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Why It's So Common to Be Misdiagnosed with PCOS for Active Women with Period Irregularities · Nourished Fertility

• 0:00
  Welcome back y'all to the Nourishing Women Podcast, your go-to podcast to
• 0:04
  get your peer back and get pregnant.
• 0:05
  I'm your host, Victoria Myers, peer recovery specialist, fertility,
• 0:09
  dietician, and owner of the virtual coaching practice, nourishing
• 0:12
  Minds Nutrition, where we work together to restore your fertility.
• 0:17
  Today I am.
• 0:18
  So fired up about today's conversation 'cause this is a topic I am
• 0:23
  incredibly passionate about and what we're gonna be talking about
• 0:26
  today and pulling up my notes here.
• 0:28
  Hi.
• 0:28
  Hello.
• 0:29
  By the way, if you're watching this on YouTube, the reason why we have had
• 0:33
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  That's partly why we're going down to two episodes a month.
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• 1:22
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  I'm doing it.
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  watch something but also hear it, I retain the information so much better.
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  give the podcast on YouTube.
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  So all, I'll just say, let's get back, back to what we're talking about today.
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  We are talking about why it is so common.
• 2:00
  For active women, specifically with period loss or unpredictable
• 2:04
  cycles, why it's so common for them to get misdiagnosed with PCOS.
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  And since I see this over and over and over again in my practice, this
• 2:12
  is something I feel very confidently in speaking to of the reasons in
• 2:16
  which this misdiagnosis occurs.
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  So rampantly and if you were someone who, you know, you've had a missing
• 2:24
  period, may, you've had like maybe a PCS diagnosis or maybe a doctor or.
• 2:28
  Functional medicine providers say to you very confidently, like it's
• 2:31
  definitely PCUS, but something about it just doesn't fit for you.
• 2:35
  You're not as confident as the other providers are about what you can
• 2:40
  truly feel in your body and what you know to be true to your experience.
• 2:43
  This episode is for you and honestly, I think in both the conventional and the
• 2:47
  functional medicine spaces, this is so often overlooked and it needs to stop now
• 2:53
  because what happens in these cases is.
• 2:55
  Women like you go further and deeper into their ha, which
• 2:59
  we'll talk about specifically what that is in today's episode.
• 3:02
  If you're not familiar with the term HA or hypothermic eight amenorrhea,
• 3:06
  and it further perpetuates the period loss all because they're just
• 3:09
  simply trying to manage their PCUS.
• 3:12
  So whether you know you have a missing or regular period, whether or not
• 3:15
  you even have A-P-C-O-S diagnosis, or you're just kind of wondering,
• 3:18
  is that why my period is missing?
• 3:20
  Is it that, is it.
• 3:21
  Something else.
• 3:22
  Um, whether your management of PCOS is actually driving things worse, and
• 3:27
  ultimately, like if you just can't get pregnant with a missing on irregular
• 3:30
  period, this episode is for you.
• 3:34
  And I think we just should start first with the overlap and the understanding
• 3:39
  of, you know, have some compassion for both, again, conventional doctors
• 3:42
  and functional medicine providers for why it can be so incredibly
• 3:46
  common to misdiagnose this condition.
• 3:48
  Because in both conditions.
• 3:50
  You can have a missing or in irregular period, you can have
• 3:54
  lack of regular ovulation, which is required to get pregnant.
• 3:58
  That's the main piece that causes the infertility in both PCS and Ha.
• 4:02
  And in both conditions you can have multiple follicles on
• 4:05
  your ovaries, sometimes called cyst when viewed on ultrasound.
• 4:09
  So already you can see like, Hey, that could be pretty understanding why.
• 4:13
  There can be some, some pretty dramatic overlap and some understanding of why
• 4:17
  a misdiagnosis may occur, and what you'll learn in today's episode is
• 4:21
  what we need to do to prevent that so that people get the correct diagnosis.
• 4:26
  Because in these cases of period loss in irregular periods from PCS versus Ha.
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  The treatment is so dramatically different, so we need to be
• 4:36
  so thoughtful about what we're truly diagnosing people with.
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  I will also, I'm about to get into like the specifics of how they get
• 4:43
  diagnosed with PCOS, but one thing I just wanna go ahead and mention.
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  Because this often is part of why I think PCOS diagnosis is more common
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  for clients with irregular periods in particular, is with hypothermic Amenia.
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  To be technically diagnosed with this condition, you need to have a missing
• 5:02
  period for three or more months.
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  But what we, in our see in our practice more often actually is irregular periods.
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  So the level of hypothermic dysfunction hasn't led yet to an entirely missing
• 5:14
  period, or you've actually already done the work to regain one, two, maybe three.
• 5:19
  Cycles, but your cycle's still wildly unpredictable and so very irregular.
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  In both of those cases, I think it's just really common to get immediately slapped
• 5:28
  with a diagnosis at PCOS if your period hasn't been missing for 10 plus years.
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  So those people still though, can have the root cause that similar to someone who's
• 5:37
  had a missing period for 10 plus years.
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  So let's officially dig in.
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  So first, let's begin with how do you get a diagnosis of PCUS
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  to be diagnosed with PCUS?
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  You need to meet two of the three Rotterdam criteria and the great
• 5:51
  news about some of the most recent updates to the Rotterdam criteria.
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  If doctors are using these most recent updates, is it now includes
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  the exclusion of other causes, of missing periods, including.
• 6:03
  Elevated prolactin caused from a benign pituitary tumor as
• 6:07
  well as hypothalamic amenorrhea.
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  So your doctor theoretically should be excluding hypothalamic amenorrhea
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  first, but because of what I just mentioned a second ago with it not
• 6:19
  always presenting as missing periods.
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  Also because lab work can often present as normal, including estrogen,
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  LH and FSH, and especially because many women who have HA actually are
• 6:30
  in normal weight in a normal BMI.
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  It's so often overlooked, so I'm so grateful that they've updated the Rodder
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  Dam criteria to include this exclusion.
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  However, I still see it rampantly not used.
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  And if we're looking at the broader name criteria, there's three things
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  that you need to meet, or, sorry, specifically two of the three in
• 6:49
  order to be diagnosed with PCOS.
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  But there's three criteria, either biochemical or clinical, elevated
• 6:55
  androgens, meaning you either have elevated total testosterone, free
• 6:59
  testosterone, D-H-E-A-S can also be used, or you have signs and symptoms
• 7:04
  within your body of elevated androgens.
• 7:06
  We're talking about, uh, hair growth in areas that are particularly male dominant.
• 7:10
  For example, like chin growth.
• 7:11
  Chin hair growth called her wisdom.
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  Uh, it may also mean that you're having signs like acne that would
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  be, you know, typical of elevated androgens or having weight gain very
• 7:20
  specifically in your abdomen area.
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  So that's the hyper androgyn piece.
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  The second piece to being diagnosed using the ruter and criteria with PCS is either
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  a missing or an entirely irregular period.
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  You would need to have your period.
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  More than 35 days apart, or no more than eight periods a year to meet
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  that criteria of the diagnosis.
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  And finally polycystic ovarian morphology, meaning that you have mini follicles,
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  again, sometimes called cyst on your ovaries when viewed on ultrasound.
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  But here's the kicker.
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  You can have that with ha too because you are not ovulating.
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  Ha can present with either no follicles at all or can present with mini follicles.
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  And this is like the conundrum of many with ha.
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  But if we can kind of separate and get a little bit more.
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  Distinct with that, PCOS will present a bit differently, even if there's
• 8:07
  follicles on your ovaries with HA.
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  Specifically, there should be 20 or more follicles per ovary on
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  either ovary with PCOS or an ovarian volume greater than 10 centimes.
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  And it may also have that per like presentation that's so typical to PCOS in
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  the cases of HA, while I. Have mentioned in reference multiple times already that
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  you can have cyst on your ovaries too.
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  It likely won't be that amount of volume that that amount, it won't
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  be between you on each ovary, and it should not theoretically have
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  that, that per light presentation.
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  But again, I can't tell you how often I see women who have absolutely no
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  signs of elevated androgens, which you don't technically have to have
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  to meet the diagnosis of PCOS, but it is obviously very common.
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  But because they have irregular period, because they have a few follicles
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  on their ovaries when viewed on.
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  Ultrasound, boom, bam.
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  They're slapped with a POS diagnosis and told to diet harder, work out harder,
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  maybe given medications that would perpetuate ha even worse, like metformin.
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  And it really makes this, this cycle so much worse.
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  So.
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  With the Rotter Damm criteria, if they're using the recent updates,
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  that should help prevent some of this misdiagnosis from happening.
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  And that's something, you know, as you being your own advocate here, you can
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  really ask the doctor for moving forward, being very specific of like, Hey, I
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  know what this rotter, Damm criteria is.
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  Can you make sure I truly meet this criteria?
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  And that you've also ensured that you have excluded, you know, ha, I also wanna
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  reference with a Rotterdam criteria.
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  A MH has recently been included, and I do think that's great.
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  In most cases, A MH or anti malian hormone is your ovarian reserve
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  match your age related peers.
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  And with PCOS, we must commonly very elevated A MH levels.
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  But in the case of ha, you can actually have very, very low AM h and very,
• 9:54
  very high am H depending on what your follicles are presenting like.
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  When viewed on ultrasound, and that's because a MH is is created by the
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  antal follicles in your ovaries.
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  So again, with ha, we can't really use a MH as the clear distinction between the
• 10:10
  two conditions because you can have low and high A MH and in both cases, either
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  low or high A MH with HA as we resolve and fix the HA that should resolve itself
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  and get back to a healthy A MH level.
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  So overall, um, I think you can see here why it's so easy.
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  So like, clearly easy.
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  Again, I have a lot of compassion for both conventional doctors and functional
• 10:33
  medicine providers for why it's so easy to get this diagnosis, to get
• 10:37
  it mixed or to not fully understand the differences between the two.
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  And this is why, in my opinion, we need comprehensive lab work,
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  but also an in-depth assessment.
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  And that's probably the more critical piece that's often overlooked,
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  is really asking a lot of.
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  Detailed questions to more clearly distinguish the difference between HA
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  versus PCOS, especially not only in, you know, misdiagnosis of PCOS, but
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  especially in cases of lean PCOS, where it's even more common to be misdiagnosed
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  and again, while you can have a missing period in a regular period caused from.
• 11:11
  The chronic energy deficiency in your body.
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  Ha.
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  Um, you can have that at any body size.
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  We often, most often actually work with women at normal weights and normal bmi.
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  It is why, you don't wanna think to yourself like, Hey, I can only have
• 11:24
  HA if I'm like critically underweight.
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  That is just simply not true.
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  So as we're talking about the differences between PCOS and HA
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  before we talk actually about more comprehensive blood labs.
• 11:35
  So it's just what I have written down to discuss next.
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  I think we real quickly need to define kind of the different ideology of
• 11:41
  these two conditions to help you more.
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  Clearly distinguish them, right?
• 11:44
  'cause you're watching this episode potentially as someone who's been
• 11:47
  misdiagnosed or you're questioning your diagnosis, you're trying to
• 11:50
  figure out as you're working to get pregnant, is this ha, is this PCOS
• 11:55
  and the etiology of how we get to this place of a missing or regular period.
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  So vastly different in PCS versus Ha.
• 12:03
  So let's address that first before we talk about lab work.
• 12:09
  You've been told you need to gain weight, stop exercising or do IVF
• 12:14
  to get pregnant with no period.
• 12:16
  What if I told you that's not actually true?
• 12:19
  You're tracking your food, working out, trying everything to be healthy,
• 12:23
  but your period is still missing and now pregnancy, it feels impossible.
• 12:28
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• 12:33
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• 12:36
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• 12:39
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• 12:41
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• 12:46
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• 12:51
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• 12:53
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• 12:57
  that actually works even if you've tried.
• 12:59
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• 13:01
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• 13:09
  It's time to restore your period, your fertility, and your hope.
• 13:13
  Now let's get back to today's episode.
• 13:16
  So I have this wonderful graphic pulled up that I'm looking at right now.
• 13:19
  I recently took a course from the Women's Health Nutrition Academy.
• 13:23
  If you're a clinician watching this, I couldn't recommend their courses enough.
• 13:25
  Like I mentioned earlier, I'm a visual person.
• 13:27
  I really love seeing visuals.
• 13:29
  So if I can find a way to put this graphic up on this YouTube video, I will.
• 13:33
  But it does such a great job of representing the vicious cycle,
• 13:36
  which is what I a bomber in the.
• 13:37
  Course really addresses of what causes the, the kind of the cycle of
• 13:43
  perpetuation of PCOS, specifically between hyperinsulinemia and Hyperandrogenemia.
• 13:48
  So specifically.
• 13:50
  Insulin resistance, which is in almost all cases with POS, what's
• 13:53
  driving the condition causes the state of hyperinsulinemia in the body.
• 13:58
  This state of hyperinsulinemia it causes the pituitary gland to release excess
• 14:04
  luteinizing hormone or lh, which then affects the faca cells and the ovary to
• 14:08
  release excess androgens and indirectly affects the liver and reducing the amount
• 14:12
  of sex hormone bodying globulin produced.
• 14:15
  And all of this creates a situation in the body of hyper ando anemia, and
• 14:19
  this causes an increase in visceral adipose tissue, which then in turn
• 14:23
  increases free fatty acid production.
• 14:27
  Creating again, that vicious cycle, even more so driving the hyperinsulinemia,
• 14:31
  which causes a hypertro anemia, and the vicious cycle continues, which
• 14:34
  you can see here on this graphic.
• 14:36
  In contrast, in like complete contrast, hypothalamic amenorrhea, or even if we're
• 14:42
  gonna include hypothalamic dysfunction, meaning you have an obligatory bleeds,
• 14:46
  you have long periods, you have short, light periods, is caused from chronic
• 14:51
  energy deficiency, meaning your body is not getting enough calories.
• 14:55
  Rest and overall nourishment to support basic physiological functions in the
• 15:00
  body, let alone fertility like your body perceives that you're in such a
• 15:04
  state of unsafety, that it reduces the frequency in the intensity starting in
• 15:11
  your hypothalamus of a hormone called Gogo Trap and releasing hormone or GNRH.
• 15:17
  And without proper GNRH signaling, this causes the amount of follicle stimulating
• 15:22
  hormone and luteinizing hormone from the pituitary gland to drop, which means
• 15:26
  that follicles don't mature properly.
• 15:28
  And since estrogen is produced primarily in our follicles, in our
• 15:31
  ovaries, we don't have enough estrogen, proper estrogen production, which
• 15:35
  then in turn ceases ovulation because we don't have sufficient estrogen,
• 15:39
  nor sufficient FSH or lh.
• 15:42
  And because there is no ovulation, there is then no increase in progesterone.
• 15:46
  So there is just dramatically low levels of all hormones, estrogen,
• 15:51
  FSH, lh, and progesterone.
• 15:54
  And with lab work specifically, let's get into that.
• 15:57
  'cause you can again see like, gosh, that's just so different reasons why the
• 16:01
  body is essentially not ovulating and not cycling and therefore having infertility.
• 16:05
  But the.
• 16:06
  Reason that the root of these are happening are so dramatically different
• 16:09
  that of course the treatment for both needs to be so dramatically different.
• 16:13
  And part of that treatment, in my opinion, always needs to start first and foremost
• 16:17
  with a true root cause investigation.
• 16:19
  So let's dig into that component of this.
• 16:21
  So we talked about the Rotterdam criteria, right?
• 16:23
  But in my opinion, we need to be ordering really comprehensive blood labs.
• 16:27
  This is something we actually, we order for all of our clients.
• 16:29
  We order our own blood work because it.
• 16:32
  To be frank, very hard to get enough and to get sufficient amounts of this.
• 16:36
  The hormones that we want to see to clearly distinguish between PCOS and HA,
• 16:41
  because if we ever have a client come to us that actually does have missing
• 16:45
  periods from PCOS, we wanna address that in this specific matter in which
• 16:48
  it needs to be addressed through blood sugar regulation addressing the insulin
• 16:51
  resistance, the likely inflammation.
• 16:54
  Where again, h ha.
• 16:55
  Just such a different kind of like path forward as to what we would
• 16:58
  do to get the mi, the missing or regular period dealt with.
• 17:02
  So for us, again, we order labs 'cause it's rare to get all of this from a
• 17:05
  doctor, but if you can get this all from a doctor, what you want to be ordering is.
• 17:10
  Total testosterone free testosterone estrogen, LH
• 17:14
  F-S-H-D-H-E-A-S-A-M-H if you can get it.
• 17:18
  And then six, hormone binding globulin and typically PCOS is going to present
• 17:22
  with normal to high normal of both free testosterone and total testosterone.
• 17:27
  Normal to high estrogen.
• 17:28
  That really helps with distinguishing HA high LH compared to FSH.
• 17:33
  We're gonna come back to that one here in a second.
• 17:34
  But usually with PCOS cases, it'll be a two to one, to three to one
• 17:38
  ratio high D-H-A-A-S, high a MH, like very, very high, , and then
• 17:42
  low sex hormone binding globulin.
• 17:45
  Where in contrast with ha, what we typically see is low to normal
• 17:50
  estrogen, low to normal FSH and lh.
• 17:53
  Low free in total testosterone and either low or high a MH Because of
• 17:59
  what we talked about earlier with how if you have many follicles on
• 18:02
  your ovaries with ha, you could also have el elevated a MH levels with ha.
• 18:07
  It often gets missed too because the levels can be normal.
• 18:10
  Like if your estrogen is.
• 18:11
  50 or 60, your Dr.
• 18:12
  May say, Hey, that's a normal, technically speaking, but
• 18:15
  that's still on the lower end.
• 18:17
  Same goes for FS, H and lh.
• 18:18
  You know, if it's right at, you know, an eight, nine, or 10, they
• 18:21
  might say, Hey, that's normal.
• 18:22
  But for us, we know if we combine that with our in-depth assessment with
• 18:26
  eating and exercise and we identify there's some clear issues there, we
• 18:29
  know that we're dealing with an HA case.
• 18:32
  Okay.
• 18:32
  So when we're looking at lab work, I mentioned just a second
• 18:37
  ago, LH to FSH ratio, so.
• 18:40
  PCUS will typically present with an elevated lh, especially
• 18:44
  in comparison to FSH.
• 18:46
  But here's the kicker.
• 18:48
  Your LH luteinizing corpsman temporarily overshoot production as your hypothalamus
• 18:53
  begins to essentially like wake back up.
• 18:55
  This is pretty common in recovery and doesn't necessarily indicate true PCOS.
• 19:00
  So if we see that in lab work, which I'll be totally honest with
• 19:02
  you, can be pretty common to see, we typically want to reorder again.
• 19:07
  As we get the cycle more and more regulated, and if we see consistent
• 19:11
  patterns of a high L-H-F-S-H ratio, that indicates to us a true PCS
• 19:15
  case or an even more rare case.
• 19:18
  But this can happen, and again, it's why root cause
• 19:20
  investigation work is so important.
• 19:22
  You can actually have HA and PCS.
• 19:25
  And these can sometimes be the cases where the LH FSH ratio
• 19:28
  remains elevated consistently.
• 19:31
  So if that does happen, by the way, what we always do in those
• 19:34
  instances is to treat the HA first.
• 19:37
  We always start with renourishment.
• 19:38
  Getting the body in state of safety, regulating your nervous system, giving
• 19:42
  your body the rest required and.
• 19:45
  Throughout that we would always be supporting blood sugar.
• 19:47
  We do that with any cases because blood sugar dysregulation
• 19:50
  can affect egg quality.
• 19:51
  So in our practice we're just always considering, you know, anything
• 19:54
  that could affect egg quality.
• 19:55
  We want to support that as we are doing the work to get your period back.
• 19:59
  So in those cases of an HA versus P two s or a combination of both, we
• 20:03
  would be doing that from the get go as we do in almost all cases anyways.
• 20:07
  And then as the HA is addressed, uh, we would get into much more.
• 20:12
  Detailed work with A-P-C-O-S determining the root cause of
• 20:16
  PCOS 'cause that's a different conversation for a different day.
• 20:19
  More specific narrowed supplementation for that potentially medication if
• 20:23
  we think that would be warranted to work with our doctor to get that.
• 20:26
  Um, looking at again, inflammation and deeper blood sugar regulation work too.
• 20:31
  Okay, so I mentioned as we're doing kind of like an in-depth assessment, you
• 20:36
  always need to be looking at eating and exercise, and whether you're a clinician
• 20:40
  or a client watching this, and you are either working with a doctor, a functional
• 20:44
  medicine provider, you're considering working with our team, or you're just
• 20:47
  simply like going about this, trying to figure out what the heck is going on.
• 20:51
  You always wanna combine looking at the rdy criteria, the
• 20:55
  comprehensive blood lapse, not just simply, you know, testosterone
• 20:59
  and estrogen calling that day.
• 21:01
  You know enough.
• 21:02
  Um, you always have to intake account.
• 21:04
  Your history with dieting and disordered eating, your current eating and
• 21:09
  exercise patterns, and your stress load and nervous system regulation.
• 21:14
  When it comes to nervous system, we always address this through an HTMA
• 21:17
  or a hair tissue mineral analysis that helps us clearly see like the state
• 21:21
  of stress that the body is under.
• 21:23
  And while we don't use that to diagnose.
• 21:26
  HA versus PCOS.
• 21:27
  We do use that in the picture of, okay, what is going on in that person's body
• 21:31
  and how do we support them to restore their fertility and get pregnant?
• 21:34
  Um, and I say that specifically because with both PCOS and ha, you can have
• 21:38
  a dysregulated nervous system, but specifically eating and exercise will
• 21:42
  really clearly help us see HA versus PCOS.
• 21:45
  People with HA are going to have.
• 21:47
  You know, really low carb, high protein, very strict diet, sort of the people
• 21:52
  who originally, you know, put their, their food on my fitness call every day.
• 21:55
  They count their almonds, they weigh themselves daily and
• 21:58
  certainly PCOS can Many people with PCOS have disordered eating.
• 22:02
  There's actually statistics that show that you can have four times higher
• 22:05
  likelihood of disordered eating with PCS, which again, kind of add the complexity
• 22:09
  here and why I just so personally.
• 22:12
  Believe deeply in working with a peer recovery specialist, but all to
• 22:15
  say, typically with an HA case versus PCOS, you're just gonna see a lot more
• 22:21
  stricter diet and exercise patterns.
• 22:23
  Um, a lot of intense exercise specifically and a lot of, uh, lack of rest days.
• 22:28
  Typically, these are gonna be people who are exercising.
• 22:30
  5, 6, 7 days a week, as well as walking 10, 20, 30,000 steps per day.
• 22:35
  They're gonna be the more type A perfectionistic, highly overachieving.
• 22:40
  There's just like some common characteristics that come alongside Ha,
• 22:43
  and that really speaks to the stress load and nervous system piece too.
• 22:47
  Okay.
• 22:48
  So if we are like my clients, Allison Caitlyn, Sarah Lard, who all came
• 22:56
  to me with a dis a diagnosis of PCS, they got it in their teens actually
• 23:00
  when they had eating disorders.
• 23:02
  Um, and were put on birth control for over a decade and then came up
• 23:05
  birth control to try to get pregnant and boom, their periods went missing.
• 23:07
  And they've been, sit down this, you know.
• 23:10
  Crazy rollercoaster ride of trying to figure out what's truly going on here.
• 23:13
  PCS versus Ha.
• 23:15
  If you are like my clients, here's what I want you to do.
• 23:18
  The solution is not just to assume you have PCS simply because you have
• 23:22
  a missing or an irregular period.
• 23:24
  You wanna start with a comprehensive root cause investigation.
• 23:28
  You want to have a personalized protocol based off your root cause investigation,
• 23:33
  what your blood labs show us, as well as your HMA testing and your.
• 23:37
  Full health history, including current eating and exercise patterns, and we
• 23:43
  really need to make sure that you're getting support every step of the way so
• 23:45
  that we can address really in the cases of ha the root of why that's happening
• 23:50
  is your relationship, your strange relationship with food and exercise.
• 23:54
  So we have to address that as we're following the customized protocol to
• 23:58
  get your peer back and get pregnant.
• 24:00
  If you, at the end of watching this are like.
• 24:02
  Hmm.
• 24:04
  This is like, this has piqued my interest.
• 24:06
  I think there is a high likelihood here that I could have a misdiagnosis
• 24:11
  or an unsure diagnosis, or I'm personally trying to figure out what
• 24:14
  the hell is going on in my body.
• 24:16
  Let's figure that out together.
• 24:17
  Like that is so much of a heavy burden to bear on your shoulders and having an
• 24:22
  expert to guide you who understands just so deeply why active women so commonly
• 24:28
  get misdiagnosed with PCS and help you truly see what's going on in your body.
• 24:32
  Because we need to understand your body's unique reason why it
• 24:35
  has a missing, a regular period so that you can get pregnant.
• 24:38
  We would love to work with you.
• 24:40
  This time of the year is very busy for our practice.
• 24:42
  We have very limited spots left inside, premier period recovery for fertility.
• 24:46
  But if you reach out today, we may be able to get you in by
• 24:48
  the end of this year so that.
• 24:50
  You can get pregnant in 2026.
• 24:52
  If you have any questions, drop them below in the YouTube comment section.
• 24:56
  So glad to be officially on YouTube and cannot wait to be back in
• 24:59
  two weeks for another episode.
• 25:00
  Until next time, know that Nourish Body is a powerful one.