8: PCOS & Dysbiosis: How Your Gut Microbes Influence Your Hormones

Episode Transcript
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(00:00):
What's happening is your body's producing way too much insulin,
right? And then you're given metformin
for it, for your blood sugars, right?
So that's another really common medication for PCOS is like here
you go take metformin. Great.
So metformin is really good at like improving the cell
sensitivity to that insulin being produced.
But what about the production? Like where is that coming from?

(00:22):
What is going on? Why is there so much being
produced in the 1st place? So that's typically the the
starting point is what I feel when we talk about the metabolic
nature of PCOSI feel like that plays one of the biggest roles.
Welcome to the Gut Fit NutritionPodcast, the show where we dive
deep into the world of gut health, nutrition, and fitness

(00:42):
to help you unlock your best self from the inside out.
I'm your host, Lee Morado, a registered dietitian, gut health
expert, long distance runner, and movement enthusiast on a
mission to empower you with science backed whole body
strategies to fuel your body, heal your gut, and thrive in
your active life. Whether you're here to finally
break free from IBS and digestive symptoms, optimize

(01:03):
your fitness performance, or learn how to support your gut
health with natural strategies, you're in the right place.
Each week we'll explore topics like conquering digestive
symptoms, building a gut friendly lifestyle, enhancing
endurance and strength performance and.
More. So grab a cup of your favorite
gut friendly tea and settle in because we're about to get gut
fit together. Today, we're diving into a topic

(01:26):
that bridges 2 important areas of health that are often treated
separately, your gut and your hormones.
In today's episode, we're exploring PCOS and dysbiosis.
Specifically how your gut microbiome can influence the
development and management of polycystic ovarian syndrome.
We'll break down the science, but behind the gut hormone
connection and what it means forthose navigating gut symptoms

(01:47):
like IBS, SIBO, or GERD alongside hormonal conditions
like PCOS. Whether you've been diagnosed
with PCOS, suspect that you may have it, or simply wanna
understand more about how your gut health impacts your
hormones, this episode is packedwith insight and actionable
strategies. Joining us today is the
incredible Sana Mutlakar, a registered dietitian with a

(02:07):
Master of Public Health specializing in PCOS, weight
loss, fatty liver, and diabetes.Based in Toronto, Sana brings
over 12 years of experience helping women feel at home in
their bodies without restrictionor sacrificing their cultural
food roots. Her approach is deeply personal
and holistic. She blends science based
nutrition care with yoga, somatic practices and nervous

(02:30):
system regulation to help her clients build sustainable habits
and reclaim their health. Let's get into today's
discussion. Hi Sana, welcome to the show.
So happy to have you on today. Thanks for having me, really
excited to chat. Yeah, I've actually gotten quite
a few requests to do either likean article or a podcast episode

(02:52):
about PCOS and got potentially IBS connection.
So I'm really happy to have you on because I know you specialize
in this specifically. So it'll be really good to have
a chat and PCOS is obviously like very common.
I think last check the stat is like 6 to maybe 12% of the

(03:13):
population but. It'll like, yeah, for sure,
totally. Because usually the standard is
like, one in every one in 10 women has PCs, right?
But that's based on the information we have and the
statistics they've collected. But I'm sure there's more
because a lot of people get diagnosed way down the line, or

(03:35):
they get sort of, you know, justdismissed by their doctors and
nothing's done about it. And then much later they'll get
to realize that, OK, that was PCs all along.
So yeah, it's very, it's very under diagnosed.
Yeah. I think I saw the stop was like
70% people go undiagnosed. So even having 10 is probably,

(03:57):
yeah, a real underestimate in terms of totally for sure.
That's our so, yeah. And I think The thing is too, it
also like, obviously there's like the symptoms that you deal
with directly, like the irregular periods, but I know
that it could contribute to, I think other sort of whole body
issues specifically like metabolic issues, blood sugar

(04:20):
dysregulation, weight gain. So, yeah, considering it so
common and important, I'm, I'm happy to, to chat about it
today. Yeah, yeah.
Just to start off, why don't youmaybe give us some background
about yourself? Probably some people listening
are familiar with you, maybe came from your audience.
But for those that aren't, you can tell us like who you are,

(04:41):
what you do, who? You help and yeah, yeah, for
sure. So yeah, my name is Senna and I
am APCOS and weight loss dietitian.
Obviously, I didn't sort of likefall into this right off the
bat. Like, you know, when you go
through university, it's not like we get specialized and
anything specific. So we get to explore all

(05:03):
different areas. So I've done like a little bit
of renal, I did a little bit of bariatric, a little bit of
cancer and whatnot, right. And I think I was, it was second
year of university and I was on holiday.
So I was visiting my family backhome and I noticed my sister had
like Metformin. I'm like, oh, this is a blood

(05:24):
sugar medication, why do you have it?
And then she said like, oh, I went to the doctor and she said
I had PCOS. I'm like, what is PCOS?
And I had no idea what the hell it was.
And so honestly, that is the light bulb moment for me because
I was like, what is going on? Why they using blood sugar
medications for this? And I started sort of like going

(05:44):
through my own sort of like research.
And again, even at university level, everything is very
generalized. So they'll just tell you, yeah,
make sure you're eating more complex carbs and increase your
protein. It's very generalized
guidelines. So you can't really make much of
a difference with just that, right?
Because again, when I went through the whole like research

(06:08):
phase, I'm like, OK, PCs shows up very differently for every
individual. So not like two women can't have
the exact same symptoms. They can have very different.
It shows up very differently. We have lean PCs.
We have clients who are also trying to manage their weight.
So yeah, it was, it took a while, just sort of like going
down that rabbit hole of sort ofunderstanding what it is, what

(06:30):
the connections are. So, you know, even though it's
like a period issue, but if you told me to round out what PCOS
is, I would say it's a hormonal and metabolic condition.
So, yeah, so that's kind of where I started and then
obviously started my practice and I worked only with women and

(06:50):
also women who come from different cultural backgrounds
because that's really important to me because that was also a
huge gap in terms of finding resources that can be sort of
adapted to people who came from different cultural backgrounds,
right? Again, when I was doing my
internship, every document, every resources we had that we
could sort of share with people,it's very, very generic, right?

(07:14):
So, yeah, that was my interest in just sort of learning
different culture, diets. A lot of my friends come from
different cultural backgrounds, so that's super, super helpful.
I learned so much from just sortof, you know, interacting with
different people. And yeah, that's where my sort
of practice started from. Yeah, I guess.
Yeah. Going back to that, have you
like helped your sister at all or?

(07:34):
Yeah, it's actually my, my. Yeah, I know.
I know. Yeah, totally.
Yeah. Huge difference.
And the other thing is, like every woman in my family, so
genetically, there's a huge sortof genetic component that runs
in my family. So every woman, every cousin of
mine, we all have some form of PCOS.

(07:54):
Some are able to get diagnosed and some can get diagnosed for
it just because they don't meet that criteria right.
Being that you know you need to meet two out of the three
criteria to to get diagnosed forPCOS.
Right, right. Yeah.
So yeah, I guess it's, it's described as like a hormone
imbalance that impacts like the ovaries, yeah, you know, play a

(08:17):
role in the reproductive system.Can you sort of break down like,
yeah, just what the, what the diagnosis of, of PCOS is?
Yeah, for sure. So, so typically the way it
shows up, a lot of times when people are like, oh, something
is going, something is off with me, it's usually the period
because that's something that comes every month for women.
And when that starts to sort of like go missing, they're like,

(08:41):
OK, what's going on? So missing period is one of the
the criteria or irregular periodis one of the criteria.
Second being sort of having morefacial hair growth or or hair
loss. So just kind of signs of
elevated androgens. Now something important to see
that I have clients who tell me that they've done labs and

(09:04):
everything looks normal. So the doctor's like, no, you're
fine, Your androgens are OK, butI always tell them that you want
to go by the symptom. Your body is showing up, right?
So if you're still having excessive hair growth, hair
loss, it's telling me that your body is not loving even maybe
that uptake, 1 uptake point in your androgen levels, even
though if it's in that normal range.

(09:24):
So we can't look at it as like, OK, black and white situation,
right? So the androgens.
And then of course, third, if you end up getting an ultrasound
and there's cysts on the ovaries, then that's the third.
So you just need 2 out of the three to meet that.
And even with like the, the, thescan of like the ovaries, I
always tell my clients that it'snot permanent.

(09:45):
Like those cysts are not permanent.
They change every three months. The picture of your ovaries
start to change depending on obviously the input you're
giving them in terms of like, you know, your diet, lifestyle,
environment changes and all thatstuff.
I think it's breaking down the irregular periods a bit more.
Is that either like a skipped period or long cycles, which I

(10:07):
think is defined as? Like it could. 35.
Yeah, yeah, exactly. So it could be like people don't
get it for like 3 months, could be anywhere like 35 to 45 days
and longer sometimes. So I have clients who start off
with me and they'll haven't gotten one in six months.
So it could also show up as that.

(10:29):
And in terms of like the, the science behind or like what's
manifested in the body that causes your periods to go
missing again, it's so like PCOSis so complex.
You can't just like pinpoint that one thing, but like, Yep,
that's it. And so when there was all these
things on social media, but what's your type of PCOS?

(10:51):
Let's do a quiz and tell me whatyou know.
I'm like, no, no, there is no type.
It's usually a manifestation of these different things, right?
So I, I usually describe PCOS aslike a spider web.
And in order to kind of clean that web down or bring it all
down, you can just like pull on that one string.
You kind of need to like work simultaneously on all these

(11:12):
different different different areas in order to kind of sort
of put your symptoms into remission.
Yeah, that makes sense. I guess going back to it being
like undiagnosed for a long period of time, do you find it's
also like misdiagnosed first? Like people are sort of told
that there's another condition, or do you think it's just more
commonly they're told that nothing is wrong?

(11:35):
You know what the most common thing?
Not like I know endometriosis isoften misdiagnosed, I've heard
that a lot. But with PCOSI, often just find
that they're just dismissed in the sense that they're typically
showing up at your doctor's office potentially a little
overweight or whatnot, and your doctor's like, oh, it's because
you're not active or it's because of your weight, right?

(11:57):
So that's why your parents, theydon't you don't get a diagnosis
and they're not taken seriously because that's what's typically
happening. Have you sort of like come
across something else in terms of like misdiagnosis?
No, not specifically with PCOS. Yeah, I would say rather just
being like undiagnosed. Or just undiagnosed?

(12:18):
Yeah, for sure to get. Like due to investigations,
especially here in Ontario, it'slike delayed to do the pelvic
ultrasound and then. Oh my God, yes.
Work and then referral to an endocrinologist and like it
could take a year to go through like the testing.
Yeah, actually, having said that, it's usually also when you
show up to your doctors and asking that, hey, I feel

(12:40):
something is awe and I need to run these labs.
They often say no. And then sometimes clients are
like, yeah, my doctors ran labs for me and I take a look at it
and it's the very generic, very basic things.
That's not going to tell them anything, right.
So that's happening. And then again, depending on
your cultural background, if you're South Asian or Hispanic

(13:01):
and you generally have a little bit more facial hair or just
like more body hair, then you'rejust like dismissed.
You're like, no, it's normal. It's just genetics.
It's just, you know, how things are with your cultural, you
know, women. So that could sometimes also be
an issue. Same thing with women with hair
loss. They're complaining, Hey, I've
got a lot of hair loss now. If you are South Asian you have

(13:25):
like good like thick. Hair.
The doctors are not going to take you seriously.
They're like, you look fine, like there's nothing wrong.
You're fine. Just wait for a couple months
and then come back. But that's why like they just
don't don't take the patients seriously.
Yeah, yeah, it can be tough. I know.
Yeah, just with our medical, medical system, there's only

(13:47):
limited time, I think. Doctors, I feel for doctors too.
Absolutely, absolutely. There's just not much time.
They work till, you know, death themselves.
So I get it. It's the system that's the
problem, right? And the doctors are just doing
what they're expected in that certain time frame.
Yeah, for sure. Yeah, I know from you
personally, I don't, I think I was misdiagnosed.

(14:10):
But maybe the way that you describe the, the like the
cysts, how they can change, maybe it wasn't.
But when I was in my late teens,maybe it was early 20s because I
had like, I'm open about this. But since I first got in my
cycle, like it had always been aregular, like I would sue months
at a time and then it would be normal for a little while and
then go away. I did like the lab work.

(14:33):
We also did a pelvic ultrasound.Doctor said that there were some
small cysts, but I didn't have high androgen levels.
And what happens with that? But I was told by like my family
doctor at the time that I had PCOS and then told to go on
birth control is the way to fix it, which we'll get more into.
But since then, I actually endedup seeing like another doctor

(14:55):
and we did more testing and I actually was referred to like an
endocrinologist who's really great.
And for me, it wasn't, I think we detected it wasn't PCOS for
me. It was actually just
hypothalamic menorrhea. Like I was just, I founded like
that activity, not eating enough.
Yeah, high stress. And based on that, I actually

(15:16):
had low estrogen and wasn't ableto have like a normal cycle.
So all that to say, I became a little bit of an expert in PCOS
because I thought that I had it.But I think yeah, yeah, yeah.
Not quite the full picture, but like you said, it can be complex
and like it's, it's definitely like polycystic ovarian
syndrome, right, with a syndromecollection of symptoms which can

(15:36):
exist in other conditions too. So it can be quite complex and I
think even just to like nail down the diagnosis.
Can be totally. Yeah.
Yeah. I guess, yeah, with with all
that said, like I know it's one of those conditions too where
we're like, no, we don't really know what causes it.
It's unknown, but I'm assuming there's some pretty strong

(15:58):
theories. I guess.
Do you want to maybe walk through what, what what's?
Yeah, yeah, for sure. As I said, like it's a web,
right. So it's often like a combination
of things that I see in my practice with women.
One of these starting point is often the insulin resistance
aspect, which which is also something that honestly gets

(16:20):
missed so often in the labs because what's usually done is
you check your HBA 1C, right? And that's often in the normal
range and you're done. Your fasting blood glucose,
that's in the normal range. Your doctor's like, yeah,
everything's looking good. However, when you're looking at
the those numbers together and you're looking at your Houma IR,

(16:40):
you will always get an indication of that.
Oh, this person is actually insulin resistant, right?
So it takes a while for the stuff to sort of like unravel.
So there's so much we can do if we're just told properly that
day. I've checked these numbers, I've
done your ratio, and this is what's sad.
So just be mindful and try to work on improving your cell

(17:02):
sensitivity to insulin. Now, that is typically the
biggest piece. So I often would start my
clients off there. That's like my first phase is
helping them just regulate your blood sugars better, improve
your cell sensitivity to the insulin because what's happening
is your body's producing way toomuch insulin, right?
And then you're given metformin for it, for your blood sugars,

(17:26):
right? So that's another really common
medication for PCOS is like hereyou go take metformin.
Great. So metformin is really good at
like improving the cell sensitivity to that insulin
being produced. But what about the production?
Like where is that coming from? What is going on?
Why is there so much being produced in the first place?
So that's typically the the starting point is what I feel

(17:48):
when we talk about the metabolicnature of PCOSI feel like that
plays one of the biggest roles, right.
And then of course, we do know that more insulin means a
communication with your ovaries is telling it to produce more
testosterone. More testosterone means like,
OK, your periods are going to get irregular and then all the
other symptoms start off with that, right?

(18:10):
So we want to take care of that piece genetic.
I mentioned as I said that this it's a very common thing like if
your sister has it or your cousins or your aunt, someone in
the family has it, there's a higher likelihood of you having
PCOS as well. So that's important to look at.
And then it's like a did the chicken or is it the egg that
came for a situation because there's always inflammation.

(18:32):
So we don't know that, Oh, is itinflammation that that makes you
insulin resistant and then the insulin or is it that, Oh no,
the insulin resistant then makesyou more inflamed because that
that's also a pathway, right, where you start to develop more
inflammation in the body. And then the one that I focus on
a lot is the stress and your nervous system.

(18:53):
And of course with you also doing you're you coach for IBS
and the nervous system plays a huge role in your gut too,
right? So that's another pathway where
I find that clients who've oftengone through really major
episodes of either trauma, whether it's in childhood or
adulthood, that typically put your body into fight or flight.

(19:16):
So even when the stress is sort of like taken away, their body
is still still reacting the sameway.
It's not able to sort of down regulate and move into their
safe space. So then again, your body's
making all that like cortisol from your adrenal.
So that has a lot to do with your adrenals working really
hard. So that's where I find a lot

(19:36):
adrenal issues are common with lean PCOS women as well.
I find that in terms of the trend that I've noticed with my
clients and the pattern I've picked up on, that's very
common. So often their DHEAS is
elevated, which is like a the other androgen, not the
testosterone. And that will only come from
your adrenals. So that's very responsive to

(19:57):
cortisol. So these are like the typical
things that I find is like basically rude driving, like
rude drivers of PCOS, yeah. Yeah, Yeah, that makes sense, I
guess. Yeah.
Going back to the insulin and just to define it, so insulin is
a hormone produced by a pancreasthat essentially acts as like

(20:18):
the gatekeeper, I guess to tell,yeah, like a lock and key sugar
into the cell. Yeah.
So if insulin, if our cells are not as like sensitive to
insulin, then correct, our, our sugars are going to build up in
our blood because they're not making their way into the the
cell, correct? We're, you know, we're in sort
of like a place of like Wellnessinformation is so accessible and

(20:42):
everyone's into their health. But I think we're also seeing
like globally an increase in sort of like insulin and maybe
metabolic driven condition. So I think not even just with
PCOS, but also fatty liver is onthe rise exactly like obesity,
other things too. So I think even going back to
not knowing what causes PCOS, the way that you break it down,

(21:04):
I think that we can kind of see how maybe it's, you know, the
part of the the greater picture of of.
Health society Health, that may be, yes, honestly, totally.
There's so much more research left to do, right?
We just don't, we don't even have all the information, but
just from like what we're seeing, the patterns we can make
sense and we're like, OK, where should we focus our energy on

(21:27):
and what can I do? What changes can I make to sort
of like improve the symptoms? At least at least we have like a
starting point. But yeah, yeah.
Interesting. I guess with the the chicken or
the egg idea, like I was going to ask, do you think that
insulin resistance is often the cause of PCOS?
I guess I had always thought of it as like PCOS leads to insulin

(21:49):
resistance. But now that it now that you
explain it that way, actually, yeah, that maybe it's it's the
first to happen and then it can.Change, I think so like if I
would yeah, I would think that something is happening, right?
Whether it's like lifestyle changes have happened or
something like I have clients who've gone to university and
now your environment has completely shifted, your stress

(22:11):
hormones have gone up, and then they start to notice all these
symptoms. So it's again like a combination
of like the stressors, your blood Sugar's going out of whack
or your insulin is being produced potentially from
stress. Even if you're eating really
well, your body can still be producing all that excessive
insulin just from responding to that excessive cortisol

(22:31):
production, right. So again, it's like I feel like
there's some, there's always something happening in the
background apart from like, OK, there's insulin production, but
I feel like there's always something else.
So it could be the stressor or it could be, yeah, the
environmental aspect. Yeah, for sure.
Even diet components which we can get more into.
Yeah. I think like just a common lack

(22:52):
of fiber. In the diet.
Oh my. God, yes, eating patterns, like
all that stuff definitely contributes and you see it
amongst like other, other conditions too.
From yeah, from your perspective, I know I mentioned
like personally, I was told to take your control pill to help
with PCOS. What do you see as like someone
goes to their doctor tell like they find out they have PCOS,

(23:14):
they're given information to manage it from like a medical
perspective. And then second layer to that
question is like what? Yeah.
Maybe you dive into a little bitmore around what you feel is
like sort of primary management.Yeah, for sure.
I feel like the most common onesthat are prescribed is
definitely birth control and then metformin.
So those are the 2 common options provided.

(23:37):
But when you look at the first line of treatment, it's actually
nutrition and lifestyle that is the first line of treatment for
PCOS management. But anyways, then you're
provided like birth control and metformin.
And yeah, in terms of like, did you say like what to sort of
like how to address it? What was your other question

(23:58):
like? Going back to that, what like do
you feel like either metformin or birth control really helps
the PCOS or what is your good? Question, I like to keep an open
mind, right? But I would say when like with
the women that I've worked with,I would say only two clients I
found would be were good candidates to get a go on birth

(24:20):
control because they saw no changes.
And that's a very small percentage of my clients, like
extremely, extremely small because majority of them when
they sort of like work on your blood sugars, they worked on the
nervous system, they're working on their gut health, they are
symptoms sort of like just fall into place.
So they kind of experienced the remission of all the symptoms,

(24:43):
right? Metformin again, when I
explained what like metformin isdoing, yes, it can get you to a
certain point in the sense your cells can just be more sensitive
to that insulin, but it's not going to stop your body from
producing all that insulin. So you need to still look at
what's driving the issue rather than putting like, OK, just sort
it, sort the cells out, like just it's a Band-Aid solution,

(25:06):
right? And in my opinion, so that's
kind of how I feel about it. It's like fine, go for it, but
you can't just not look into thedeeper drivers of your symptoms.
Yeah, definitely. I think the argument too with
the birth control is that if someone is like missing periods,
I think it's a risk to go more than three months without having
a period. Like I think it's correct,

(25:27):
increases your risk for. Endometriosis, cancer and yeah,
yeah, yeah. Endometrial cancer, yeah, I
guess. That's the big concept, or what
the doctor's thinking is maybe just the fastest way to minimize
the risk. In a sense, it's like, take this
pill, then you bleed, then we'rereducing this like the risk of
cancer. But to your parents, like if we

(25:47):
really want to get to the deeperroot of the issue and, you know,
maybe prevent like other conditions that are related to
insulin resistance, then absolutely, you know, absolutely
dietitians. But I always think, yeah,
totally dietary lifestyle. Component, I mean, I do tell, I
do tell my clients that when they come to Maine, if they
haven't had a period for a really long time and they're

(26:07):
rocking up at like 6 month, no period, I'll tell them that.
OK, let's let's get started. However, you may want to talk to
your doctor and get like a period induced, right?
So you can be on that seven day pill and just sort of like shed
the lining. And then while we work, we can
sort of like work on regulating your cycle.
But I've also had clients who decided not to go that route and

(26:27):
then two-month end, three month end, they ended up getting a
period anyway, but it was a really long period, right?
Because there's all that lining that needs to be shed too.
And then it just sort of like improves from from that point
on. But yeah, there's a place for
everything. It just depends what you're
comfortable with and having all the information.
That's like the really importantthing is not, not everyone is is

(26:49):
been told that, OK, this is whatthe birth control is doing.
When you come off it, it your symptoms can go worse, right?
Same thing with metformin. You need to be on it, but
doesn't reduce all that insulin production.
So as long as you have all the information and make a sort of
informed sort of decision that I'm OK with and I'll support you

(27:10):
with the nutrition side of things, it doesn't matter.
Yeah, yeah. And yeah, I think we're sort of
in a situation now where there'slike information overload, like,
oh. My God.
On social media before I was so maybe in some sense like we have
access to a lot of information about this, but I think for
people who are maybe not as likehealth literate literate, it can

(27:31):
be hard to make sense of all theinformation.
So I think to that point, like ask your doctor like lots of
questions, like I'll make sure that they inform you of all the
risks. But I think connecting with
someone who does have a strong science background, a regulated
health professional, someone whospecifically specializes in PCOS
in this condition, like that's where you get your information

(27:54):
from. And maybe be a little bit
critical of everything online because I'm sure you could find,
Oh my goodness, talk about what to do for your.
I don't even know what to say toyou.
I have clients who have come to me after working with so-called
PCOS coaches who are people who've had PCOS and now they're
going ahead and coaching people,right?

(28:14):
Very unregulated stuff. And that really scares me in
terms of like putting your health in someone's hands that
haven't had the educational background.
So yeah, you. Are right, Yeah.
And it can be stressful too. Like I, I don't, I have someone
who posts my videos on TikTok, but I've never spent more than

(28:35):
like 5 minutes on there because I find it like for me it's
stressful because I see all thislike weird stuff.
But I can imagine for people whomaybe don't have a health
background, it can be like overwhelming.
And then you get more anxious about how to manage your
condition and then point about the nervous system regulation.
Then you're anxious about how you're feeling, what you're
doing for it, and you're maybe developed disordered eating and

(28:56):
it can kind of spiral into, you know, not the best coping
mechanisms for the condition. Totally.
Yeah. I feel like this person's
telling me don't eat Glenn, thisperson telling me don't eat
dairy, this person's eating, don't eat this, don't eat that.
And then it's like, OK, what do I eat?
And you get like paralyzed, right?
To like a decision paralysis. So you're like, OK, I don't know

(29:16):
what to do. So yeah, it's very overwhelming
to be on social media and seeingall that, for sure.
So yeah, maybe say to whoever's listening, take breaks, don't
have the app on your phone, and be very careful about who.
You, yes. I often even tell my clients
unfollow as many as possible andjust limit it to a few people

(29:41):
whose messaging and content you like.
It's professional and it's positive and it's not making you
feel like shit. So then just limit and then lock
the rest so that you can focus and just like work on you and
not look at what everyone else is doing or you know, what your
colleague is trying today and what your neighbor said would

(30:03):
help and things like that, right?
So you can just shut that noise off a little bit.
Yeah, exactly. Definitely going back to the
period piece too. I think yeah, like 2 point about
weighing the pros and cons of the birth control because I do
want to say like it is it is important to be having like a
regular cycle and that is something that we want to fix.

(30:23):
But maybe you know, birth control maybe is like layer down
the track if you've tried sort of the.
Exactly, exactly. Yeah, As I said, like I've come
across like 2 clients. I'm like, Yep, I think you are a
good candidate. Let's let's talk to your doctor
and and do that, right. As I said, there is room for it
there. There's a place for it.
Once you've sort of like done all your basics, right, You've

(30:46):
worked on your nutrition, you'vedone all the done everything
else. And if still your body's not
responding, then yeah, there's aplace for it for sure.
And I do want to go back to, I guess for whoever's listening,
my periods are now regular, if anyone.
Oh. Good to know anymore, but good
to know. Yeah, I think I saw the endo

(31:07):
maybe we worked together like 5-6 years ago and once I had an
understanding of that's what it was, then it just for myself
because obviously like I'm, you know.
You exercise a lot as well, right?
Yeah. And you exercise a lot.
And then you just have to kind of like fine tune your your
food. And make sure you're getting
enough like nutrients and stuff like that.

(31:28):
Yeah. Was that the main thing, the
balance of the the stress? Like I think like work out a lot
not having enough carbs and thenlayer on correct.
And not the best sleep hygiene. And once I sort of realized that
and figured it out actually for the last like 4 years cycle has
been like beautiful spot on. And I my endo said like she's

(31:49):
very rarely ever seen someone cure their HA.
So I was like, yes, for. Yes, of course you're like,
yeah, you're like I'm the research here, I'm the project.
So I'm going to work on myself and see trial and yeah, that's
amazing. That's.
Amazing. It's interesting and yeah, yeah,
once like just being yeah, consistent with it, but.

(32:11):
Yeah, I do think, yeah, I do think a body is a very
intelligent system. I truly, truly believe that your
body is extremely smart. The feedback you give it or
whatever, like the inputs you'regiving it, it's going to then
tell you how things are going, right?
So your symptoms are often just like, cry for help, but hey,

(32:32):
something is not right or something is off.
Let's let's dive in and figure out figure this out.
Exactly. Yeah, we need to, I think to
that sense pay more, pay more, pay attention to like what it's
what it's telling us for sure. So let's dive into a little more
around like the gut hormone connection.
So I guess to start, yeah, I'll ask you, do you see like an

(32:55):
overlap of people with PCOS and then digestive conditions like
IBS or GERD or IBD? Yeah, so I will often see common
symptoms such as bloating. That's a big one.
Bloating Constipation is a big one too.

(33:16):
I see some IBS, so they're actually diagnosed with IBS as
well. And yeah, acid reflux.
So these are common with women who have PCOS with the bloating
and then the Constipation. Like if your bowels are not
regular, it's kind of giving youlike it's telling you that your

(33:37):
one of the pathways where you can get rid of the excessive
circulating hormones or androgens, that pathway is not
working. So then it makes sense if you're
seeing these uptick in certain hormones like your estrogen or
your androgens, right? So again, so it looks like OK,
gut needs to be worked looked at.
So that's one of the phases. I said, like my program has the

(34:00):
blood sugar piece, which is phase one, the nervous system
phase two. And then the phase 3 is the gut
because we can't like we cannot bring anything into balance
without like looking at the gut for sure.
Yeah, yeah. So yeah, those are very, very
common. Yeah, but with with IVS like the
main or we know now like the main driver driver symptoms is

(34:23):
gut dysbiosis. So something is off track like
in the intestinal microbiome, mainly the large bowel, but
sometimes it can be in the smallbowel and there's some imbalance
there where there's more pathogenic bacteria and not
enough of the good. And we know the good stuff.
Pathogenic, they create sort of endotoxins, the common ones
being like the lipoplate polysaccharides, which then can

(34:45):
create like inflammation on the the lining of the gut and then
also sort of causes like a heightened response with the
immune system. So we tend to see like more
mast. Cells which are like our immune.
System cells and those with IDs and then that leads to actually
the symptoms and the oversensitivity too.
Interesting. And what about histamines?

(35:05):
Do you see that too? So there it the, the idea is
that like the increase in mast cells in the like intestinal
tract is where maybe like the response to high FODMAP foods or
just like a, a hypersensitivity response to even just like
normal fermentation of fiber or portions can result in that just

(35:27):
like more sensitive nerves of the gut in IBS.
So there's actually like a strong like immune system piece.
But that said, like there even we know now like the imbalance
or the dysbiotic state in the microbiome can also contribute
to like difficulty regulating blood sugars and even diabetes
is linked with dysbiosis. So I can see how like and PCOS,

(35:51):
which maybe you said the root isthat insulin resistance, yeah
actually be maybe even driven by.
Like absolutely, absolutely. Yeah, totally.
So usually when you look at the gut of a woman who has PCOS
versus someone who doesn't have PCOS, the the person who has

(36:13):
PCOS, their gut bacterial population is definitely off.
So you see a higher population of the bad, lower population of
the good. So the Lactobacillus, those are
quite low in women who have PCOS.
So all the helpful bacteria are on the lower, they're trending
down downward. So that also makes sense because
your cells get more resistant too.

(36:34):
So if your gut bacteria is not sort of, if you don't have the
best population of like your helpful bacteria, then yes, you
get more insulin resistant over time.
Inflammation is also coming fromthere because your immune system
is literally all in your gut. You see mood fluctuations.
Again, that's connected to your gut.
We talked about the nervous system, which obviously runs all

(36:56):
the way down to your gut. So yeah, that's a very common
thing for sure. Yeah, I know.
I was reading that the I think the gut microbiome profile yeah,
PCOS was seemed to be different than.
Correct. Those without, yes, I think it's
the two that are definitely low is the lacto and then the the

(37:17):
bifidobacterium. The both are on the lower end
which we want more off. So yeah, yeah.
And we see those low in in IBS as well.
Yeah. And unfortunately they can
further decrease if someone is on low FODMAP diet for.
Too long? Yeah, that's true.

(37:37):
So how long do people typically stay on low FODMAP with you?
So we say low FODMAP diet is a as a process like it's a three
phase process. So the first phase, which is
like our elimination phase whereyou're just eating low FODMAP
servings as per flash or FODMAP.Friendly one, actually testing.

(37:57):
Minimum two weeks because you need that amount of time for an
elimination diet up to about sixweeks.
Sometimes I have people like do a little bit more if we're
working on other things because I don't like we don't do just
low FODMAP. There's more going on.
And then I like to start people on the challenge phase where?
We. We introduce foods and then
personalize. But that said, you know, I have

(38:19):
so many clients that come to me that are like they saw their
doctor handed her. Diet list, Yeah.
Oh damn, to me. And we have to get them.
Get them off of it. Yeah, to correct the the
microbiome because it's just their diet's been so restricted
because Fodmaps are prebiotics, there are a lot of really good

(38:39):
healthy foods. So being on it too long actually
works works against us so. Absolutely.
Yes, for sure. I guess with the the connection
between like our sex reproductive hormones, which I
believe includes like our estrogen progesterone and then
the androgens like testosterone and DHES.

(39:01):
How did those like maybe connectwith the the guts?
Like I, I sort of have like somewhat understanding of this,
but you can maybe explain like how, yeah, how like what, what
regulates or yeah, if what the connection is between how the.
Gut regulates those. Yeah, for sure.
So as we were talking about earlier in terms of, you know,
we've got like these good bacterial population and then

(39:22):
the not so good population, right?
So out of one of these good ones, we've got something called
Estrobilone. And that's a set of this
bacteria that helps your body sort of metabolize all the
excessive circulating estrogen in your system and then actually
get it out of your system. So excrete it.
But now if you have lower amounts of that, that means

(39:42):
you're recirculating a lot more of that estrogen in your body,
which means severe PMS symptoms,you know, really tender breasts
before period, irregular period and cycles too.
So you see all or really heavy periods.
That's another one right with it.
So you see these like signs whenyour gut is not supportive of

(40:04):
the meta, like to get rid of theexcessive estrogen in your
system. Now with the androgens the way,
so we were talking about how like the the bacteria help, but
the healthy bacteria help your cells being more sensitive,
right? So now if your cells are
starting to get more insulin resistant due to a poor

(40:26):
bacterial population, so then that's now telling your ovaries
to continue to make all that excessive androgens.
So that's the pathway in terms of like how the gut will also
affect your androgen metabolism.Yeah.
And then there's there's anotherthing too.
I mean, it's kind of connected because we've got these binding

(40:49):
hormones like the sex, sex hormone binding globulin that
sort of attaches testosterone and the other androgens, right,
which is kind of made in your liver.
But one of the ways, like a lot of times we see lower levels of
that with women in PCOS and in order to actually increase it,
one of the recommendation is to actually increase fiber intake

(41:11):
just because the higher, the more fiber you eat, it also
improves your gut lining. It's producing that short chain
fatty acid. So it's sort of like again,
helping your liver also improve its function, which again, and
there's fatty liver, then these hormones, these binding hormones
start to drop down too. So it's very like
interconnected. You can't be like, yeah, this is

(41:33):
the pathway, this is how gut does it.
It's like the gut is connected to something else and then
something else is doing something else and then it will
get you to the results that you're looking for.
Yeah, I think it goes back to like the health literacy piece.
But I think that sometimes it's like a common, I guess maybe
thing amongst people who don't work in the healthcare space or

(41:54):
you're not talking about it all the time.
But sometimes we we don't realize like how complex our
body is and that. There's so many different.
Things and it's trying to regulate things and if
something's out of balance, it'sgoing to show up in other places
and it's good to remember that too.
Even with conditions like PCOS and IDs, it's generally not just
like one thing that you're doing.
It has to be a combination and probably a combination that's

(42:16):
right for you that's getting to really the root of your specific
drivers and and the heart. Absolutely it could take.
Absolutely. To figure that out.
But once you do it, as you're saying, like, it can be well,
well managed. Yeah, very responsive.
Your body is responsive. I always tell my clients think
of that, that yes, your body is not broken.
It's responsive. It's an affirmation I tell you

(42:38):
to repeat over and over while you're on your healing journey.
Yeah, for sure. Now that's a good point.
Point about the fiber. I know if someone has like low
estrogen or may be told to like drop fiber because fiber can too
much fiber can pull out like extra estrogen.
But to that point, I guess if someone maybe is he's not
getting enough fiber or if they're constipated like they're

(42:59):
getting backed up, then maybe they're getting a build up of
these types of hormones because it's not properly getting
eliminated or I guess balanced. Would you say is it just like
estrogen in that case? Or do testosterone like the
androgen hormones build? Up or bowel issues.
Well, so the the bowel is an area for excretion for even like

(43:24):
excessive androgens, but more like the most research we have
is on estrogen rather than the androgens.
There isn't so much like clear cut information on that.
But I can kind of see how if you're not sort of passing your
souls and for example, like yourfiber is not binding to

(43:45):
excessive androgens or estrogen,things like that, that you can
technically sort of start to seethe build up of these things.
Yeah, OK. Interesting.
What would you say are maybe like key nutrition strategies?
I know take, you know, like a whole episode probably just
yeah, yeah with their own. But what would you need to lay

(44:08):
out as like top, top 4:00 to 5:00?
We'll talk about nutrition 1st and then OK, lifestyle separate
for peace. So specifically, yeah.
There so if OK, so just to simplify it, I always be like,
OK, blood Sugar's first, right? So we want to make sure you're
eating in a way like each meal is an opportunity for you to
kind of keep your sugar stable. So take a look at that and see

(44:31):
do a mental checklist. I'm like, OK, do I have enough
protein in my meal? Am I eating the right amount of
carbs? Which again, they're even the
most healthiest carbs in large amounts than what your body
needs is still going to cause a blood sugar spikes.
It doesn't matter if it's quinoaor something super fiber rich.
If you're going over the carb dose that your body can tolerate
at that time while you're sort of like trying to reverse your

(44:52):
symptoms, it may not be effective.
So a plate model is generally a really good place to start, to
be honest, right, which is ask your plate being veggies,
quarter of it being your protein, another quarter being
like a complex car, and then spacing your meals.
That's another one great tool for keeping your blood sugar
stable is rather than having very abrupt meal timings, not

(45:13):
eating like for six hours at a time and things like that, that
can also just regulate your blood sugar.
So I always tell my clients to just base your meals out every
like 3 to 4 hours. That's a really good place to
start. Again, it's very easy.
These are like really easy toolsto kind of start with even
eating breakfast. So I know we have this thing

(45:34):
like, oh, breakfast is the best meal, is the most important
meal. But it is especially because now
the research is showing that when you eat large amount of
calories at breakfast, you have lower androgen levels.
So having a decent breakfast within that first hour is a
great way to sort of set yourself up because you're
fasting overnight. So you're already in a fasted
state, which is good. Like a 12 hour fast for women is

(45:56):
fantastic. You're working with the
circadian rhythm. Lovely.
But then if you're going to keeppushing it like intermittent
fasting and things like that, then that could be an issue.
How many do we have right now? So we talked about late, we
talked about meal spacing, eating a breakfast.
Three. OK, you want a fourth one?

(46:16):
OK, let's think about. And then the 4th one I would say
is fiber. So I know people focus a lot on
protein and like, yeah, protein is everything.
And I would beg to differ that Iwould say fiber is the star.
You want to really make sure you're getting in a fiber.
In women who actually do have high antigens, I do tell them to
aim for 30. So usually for women, we need to
eat like up to 25, but I go overif you're, if you're having

(46:40):
higher antigens, because I do see that.
It's just that we don't have that solid research papers
showing that. Yeah, it's really helpful.
But I'm like, I see it. So I'm like, OK, let's aim for
the higher amount. And so the fiber, yeah.
Yeah, I can see like overlap I guess with those strategies for
IBS too. A lot of times it is like eating
earlier in the day, getting gooddose of protein at breakfast.

(47:03):
Also if someone is maybe under eating or skipping meals, that
can actually contribute to anxiety because of blood sugar
drops. And then because of the gut
brain connection, I find it can actually worsen like IDs or gut
symptoms. Yeah, for that case like protein
is key and especially for women too, like getting more, more in
the morning to the fiber piece. Definitely.

(47:24):
Yeah, fiber is like is so under eaten.
I know it is so under. Eaten, yes.
Yeah, just in like regular population, but specifically
with like IBS or I have IBM inflammatory bowel disease, like
there's a bit of a fear around fiber because of the Fodmaps.
But if someone did have like PCOS and IBS like there are ways
that you can get the right typesof fiber in the balance so that

(47:46):
you can still shoot for 30 or I have clients do 4050.
Without like, amazing, so amazing.
In that case, like just goes back to working with a dietitian
can be helpful if you find your totally these things and like
you're trying to reach a goal that you think that will be
helpful for you, but maybe how you can actually implement it
into your life. I think that's.
Absolutely. Exactly.

(48:07):
If someone's not eating like fiber, no one starts at like 30,
right? Like, I have clients, when I'm
doing an assessment, they're like, yeah, whenever I'm eating
like lentils or beans and chickpeas, I'm very gassy, very
this very bad, right? And I'm like, OK, when you look
at the diet, your diet is so lowin fiber.
So when we're also eating these foods in larger quantities all
at once, your body has no way tosort of like, digest it as

(48:31):
efficiently as it it can. So it takes time to build that
up too, right? But again, the more you sort of
introduce it slowly and strategically into your diet,
you can sort of see benefits of these foods too that typically
like, no, it gives me bloating, but it may not be a bloating
issue. It actually is just improving
your digestion a little bit more.
Sometimes it's bad. Yeah, that's a good point.

(48:52):
Yeah, I do talk about sometimes like retraining the microbes
because if you eating a long like a low fiber diet in a
period of time, your microbes are used to that.
So we kind of have to retrain them to or build more of the
types that actually breakdown beans and fiber.
Totally. Yeah, getting into the the
lifestyle strategies and yeah, Idid want to ask if maybe like

(49:16):
sort of the the products that weuse sort of our like
environmental. I love that.
Toxins will relate to this, but maybe you can highlight like
top. 4 lifestyle yes, I love that question.
Yes, I honestly the environment we we obviously that's another
piece. I forgot to mention this, but
someone thing I explained to my clients I'm like, look, we can't

(49:38):
be in a bubble. We can't protect ourselves from
like these microplastics and like people wearing perfume on
the subway and you know you being exposed to all that.
But guess what you can do your gut bacteria actually helps to
get rid of these microplastics out of your system.
So that's another opportunity for you to work on the gut in
order to actually protect yourself from the environmental

(49:59):
stuff that you're getting exposed to.
So I forgot to mention that, butyeah, cookwares is really
important. So because that's something
you're using often. So really look at like using
stainless steel, cast iron, trying to avoid like the Teflon,
those non stick pans. Those are really important as a
women, of course products, so just opting for like fragrance

(50:21):
free. So these are like really small
switches. It's not like, Oh my God, I
can't wear makeup any more of myfavorite brand and things like
that. Like just try to produce the
load as much as possible. I know what was that Bath and
body works or something was so popular.
I don't know. I think it's still popular.
I have no idea. But like that is like place for

(50:41):
disaster because everything fromback there, candles to your
sprays and everything, they're like hacks.
So if you're constantly putting it on your skin, right, even
perfumes, women love to spray itright on your wrist or right
behind your ears and stuff just to smell good.
It's going right into your bloodstream.
So just being a little bit mindful of that, like, Oh my

(51:03):
God, I used to love perfumes. Like I came from the Middle East
and Middle East is like known for just perfume overload.
And from there to like, I do have a perfume, but I only wear
it on my clothes if I'm going out.
And I'm just like significantly reduced.
It changed my deodorant. So those are really good little
changes you can make. And then of course, supporting

(51:23):
your body in terms of like stress, right?
So your nightly routine, your morning routine, even if you
have just 5 minutes, trying to like, set that up for yourself
and make sure you're dedicated to like unwinding before bed
because again, we're so overstimulated.
I feel that also plays a huge role in the quality of your
sleep. So those are some like habits

(51:44):
that I can really help in terms of the lifestyle.
Yeah, that makes sense. Yeah.
To the body products one like I,I forget about that because it's
something I actually changed like a long time ago.
I think I was like, maybe, yeah,1617.
Oh wow, that's amazing Detox of like Oh my God, that's.
Amazing. So to this day, like I, yeah, I

(52:06):
don't wear perfume If I body products or makeup, I get them
from we have like Big Carrot here or Healthy Planet, in fact,
that they're like environmental working group certified and oh
so cool. Minimize it.
I find for me like it. I just feel it like I noticed
now if someone's maybe wearing like those sort of artificial
scents like it. You get a headache because I do,

(52:27):
yeah. Yeah, and it just feels so much
like later, I've heard like somepeople say that maybe, you know,
there may be problems with the product in the marketing.
It's not as clean as it says. But for me, like I do notice a
difference and I I do believe that.
I think what we put on our body and our skin gets absorbed.
And I think just trying to be like as mindful of, of that too.
Like if we're going to care about our diet, we want to like

(52:48):
care about the body products as well.
Absolutely, Yeah. You didn't say exercise though,
so. Yeah, good question.
Good, good, good. Yeah, honestly, we even with the
work I do with my clients, the first, first area we work on
when it comes to movement is just gentle movement.

(53:09):
So walking, walking is my first choice when it comes to sort of
hormone health because, you know, your cells start to get
more sensitive to your insulin. So that's a great place.
People are coming to me, they'realready fatigued.
Like imagine them telling them that, hey, I think you should,
no, that's, you know, not a great way to start.
So once they start with the walks and just getting their

(53:30):
body moving and they start to feel better, their fatigue
starts to reverse in Week 2 itself.
But then they're now more invested in like doing other
little, little things, right? And then in the long run, of
course, just strength training is one of the best ways you can
also regulate androgens because it's really good to sort of like
maintain that balance. When you have more muscle mass,

(53:51):
more muscle mass, your metabolism is better.
It's also like a sponge for sugar.
So when your blood sugars are rising, your muscles are able to
soak that up. So that would be like the next
phase when it comes to how it, when you're building like a nice
exercise plan that was look at first, if you're not doing
anything, start with walking. Now if you already are someone
who's hitting like 7 K steps daily and 7:00 to 8:00, then

(54:14):
maybe your next step could be starting to add in one or two
days of strength training and then sort of like move your way
up. Yeah, yeah.
Always want to build the base, not going too heavy.
I know with yeah, sort of maybe just general population.
Then also with IBS, like we're seeing now that for women too,
like having some high intensity exercise, like within the right

(54:37):
balance, not over the right balance, having rest days, like
should be balance training and myself as like endurance
athlete, like you don't do hard everyday.
But for the PCOS population specifically, do you think like
high intensity interval trainingis beneficial or do you feel
like more strength training, moderate intensity?

(54:57):
Moderate. I mean, to be honest, there is
room for it, but that's like if someone's coming to me and they
have really poor stress management and the the evidence
is like, OK, this person is likecortisol driven.
They're waking up randomly at 3:00 in the morning.
They're unable to sleep and it'slike the classic cortisol sign

(55:19):
right where you're not hungry inthe morning.
Those are the ones I would tell them to sort of like take a step
back from the high intensity forshort duration, which again is
not something you do for a long term.
It's for short duration till youstart to like learn how to sort
of stabilize your lifestyle a little bit with your nutrition,
supporting yourself, supporting your nervous system.

(55:40):
So we do a lot of nervous systemwork, which is all the somatic
work. And then when they start to feel
better then we start to introduce it.
But usually no more than like 15minutes to be honest.
Like 15 to 20. And I would typically keep like
couple days off rest in between.So you might want to do a more
slow weighted exercise rather than doing 2 back-to-back HIT
training. Yeah, for sure.

(56:01):
Yeah, yeah, yeah. I mean with with high intensity
interval training like it does we know it like increases
cortisol, but it can actually. But brings it down, yes.
So it's more about how your bodycan bring it down, bring it to
exactly. It's not like, yeah, not
managing stress well, not sleeping enough.
They've got a lot of like external.
Stressors then, correct, but I think the term they have shown

(56:24):
that it can help with insulin. Exactly.
Yeah, insulin, yeah, absolutely.Yeah, great cardiovascular
benefits too, right. With again, with like the blood
sugars, the fatty liver that's showing up part health is a big
issue with women who have PCOS as well.
So it it can be a really great way to even improve your
cardiovascular fitness for sure.Yeah.

(56:44):
And it's efficient too. Like even, yeah, the true
definition of high intensity training is it, it shouldn't be
like 3045 minutes because technically if you're, if you're
working really hard on those intervals, you can't sustain too
long. So yeah, 15 minutes, like it can
be, it's hard, but it can be a very efficient workout.
So totally again, a whole notherlike topic, but I wanted to

(57:05):
bring that one up because I feellike it's a common maybe I don't
know if it's a myth, but maybe amisunderstanding that like if
you have. PCOS, you can never do high
intensity. Oh, no, no, not at all.
Yeah, no, no, no, yeah. But people do believe that.
I I do. I've heard that we're like, oh,
you can never do this or you cannever do that.
It's all about like retraining your body a little bit, right.

(57:26):
So as I said, like you want to look at your lifestyle and be
like, OK, if I'm not managing mystress, I can't stress my ball
and you're not eating enough calories and you're skipping
meals. And so if your stress bucket is
like overflowing, then let's notstart with high intensity
workouts, right? Let's start with something
gentle. And then as you start to sort of
like sort that bucket out, then yeah, bring in the I like a

(57:50):
variety. So a little bit of strength
training, make sure you have your need like your walks going,
you know, a few days of like high intensity training.
It's it's not that you can neverdo it.
You have to train your body for it.
Like I had to do that for a while too, because I was, I used
to Sprint a lot. Then I stopped because I was
starting to see some like more androgens again, my periods are
completely regular, so I can't like be diagnosed, no cysts or

(58:14):
no res. It's just more elevation of like
androgens. And so I had to take a step back
because the nervous system pieceis a big one for me.
And then as that started to get better, then I was able to go
back to like Sprint training andthings like that and no issues,
no side effects, not like I'm exhausted or anything like that.
It was it was great. So it's just paying attention to
what your body's like, telling you I think is really important

(58:36):
and just getting like just understanding that it's not
maybe for now, but doesn't mean you can't do it forever.
Yeah, for sure. I think even building the base
with diet because you mentioned stress like yes, stress can be
sort of like personal and emotional common under eating,
like just not getting enough of the right calories or enough

(58:57):
calories during the day. And then also, you know, maybe
fasting or not feeling up for those workouts that will then
increase the stressful impacts that it has on your body.
So I think even. 100%. Nailing down your diet and just
get like fueling properly to setyourself up for success and then
maybe layering on the more intense training once you're
feeling better so that your bodyis totally able to like get the.

(59:19):
Beneficial effects, Totally. Yeah.
Age difference, totally. There's a simple thing, right?
Like jump rope. It's like short sprints.
If you want to do that on your treadmill, there's just so many
little things you can do. And it doesn't have to be like
going from zero to 100. You can just build up your
stamina, build it up and then gofrom there.

(59:40):
Yeah. I guess maybe if you were to
like nail it down to two takeaways for listening and how
they can better support, let's link it to like support their
gut health for better hormonal health.
Maybe what would you say are like 2-2 like key things that

(01:00:01):
maybe we can. Start with OK, one is I think
more of a mindset thing to be honest.
So one thing I would suggest is just giving yourself time and
being patient as you're startingto like put things into practice
because it takes time like to change the your gut environment.
It's a slow process, but you will start to you will see the

(01:00:22):
benefits of it. So just being patient and not
giving up right off the bat thatOK, I'm not seeing any changes.
So patience for sure. And then what else would I say
would be a take away for PCOS and and gut?
I think what we were talking about earlier is if you're
looking for sort of like supportor you're trying to implement

(01:00:45):
things is making sure you're actually getting the information
from like credible information from someone who's actually
educated in the field and has a degree versus someone, hey, I've
just been on this journey and I can show you what I've done.
So trying to be mindful of that.I think those are probably the
two takeaways I would suggest. Yeah, I like those.

(01:01:07):
OK. I thought you were going to say
fiber, but I think those are better.
I was thinking of fiber. I'm like, should I say fiber or
should I say this? I'm like, I was, I don't know.
I felt like I think people need to work more on your mindset
when it comes to these complex like health situations because
it can really like wear us down,right?
So just taking time and then making sure like take your time,

(01:01:29):
be patient. And then two, make sure the the
plan that you're starting off onis actually good for you, right?
So not trying like, OK, I'm going to try to reverse my
insulin resistant. OK, let's cut out carbs because
you know, they're saying that carbs raise the blood sugars.
No, let's, let's take a step back and see how it's just going

(01:01:49):
to affect you in the long term. So it's just those things.
I feel like I'm more important than anything else because once
you have the plan and it's a solid plan that's going to work
for you, that's your lifestyle, you're going to continue to chip
at it, right? It's not like an end date that
you have in mind that, oh, I'm going to balance my hormones and
improve my gut health until thisdate.
It's a long term thing. So you just got to make sure

(01:02:11):
that the plan is really supportive for your lifestyle,
your cultural eating pattern, the way you live, right?
Just looking at all of those things.
Right, That makes sense. And yeah, like the mindset
definitely to work on that for myself.
Like personally, I try to apply,but my clients do.
There was a good quote from the,I don't know if you've read it,

(01:02:32):
but Kelly Mcgonigal, she's like a researcher at Stanford, but
OK, the upside of stress. And I think her quote was like,
mindset puts in motion like a series of sort of processes and
actions that perpetuate like progress.
So very good. Momentum.
It's not. That mindset is like a miracle
worker. Like if you think it's going to

(01:02:52):
happen, it's going to happen. But it's more than just thinking
positive and like sort of like even just internally vocalizing
that you're working on things toget better, your condition is
going to get better. That will just help you to feel
more motivated to do the things that you'll actually get better.
So it just sort of puts you on sort of a positive trajectory.
I love that. Yeah, it's a good book too.

(01:03:13):
We'll link to it. Is it OK link?
I'm going to OK, send me the link.
I want to look into it. That sounds nice.
Yeah, it's it's more around likethe idea is that there's well,
the book is called Upside of Stress.
So the idea is that like stress can be good for us.
It's more just how maybe we respond to it or how we use it
in our life. So like, yeah, sometimes stress
has negative effects, but like how we how we can actually use

(01:03:36):
it as like a positive force. So I think you might find it
helpful just from like the. Oh, for sure, for sure.
All that, yeah. Just to wrap things up, it's
been very, very detailed conversation.
We might have been. I'm glad.
Instead we would, but how can listeners get in touch with you
and find more evidence based andcredible content on PCOS?

(01:03:59):
Yeah, you can find me on Instagram.
So my handle is PCOS dot weight loss dot dietitian.
I'm sure you'll you'll add it into your list and then you can
also find me on my website. So it's just
www.pcosweightlossdietitian.com and yeah, just send me Adm or
send me an e-mail and we can getconnected.

(01:04:23):
Cool. Yeah, I will definitely.
I'll link your Instagram and website below and I'll link
those resources we mentioned. Oh, that would be good, yes.
And then? If people want to work with you,
they can. Apply.
Yeah, they can just reach out through the website.
There's an application, they canjust fill that in and then we'll
set up like a 30 minute complimentary conversation just
to get to know them, just to make sure we're a good fit and

(01:04:45):
then sort of go from there. Yeah, awesome.
OK. Well, thanks SO.
Much. Well thanks for having me, this
was lovely. Yeah, for sure.
I, yeah, if anyone has any questions, if they're listening
or any comments, feedback, feel free to leave it.
Hello and yeah, thanks so much. Awesome.

(01:05:05):
That's a wrap for today's episode.
Thank you so much for listening and being a part of our
community here. If the Gut Fit Nutrition podcast
is giving you value, helped yourdigestion and fitness, made you
rethink how you approach your gut health, consider leaving a
review on Apple, Spotify, or wherever you're getting your
podcasts. If you have questions for my
listener Q&A episodes, you can submit them as a comment on this

(01:05:28):
episode or send me an e-mail at lee@leemorado.com.
For more digestible IBS gut health and fitness tips, be sure
to follow me on Instagram at LeeMorado under score Rd. and to
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Thanks for tuning in. We'll be in touch soon.

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