Latest / The Driven Athlete / From Confusion To Control: A Dietitian’s Guide To PCOS, Training, And Everyday Choices | Ep 105

Transcript

From Confusion To Control: A Dietitian’s Guide To PCOS, Training, And Everyday Choices | Ep 105 · The Driven Athlete

0:00
SPEAKER_03: If you're a driven, active person who wants to reach and pursue a higher quality life with some ambition, then guess what?
0:06
SPEAKER_03: This podcast is for you.
0:08
SPEAKER_03: This is the Driven Athlete Podcast.
0:12
SPEAKER_03: Hi everyone.
0:13
SPEAKER_03: Welcome to the Driven Athlete Podcast.
0:14
SPEAKER_03: It is not your man, Dr.
0:16
SPEAKER_03: Kyle.
0:16
SPEAKER_03: It's your girl, Alex.
0:17
SPEAKER_03: And I serve ARC as its director of community outreach.
0:20
SPEAKER_03: And I am joined today by Dr.
0:21
SPEAKER_03: Gianna and the wonderful and the beautiful Miss Courtney Meinant.
0:26
SPEAKER_00: Hello.
0:27
SPEAKER_00: Hi.
0:29
SPEAKER_03: So we have a very special guest and a friend of athlete restoration.
0:33
SPEAKER_03: She and her husband were actually patients of ours.
0:36
SPEAKER_03: She is a Dalhousie University graduate where she received her bachelor's in Nova Scotia, Canada.
0:41
SPEAKER_03: It's a research university.
0:43
SPEAKER_03: Very, very cool.
0:44
SPEAKER_03: And she's a fellow Panther.
0:46
SPEAKER_03: You have to put our pause up if you go to FIU.
0:48
SPEAKER_03: Well, you know, pause up.
0:49
SPEAKER_03: But she got her master's degree from Florida International University.
0:52
SPEAKER_03: And she has served as an adjunct professor, clinical dietitian, nutritionist, and PCOS coach.
0:58
SPEAKER_03: So, Courtney, if you could please share a little bit about yourself that I didn't cover and um how ARC has gotten its way into your life.
1:06
SPEAKER_00: For sure.
1:06
SPEAKER_00: Well, first off, thank you for having me.
1:08
SPEAKER_00: It's so exciting to be here to talk all things PCOS.
1:12
SPEAKER_00: So I am a registered I am a registered dietitian and I have been practicing for about 15 years, um, so quite some time now.
1:22
SPEAKER_00: Um and I got into the space of PCOS because I myself have PCOS and polycystic ovary syndrome, and I've been living with that for almost two decades now.
1:34
SPEAKER_00: So I understand firsthand how nutrition can be really influential in the disease process.
1:40
SPEAKER_00: Um, and that led me to kind of specialize in PCOS.
1:44
SPEAKER_00: And the way that I got into the ARC family is that I love to run, have run my whole life in high school.
1:53
SPEAKER_00: I ran track cross-country and continued that into my 20s.
1:58
SPEAKER_00: And, you know, like every athlete knows, injuries happen.
2:03
SPEAKER_00: And I struggled with plantar fascitis, Achilles tendinitis, and you guys truly took the best care of me.
2:11
SPEAKER_00: And I am back to running many miles.
2:13
SPEAKER_00: I feel my best self.
2:15
SPEAKER_00: So amazing.
2:16
SPEAKER_00: Love it.
2:16
SPEAKER_00: That's great.
2:17
SPEAKER_03: And Dr.
2:18
SPEAKER_03: Gianna, introduce yourself for those that haven't watched my favorite podcast episode with her and Dr.
2:23
SPEAKER_03: Matt and Mrs.
2:24
SPEAKER_03: Volstad.
2:26
SPEAKER_02: Hi, I'm Dr.
2:27
SPEAKER_02: Gianna.
2:28
SPEAKER_02: Um, I'm a physical therapist here at Athlete Restoration uh company.
2:32
SPEAKER_02: I've been a PT for about two years.
2:36
SPEAKER_02: I am a New Jersey native, so born and raised in New Jersey.
2:40
SPEAKER_02: I went to school, um, my undergrad and graduate school at Quinnipiac University up in Connecticut.
2:46
SPEAKER_02: Go bobcats, not Panthers.
2:48
SPEAKER_02: Sorry, everyone.
2:49
SPEAKER_02: Um and then I moved down to Florida right after I graduated.
2:53
SPEAKER_02: So happy to be here.
2:55
SPEAKER_02: Um, my guess journey with PCOS as well.
2:58
SPEAKER_02: Um, I was diagnosed probably 10 years ago.
3:01
SPEAKER_02: Um, I know we chatted briefly outside, you know, just trying to find answers and what is PCOS?
3:07
SPEAKER_02: How do you treat it?
3:08
SPEAKER_02: How do you cure it?
3:09
SPEAKER_02: And what it like, what impact does it take on your life and um kind of all the ways to work around it.
3:15
SPEAKER_02: So excited to chat all chat about all that and learn um a lot from you today.
3:20
SPEAKER_03: So I'm very happy to have these two wonderful women next to me because everybody seated here has PCOS, and PCOS is not a monolith, it is essentially something that affects each and every woman differently, and everybody has different symptoms, they have different problems, they have different things that they can do well because of their PCOS.
3:39
SPEAKER_03: And um, I think today I really want to reframe it in a way that it's not so much so negative that it's something that you can use and it can kind of be a superpower for yourself.
3:49
SPEAKER_03: So, um, question for all of us, really, is why did you choose this career path into your life?
3:56
SPEAKER_00: So, dietetics and nutrition.
4:00
SPEAKER_00: So, my undergrad, like you mentioned, I did in Canada, and um it was I was on the pre-medicine track.
4:07
SPEAKER_00: So my whole life, I was like, I'm gonna be a doctor, this is it.
4:11
SPEAKER_00: And then I just happenstance took a nutrition elective, fell in love, saw that you can actually prevent disease with nutrition versus treating it from the lens of conventional medicine.
4:24
SPEAKER_00: So I started my master's before I even graduated with my bachelor's, and I was like, this is it.
4:30
SPEAKER_00: Um, and the rest was history.
4:32
SPEAKER_00: I've worked in inpatient acute care, I've worked in outpatient, I've worked in diabetes, um, the gamut.
4:40
SPEAKER_00: And I would say, like I said, PCOS is very near and dear to my heart because I struggled early on in my diagnosis, and it was around the time that I was in undergrad and learning about sciences.
4:54
SPEAKER_00: And if you can imagine 20 years ago, this was before the whole world of social media existed.
5:01
SPEAKER_00: I think we barely had Facebook.
5:03
SPEAKER_00: I was probably like one of the first people on Facebook.
5:06
SPEAKER_00: So there wasn't a lot of places to go, especially from a community sense to learn about PCOS.
5:12
SPEAKER_00: So a lot of my learning was me going to the library and reading research articles at that time, learning about anti-inflammatory lifestyle.
5:22
SPEAKER_00: I started a Nosotol many, many years ago to help regain my period.
5:27
SPEAKER_00: And, you know, the rest was history.
5:29
SPEAKER_00: And that's where I developed my Power with PCOS program, which is specifically designed to help fast track women to that symptom recovery, as opposed to kind of just how we've probably all felt where you're like floundering, trying to figure out what is this, how to heal myself.
5:47
SPEAKER_00: Um, so that's kind of what led me in that path.
5:50
SPEAKER_02: Awesome.
5:51
SPEAKER_02: Yeah.
5:51
SPEAKER_02: And the personal experience too, of just having like that passion for because you are work dealing with it, have dealt with it.
5:58
SPEAKER_02: So giving that insight when helping people too, it's always so much like, oh, you understand like what I'm dealing with and can relate, which is, I feel like, huge when like meeting with a provider.
6:08
SPEAKER_02: Yeah.
6:09
SPEAKER_02: Um, so I actually, PT aside, I did a uh concentration and nutrition in undergrad.
6:16
SPEAKER_02: Um, we had to pick one in school, and everyone was doing like psychology, biology, and none of them really stuck with me.
6:22
SPEAKER_02: I always was infatuated with um nutrition, and I also have type 1 diabetes.
6:28
SPEAKER_02: So having that growing up when I have celiacs disease as well.
6:32
SPEAKER_02: So nutrition always played like a big role in my life.
6:35
SPEAKER_02: Um, so as well, I didn't become a dietitian or study that primarily, um I took a bunch of just nutrition classes and it's kind of I say a hobby now because I didn't further like my education um in grad school.
6:48
SPEAKER_02: I went for PT.
6:49
SPEAKER_02: Um, but I always thought it was so interesting, even from a physical therapy recovery standpoint, and how someone's nutrition and diet can play such a role in how they recover uh physically.
7:02
SPEAKER_02: And it's like, all right, we're doing everything we can.
7:05
SPEAKER_02: You're doing everything, you're listening to what we're saying.
7:08
SPEAKER_02: What is the missing link?
7:09
SPEAKER_02: And you look at the broader picture, and a lot of times it's are you what are you eating?
7:14
SPEAKER_02: Are you getting enough protein?
7:16
SPEAKER_02: Are you vitamins, minerals?
7:18
SPEAKER_02: Uh, are you eating fruits and vegetables?
7:20
SPEAKER_02: Like more of that like clean eating, like back to the basics.
7:23
SPEAKER_02: And people do see like very big um changes just by looking at their nutrition.
7:30
SPEAKER_02: So for sure.
7:31
SPEAKER_02: Yeah, a ha a little bit of a hobby, but something that we also use like in our uh day-to-day practice.
7:37
SPEAKER_03: I love it as well.
7:38
SPEAKER_03: Yeah.
7:38
SPEAKER_03: So similar to Courtney, I actually was pre-med in undergrad and I actually studied shout out FIU again.
7:45
SPEAKER_03: Pause up.
7:46
SPEAKER_03: Um I studied um public relations, and then I concentrated in education, and then I specialized in social media.
7:53
SPEAKER_03: So um I think my purpose in life has always been to heal since I was a child.
7:57
SPEAKER_03: So I was like, what's the easiest way to heal?
7:59
SPEAKER_03: Is to be a doctor.
8:00
SPEAKER_03: Um, my aunt, which is she's a very smart and wonderful lady, she helped raise me.
8:06
SPEAKER_03: And so she um specializes in breast cancer and general surgery.
8:10
SPEAKER_03: And so seeing her help people each and every day and seeing the impact that she had definitely left a lasting impact on me.
8:16
SPEAKER_03: And I was like, that sounds good.
8:18
SPEAKER_03: And then I got to bio too, and I was like, this is usually very easy for me, what's going on?
8:23
SPEAKER_03: And so I decided to pivot then, and I was like, let's do sociology.
8:26
SPEAKER_03: So that's my minors in sociology.
8:28
SPEAKER_03: But I was like, okay, beyond that, beyond me being a professor, what can I do?
8:32
SPEAKER_03: And um, there was a young lady who she was the president of BSU while I was in Black Student Union at FIU, and she was like, I'm studying PR.
8:40
SPEAKER_03: And I was like, what is PR?
8:41
SPEAKER_03: And then she was like, Well, it's really just about helping the public.
8:45
SPEAKER_03: Like, you would be serve as an educator to a general consensus to a large group of people and relay information.
8:52
SPEAKER_03: And I thought it was just very interesting how depending on demographics and whatever it may be, people really intake information differently.
9:00
SPEAKER_03: If I were to tell you say hi, you would say hi.
9:03
SPEAKER_03: And if I was to tell somebody else that, they would be like, hey.
9:06
SPEAKER_03: And so it's all very different, just depending on the ears that are listening.
9:09
SPEAKER_03: And so um, I've chosen this path, and obviously at Athlete Restoration, I'm the director of community outreach.
9:14
SPEAKER_03: So I really get to use my major.
9:16
SPEAKER_03: Um, I very much get to be involved with the community and connect people, and I think that's one of my strengths, and it's wonderful because you get to talk, you get to learn.
9:26
SPEAKER_03: And I think that's kind of what public relations is.
9:29
SPEAKER_03: It's just learning, and it's learning about other people, learning about yourself, learning how you can change things, how a new perspective in life can just shift you and make you a better person as a whole.
9:40
SPEAKER_03: So that's why I chose to study that.
9:42
SPEAKER_03: And yeah, so that's that's me.
9:46
SPEAKER_03: Um so I have a burning question for you, Cornley.
9:49
SPEAKER_02: Are we ready?
9:50
SPEAKER_02: Are we ready to dive in?
9:52
SPEAKER_03: We're ready to learn.
9:53
SPEAKER_03: Is PCOS reversible?
9:56
SPEAKER_03: Do you think that PCOS is actually reversible depending on um the methods that you take, the steps that you take, and also the person?
10:02
SPEAKER_03: Because again, everything is subjective to each person.
10:05
SPEAKER_03: So do you think it is reversible?
10:07
SPEAKER_00: Yeah.
10:08
SPEAKER_00: So PCOS, um, just to take a step back, polycystic ovary syndrome, it is basically it's a rule out condition, right?
10:17
SPEAKER_00: So you might go to your doctor saying, I have irregular cycles, or I'm growing hair out of my chin, or I've got this crazy acne.
10:26
SPEAKER_00: They're gonna do a series of tests, blood tests, potentially ultrasound, to identify the diagnosis, right?
10:32
SPEAKER_00: So everybody's kind of symptoms look very different when it comes to PCOS.
10:39
SPEAKER_00: And then to take a step further, everybody's root drivers look a little bit different.
10:44
SPEAKER_00: Now we know that in PCOS, about 95% of people with PCOS, it's estimated, have some degree of insulin resistance.
10:53
SPEAKER_00: And with that, that tends to cause a lot of high testosterone, which causes irregular cycles and acne and facial hair and things like that.
11:02
SPEAKER_00: Can insulin resistance be reversed?
11:04
SPEAKER_00: It can totally be reversed.
11:07
SPEAKER_00: We can move that insulin into a healthy level.
11:10
SPEAKER_00: Obviously, type 1 diabetes completely different, right?
11:13
SPEAKER_00: Totally different.
11:14
SPEAKER_00: But when we're talking strictly about PCOS, yes.
11:17
SPEAKER_00: Can the PCOS diagnosis be reversed?
11:20
SPEAKER_00: Unfortunately, no.
11:22
SPEAKER_00: It is a chronic metabolic condition, something that you live with lifelong, just like diabetes, right?
11:29
SPEAKER_00: You might have, just to put it in diabetes terms, an A1C of 5%.
11:35
SPEAKER_00: Yay, you, right?
11:36
SPEAKER_00: Woo-hoo, good control.
11:38
SPEAKER_00: But it doesn't necessarily mean that the diagnosis goes away.
11:42
SPEAKER_00: Same with PCOS.
11:43
SPEAKER_00: You can put your symptoms into remission, you can reverse your symptoms, um, which is like what I've done.
11:49
SPEAKER_00: I struggled with severe acne, with facial hair.
11:53
SPEAKER_00: My cycle was like gone for over a year, right?
11:57
SPEAKER_00: But now I have regular ovulatory cycles every 30 days, no more acne, no more facial hair.
12:03
SPEAKER_00: When you look at my blood work, you would think it's not someone who has PCOS, right?
12:07
SPEAKER_00: My insulin's fine, testosterone.
12:10
SPEAKER_00: So you can live with those symptoms being in remission, but the diagnosis still stays with you.
12:16
SPEAKER_00: Because imagine if I just chose to eat pancakes and syrup for breakfast all day, and then just coffee and maybe, I don't know, like fried chicken and just did that for egg cookies and pastries, right?
12:32
SPEAKER_00: Like eventually, because I have that underlying metabolic condition, my insulin is gonna start to go up potentially, right?
12:40
SPEAKER_00: But I keep everything in remission through nutrition, lifestyle, stress management, sleep, exercise, right?
12:47
SPEAKER_00: Yeah, um, all of that good stuff.
12:49
SPEAKER_02: So your symptoms can come back.
12:51
SPEAKER_02: Correct.
12:51
SPEAKER_02: So you just work to manage them so that you don't have the flare-ups of exactly acne and because of the insulin resistance.
12:59
SPEAKER_02: What would you say, like if someone came to you and was like, I have diagnosed with PCOS, or even you personally, what were kind of the the first things you look at?
13:08
SPEAKER_02: Um, like lab work, tests, like what are you what are you first telling that um client or patient to go get done?
13:15
SPEAKER_00: Right.
13:16
SPEAKER_00: So when someone's diagnosed with PCOS, the first thing is that we know when we look at the 2023 international guidelines for PCOS, which they aren't that old.
13:27
SPEAKER_00: So we have a lot of good new information.
13:29
SPEAKER_00: We know that treating the person should be on an individualized, holistic basis, meaning that there's no PCOS protocol.
13:37
SPEAKER_00: It just doesn't exist, right?
13:39
SPEAKER_00: So I co-create plans with my clients, right?
13:44
SPEAKER_00: With their input.
13:45
SPEAKER_00: So when someone comes to me, I'm getting a background of what their symptoms are.
13:50
SPEAKER_00: When was your last cycle?
13:52
SPEAKER_00: Tell me a bit about your period history, how's your digestion?
13:55
SPEAKER_00: How's your sleep?
13:56
SPEAKER_00: Your stress, your energy.
13:58
SPEAKER_00: What are you eating?
13:59
SPEAKER_00: What are you not eating?
14:01
SPEAKER_00: How are you doing with water and hydration?
14:04
SPEAKER_00: And then from there, once I have a full clinical picture, just like you do your assessments, right, with your PT patients, then I come up with okay, what's the game plan?
14:12
SPEAKER_00: And step one is to figure out what their root driver is, right?
14:17
SPEAKER_00: What's causing the symptoms?
14:19
SPEAKER_00: Because we know in conventional medicine, and I think all of us shared the same feeling is that you've got these symptoms, you go to your doctor, and they're like, okay, no cycle, here's birth control, right?
14:31
SPEAKER_00: Oh, you've got acne, here's spirinalctone, right?
14:35
SPEAKER_00: Nothing wrong with that, right?
14:36
SPEAKER_00: We need conventional medicine, it's very important.
14:39
SPEAKER_00: But conventional medicine treats the symptom, right?
14:44
SPEAKER_00: Whereas, like a functional nutritionist, I'm looking at, okay, she's got acne, but why?
14:49
SPEAKER_01: Yeah.
14:50
SPEAKER_00: It's a root cause.
14:52
SPEAKER_00: Instead of just throwing bandation over.
14:56
SPEAKER_00: Exactly.
14:56
SPEAKER_00: Right.
14:57
SPEAKER_00: And with acne in particular, could be inflammation.
15:00
SPEAKER_00: It could be a food intolerance that's triggering that.
15:04
SPEAKER_00: Most oftentimes it's gut imbalances and digestion, which digestion and hormone health so closely linked, right?
15:12
SPEAKER_00: So we're doing a lot of work around that.
15:14
SPEAKER_00: But again, to answer your question, some blood work that would be essential, definitely a full hormone panel, right?
15:22
SPEAKER_00: Because we want to know about those sex hormones, what's happening, right?
15:26
SPEAKER_00: And making sure you test them on the right day.
15:30
SPEAKER_00: And you're, you know, you don't want to be testing estrogen on day, I don't know, 16 of your cycle, right?
15:38
SPEAKER_00: Things like estradiol, that should be checked day one to day three of your cycle, which is day one to day three of your bleed.
15:44
SPEAKER_00: Um, if you know when you're ovulating, right?
15:48
SPEAKER_00: Testing seven days after that to get an ideal progesterone level, right?
15:54
SPEAKER_00: Also checking things like free testosterone, total testosterone, bioavailable testosterone, DHT, right?
16:01
SPEAKER_00: To see, okay, is it more testosterone driven?
16:05
SPEAKER_00: Some of these androgen symptoms, or is it more adrenal driven, right?
16:10
SPEAKER_00: Because there's ovarian um, basically the ovary will produce testosterone, which can cause these symptoms, or the adrenal glands can produce DHEA, which can cause some similar symptoms.
16:22
SPEAKER_00: So it's me figuring out, okay, what is causing this?
16:26
SPEAKER_00: And blood work can be helpful.
16:28
SPEAKER_00: I also, as a dietitian, I do functional testing.
16:32
SPEAKER_00: So I'll do functional GI testing where we're looking at your stool to identify, okay, does she have enough of the good bacteria or some overgrowth bacteria taking over that are impacting hormones, right?
16:46
SPEAKER_00: Because I don't know if you guys are aware, but certain bacteria in our gut actually tell our body to produce more testosterone.
16:55
SPEAKER_00: Crazy, right?
16:57
SPEAKER_00: So just by focusing on gut health and getting to the nitty-gritty, it can cause this cascade of symptom improvement.
17:05
SPEAKER_00: That's a good point, too.
17:06
SPEAKER_02: About um, I didn't even realize it with blood work.
17:09
SPEAKER_02: It says I go just yearly to get blood work.
17:11
SPEAKER_02: So they always run my hormone panel.
17:14
SPEAKER_02: And sometimes my testosterone will be like extremely high, other times it's high, but it's closer to the range.
17:22
SPEAKER_02: So it's so confusing.
17:23
SPEAKER_02: So I'm like, I've had such a jump back and forth.
17:26
SPEAKER_02: Like, am I doing something different?
17:29
SPEAKER_02: But I've never considered where in your cycle are you to show those fluctuations.
17:35
SPEAKER_02: Yeah.
17:35
SPEAKER_02: So will you have patients run uh the different tests different times of like the month, technically?
17:42
SPEAKER_02: Like, all right, we're gonna test this on day three versus we're gonna test these hormones later in the month, just to get all of the data picture.
17:51
SPEAKER_00: Exactly.
17:51
SPEAKER_00: And that would be in the beginning.
17:53
SPEAKER_00: And I wouldn't say, okay, you need to have these tests done like every month or every three months, right?
17:59
SPEAKER_00: Definitely baseline is important.
18:01
SPEAKER_00: Um, and then going whether it's every six months to every year.
18:05
SPEAKER_00: Um, and again, I mentioned a little bit about insulin resistance being extremely common in PCOS.
18:13
SPEAKER_00: So it's important to know where are you?
18:15
SPEAKER_00: Are we getting a fasting insulin in conjunction with the fasting glucose?
18:20
SPEAKER_00: So we can know what your HOMA IR score is.
18:23
SPEAKER_00: And that obviously monitoring.
18:25
SPEAKER_00: Yeah.
18:26
SPEAKER_02: Do you find there's a correlation between people?
18:29
SPEAKER_02: I know I have type one, which is uh a little different is different than type two.
18:34
SPEAKER_02: Um, is there a correlation between between people who have PCOS and type one or people who have PCOS?
18:39
SPEAKER_02: I'm assuming it's probably a little more common to see people who also have type two with the insulin resistance.
18:44
SPEAKER_00: What's your experience with that?
18:46
SPEAKER_00: So actually, there is a correlation between PCOS and autoimmune conditions.
18:52
SPEAKER_00: Type one is an autoimmune condition, rheumatoid arthritis, which I also have, um, which is another autoimmune condition, Hashimoto's thyroiditis, another autoimmune condition.
19:04
SPEAKER_00: So there is a relationship between celiac, celiac as well.
19:08
SPEAKER_00: Well, another, right?
19:10
SPEAKER_00: With PCOS and those autoimmune conditions.
19:12
SPEAKER_00: Um, but then to take it a step further, yes, with type 2 diabetes, because of that underlying insulin resistance.
19:20
SPEAKER_00: So it's two different things that are happening.
19:23
SPEAKER_00: And we know with the insulin resistance doesn't mean that someone with PCOS will get type 2 or has to get type 2.
19:31
SPEAKER_00: We're just at a higher risk.
19:33
SPEAKER_00: And we know by age 40, 50% of people with PCOS will develop type 2 diabetes.
19:41
SPEAKER_00: 50%.
19:42
SPEAKER_00: So the odds are gauge.
19:44
SPEAKER_00: But well, I have type 1 already.
19:46
SPEAKER_00: I know I know, right?
19:48
SPEAKER_00: Like I'm good.
19:49
SPEAKER_00: It's me.
19:49
SPEAKER_00: Right.
19:50
SPEAKER_00: Like that's so I'm I would say a lot of my work is to help mitigate that.
19:55
SPEAKER_00: Of course, you know.
19:56
SPEAKER_00: Like prevention.
19:57
SPEAKER_03: Would you say then that the rate at which women then develop and later in their life when they develop type 2 diabetes was is it because the insulin resistance was never addressed early on in life?
20:11
SPEAKER_03: And so they had underlying PCOS, which they never knew.
20:14
SPEAKER_03: And then suddenly one day, which I think is just true for a lot of women, is that oh my gosh, how did I get type 2 diabetes?
20:19
SPEAKER_00: Yes.
20:20
SPEAKER_03: Out of nowhere.
20:21
SPEAKER_03: It's like, well, you've had insulin resistance for 20 years.
20:23
SPEAKER_02: Yes.
20:24
SPEAKER_03: Just not checked.
20:25
SPEAKER_02: Yeah, obviously.
20:26
SPEAKER_02: And I feel like type 2 diabetes could be very like stereotypical.
20:30
SPEAKER_02: Oh, they must be overweight, they must just eat sugar and candy all day, where sometimes they don't exercise.
20:38
SPEAKER_02: And there's plenty of women and sometimes even men who are like, you're in great shape.
20:44
SPEAKER_02: Like I work out, I run, and I just went to the doctor and he told me like I'm pre-diabetic.
20:50
SPEAKER_02: I have I'm gonna get type 2 diabetes within the next few years.
20:54
SPEAKER_02: Yeah.
20:55
SPEAKER_02: So it's interesting that there could be something more functionally going on internally that just wasn't surface level diagnosed.
21:04
SPEAKER_02: Like I'm not sure how you were diagnosed, but mine was like irregular cycles.
21:10
SPEAKER_02: Um, I was still young, so I was going to the normal OB, and they were just like, We're gonna tell symptom, like symptom management and then a diagnosis because they ruled everything else out.
21:22
SPEAKER_02: They're like, Oh, you don't have anything else, you're 16 years old.
21:25
SPEAKER_02: Yeah, you have PCOS.
21:27
SPEAKER_02: Um, but I never had any of like the bad like acne or facial hair symptoms.
21:33
SPEAKER_02: Um, the type one diabetes was kind of like a red flag a little bit to check it, and then it was just the irregular cycles.
21:40
SPEAKER_02: Um, but I guess if your cycle's not too irregular and you're like, I'm just tired, it might be something that you gloss over.
21:48
SPEAKER_02: Right.
21:48
SPEAKER_02: Um, so for you, did you was did you go because of the irregular cycles and then you've kind of correlated those other symptoms with your diagnosis once you figured out that's what was causing it?
22:00
SPEAKER_00: I would say my journey to diagnosis is pretty unheard of.
22:05
SPEAKER_00: Um, I got diagnosed pretty quickly.
22:08
SPEAKER_00: So I went on birth control maybe in my early teens because of acne.
22:13
SPEAKER_00: Red flag, it was probably just PCOS at the time.
22:17
SPEAKER_00: But it was a low dose birth control.
22:18
SPEAKER_00: And then I was finding I didn't feel good on the birth control, getting depressed.
22:23
SPEAKER_00: This was like my early years of undergrad.
22:25
SPEAKER_00: I was like, screw this.
22:26
SPEAKER_00: So I just took myself off of it.
22:29
SPEAKER_00: That's two months my story, three months, four months, six months.
22:34
SPEAKER_00: Like still, yeah.
22:36
SPEAKER_00: Maybe I'm pregnant, what's going on?
22:39
SPEAKER_00: You're taking pregnant tests.
22:40
SPEAKER_00: Like, okay, it's not that.
22:42
SPEAKER_00: So then I ended up at my doctor, it'd been like a year now, no period.
22:47
SPEAKER_00: So I had the acne, no cycles.
22:51
SPEAKER_00: At that time, facial hair as well.
22:54
SPEAKER_00: So she was picking up on it.
22:56
SPEAKER_00: Now I was always lean, like I told you, I ran track and all these things.
23:00
SPEAKER_00: So I never struggled with my weight.
23:02
SPEAKER_00: Um, but she did the blood test, and boom, I got the diagnosis like pretty quickly.
23:09
SPEAKER_00: Um, which I listen, it's unheard of.
23:12
SPEAKER_00: Most people have to see three or four different providers.
23:16
SPEAKER_00: It can take seven plus years to get the diagnosis.
23:19
SPEAKER_02: So I never had blood work, they just did the ultrasound, and they were like kind of just like they saw the cysts and was like PCOS, they offered birth control.
23:31
SPEAKER_02: Um, at 16, my mom was like, We're gonna hold.
23:35
SPEAKER_02: Yeah, I was like, okay.
23:36
SPEAKER_02: Um, and then in college, I was like, I'm gonna try it.
23:40
SPEAKER_02: My yeah, I feel like I should do it, like at least try all these people are on it because it's very normal.
23:46
SPEAKER_02: Like everyone in college is on it, just because they're like, I don't get my period, it's too heavy.
23:51
SPEAKER_02: I have acne.
23:52
SPEAKER_02: So I was like, I'll give it a try.
23:54
SPEAKER_02: And same as you, I was so I was on it, I think for like a year, super, super depressed, super tired, like very not myself.
24:02
SPEAKER_02: Um, so I self-removed it.
24:04
SPEAKER_02: Yes.
24:05
SPEAKER_02: All right, so I'm not gonna take it anymore.
24:07
SPEAKER_02: And I was hoping like maybe that kick started it, which I don't even know if that's backed by any science or evidence, but in my head as a 21-year-old, I was like, I'm gonna go off of it.
24:17
SPEAKER_02: Yeah.
24:17
SPEAKER_02: And maybe this will kick start what's had to be addressed.
24:22
SPEAKER_02: It didn't.
24:23
SPEAKER_02: Um, so that's kind of where I think a lot of people are left and they're like, now what do I do?
24:28
SPEAKER_02: Um, how do I I I guess I have to take it for symptom management, or am I just gonna kind of be without it until one day?
24:35
SPEAKER_02: I was thinking my next question would be like fertility, like how are you help a lot of women recover so that they can become pregnant?
24:44
SPEAKER_00: Yeah, yeah.
24:45
SPEAKER_00: A lot of my clients come to me because of that.
24:48
SPEAKER_00: I have about eight clients right now who are in their third trimester.
24:52
SPEAKER_00: So I think they're like all my little babies do.
24:55
SPEAKER_00: Um, but yes, people come to me.
24:57
SPEAKER_00: I would say the number one reason would be irregular cycles and fertility planning and weight management would be some of those number one things.
25:06
SPEAKER_00: But the amount of benefit they get from working together, their energy improves, digestion improves, sleep improves, symptoms they didn't realize at the moment that were and they were tired.
25:18
SPEAKER_02: Oh, I didn't know I was tired because yes, exactly, exactly.
25:22
SPEAKER_03: So very in undergrad.
25:25
SPEAKER_03: I remember I would just literally be like, okay, guys, bye.
25:28
SPEAKER_03: I'm gonna go take my nap of the day.
25:29
SPEAKER_03: I'd just sleep for three hours in the middle of the day.
25:32
SPEAKER_03: And I was like, okay, and I would wake up and I would still be tired.
25:35
SPEAKER_03: And so um, so my symptoms, I never had polyps or anything on my ultrasound or anything, and I got diagnosed because of my blood work panel, actually.
25:44
SPEAKER_03: So um, it was a little different than you guys because my cycle's always been pretty regular.
25:48
SPEAKER_03: Um, but there are so many underlying symptoms.
25:51
SPEAKER_03: Like I always had severe, like I had cystic acne in high school, just really bad, and I just always tired.
25:57
SPEAKER_03: If you guys knew me, like my friends would be like, Oh, there's Alex, she's asleep.
26:00
SPEAKER_03: I would sleep anywhere, and I still will low key.
26:04
SPEAKER_03: But um, it was it was incredible because I was doing so much and I was like, well, that's why.
26:08
SPEAKER_03: But it's like, how was I eating in college?
26:10
SPEAKER_03: I was like, oh, it's 4 p.m.
26:12
SPEAKER_03: I went to class, I had a full day of stuff, and I'm just now eating my first meal at 7 p.m.
26:16
SPEAKER_03: This is great.
26:17
SPEAKER_03: And it would be like, Oh, I had a bag of Doritos at three.
26:20
SPEAKER_03: And that was about, and that's as far as I took my nutrition because I mean at 21, you're just so busy, and honestly, I didn't really care.
26:27
SPEAKER_03: I was like, well, what can I do?
26:29
SPEAKER_03: Um, but I will say that getting diagnosed has definitely reset my mindset surrounding not only food but exercise, because there's so many tried and true methods that we think because they apply to one person that they would apply to us.
26:43
SPEAKER_03: Um, I was talking with Courtney a little bit in the at ARC a little earlier, and I was just telling her that per TikTok, which gave me a lot of great information about how to manage my PCOS, but I also was like, okay, I have to do soft exercises.
26:57
SPEAKER_03: I have to walk instead of run, or I have to be the Pilates princess.
27:02
SPEAKER_03: I have to be a Pilates princess.
27:04
SPEAKER_03: I literally have to be a Pilates princess and I have to do low impact because I don't want to raise my cortisol levels.
27:08
SPEAKER_03: But I've never done that my whole life.
27:10
SPEAKER_03: I um I played, I've been playing volleyball since I was four in fourth grade, and um I played volleyball, basketball all throughout high school, and so it was just like it didn't feel like me.
27:22
SPEAKER_03: Like it was fine, but I was bored.
27:24
SPEAKER_03: I was like, okay, time for to go on my walk and listen to my podcast.
27:26
SPEAKER_03: And it was like, it was cute, it was nice, but it wasn't, I wasn't like excited to go do it every day.
27:32
SPEAKER_03: Um, I loved yoga and I still do a little bit of yoga after my workouts, but I'm lifting now.
27:36
SPEAKER_03: So um I train at 1822, finish at 1822, and um it's a wonderful place because you they train us like athletes, and that's how I've been working out my whole life.
27:46
SPEAKER_03: And so I've seen that that has made a difference in my PCOS because I used to get severe chronic pain.
27:51
SPEAKER_03: Um, just I used to get muscle spasms in the middle of my back, and it's like as soon as I got to athlete restoration, suddenly it's left.
27:58
SPEAKER_03: So um it's something that was happening in college and especially post-college, like when I entered the workforce.
28:05
SPEAKER_03: Um, I was getting these just crazy muscle spasms.
28:09
SPEAKER_03: And I was like, why am I getting all of this?
28:11
SPEAKER_03: And then I was like, okay, well, let's see the nutrition.
28:14
SPEAKER_03: Let's look at that first.
28:15
SPEAKER_03: Let's look at the exercise that you're doing.
28:16
SPEAKER_03: Do you have back muscles even?
28:19
SPEAKER_03: And I was like, well, not really.
28:20
SPEAKER_03: Didn't I wasn't as ripped as I am now.
28:22
SPEAKER_03: But um, I would say my next question would then be to a woman, a young lady, who however old you are, um, who's just figuring out her PCOS or who's maybe she's thinking, maybe I have PCOS, maybe I don't.
28:36
SPEAKER_03: She doesn't really know.
28:38
SPEAKER_03: But um, what would you tell her?
28:40
SPEAKER_03: What would be the first step besides the blood panel to do?
28:42
SPEAKER_03: Somebody that's maybe like, I don't want to get blood work done, I don't want to do this, somebody that's just trying to self-manage immediately.
28:49
SPEAKER_03: Like, what's the change that they can make day one right now that would positively affect their symptoms or their life?
28:56
SPEAKER_00: For sure.
28:56
SPEAKER_00: Yeah.
28:57
SPEAKER_00: And I think that's a really good question because when you think about the prevalence of PCOS, right, it affects one in ten.
29:05
SPEAKER_00: There are estimates up to one in five.
29:08
SPEAKER_00: So, you know, some people don't have the luxury to go to their doctor and get blood work, which if you don't have insurance, is crazy expensive.
29:17
SPEAKER_00: Some people live in rural areas and don't have access to a lot of the options that we do here, right?
29:25
SPEAKER_00: So, yeah, I think there are some things that you can do beyond, you know, going that route.
29:30
SPEAKER_00: And I would say number one, because like I said, the insulin resistance is so prevalent for so many people, is to work on blood sugar balance, right?
29:40
SPEAKER_00: And what I mean by that is keeping those blood sugars stable, which I know you know all about.
29:46
SPEAKER_00: Yes, specialty.
29:48
SPEAKER_00: Yes, exactly, right?
29:49
SPEAKER_00: So keeping those blood sugars stable and trying to prevent any sort of insulin spikes.
29:55
SPEAKER_00: Spikes and drops.
29:56
SPEAKER_00: Exactly, exactly.
29:57
SPEAKER_00: And not only is that going to help with energy.
30:00
SPEAKER_00: That's going to help with sleep, right?
30:02
SPEAKER_00: But that is going to help have a trickle-down effect.
30:05
SPEAKER_00: Because if you're releasing less insulin to help keep those spikes from coming down, then insulin, remember that triggers the ovaries to release more testosterone.
30:15
SPEAKER_00: Testosterone causes all these symptoms, right?
30:18
SPEAKER_00: So if we can start from the root, which is blood sugar balance, that would be great.
30:22
SPEAKER_00: And you mentioned a little bit about skipping meals, right?
30:26
SPEAKER_00: No, no, no, don't do it.
30:28
SPEAKER_03: No more.
30:28
SPEAKER_03: Well, I have a question about that before we're finished.
30:31
SPEAKER_00: And there's, listen, don't get me wrong, there's a lot of studies out there that look at intermittent fasting.
30:37
SPEAKER_00: Most of them are done in men.
30:39
SPEAKER_00: Right?
30:40
SPEAKER_00: Interesting.
30:40
SPEAKER_00: Yeah.
30:41
SPEAKER_00: There's not a lot that are done in women with PCOS.
30:44
SPEAKER_00: And the small subset that are, they actually found the best results when we ate between the window of eight and four.
30:51
SPEAKER_00: Right.
30:51
SPEAKER_00: So had breakfast, had three square meals, right?
30:54
SPEAKER_00: So not saying that you have to eat between eight and four, but eating within that first hour of waking up, right?
31:01
SPEAKER_00: Trying not to go more than three, four hours without eating, right?
31:05
SPEAKER_00: And then balance meals for sure.
31:07
SPEAKER_02: I was gonna say, I feel like intermittent fasting is one of those like trends or fads where everyone's like, I only eat 12 to 8.
31:15
SPEAKER_02: Yes.
31:16
SPEAKER_02: Um, I skip breakfast.
31:18
SPEAKER_02: And I would say, how what do you educate your clients on?
31:22
SPEAKER_02: Like if they're like, I want to intermittent fast, do you suggest doing smaller meals like every two to three hours?
31:29
SPEAKER_02: Um, instead of just having because I found personally with my numbers, if I eat a huge meal, then like it spikes and then like three hours later it crashes.
31:39
SPEAKER_02: And you feel it, and you're like, now I have to eat again, but I'm not even hungry because I just ate so much.
31:44
SPEAKER_02: Um, so having those like little meals, I feel like helps.
31:48
SPEAKER_00: So is that something that you educate definitely on as well?
31:53
SPEAKER_00: And I would say eating the breakfast within the first hour that also plays into hormone balance, particularly around cortisol.
32:00
SPEAKER_00: Um, and with PCOS, we are more likely to have circadian rhythm dysfunction, which impacts our cortisol hormone.
32:08
SPEAKER_00: Um, and with that, any sort of stress on our body will trigger more cortisol to be released.
32:16
SPEAKER_00: And guess what?
32:16
SPEAKER_00: Cortisol triggers, you know, well, sugar, right?
32:20
SPEAKER_00: It suggers our body to release more blood sugar, which then releases more insulin and more testosterone, right?
32:26
SPEAKER_00: So that whole idea of skipping the first meal, it triggers that stress hormone response.
32:33
SPEAKER_00: It causes the cascade.
32:35
SPEAKER_00: Exactly.
32:36
SPEAKER_00: So, no, I don't recommend like large meals, right?
32:39
SPEAKER_00: But definitely balanced, where there's enough protein, there is some healthy fat, and a ton of fiber, right?
32:47
SPEAKER_00: So that that way that meal can hold you for the three to four hours without you having these spikes.
32:54
SPEAKER_02: Yeah.
32:55
SPEAKER_02: And is there, I know every plant, every person is different.
32:59
SPEAKER_02: Um, is there like a trend that you find that you usually are prescribing or giving out plans that are less in dairy?
33:08
SPEAKER_02: I know protein, healthy fat, and like carb, even though people are like, I'm carb free, I know there's just a good benefit of fueling your body with carb.
33:18
SPEAKER_02: So how do you manage or what do you find most common with um prescribing foods like dairy or yogurt?
33:26
SPEAKER_02: Because it's high in protein, they have the probiotics, but dairy is also inflammatory.
33:31
SPEAKER_02: So is that something you find PCOS you tell people to avoid?
33:35
SPEAKER_00: Great question.
33:36
SPEAKER_00: And so the whole idea, which again, if you've been on TikTok and looked up PCOS, there's a huge school of thought that you have to be dairy-free and you have to be gluten-free, right?
33:47
SPEAKER_00: If you have celiac, yes, you do have to be gluten-free.
33:50
SPEAKER_00: Okay.
33:50
SPEAKER_00: No choice.
33:51
SPEAKER_00: No choice.
33:52
SPEAKER_00: Okay.
33:53
SPEAKER_00: But outside of that, right, when we think about dairy, there's actually some really good uh research to show the benefit of dairy, in particular, full-fat dairy for supporting ovulation, regular cycles, and fertility.
34:09
SPEAKER_00: So it can be benefit for a subset of people with PCOS, but dairy can exacerbate acne and be inflammatory for another subset of people with PCOS.
34:21
SPEAKER_00: So it's not something I say no.
34:24
SPEAKER_00: Um and rises.
34:27
SPEAKER_00: Exactly.
34:28
SPEAKER_02: And with the gluten, so I'm not a good example because I have to be gluten-free.
34:33
SPEAKER_02: Um, but do you find that people do have a more like inflammatory response if they eat gluten?
34:39
SPEAKER_02: Like is just gluten intolerance um like a common finding as well?
34:44
SPEAKER_00: I would say, especially with the autoimmune gorlease, yes.
34:47
SPEAKER_00: So if someone comes to me PCOS Hashimoto's, I'm gonna say, okay, what's your comfort level?
34:53
SPEAKER_00: How can we start to minimize gluten?
34:55
SPEAKER_00: Right.
34:56
SPEAKER_00: Um, but if someone's more PCOS insulin resistance driven, I probably won't go that route first.
35:04
SPEAKER_00: Um, because we know that, and you're probably aware, a lot of the gluten-free products are void of many key nutrients.
35:12
SPEAKER_00: Yeah.
35:12
SPEAKER_00: B12, iron, folate.
35:15
SPEAKER_00: Guess what?
35:15
SPEAKER_00: Yeah.
35:16
SPEAKER_00: High in carbohydrates.
35:17
SPEAKER_00: And high in carbs and lower in fiber.
35:19
SPEAKER_00: Yeah.
35:19
SPEAKER_00: Right.
35:20
SPEAKER_00: So for a PCOS girly, that's just gonna set you up and worsen other symptoms, right?
35:25
SPEAKER_00: We need B12, folate, and iron for healthy cycles.
35:29
SPEAKER_00: Um, so it's not, I try not to restrict people unless I absolutely have to.
35:35
SPEAKER_00: Yeah.
35:36
SPEAKER_03: My next question would be um, what do you think about alcohol?
35:40
SPEAKER_03: So I've read a lot of things that people with PCOS should either minimize their alcohol intake or be very specific when they are consuming alcohol.
35:49
SPEAKER_03: Um, I don't anymore.
35:52
SPEAKER_03: I stopped just because I was like, oh, this makes the PCOS feel better.
35:55
SPEAKER_03: And it's just a lot of other reasons.
35:56
SPEAKER_03: But for somebody that just, you know, wants to have a drink or a cocktail or whatever, is there um certain types of alcohol that are maybe healthier?
36:06
SPEAKER_03: Or is there certain like maybe don't have a lycci martini or have something else, have something.
36:14
SPEAKER_03: So is there sugary?
36:15
SPEAKER_03: Is there like a hierarchy of um better and then worse alcohol, if you would say?
36:21
SPEAKER_00: That's a great question.
36:22
SPEAKER_00: And listen, we're on the tip of the holiday season.
36:25
SPEAKER_00: So I think this is a great question.
36:27
SPEAKER_00: Good tip.
36:29
SPEAKER_01: Yes, yes.
36:29
SPEAKER_01: Oh, it's a nice cocktail around holidays, Thanksgiving, Christmas, you know, yeah, and New Year's.
36:35
SPEAKER_00: For sure.
36:36
SPEAKER_00: And like I said, I'm not a person to say no, never.
36:39
SPEAKER_00: And again, I like to co-create my plans with my clients.
36:44
SPEAKER_00: So if we were working together and you were just like, okay, I don't want to drink alcohol, that's fine.
36:49
SPEAKER_00: Um, but you always want to ask yourself, okay, well, why am I drinking the alcohol?
36:53
SPEAKER_00: Is this to soothe me?
36:55
SPEAKER_00: Is it like every Friday?
36:56
SPEAKER_00: And how much are you drinking?
36:58
SPEAKER_00: Those are really important questions, as opposed to just saying, okay, I need to stay away from it or I can't drink it.
37:04
SPEAKER_00: Um and understanding what happens in our PCOS bodies when we drink alcohol.
37:11
SPEAKER_00: So we know that alcohol is a toxin.
37:12
SPEAKER_00: It's a poison.
37:13
SPEAKER_00: Let's be real.
37:14
SPEAKER_00: It may taste good to some people, but it's a poison.
37:17
SPEAKER_00: Yeah.
37:17
SPEAKER_00: And with that, like any other poison we put in our body, our liver clicks on to start detoxifying.
37:24
SPEAKER_00: And so your liver will start to break that alcohol down into water-soluble molecules so that you can then, you know, pee it out, get rid of this toxin.
37:33
SPEAKER_00: And it does that immediately because it's not something we need.
37:36
SPEAKER_00: Keep in mind with PCOS, all of those excess hormones that are floating around our body, how do you think they get out?
37:45
SPEAKER_00: They don't just evaporate off of our skin, right?
37:48
SPEAKER_00: We have to detoxify those hormones so that we can get rid of them.
37:53
SPEAKER_00: So if your liver is busy working on that alcohol, those hormones will get reabsorbed back into your bloodstream and continue to wreak havoc, right?
38:04
SPEAKER_00: So you do want to understand that that you may notice even the next day, which you probably felt, your symptoms may pop up.
38:12
SPEAKER_00: They might feel a little bit worse.
38:13
SPEAKER_03: Exploding, a lot of grogginess and tiredness across the week.
38:17
SPEAKER_00: Yeah.
38:17
SPEAKER_00: Exactly.
38:18
SPEAKER_00: Now, again, I don't I'm not a huge drinker or anything like that, but once in a blue moon, New Year's, I might have a champagne or whatever.
38:26
SPEAKER_00: But some things you can do, don't do it on an empty stomach, right?
38:30
SPEAKER_00: Make sure you're eating with the alcohol.
38:33
SPEAKER_00: Okay.
38:33
SPEAKER_00: And then thinking about, like we said, avoiding the sugary ones, obviously, the pina coladas, the ones with tons of juices and sodas, right?
38:41
SPEAKER_00: If you can stick with more of a straight liquor, a tequila or a vodka, and maybe you do a non-sugary chaser, soda, you know what I mean?
38:51
SPEAKER_00: Um, something like that.
38:52
SPEAKER_00: Fresh lime juice, a seltzer.
38:55
SPEAKER_00: Exactly.
38:55
SPEAKER_00: Exactly.
38:56
SPEAKER_00: Would be fine.
38:57
SPEAKER_00: Okay.
38:57
SPEAKER_02: So and then, so I know we kind of touched on this briefly when we were talking about like exercise and Pilates and running.
39:06
SPEAKER_02: How do you correlate um people when they're managing their PCOS cycles and are doing certain types of exercise at different phases of the cycle while they're recovering from PCOS?
39:21
SPEAKER_02: Or do you kind of tailor that based on like you're a runner, you like to run.
39:25
SPEAKER_02: So I'm gonna encourage you to do the form of exercise and activity you like.
39:30
SPEAKER_00: Yeah.
39:31
SPEAKER_00: And I'm always with the thought when it's whether it's food, exercise, whatever it is, doing what you enjoy.
39:38
SPEAKER_00: Like I loved seeing your face light up when you're like, yes, I'm doing this workout, I love it.
39:43
SPEAKER_00: I was like, you go, girl.
39:45
SPEAKER_00: You know what I mean?
39:46
SPEAKER_00: So to tell someone, okay, you cannot do this when they're so used to being that person, that doesn't work.
39:54
SPEAKER_00: But at the same token, where are they in their journey?
39:57
SPEAKER_00: Are they, you know, at that point where their vitamin levels are so low that they're barely getting out of bed and they don't have the energy?
40:06
SPEAKER_00: It's like, okay, let's work on boosting your nutrient levels, getting a good nutrition flow, and then slowly working our way into exercise that way.
40:16
SPEAKER_00: And maybe it's just walking to start and then we can build from there.
40:20
SPEAKER_00: But we know again, going back to the guidelines, when it comes to exercise, we want that combination of cardio.
40:27
SPEAKER_00: Why?
40:28
SPEAKER_00: Not only are we at higher risk for diabetes, we are at higher risk for cardiovascular diseases as well.
40:34
SPEAKER_00: Right.
40:36
SPEAKER_00: Exactly.
40:36
SPEAKER_00: It's a metabolic condition.
40:38
SPEAKER_00: Exactly.
40:39
SPEAKER_00: So we have to be exercising that heart.
40:42
SPEAKER_00: So you need that balance of cardio in conjunction with strength training, which is great for the insulin resistance, and then some restorative work, right?
40:51
SPEAKER_00: Which you can probably speak more to, but I love yoga, I enjoy Pilates, but those aren't the only things that I do.
40:57
SPEAKER_00: Yeah.
40:58
SPEAKER_00: Yeah.
40:59
SPEAKER_02: I always find that too, like a well-rounded approach to something.
41:02
SPEAKER_02: Um, because even like we'll see people in the clinic and they'll be like, all I do is I love running.
41:09
SPEAKER_02: And it's like, all right, well, let's take a step back.
41:12
SPEAKER_02: Yeah.
41:12
SPEAKER_02: Like, what is your stability like, your strength?
41:15
SPEAKER_02: Um, yeah.
41:16
SPEAKER_02: So I always feel like taking like that, not like one lane approach.
41:22
SPEAKER_02: You have to look at it well-rounded.
41:24
SPEAKER_02: Um, so I guess similar to with exercising in PCOS, do what you love, but also consider the different forms of exercise, diversify, and say, all right, I've been to strength training at least once a week because I know there's really good benefits to it.
41:38
SPEAKER_02: Running is what I love to do.
41:39
SPEAKER_02: So I'll run three times a week and then I'll still mix it in, which is I find even in our practice too, is kind of how you get a well the best outcomes.
41:48
SPEAKER_00: Yeah, less injury too, right?
41:50
SPEAKER_03: Less injury.
41:50
SPEAKER_03: Yes, with our athletes as well, is that um it's always recommended that for instance, we have a lot of volleyball, baseball players.
41:57
SPEAKER_03: We're like, okay, go either run track, go play basketball, do softball, do something else that you're not used to doing.
42:04
SPEAKER_03: And um, it is very good for injury prevention and just to diversify movement.
42:09
SPEAKER_03: And it does help, like as you try something new, I've I've run, but I've never been like, oh my gosh, I'm a hardcore runner.
42:15
SPEAKER_03: I do my mile and I'm done.
42:17
SPEAKER_03: That's that's that's my limit.
42:18
SPEAKER_03: But um, I've been seeing that I'm like, okay, when I don't have time to work out, I have feet, I got legs, let me use them, you know?
42:25
SPEAKER_03: And even if it's just that joy of pushing yourself to do something that maybe it's not your favorite, and maybe you just want to improve, right?
42:32
SPEAKER_03: I want to cut down a little bit of my time each week.
42:34
SPEAKER_03: And so um those things also spark joy.
42:38
SPEAKER_03: And so that falls into my next question.
42:40
SPEAKER_03: Um, how do you think PCOS affects mental health?
42:44
SPEAKER_03: And um, what are some maybe telltale signs that are kind of red flags that you could be like, okay, hi.
42:50
SPEAKER_03: Um, I'm experiencing this, I'm experiencing along with the fatigue, I'm experiencing anxiety or depression or all these things.
42:55
SPEAKER_03: And you can't really remember when the last time you were maybe happy, or you see, like, okay, well, when my symptoms are worse, I feel worse.
43:04
SPEAKER_03: I'm getting an anxiety attack or whatever.
43:06
SPEAKER_03: So, how do you think that it um that it affects mental health?
43:09
SPEAKER_00: It it's not a question of how it does.
43:12
SPEAKER_00: It really does.
43:13
SPEAKER_00: And, you know, PCOS, like we said, comes with such a huge variety of symptoms, facial hair, acne, weight gain, irregular cycles.
43:24
SPEAKER_00: And it affects our body image.
43:26
SPEAKER_00: Like, let's be real.
43:28
SPEAKER_00: You know, I know when I did not have a cycle, it's like I felt less than as a woman.
43:32
SPEAKER_00: Like, why is my body not functioning right?
43:35
SPEAKER_00: Yeah.
43:36
SPEAKER_00: Um, or if you're eating right and moving your body and you can't lose weight, and you go to your doctor and they're just like, well, you need to move more, right?
43:44
SPEAKER_00: And it's like it becomes frustrating, you know.
43:48
SPEAKER_00: So, yes, we have higher rates of anxiety, depression, body image, disordered eating, eating disorders within the context of just having PCOS.
43:58
SPEAKER_00: So, knowing that, you know, PCOS, because of its complexity, you're gonna need a lot of people on your team to help support you.
44:07
SPEAKER_00: Of course, having a good quality like therapist or mental health support if you need is ideal, right?
44:14
SPEAKER_00: Having a dietitian to help with your nutrition, right?
44:17
SPEAKER_00: Having someone to help with movement, having a good OBGYN endocrinologist.
44:22
SPEAKER_00: You've got to have the right team members, yeah, for sure.
44:26
SPEAKER_01: For you, absolutely.
44:27
SPEAKER_02: Um, another thing I meant to ask earlier too, and we were talking about um food is like supplements and how do you go about prescribing um what maybe think of it was the anxiety and depression?
44:41
SPEAKER_02: I know a lot of people will be like, you can cure your anxiety and depression, you can help um decrease the symptoms um by supplementing with things.
44:50
SPEAKER_02: So, how is PCOS like what are the common supplements that you will recommend or which ones you find to have the most benefit?
44:57
SPEAKER_02: That's a great question, too.
44:59
SPEAKER_00: No, it really, really is because it's a huge topic.
45:02
SPEAKER_00: And I hate to see because on places like TikTok shop and online, you know, there's always a new PCOS supplement coming up.
45:13
SPEAKER_00: And one thing about me as a dietitian, uh just with your career too, we're evidence-based, right?
45:19
SPEAKER_00: Of course, rooted in science because of safety.
45:22
SPEAKER_00: And, you know, I'm making sure number one, regardless of the supplement, that it is third-party tested, right?
45:28
SPEAKER_00: So that way what they say is in the product is the right dose to what you're getting, you know, not only because you don't want to waste money, but you want to for safety, right?
45:38
SPEAKER_00: And there have been a quite a few class action lawsuits against supplements because of that very reason.
45:44
SPEAKER_02: So they're not a like in other words, not regulated, not regulated as much as like medications, medications or a lot can be put out there exactly with a name and no one's verifying correct what it is, right?
45:57
SPEAKER_00: So like the FDA oversees prescription meds, there's no kind of body.
46:02
SPEAKER_00: So a lot of these companies and supplements, they pay third parties to come in and blind test our products.
46:09
SPEAKER_00: That's a good thing.
46:10
SPEAKER_00: We want that.
46:11
SPEAKER_00: Um, so looking for things like NSF, that stamp of approval on your supplement.
46:17
SPEAKER_00: Um, one in particular I love is called ovacitol, um, or it's an inositol.
46:23
SPEAKER_00: Um, and that's one that's been studied for many, many years.
46:27
SPEAKER_00: Um, and we have a lot of good research, and it's been shown to be more effective than metformin for uh PCOS, which is pretty crazy.
46:36
SPEAKER_00: Yeah.
46:37
SPEAKER_00: Um, but making sure that you're looking for that NSF, that GMP, that third-party testing is really important.
46:44
SPEAKER_00: And just tying it back to anxiety, right?
46:46
SPEAKER_00: A lot of the anxiety and depression we have are oftentimes exacerbated because of vitamin deficiencies.
46:54
SPEAKER_00: Low vitamin D symptom, depression, low B12 symptom, low energy, low drive, right?
47:03
SPEAKER_00: So sometimes it's just a matter of checking the vitamin levels, correcting what's deficient, and the mental health just like flourishes.
47:14
SPEAKER_00: Yeah, yeah.
47:15
SPEAKER_03: Absolutely.
47:15
SPEAKER_03: So our last question for today.
47:17
SPEAKER_03: Tell me it's the holidays, so I know everybody's either gonna be traveling or eating a lot and eating twice as a lot because hello, it's Thanksgiving.
47:26
SPEAKER_03: We need to eat the yams.
47:27
SPEAKER_03: So, um, what would you say is maybe a hack or um just maybe a method, I would say, for people that are either traveling and that they wanna just people that travel in general frequently.
47:38
SPEAKER_03: It's like, okay, I'm at the airport, I was running maybe a little behind, so I didn't get to grab any food or I didn't go get my snacks the night before.
47:44
SPEAKER_03: And so I'm at the airport buying a five dollar water.
47:47
SPEAKER_03: And what is either a snack they should be grabbing?
47:52
SPEAKER_03: Um, what do you think about like, I don't know, beef jerky as a snack or how that affects, and just any tip that you would give for people that are traveling during the holidays and just in general to kind of help manage when you're not on your schedule and in your routine.
48:05
SPEAKER_00: Yeah.
48:06
SPEAKER_00: So travel, snacks, things like that, very important because traveling during the hot holidays guaranteed to have a delay, okay?
48:14
SPEAKER_00: Which means you're gonna be stuck in that for longer.
48:18
SPEAKER_00: Longer than you want to be.
48:20
SPEAKER_00: Yes.
48:20
SPEAKER_00: So I love to personally always have snacks on me roasted at a mommy, right?
48:26
SPEAKER_00: Which is quick protein fiber.
48:28
SPEAKER_00: Jerkeys are great, but just be careful.
48:30
SPEAKER_00: A lot of them can have added sugar.
48:32
SPEAKER_00: So you definitely keep an eye on that.
48:35
SPEAKER_00: Anything below six grams of added sugar is considered lower.
48:39
SPEAKER_00: Um, so keep an eye out for that.
48:41
SPEAKER_00: Um, but if you're like in the airport and trying to figure things out, nuts are great because that gives you a little bit of protein, some healthy fats, so some satisfaction.
48:51
SPEAKER_00: The jerkies are great.
48:52
SPEAKER_00: Even if you don't mind a boiled egg, like I personally only like boiled eggs at my house.
48:59
SPEAKER_00: You know, they usually have those available too.
49:02
SPEAKER_00: Or I'll hit up like Starbucks, get their like egg white bites for some quick protein.
49:07
SPEAKER_00: But ideally, you're looking for something that'll give you protein and fiber that is essential for PCOS for a snack.
49:15
SPEAKER_00: Okay, yeah.
49:16
SPEAKER_02: So I was gonna say, like, if someone's like, oh, I'm just gonna eat this apple, right?
49:20
SPEAKER_02: It's not the best fiber, but it's just straight sugar carbohydrate.
49:25
SPEAKER_02: So that's how you'll see the crash more exactly than if you paired it with the egg bites.
49:29
SPEAKER_02: The egg bite or peanut butter.
49:31
SPEAKER_02: That's like a healthy fat, not as no protein.
49:34
SPEAKER_02: Um, but yeah, I guess um something to pair it well.
49:41
SPEAKER_00: Because remember, at the core of it, we're just trying to prevent those blood sugar spikes.
49:45
SPEAKER_00: And yes, if you eat a banana or grab an apple, yes, that has nutrients, it has fiber.
49:51
SPEAKER_00: There's nothing wrong with fruit, but it will cause your blood sugar to spike, come crashing down, and that's when you're gonna be looking for a bagel next, right?
50:00
SPEAKER_00: So, yes, penicillo.
50:02
SPEAKER_00: Exactly.
50:03
SPEAKER_00: Start with a protein, yeah.
50:04
SPEAKER_00: Protein, protein, fiber.
50:06
SPEAKER_02: That's the magic.
50:08
SPEAKER_02: Okay.
50:08
SPEAKER_02: Good tips.
50:09
SPEAKER_02: I'm traveling this uh me too holiday season, so I'll be an eye.
50:14
SPEAKER_02: Yeah, I'm gonna have to try that.
50:16
SPEAKER_02: I haven't had roasted edamame.
50:17
SPEAKER_02: I just started liking like regular edamame.
50:20
SPEAKER_02: It took me years.
50:21
SPEAKER_02: Um, my palate is expanding.
50:23
SPEAKER_02: Wow.
50:23
SPEAKER_02: So I'm happy to try to do that.
50:25
SPEAKER_03: It's expanding.
50:26
SPEAKER_03: She's growing.
50:28
SPEAKER_02: Um, but yeah, no, it was great.
50:30
SPEAKER_02: Uh so much helpful information.
50:32
SPEAKER_02: I'm sure for us who also have PCOS, but I'm sure people listening, um, other patients, we can now take the knowledge that you gave us and at least guide them in the right direction.
50:44
SPEAKER_02: Um, looking at that whole picture type of um care.
50:47
SPEAKER_02: But yeah, it's a great having you uh on the podcast.
50:50
SPEAKER_02: We uh gotcha takeaway for uh Dr.
50:53
SPEAKER_02: Kylo for today.
50:54
SPEAKER_02: So yes.
50:55
SPEAKER_03: Um we are very happy to have had Mrs.
50:58
SPEAKER_03: Courtney Miners here with us.
51:00
SPEAKER_03: Um, it's great to get good information from somebody who knows what they're talking about.
51:04
SPEAKER_03: Um, there is so much misinformation on the internet and just social media.
51:09
SPEAKER_03: People do want to help, it's always with good intention.
51:11
SPEAKER_03: But the reality is that my girl has her master's degree and she's been doing this for a long time, so she knows.
51:17
SPEAKER_03: So we're very happy to have her, and we want you all to tune in to the next Driven Athlete Podcast.
51:23
SPEAKER_03: Thank you.