Table Talk 012

Melody00:00

Welcome back to the Table Talk podcast. Today, we are sitting down with Dr. Megan Morrison and Dr. Lauren Castle to talk about PCOS or polycystic ovarian syndrome. So this is hot topic because it affects so many women and really is the most common endocrine disorder of women of reproductive age. So many of our listeners are in that category and it effects almost 10% of the women in the U S so before we get started, I just want, Megan's been on the podcast recently, but we'll have her re-introduce herself and also Dr. Castle reintroduce herself. So Megan why don't you go first.

Megan00:36

Yeah. Hi everybody. I'm Megan here. Thank you Melody. For having me back, I am excited to talk about PCOS. Like you said, it is, just a really hot topic that so many women struggle with and may not even know it. So I'm excited to talk about it and bring some light to the topic.

Melody00:54

Awesome. And Lauren.

Lauren00:57

Hi everyone it's Lauren, I'm excited to be back as well. PCOS something that I started digging into personally with my own journey over the last year, and trying to figure out what was going on with my hormones and my cycles post-birth control. So I'm sure we'll get into that as well.

Melody01:15

Yeah. Yes. Yes. Post-birth control syndrome is a thing for sure. So you can definitely tell us all about that.

To get started, the syndrome is characterized by excess androgens, like testosterone and ovulary disfunction. And so this means that a lot of women with PCOS, don't actually ovulate and they also have cyst along the ovaries. And so this is though only two of those three criteria need to be present for diagnosis.

The name polycystic ovarian syndrome is a bit confusing, since not all women necessarily with PCOS do have that characteristic polycystic ovaries, which is interesting because a lot of people that's like what they. I must have this presentation if I'm diagnosed with this, but it could just be those excess androgens, like the testosterone and not having normal cycling.

And so it's really thought to be increasing in incidents, both in not only countries like the US and developed nations, but also in developing countries and a lot related to lifestyle, which we're going to dig into and diet quality and the physical activity. So a lot of insulin resistance components that we're going to talk to, and Megan's going to talk a lot about the environmental endocrine disrupting chemicals that we've been talking about on, on some of our last few podcasts. And then even the circadian rhythm alter light exposures and sleep disturbances can also impact those the insulin resistance and then also that stress component. And so we always say that we're going to talk about stress on every single podcast.

And here we are talking about it within the first three minutes of the podcast. Lauren, do you want to lead us off with the signs and symptoms of PCOS?

Lauren02:47

Sure. So I think for a lot of women, there's kind of this stereotypical, visual of PCOS that we see, which is, you know, obesity or being overweight, having a high hip to waist ratio, having a BMI over 30, of course the signs of excess androgens, like her statism or the oily skin and acne, some might actually also have. thinning hair or alopecia. There's also something called acanthosis nigricans , which I can never say it right. But basically like the skin actually starts to dark in, in certain areas, like the neckline is most common and then also skin tags can be present. And then outside of some of those physical kind of visual symptoms that you might see. Of course the main ones are irregular or absence, menstrual cycles, infertility or miscarriages. And then other symptoms like depression or irritability, and then some people also have sleep apnea, pelvic pain, or even breast discharge that might be gray or white.

So lots of different signs and symptoms that might show up. But of course not everyone is going to look the same. So there are patients who aren't overweight and have PCOS. There are patients who don't have some of these other kind of stereotypical symptoms that don't fit that picture. And so their doctors may not think that they have PCOS, which can make it really hard for women to actually come to a diagnosis.

Melody04:25

Yeah, for sure. And I think I was one of those people that didn't fit the stereotype as far as not being overweight. And I had irregular cycles from the beginning until, until I had my son four years ago. So the doctor was doing all these tests and a lot of these tests that we're gonna talk about, like all came back normal for me.

And it wasn't until someone tested a very specific hormone that we'll talk about that and then did an ultrasound to confirm. And it was still probably speculated cause I still don't have two of the three pieces of the puzzle there required for a diagnosis, but definitely, probably was a probable diagnosis.

So I know if Lauren, you said post birth control. So tell us a little about that.

Lauren05:00

Yeah. So for me, I was trying to figure out what was going on, had been on the NuvaRings specifically for over 10 years, and finally had gone off of it back in 2020. And it took over a whole year before my cycle came back, ultimately, and in that year I started trying to research what was going on.

And of course, one of the first things that came to my mind was PCOS. I did a Dutch test initially. It was kind of my first foray into trying to look at hormones and see what was going on. And my testosterone was basically the highest end of normal that it could be. So I was suspicious. But it wasn't quite high enough that it was really indicative of PCOS but.

What was key for me and realizing, okay, this probably is not PCOS is that my estrogen levels were basically menopausal. They were like non-existent. And so for me, it was then trying to tease out, okay, what other things could be going on here, besides just what we call post-birth control syndrome.

But also something called hypothalamic amenorrhea, which a lot of women that kind of the opposite picture of PCOS may present as which is thinner and still have some overlapping symptoms, things like the thinning hair, even things like acne and things like that too. But ultimately you're kind of on the opposite end of the spectrum in terms of the estrogen production there.

So that ended up being where my symptoms were mostly falling into there, but there's, there can be overlap.

Melody06:33

Yeah, that and that same thing happened to me. After my first child, I nurse Kenley for 14, well, 13 months. And then I did not have another cycle for like another eight, nine months. And I was like, okay, my hormones should be back.

You know, a lot of women cycle again, and three months into, after, during still nursing. So the fact that eight months after I was finished with that, I was still not cycling. You know, it took some investigation and my hormones were also in the tank. I didn't have any estrogen or progesterone. So sometimes I think there can even be an overlap between those two syndromes, as far as what's going on and stress certainly can play a role in that hypothalamic, low production, basically the brain signaling the hormone production from happening stress really impacts that.

So lots of things to dig into and Lauren mentioned the Dutch test. So the Dutch test, if you're not familiar with the Dutch test is a dried urine test that we can use, and it doesn't directly measure the hormones because when the hormones come out into the urine, they're in the metabolite form, but then metabolites have been well studied to correlate with the blood levels.

And so we can use them as a marker to estimate our blood levels. But the cool thing about the metabolites that, you know, we'll talk about probably in more detail and other podcast, is that it shows us how the estrogen is getting out of the body and how the testosterone preferences.

Cause there's different ways that the testosterone can go is it's broken down in some are actually more androgenic and more likely to cause this acne and this hair growth and things like that. So it helps us from a functional medicine standpoint, find out your individual break down of hormones, what you need help with and what part of that hormone cascade really needs support.

And some people, their hormones are so low that we can't really do much with the excretion piece because the hormone was so low to begin with. It's hard to say if you're too high, too low, but a lot of people have genetic polymorphisms that affect liver enzymes that are essential for metabolizing hormones.

And so it really speaks to the whole functional medicine thing that we're going to actually look at you as an individual and what your situation is instead of just assuming the everyone's metabolizing these hormones the same. So, so the Dutch test is really cool. And when we could probably do a whole podcast, just talking about the Dutch test.

Megan, do you want to move into sort of the lab monitoring that we use for PCOS?

Megan08:47

Sure. you know, some of those labs and the ladies mentioned before, high androgens can be measured specifically like high testosterone. You may have elevated insulin level and that goes into this whole insulin resistance piece that we'll get into in just a little while.

But that is very, tightly correlated with PCOS. You can have an abnormal lipid profile. Also high blood pressure, elevated DHA levels, decreased steroid hormone, binding globulin. And then we can look at the LH and FSH and there can be an elevated ratio. So you'd have elevated LH, and decreased FSH.

So just a few different labs and other tests that we can kind of look at to try to piece together the PCOS picture. Like both women said this is a syndrome. And so there's a wide variety, of what people look like, you know, presenting symptoms and signs. So, yeah, you kind of had to exclude certain things and look at so many different things to, to get this PCOS it's not a diagnosis, but,

Melody09:57

But it is technically a diagnosis of that syndrome, you know, that you have these collective, two of those three things, it's an ICD 10 code.

But, multiple factors and multiple layers. It's not just like this one thing, like you've got this virus, you know, it's this compounded multi-layer piece. And that's really what we're going to talk about next is that complex relationship to obesity, insulin resistance and type two diabetes.

It's funny, these estimates of 30 to 70% of females in some studies, which is like, that's a wide range, but it depends on the study and who they're looking at and what they found. But basically obesity is found to be one of the most prevalent disorders that complicates the condition of PCOS.

And so PCOS women often have the cyclical pattern of the hypersecretion of androgens that we talked about, but basically they also favor depositing abdominal fat, which triggers the adrenals and ovaries to produce excess estrogen. So we have sort of this compounded issue.

So I've been putting together a presentation for pharmacist about diabetes this weekend. And so much of the inflammation that starts the process of type two diabetes is related to what's going on at the cellular level. And so PCOS is also considered to be an inflammatory state. So this expression of what we call inflammation, producing cytokines is also elevated in PCOS patients.

And, really there's more of those pro-inflammatory cytokines. Then there are anti-inflammatory cytokines, which may be why there's disruption to the ovarian release of the egg and altered steroid production and really impairment of that follicule maturing which would allow it to be mature and ready for fertilization and implantation.

So interesting when we're looking at inflammation, there's also studies to show that CRP, which CRP is a very general inflammatory marker. It doesn't link to any one specific inflammatory condition. It's more that overall there's some kind of inflammation going on.

But that has been found to be high and many PCOS patients as well, both obese patients and non obese patients. We know that patients with higher CRP have more risk of cardiovascular disease because of that inflammation. It's really gets back to this whole inflammatory metabolic process.

And so that leads us into the whole concept of insulin. And we have the hallmark characteristics, like we talked about, but insulin resistance is one of those hallmark characteristics. And because your cells then are not responding to the insulin, your body tries to make more insulin.

And so that's why we see that high fasting insulin level. And this high insulin and ovaries stimulates the ovaries to produce androgens like the testosterone and reduces those sex hormone binding globulins, which creates more high testosterone. And so it just becomes this vicious cycle and we get more high insulin, more high androgens.

But people can have insulin resistance and be normal weight. And so there's a lots of causes for insulin resistance. There's gut dysbiosis is actually starting to be talked about more and more. There's a paper by a well-known endocrinologist, Schulz that talks about these 11 mechanisms that happen with type two diabetes and in the development of type two diabetes.

And the gut microbiome is actually one of them. There's so much evidence mounting about basically this leaky gut that we talk about a lot can allow for more inflammation, more of those cytokines and also even damage to the pancreas, which produces the insulin, but also damage in the liver area where, where the insulin has to bind and sort of regulate the glucose.

So, so we've got a lot of things that get out of whack when we have insulin resistance. And that's really where we need to start with PCOS patients. When we get this diagnosis, we have to start to figure out are they insulin resistant? How do we help them to use their insulin better? And so that's where we're going to talk about today.

And I know Megan's going to talk about these endocrine disrupting chemicals. First, how do we address PCOS from a functional medicine standpoint.

Megan13:45

Okay. So we've talked about endocrine disrupting chemicals on a few of our other podcasts, and I think we're going to dedicate a whole podcast to these chemicals because more and more research comes out all the time about how detrimental they are to human health.

Basically EDCs, endocrine disrupting chemicals are chemicals found throughout the environment, the air, water, and food. That we eat, but also personal care products and cleaning products in our homes and they're everywhere. And they interfere with the production and secretion and metabolism of our own hormones that our body makes.

And our body loves to be imbalanced homeostasis. And so when we have these chemicals from outside messing with our own hormones inside, it just, it creates havoc. So some of these endocrine-disrupting chemicals, specifically they've done studies in women with PCOS. BPA is a big one. I know that's gotten a lot of attention over the years.

It's you might see in like canned foods that say non BPA lined. So it's in like those can liners it's in plastics and the plastic water bottles, all that kind of stuff. And they're doing a lot, I say a lot, it's relative, but to kind of get rid of this chemical, but then there's this whole thing of like, well now what are they replacing BPA with?

Anyway, they've done studies in women with PCOS were found to have significantly higher levels of BPA than the controls. What's hard is these chemicals are everywhere. We can't totally not come in contact with them. That's impossible in today's world, but there's a lot we can do to minimize our exposures and even just helping our body and our detox pathways, keeping those open, you know, trying to get these chemicals out of our body.

There's a lot we can do but what's funny Melody was talking about insulin resistance and inflammation and the gut microbiome. Well, these chemicals, they all play into each other, right. They can alter our gut microbiome, creating the leaky gut and then that leads to inflammation.

And so it all connects. I think Melody said earlier this vicious cycle, and so women, you know, all humans really, we need to be aware of these endocrine disrupting chemicals and do things that limit our exposures, but especially women with PCOS or some of these just hormone related conditions.

Really trying to be cognizant of where they are and limit exposures. That's a really key piece to the whole puzzle.

Melody16:23

For sure. And I think that's crazy that chemicals they are exposed to in the water or pesticides and things or doing things to your gut bacteria, but they're basically disrupting the integrity of that barrier, which is our immune system.

When we think about it 70% of our immune system is our gut and it's holding together those junctions. And when we start to disrupt that, that's when we start to get these and the bacteria start to change and we get this endotoxins. So endotoxins are byproducts of gram negative bacteria.

And so those start to release into the system and cause the damage and the inflammatory process starts. So it's crazy that not only antibiotics can alter the microbiome, but we've got other things that we have to think about. So some of my favorite ways to address this, obviously there's looking at your personal care products, finding the clean ones.

And so we could talk about all those different things all day, but also filtering your water. So a lot of people don't filter their water, they drink out of plastic bottles. And if you think about plastic if we're buying it from the store, I think I saw an article that there was over like 300 chemicals in a bottle of plastic water that you buy in your case at the store.

So, definitely trying to when you can drink from stainless steel or some kind of BPA free, hard plastic that's less likely to leach into your water. And then there's a little bit of debate about, we use reverse osmosis to filter because it takes out everything it takes out, drugs, and all these different chemicals and things like that, and just purifies the water completely.

But it also removes your salts and some of those electrolytes. So some people say that you need to add electrolytes back to your drinking water. But then other people say we get enough electrolytes and the other foods and things that you're eating throughout the day. So it really depends on your needs, but there's also other things like the Berkey and some other things that also will do this.

But you also want to make sure whatever you're doing, that you're filtering the fluoride out as well, because we talked about how these chemicals can disrupt and that could be probably a whole nother podcast, but we mentioned on the thyroid podcast that fluoride can be mistaken for the iodine in that process and can disrupt the thyroid hormones.

So, so definitely want to make sure you're drinking clean water. If anything, like if that's the first place you start. Water is so crucial to our bodies and you know what we're doing each day that we want to start there, but other things you can do certainly like we talked about in, in pesticides, trying to eat as organic.

As you can. The challenge being that organic produce also has some pesticides used in it. That's different and improved, but it's hopefully safer. But we do know a lot about the organophosphates that are used and the typical crops and those do cause insulin resistance. And so as much as we can stay away from those dirty dozen the better.

So you have to do what works for your family and what works for your budget, but definitely considering those dirty dozen and trying to at least choose organic. And those are in the summer. If you're in a place where you can grow it or if maybe you're lucky and you're listening to this from a warm climate that you can grow year round, although our Floridians, this is we're recording this in the last part of January and they've got iguanas is falling from the trees because it's in the thirties in Florida.

So they might not be growing things outside right now, either. So just think about what you can do to lessen that burden. And like Megan talked about, we can certainly work on our detox pathways and help our body to get rid of those too faster, which will help you know, have them have less influence over, what their havoc that they're wreaking in our bodies.

Megan19:41

Melody I'll just say one more thing. If you don't mind. I just saw this like yesterday and it really, hit home with me when talking about this whole endocrine disrupting chemicals and going toxin free and it's whole lifestyle. It can be very overwhelming. I will just say personally, I have my own health journey and when I got really sick and this was seven and a half years ago at this point. And I started learning about these toxic chemicals and honestly it kind of freaked me out. I had never thought about what was in my shampoo and my toothpaste and all that. And I got very overwhelmed. I wanted to go live in the middle of nowhere and live off the land.

Right? Like it really freaked me out and I thought I needed to get all new makeup and cleaning products and a new mattress, like so much stuff that you can do, which is great people are learning about this and demanding cleaner, better, safer products, but it can be overwhelming.

And I think there's just the spectrum, right? So you don't have to go all the way and you don't need to feel bad if you can't afford or do all of these things. Right. Baby steps, little things can make a big difference. So, like Melody said, if the one thing that you can do, if, you know, you're, if you have access to getting clean water that's a great first step.

Don't feel like, you have go build this crazy toxic free house and it's overwhelming. And I think a lot of us in this space talk about, I certainly do, you know, I think it's a big deal. We need to be talking about it more, but it can also be overwhelming. And you don't want to feel bad for not being able to do something or afford something.

So I think just spreading the information and then letting you decide what you can and can't do them. What's important, that's a big step.

Melody21:26

Yeah. Sometimes it gets overwhelming because you can't unknow this information. And then you're starting to like dive down into all these specifics, like, oh, I got to find this car seat that doesn't have brominated flame retardants, for my kids.

And there's only a few options on the market and which one's gonna fit in my car. And then it just goes and spirals into this stress, which is also wreaking havoc on your body and your hormones. So you can't be super stressed about it in the process. Really I think the statement, you know, the endocrine disrupting nature of these products is seriously underrepresented.

We have information and we just don't know the true extent to this. You know, I always say that we know agent orange in Vietnam caused severe insulin resistance in our veterans. And that is well-documented. We have veterans at the VA all the time, getting their diabetes treatment for that, but like all these other chemicals, like the, with the factories and the farmers and all of these things, I get these people coming in and these are not necessarily women, but sometimes men coming in with like severe insulin resistance and they don't look like a patient with type two diabetes because they're not obese.

And I really think a lot of it comes down to these toxic exposures that are contributing to their insulin resistance. So, unfortunately we don't have large studies. We do start to see more and more information and hopefully it continues to grow, but I hope that someday we're going to have reason to outlaw a lot of these things.

I think there's enough evidence against glyco phosphate that we could, should probably not be allowed to be used, but it still is. And so we just have to work with what we can because we can't control that, and then not using it anymore.

So let's talk about what we can control.

So we know there's a lot out there influencing our body. We know genetics plays a role, although not a huge role in this. So I think that was about 10% of the cases might be related to genetic issues, but there's a lot of other life's bears that go into play. So. Diet wise. We're going to talk about diet and more specifics on how do you pick the diet that works for you and in a future podcast.

But really we know that a standard American diet, and we've probably said this before is full of lots of oils and lots of inflammatory oils, like canola oil and it comes from rap seed and we've got peanut oils and soy oils and things like that can become rancid quickly and they don't provide those anti-inflammatory, omega-3 fatty acids.

And so we need to incorporate more of those, but we also know that a lot of what our country goes to is quick. It's more saturated fat, although saturated fat is not necessarily the most terrible thing ever. There's some good sources of that. And in moderation, that's probably okay. But when we're looking at the whole picture, we eat a lot of that on it.

The scale is tipping to one side when it comes to that conversation. And so we really have to start putting in those anti-inflammatory foods, decreasing the sugar and the flours that are processed and focusing on those vegetables, fruits, nuts, seeds, healthy fats.

I was putting together this presentation for the pharmacist about diabetes and fatty liver. And it was amazing to me to see, you know, when we talk about like the effects. You know, we're trying to cure, you know, fatty liver and figure out why. And that's just to step back a little bit. Fatty liver is when insulin resistance gets really unchecked.

The liver starts to deposit. Those body starts to deposit fat in the liver and it becomes fatty. And then eventually can turn to five fibrosis and then eventually can turn a cancer. And so, how do we reverse that? Well, the answers, you know, as I'm starting to study this as need to have polyphenols, and we need to have these compounds and, oh, where, where are these compounds come from?

These come from nuts and seeds. And these come from fruits and colorful fruits and vegetables. So really a lot of what is happening in our diet and in our country is that we're not getting fed this rainbow of nutrients that our body really needs to process. I don't know if you guys have any other thoughts about the diet piece.

I know carb wise, we're eating a lot of carbs as well, in general.

Lauren25:05

Yeah. I mean, definitely just aiming for a whole foods diet that isn't so processed, focusing on protein sources, grass fed meats, wild caught seafood, those types of things that aren't give you a good balance of protein and fat. And then making sure of course, to really load up on all the vegetables, especially cruciferous vegetables, things that are going to support your detox pathways.

Since we know that if you're having all of this excess estrogen, you have to be able to process all of that through your liver as well. So, loving on your liver with those types of foods like broccoli and, kale and cauliflower, all the different herbs you can cook with as well. Brussels sprouts. Yes.

Broccoli sprouts too. Um, all those things are going to really help to support your liver and your detox processes. And like we said, the healthy fats, as opposed to the unhealthy fats that we find in so much of our food. So things like avocado and olive oil, would be good sources of that as well as nuts and seeds to those also can be great to add in.

Melody26:09

Yeah. And I think a good thing to talk about too, is Neutrogenomix. Nutrogenomix is like the study of your specific genetic code and how your diet, or how your body metabolizes certain foods. And if you need more high fat, or low fat. So if you really want to dive into like, what is the best diet for me, that's a great place to start is doing a test, and we can do that at PharmToTable, or there's lots of different things out there, but it can sort of give you an idea, like, well, maybe my genetics, I shouldn't have X amount of fat. Maybe my fat should be lower or maybe I do a really good job metabolizing fat and I need more protein or something in my diet for this reason.

So there's been a lot of snips, we call them or changes in genetics throughout the years. And so that can be a great place to sort of figure out what is the optimal diet for you. But certainly like everything we've talked about, you know, putting those anti-inflammatory things into your diet.

The more fruits and vegetables, you can have the better every meal we should be having them. I'm talking about this with my kids all the time. It's like, okay, what's your vegetable? What's your protein? They're always like, does this have protein? I'm like, no, does this have protein, no, let's find something that has protein because we need to balance the blood sugar.

And that's a part of this too. There's anti-inflammatory nutrients help to balance the blood sugar, the microbiome feeding piece of the those vegetables help two things to flush out and the detox, you know, so much of our detox occurs in our stool as well. And our GI systems.

We got to get things moving to make sure we're not relating these hormones which can happen in the case of constipation and, and slow bowel movements. So exercise is another important piece of this, and I know this is one that is really hard for a lot of people because the days, you know, you're taking care of your family, you're going to work.

You're driving a distance or doing the after-school carpool, there's lots of things going on. And sometimes we don't prioritize the exercise piece and some people, you know, doing it before work just isn't passable because of the time that they have to go in or they don't feel awake enough or strong enough in the morning.

So you have to figure out what works for you. It doesn't have to be every single day, seven days a week, certainly a lot of the general health guidelines recommend 30 minutes, five days a week. But that doesn't have to be hardcore 30 minutes, five days a week. You can find a balance.

I will say that in this PCOS population, we do have to emphasize resistance training. Because we have to allow our muscles to be able to work with that insulin. And so the more muscle we have the better that insulin is going to respond. And so I always talk to my patients with diabetes about that.

I talk to them, you know, it's great that you're going to walk. I love they're going on a walk, but I need you to do some squats in the process. It doesn't mean that you have to go be a CrossFit athlete to be able to do resistance training. You can use your own body weight, but we need to use those large muscle groups like our quads and do some squats do some lunges and do pushups or whatever that is, but we need to be building those muscles to be able to allow the insulin to work properly. So that will help decrease insulin resistance for sure. But cardio is important to you. It just, it has to be a balance.

So I think I've learned that in my own journey I sometimes would just, okay. My exercise of my favorite exercises on the spin bike. I get my heart rate up but that doesn't build my muscle as much as doing squats and some of these other activities. So I started to do muscle builds fat workout and I like barely could walk for like a week.

And then I was like, okay, I'm really out of shape. I need to do this more often. So you find what works for you. I mean, there's also great bar type exercises that you're doing slower, lower impact moves that are still building that muscle and doing the resistance training with your own body weight.

So there's lots of online things. There's lots of studios that are specializing in those things, but just find a way to move. And I know sometimes we get to this point where we're like, okay, you just have to move whatever you do to move. But sometimes when it comes to people that are already insulin resistant, I'm like, okay, you have to do more than move.

You have to get to the resistance training piece to really to make this work. So any other thoughts about the exercise or how you guys fit those resistance training things into your schedule.

Lauren29:59

Yeah. I mean, I think you nailed it. Like definitely adding in things like squats. If you're already doing a type of activity that you enjoy, like walking, which is great, and we're always going to encourage, um, but figuring out ways to just add in body weight movements, if it's a couple of pushups or a couple sit-ups or those types of things, even if it's something as simple as getting the resistance bands that you can keep in your house and just doing a couple of those while you're watching TV, things that you can kind of multitask to fit in that exercise. Another note too is I always like to think about exercise as also something, it can have multiple benefits.

I like to do yoga as well. And yoga can absolutely be a form of strength training for some people, if you are really out of touch with working out then sometimes yoga might even be enough that a couple of downward dogs and things like that is going to help you start to build that muscle back up as well and give you the benefit of the stress reduction, because we've talked about how that is such an important piece. And certainly when you are dealing with hormones, you don't want to kind of go the other way and create more stress by trying to work out or create more stress by freaking out over too many chemicals in your house. So it's always a balance. And if you can find a way to have multiple benefits from something you're going to do, then I think that's always a win win.

Melody31:28

Yeah, the sweat piece too also helps in the detoxification process when you get sweating. And if maybe your movement is limited due to an injury or something like that, saunas can be a great way to start sweating as well. And get that process happening. And if you are limited by an injury, definitely working with a physical therapist can be great because they can help you figure out exercises that you can do in the process.

And a lot of times, if you do have an injury, PT can be covered by insurance as well. So you can work with somebody that specializes in that, or even a personal trainer.

Awesome. We talked a lot about the lifestyle piece already, as far as reducing the toxic burden, alcohol intake is also something to consider to limit.

There's data that suggests alcohol intake can increase risk of breast cancer, and it also limits the detoxification process. So if also affects your sleep, if you're drinking alcohol in the evening, which can affect your cortisol. So there's lots of different pieces. I know a lot of people are like, well, my wine it's great.

It's antioxidants. Well, that's true. But you can also have a glass of pomegranate juice. If you don't have insulin resistance and still get a boatload of anti-oxidants or eat some blueberries or things like that. Don't use that as your excuse. It's certainly okay and part of life and has been part of life for centuries and, you know, Mediterranean diet certainly includes that, but we do want to make sure that it's in moderation to support these detox pathways.

I think the thing we have haven't talked about yet is the positive supportive relationships and helping that create balance in your life. And so a lot of people I find that are really in the stress mode sometimes are people that just aren't well put into community.

My faith journey, I believe that we're designed to be in community with people and we're supposed to be doing life alongside one another. And so that helps to reduce your stress when you have those people to listen to you and the people to help you out sometimes and you help them out sometimes. Being in isolation really increases stress.

And we've seen that in this process of the pandemic and we've seen people have more mental health concerns and things like that. Also when they're not in those supportive positive relationships with others. So we talked about the sleep and then vitamin D is another thing to think about with insulin resistance.

There's a lot of connections correlations between low vitamin D levels and insulin resistance. And so we want to get that from the sunshine and nature as much as possible, but if you're in the Northern half of the United States or probably even the whole United States and indoor working and, you know, not outside enough, we're putting on sunscreen when we go outside.

Oftentimes we don't get enough vitamin D so we may need to supplement and we're going to have some blog posts up about that soon. So stress management, we talked a little bit about stress and cortisol, but we know that PCOS women have exaggerated, sympathetic nervous system that fight or flight response and that regular work to help lower that sympathetic response can be important.

So we talked about yoga already. We talked about meditation in previous podcasts, but even things like acupuncture can be great. So there is an acupuncturist locally here that his specialty is like helping women like regulate their cycles and things. And so that can be a huge piece. And it's crazy to think that you can like walk into this room and just lay there and have these needles like put on you and I've done it several times.

I did it as part of my journey to getting my cycle back after my first child and that really does help regulate. And so sometimes there's studies that look at like sham acupuncture versus actual acupuncture because sham acupuncture, they don't put the needles in the exact places, but you still get that I'm in a room by myself and I can breathe and relax component.

So we still see that the acupuncture therapy normally wins there and especially in this particular situation. So definitely consider what modality is going to work best for you and, and addressing the stress. And sometimes supplements can be used to address this stress. We're not saying that you should never use supplements, but definitely trying some of these lifestyle pieces first can be helpful because the stressors aren't going away.

And I think that's the thing. People are like, well, I'm always going to be stressed because I'm always have these kids to take care of her. I always have this parent situation that. You know, caretaker for, and so figuring out what works for you. And if in the moment, you know, you can't do these things, then maybe some kind of supplement is the best, or maybe you need both.

That leads us into the supplement conversation. And does somebody want to talk about magnesium as a first, since that's related to stress and.

Lauren35:38

Yeah, I think magnesium is probably one of our most loved supplements just because it is used in so many different reactions in the body, I think over like 300 different reactions.

So it's really important. And so many