Latest / Motherhood Alliance Podcast / Overcoming PCOS, Endometriosis & “Unexplained” Infertility w/ Dr. Alyssa McPeak
Transcript
- Andrea Renkas: Hey everybody, welcome back to the Motherhood Alliance podcast. We are back here with Dr. Alyssa. Welcome back. We're glad to have you here. Dr. Alyssa McPeak: Thank you. Glad to be here. Andrea Renkas: yeah, absolutely. So we are, ⁓ into our second episode with you. ⁓ in the first episode, we talked all about finding your fertility ⁓ and, the work that you're doing, helping women with cycle syncing and just, keeping things really nice and ⁓ balanced, as you would say, ⁓ you guys haven't listened to take a listen. It was super informational, not just for people. Britney Suttner: Hey everyone, we are Britt Andrea from motherhoodalliance.com and we are excited to welcome you to a four episode series with Dr. Alyssa McPeak, a doctor of chiropractic and a certified functional medicine practitioner who blends the best of both worlds as a functional medicine chiropractor. Through her practice Roots Holistic Health, she specializes in pregnancy, pediatrics, women's health, hormones, and fertility. Her passion for this work is deeply personal after struggling with her own hormone imbalances and endometriosis diagnosis. Andrea Renkas: looking into their fertility, but you know, for people like me and Britt who are way past the point of wanting to be fertile, we just want to have, you know, great periods and at work, right? ⁓ In episode, we're going to kind of continue our conversation and we're going to talking deeper into like PCOS, endometriosis. Britney Suttner: Dr. Alyssa experienced firsthand how powerful it is to dig deeper and truly understand what's going on in the body. And that journey completely transformed the way she practices today. Now she's dedicated to helping women feel heard, find real answers and reconnect with themselves while also supporting children through proactive wellness focused care. Outside the office, you'll find her soaking up time with her husband and her four kids, whether that's on the water, in the woods, or at the hockey rink. We're excited to introduce you to her now. Andrea Renkas: and just other kinds of infertility kinds of issues that people experience because a lot of women do. And I think you said, is it 52 % of women can deal with infertility issues, And so I think it's important that we have this conversation. As we get into this, guess, I think a big question would be when someone comes to for these kinds of issues, What does that visit look like? What kind of testing do you do? What can they expect when they come to somebody like who knows this, this kind of stuff? Dr. Alyssa McPeak: Absolutely. I spend time with my patients. ⁓ for that first initial meeting, call it a consultation. We are sitting down for an hour ⁓ and about ⁓ their I love to hear women's ⁓ stories. it's really hearing them and listening them. Because I think that's something that doesn't always happen. ⁓ in Western medicine and get me wrong, I love my medical docs that I work with. I wanna give a quick shout out to Dr. Amos and Dr. Mandeville, they're godsons when it comes to working with ⁓ and their hormones ⁓ they can do things I can't do. They can do imaging, they can do conventional to just rule out those big that could be causing issues as well. ⁓ When I'm working with a patient though, when it comes to functional medicine, it's really sitting down and talking to them, seeing them, hearing them, looking at their skin, hair, their nails, their tongue, and figuring what they're looking That's my goal because everyone I work with, they have different needs and a different lifestyle. with a mom that has eight kids. is gonna be very different than working with a mom that has two kids and working with a mom that works from home or working with a mom that's a stay at home, right? Like everyone's lifestyle is very different and it's really meeting my patient where they're at and figuring out what's going to support them best. That's what that initial consultation is about. It's also looking at what kind of testing is going to give me the answers that are going to help serve them best. I tell my patients, I am your GPS, you are the driver. I am just guiding you and giving you options and really, you know, giving you ABC. These are our routes, which one you want to take. And again, I love bringing in other doctors, whether it's their endocrinologist or whether it's their neurologist to really provide that integrative care for them, because when they have more people on their team, they're getting more answers. So that's what that initial consultation looks like. is spending time with somebody to really figure out and hear what they're dealing with and figuring out what's gonna serve them best in their healing journey. Andrea Renkas: That's awesome. That's amazing. I love that you listen and that's what women need is they need somebody to actually just listen to them, listen to their story. And I think that's just part of the healing process, honestly, ⁓ to know that that's there. I you obviously help women with the fertility issues that they may have. And a lot of that might just actually come from things like PCOS or endometriosis. Can we talk about a bit more about these kinds of issues, specifically PCOS? And I understand there's actually four types, which I didn't know this before. So I'm interested to hear more about this. Dr. Alyssa McPeak: Absolutely. When it comes to hormone struggles, I think we are given a lot of band-aid care, whether that's Tylenol, Midol, birth control, a hysterectomy, right? Those things fix symptoms. They don't fix problems. And there for a reason, absolutely. And I never tell a woman, not to do something that their doctor is recommending. But I always say, here, let's look at some other options. And PCOS, I see so many women with PCOS that it's becoming a main topic that I'm talking about and information on. I was with endometriosis. So ⁓ I ⁓ that the struggles that that entails. But when I'm working in practice, I would say, ⁓ 80 % of my patients that are dealing with hormone struggles have some form of PCOS. And PCOS and endometriosis are very different. And I've had women come in saying, I have PCOS and endometriosis. And I kind of look at them like, it's really not possible. But I don't think they're doing the correct testing to figure out what is going on. And they're being labeled based on their symptoms. PCOS, it's actually a syndrome. It's not a diagnosis ⁓ So it's polycystic ovarian ⁓ syndrome. And ⁓ there different quantifying factors that woman to to be labeled. I call it labeled because again, it's a syndrome. It's symptoms that you're dealing with. And a couple of those things are insulin resistance, um, pearl-like cysts on their ovaries. Whereas with endometriosis, if you're doing imaging of your ovaries, cysts from endometriosis are going to be larger and these are going to be extremely painful. And you can feel that like if somebody has felt a cyst burst, it is painful. It's equivalent to what it would feel like if your appendix burst. And these are big cysts that are growing because endometriosis is a high level of estrogen in the body and estrogen grows things. It grows breast tissue, it grows endometrial tissue, which is the inside of your uterus that you shed. So you're going to have heavier periods. grows fibroids and it grows cysts on your ovaries. PCOS cysts are going to be tiny because it means that your body got a follicle ready for ovulation, but the egg never got the message to leave the ovary. So it creates this little cyst, this little pocket where it never left. And that's why we're seeing a lot of anovulation, meaning you're not ovulating in PCOS because you don't have the hormones, which is usually estrogen, to tell the ovary to release that egg. And this is where endometriosis and PCOS are so different because endometriosis usually have high levels of estrogen. PCOS, you're not making. estrogen and it's suppressing, thins are suppressing estrogen so you're not ovulating. So you'll see these pearl like pearl like a pearl necklace like cysts on your ovaries on ultrasound. You can see that with an ultrasound. And symptom PCOS is high androgens, ⁓ are testosterone DHEAS. ⁓ And these are usually symptoms of adrenal PCOS and I'm going talk about the four types. the four types of PCOS that address are adrenal PCOS, insulin resistance PCOS, inflammatory and post-pill PCOS. So adrenal PCOS and again doing deeper levels of testing is what will really identify the cause. of your PCOS and that's all these types are. It's figuring out what's causing your PCOS symptoms. Do want me to dive deeper into the types? Andrea Renkas: Sure. Dr. Alyssa McPeak: Okay, so adrenal PCOS really testing what the adrenal glands are doing. And we can see this with high levels of cortisol, which we test with saliva, salivary cortisol, which tests unbound cortisol, and blood testing, which would test bound cortisol. And these are treated differently in the body and affect your body in different ways. Cortisol is a stress hormone and it's produced by your adrenal glands. We're also testing DHEAS, which is produced by your adrenal glands, DHEAS makes testosterone. So if you have high levels of cortisol and high levels of DHEAS, you're going to raise that testosterone level. And that's when we see that suppressing ovulation because you have very high levels of testosterone, which are a male hormone. Women will often see facial hair. they will see irritability, more anger, more rage. A lot of times this can affect their libido because they literally are feeling like a man. have those high testosterone levels and makes have more male attributes. Now with... insulin resistant PCOS. We're looking at blood sugar levels. We're looking at glucose. We're looking at A1C and we're looking at insulin and you have to test all three. You can't just test one because I have had women come in that had normal glucose levels but their insulin was through the roof. comes down to a lot of food issues and dealing with diet and looking at what they're eating, when they're eating it. and how often they're eating it. And I tied this back to cycle syncing and really want to eat certain foods during your cycle to promote certain hormone production. With insulin resistant PCOS, this is where a lot of women with PCOS are put on metformin, which is a medication for blood sugar levels. And this is where this can help. But a woman that's put on metformin and they're still not ovulating, they don't have insulin resistant PCOS. They have another issue. And that's where you do deeper levels of testing to figure out what's causing their non-ovulation, their anovulation. PCOS is going to be more gut issues. This is going to be food sensitivities. This is going to be immune dysfunction. This is going to be bacterial dysfunction and gut dysbiosis. So this is really looking at gut function and why you have more inflammation. Other conventional tests for this would be CRP. ⁓ C-reactive protein and looking at even white blood cell production because these could be elevated if you have inflammatory PCOS. The last one is post-poll. So this is if you've been on birth control for any period of time. Birth control depletes nutrients. So if you have been on birth control, your body is depleted of nutrients. I speak to this because I was on birth control for 10 years. My body was so depleted in nutrients. Now, nutrient depletion can also come from inflammatory PCOS if the gut is inflamed and you're dealing with inflammatory bowel issues or leaky gut. But post-pill, we're really looking at replenishing nutrients and addressing nutrient absorption. Britney: I'm guessing people can have more than one of these, right? So when they're coming in and they're seeing you and you're doing, you're running some lab tests, those tests will tell you which one, two, three, or four of the four they're experiencing. Dr. Alyssa McPeak: Yes, and it's really, you know, I'd like to prioritize because we do supplementation, but I think you can really overdo supplements when a woman comes in and she's on 10 supplements. It's too much. It's, it's really about prioritizing and figuring out, you know, what is the main driver here. And then, I do three month protocols with functional medicine. So it's really ⁓ you let's try this. That's why they call it practice. It's a medical practice because you're literally trying to figure out what's going to work best for this patient. And I always, address the big things first. And a of times that is what your gut is doing and what your liver is doing and the communication in your body through your nervous system. Britney: Wow. Well, let's shift a little bit back to endometriosis. Are different types of endometriosis or causes like there was with PCOS or what are the common causes of endometriosis? What makes you have high estrogen? Dr. Alyssa McPeak: Yeah, great question. And endometriosis is divided into types or stages. So you can have different levels of endometriosis. So I think it four levels of endometriosis, depending on the severity of So what causes estrogen to be produced is either inside your body. So we call this endogenous estrogen or outside of your body, which we call this exogenous estrogen. that's being produced in high levels in your body can come from birth control. If you're taking birth control or had taken birth control ⁓ was estrogen dominant, which most are, this can come from your mom. If your mom had taken birth control or if your ⁓ dealt with high estrogen levels. This can be passed on to you in utero. Your mom builds your ovaries. So that can be something that has a genetic factor. But I always say with genetics, genetics load the gun. environment pulls the trigger. So you might have these underlying issues, but what you're doing in your daily life is what's gonna really allow them to show. And with endometriosis, you know, from my experience personally, it was a combination of things coming from genetics from my mom. And again, no mom guilt here, you guys. It's really testing those levels and there are easy ways to detox estrogen. And then again, looking at liver function, because your liver is what metabolizes estrogen. You want to make sure that you're metabolizing it appropriately, because there are better forms of estrogen. and not so good forms of estrogen that can affect you in negative ways. I like testing estrogen. So I test three forms of estrogen. There are nine forms of estrogen, but I test three. I test estradiol, which is your main form of estrogen that you make. And the most potent form is what you feel the most. Estrone, which is menopause estrogen. So this is converted. Estradiol a lot of times will be converted into estrone. And I call this your backup generator. This is when you're getting into later phases in life. You're not making enough estradiol, so your body will convert or make estrone instead. And then estriol. Estriol is a weak form of estrogen, a light form. You make this when you're pregnant. I call it estrogen light because if you are pregnant with a baby boy and you're producing the most potent form of estrogen, which is estradiol, you can flood your baby boy with that estrogen. And when you give a boy estrogen, he feels like a girl. Now you're throwing off his hormone balance. So body is smart, right? It does these things. And that's why I like to test these levels to see if a woman's body is making the correct form of estrogen or if she's not, why. Estrogen from the outside, I didn't touch base on that, but estrogen from the outside is gonna come from xenoestrogens. that's spelled with an X. These estrogens are toxic. So this is your plastics, ⁓ fragrances, from phthalates. These ⁓ affect you because they look and act like estrogen and they take the place of estrogen receptors. So then the estrogen that you're making doesn't actually bind and then is in the body and then stored in fat cells. Britney: mentioned that it's fairly easy to detox ⁓ estrogen. us obviously with endometriosis, someone's is going to be too high. You're finding out the type that they're making. That's all valuable information. Now is the next step to ⁓ kind of get rid some of it? Dr. Alyssa McPeak: That really depends on where somebody's levels are. For example, if they have a lot of exogenous estrogen, we will see that show up in liver testing. And we'll also see that in a protein that is made by the liver called sex hormone binding globulin. So it binds to sex hormones and it helps control them. So if that sex hormone binding globulin is really high, ⁓ but your estrogen levels that you're making are very low. This is a sign that you're getting estrogen from your environment. And in the fertile plant, I talk about that as the second step if E is for endocrine disruptors. These are endocrine disruptors that are gonna throw off your estrogen levels and your ability to get pregnant or your ability to ovulate. And this can make you grow more tissue, right? This can cause endometrial tissue growing in places it shouldn't. because you're getting outside estrogen. So, and these are simple things like get rid of the plastic Tupperware, get rid of plastic water bottles, get rid of the plastics in your environment and do stainless steel, do glass, you know, do things that are better for the environment and better for your hormones. A lot of things I see with women, it's the products they're using. So a lot of products contain fragrance that are endocrine disruptors that have phthalates and these can disrupt that estrogen cycle. So it depends where the estrogen is coming from. So it's coming from outside sources. I like doing a DIM supplement. So DIM stands for diindolylmethane. And this is what you find in broccoli and broccoli sprouts. Now you'd have to eat a lot of broccoli to get a potent form of it. But a DIM supplement is a great way to help your body metabolize estrogen appropriately. Another thing I look at is a liver detox. Now I don't do liver detoxes away because ⁓ can make somebody feel awful if they start dumping metabolites from their liver. So I'm very careful about detoxing. know detox is a trend right now. Everyone's detoxing. I people the best way to detox ⁓ is and pooping. So making sure you're sweating every day, making sure you're pooping every day. Those are the two ways your body ⁓ naturally detoxes. then definitely work with a healthcare provider when you're doing deeper levels of detox, whether it's a liver detox, estrogen detox, a parasite detox, you want to work with somebody that's supporting your function as well as getting rid of stuff. Because when you start mobilizing that stuff, you can feel really crappy. ⁓ But yeah, there's all different ways to do estrogen detoxes. It's looking at the pathways, what estrogen you're producing, ⁓ and where it's coming from. If you're making too much of it, that could be a brain-to-body communication issue, not just a production issue. So again, it's looking at that why. Why are you producing too much estrogen? Was it a genetic factor? Is it outside sources? Or is it your internal environment not functioning the way it should? Britney: Wow. ⁓ this is why I'm also like super excited about your find your fertility website, because I feel like you're just like dipping your toe into like the amount, like really we're staying, we're getting sciency, but we're also staying pretty high level. Like this stuff goes way deeper than even what you're covering right now, but kind of heading back into the fertility in general. So PCOS and endometriosis can be common reasons why somebody is struggling to get pregnant. Right. But there's also like, times that you just don't know. infertility. How conventional medicine approach that versus how do you approach that? Walk us through what you would do if somebody is not really checking boxes for PCOS or endometriosis but they're still having a hard time getting pregnant. Dr. Alyssa McPeak: Yeah, great question. I despise the label unexplained infertility and I despise it because somebody didn't look deep enough. Unexplained infertility means that we don't know why, right? And that then they just start throwing things at you. They start throwing hormones at you. I have so many women, I had a woman come in that was diagnosed with unexplained infertility. They've been trying for over a year and they were putting her on chlomid to force her to ovulate. She was ovulating. We did some tests, we looked deeper. She was making plenty of estrogen. It was outside sources of estrogen that were blocking those binding sites and estrogen was building up in other areas then. She was a emotionally. She was a, I call it the emotional roller coaster because she had all this estrogen that she was constantly exposed to. ⁓ another thing she was dealing with was ⁓ her sweat smelled terrible. And this is a sign that you are making so much estrogen and it's coming out through your pores literally. yeah, when it comes to unexplained infertility, and I never use the word infertility in my practice, I do not like that word because it has such a negative connotation. We just need to dig deeper. We need to figure out what's not functioning. what roadblocks there are in your system and why. Why you aren't ovulating or what's stopping you from ovulating or the inflammatory factor. Why do you have so much inflammation in your body and that could be stopping you from getting pregnant. ⁓ Yeah, I just, think that women need to know PCOS, endometriosis and unexplained infertility can all be reversed. I'm a walking billboard for that. I had a stage four, the worst you could have, endometriosis. I don't even know my period's coming anymore because I have addressed the issues that were causing the high estrogen levels and have detoxed it. And I'm working on it every day. ⁓ perfect. And this is something that I am cognizant of every day in what I eat, what I'm exposed to, ⁓ I'm putting on my body, what I'm breathing. the water I'm drinking, of these things play a part ⁓ hormone function. And I think it's also getting back to the basics of, you exposing yourself to natural sunlight every day? Are moving your body every day? Are you getting quality sleep every day? These are all huge factors in your body's ability to function. And I think in our world today, some of those things are just not being met. Britney: Yeah, I would agree. You know, one thing that does come to mind is when someone is trying to get pregnant, can, it can be stressful having month after month. I mean, even if it's only six months, I don't even want to say only because on that fourth time that you're looking at a negative pregnancy test, you're starting to get really discouraged and then worry. And then just, just, there's just so much emotional side of it. So how much does the stress. that you start feeling about not getting pregnant actually affect you and almost make your fertility journey worse? Like how much distress in your life affect your fertility journey? Dr. Alyssa McPeak: know, Britt, it's actually the number one thing I see affecting fertility. And that's why in my fertile plan, it's number six, right? It's L for less stress. Stress ⁓ that ⁓ every part of our body. And it comes to fertility, it's not just about ovulating. It's about how everything functions together. And if you're dealing with chronic stress, where your body has been in a stressful state, maybe since you were in high school, maybe there's been some childhood traumas that have affected you into your adulthood. These things will protect your body, right? Stress is a way to protect your body. Anxiety is an alarm system. It tells your body something is wrong. We need to protect ourselves. And one, stress is constant. Your body goes into protection mode and we call it fight or flight, right? body, your adrenal glands start to protect you. They shunt all of your blood flow to your arms and legs so that you can run away as fast as possible from danger. But it's not a lion, tiger or bear that's chasing us. It's our job, right? It's our kids. It's not getting pregnant. And I think looking at adrenal function is key to really ⁓ figuring out why you're not getting pregnant if you are exposed to stress every day. And I think we all are. We're not going to get rid of stress, but I think what we can really focus on is helping our body handle it better. And I like to use a lot of adaptogens. And adaptogens are herbs and plants and different things in our environment, foods. that can help your adrenal glands function better. And we can even go deeper and do glandular supports, which help rebuild the adrenal glands and help with that communication between your pituitary gland in your brain and the pathways of communication to your adrenal glands and ovaries. So stress is huge. And I don't think taking a vacation or a bath is always the answer, which I do recommend that to my patients is You know, we need self care in there. But I think a lot of women today, we put a lot of stress on ourselves, right? It's a lot of self stress as well. And I think it's taking that step back and really prioritizing in our life what's important looking at the people around us and building bigger boundaries, whether that's with family members, whether that's with our kids, our husbands, ⁓ work environment. I have told multiple women that have come in for fertility to quit their job. And it is amazing what happens when they let go of something that is literally heavy on their shoulders every day. I know, toxins are something that we find in our environment, but we also find them in people. getting rid of a toxic environment and toxic people in our lives and just creating stronger boundaries around that, whether it's your mother-in-law or sister. I don't ⁓ Everyone has a different story. And those are things that I ask about. There people in your life that are creating stress. Britney: Wow. Yeah, no, those are, those are excellent points and man, stress, stress is just everywhere. And so it's like this crazy cycle, right? Of trying to like decrease stress because it affects us physically, but then you're also stressed out because physically you're not getting the results you want. So I think everything you were saying is just very encouraging and very real. And I just love your approach. For those listening, I do want to mention that Dr. Alyssa is offering 20 % an initial chiropractic exam or functional medicine consult. So if this is something that you just want to just dive in and it's time for you to change something, something is off and you want to meet with Dr. Alyssa. She is offering that very gracious discount. Also, she just recently wrote a blog on the Motherhood Alliance website under her profile. It is called, What is functional fertility? A root cause approach to hormones, cycle syncing and getting pregnant naturally. So if you enjoyed the first episode of the series or this one, and you just want to just keep diving in, keep learning, you can head and check out that blog. We'll link to that in the show notes as well as her website for Roots Holistic Health, her brick and mortar, as well as her website for Find Your Fertility. There's a lot to check out, right? Like this is just the beginning of the journey. But we do have two more episodes with Dr. Alyssa. In our next episode, we're going to be talking about perinatal care. And then after that, in our fourth episode, we're going to be talking about perimenopause. So different ages and stages, but you know what? As women, all of these things matter and everything is always changing. And we're just thankful to have someone like you in our corner who can educate us along the way. So we'll be back with the next episode shortly.