your insulin resistant one was the most dominant, then you need to work on some blood sugar control. And so this is making sure that you're having a high fiber diet. And then other things you can do to support with supplement-wise is myonousetol, berberine, berberine access, the same thing as metformin. And then I would focus on a low glycemic diet. You can look up low glycemic foods, eliminate

Inflammatory Phenotype Checklist

SPEAKER_00 14:20

your added sugar and process carb, specifically things like pasta, bread, all the things. I would do a 12 to 14 hour overnight fast, unless your adrenal one was your like secondary overlap, then maybe don't do a 12 to 14 hour overnight fast. So 12 to 14 hour overnight fast would look like you eat dinner at 6 p.m. and then you don't eat again until 6 a.m. or 8 a.m. the next day. That's what I would do. Unless you have impaired adrenals, if that one was a little off, then you can do a little bit more of carbs closer to bed. And I something I like is either a little oatmeal with almond butter or sweet potato with almond butter, something like that. That's gonna be um a high fiber, higher fat

Adrenal Phenotype Checklist

SPEAKER_00 15:10

meal before bed to help calm you. And that will that can also help your blood sugar in the mornings, which sounds crazy, but it can. So like I would say hour, two hours before bed, could do that. That's specifically if adrenal thing is an issue. Now getting into supplements for that, myoenostal 2000 milligrams, berberine 500 milligrams twice a day, magnesium glycinate 300 to 600 milligrams, um, chromium, which you can just do the BQC supplement for this, but chromium 200-600 milligrams, just depending. I would always start with the lowest dose, omega-3 up to 4,000 milligrams a day, and then NAC and AC 600 to 800 milligrams. Like I said, always start with the lowest, and that's gonna help a lot with detoxification of liver as well. Excuse me.