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This was a really good one, guys! Today we are talking with my good friend Kalea about mitochondria and specifically how they impact PCOS. Now, I know it sounds a bit science-forward but trust me, Dr. Wattles and I love the mitochondria for a reason. Hope you love it as much as I did!
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Follow Dr. Wattles on ig @functionalfertility or visit her website www.drkaleawattles.com for more on her Functional Fertility Blueprint program!
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hello everyone, welcome back to an Amber a day,
the functional nutrition podcast.
I'm your host, amber Fisher,and today I am here with a
fabulous guest.
She has been a guest on ourpodcast before.
This is Dr Kalia Waddles, whoruns functional fertility and,
as I was just telling her, Ihave long admired her work.
Just look up to her, thinkshe's a fantastic, fabulous
(00:22):
person and it's incrediblyintelligent.
Love to learn from her.
So today, her and I are goingto be discussing mitochondrial
health, pcos and a little bitabout fertility, since that is
her specialty.
So, yeah, thank you for beinghere, kalia.
Speaker 2 (00:37):
Thank you so much for having me.
We're reunited and it feels sogood.
Speaker 1 (00:41):
And, yes, we, we have known each other virtually for
a few years now.
Speaker 2 (00:47):
And a few years we've had a virtual friendship.
Speaker 1 (00:49):
Yes, a lot, a lot has happened in those years, so
it's wonderful, okay, so what Iwant to do first is I'd love for
you to just introduce yourselfto everybody.
Tell us what you do, you know.
Speaker 2 (01:00):
Yeah, great.
So I am Kalia Waddles.
I'm a naturopathic doctor bytraining and then I have some
post doctoral certificationthrough the Institute for
Functional Medicine.
So I'm also an IFM certifiedpractitioner.
I am the founder of my practice, functional fertility where I
really take a root cause,evidence based, patient centered
approach to fertility using abody systems approach, which is
(01:21):
what IFM teaches us.
So I'm looking at all theaspects of someone's health to
really identify the underlyingdrivers of their fertility
struggles, and we're cultivatingresilient health that sets them
up for a healthy pregnancy, ahealthy baby and longevity in
their health so that they canenjoy this family they work so
hard for we love it.
Speaker 1 (01:39):
We love to see it.
Is she not so well spoken?
Everyone, just I, just she is.
So what we're going to kind oftalk about today is a topic that
you and I are both verypassionate about, and that is
mitochondrial health.
And when I say mitochondria,people sometimes when I look
like a deer in headlights arelike okay, this is over my head,
Like we're talking aboutsomething like really you know
(01:59):
intense here what the heck is amitochondria?
So for those of us who haveforgotten our biology, can you
explain to us what themitochondria are and why they
are important, just for ourhealth in general, but also for
our hormones specifically?
Speaker 2 (02:13):
Yes, I would love to.
Mitochondria are a beloved tome and if anyone's been on my
social media, you'll see like30% of the posts are about
mitochondrial health, becauseit's so important.
Mitochondria are tinystructures that are found in
both cells of the body and Ithink the mitochondria have an
excellent PR team, becauseeverybody knows their
catchphrase.
People always tell me I canstill hear my 10th grade biology
(02:34):
teacher say mitochondria arethe powerhouse of the cell, like
that's their thing, and peopleremember that.
What that means is thatmitochondria are responsible for
generating energy, and I say wecan think of them like cellular
batteries, because theyessentially convert energy from
things like the food we eat intoa form that our cells can use.
And this comes up in myfertility practice all the time
(02:55):
because I say ovulation,fertilization, implantation
these are energeticallyexpensive processes.
So we need really healthymitochondria to power those.
And when we look at hormones, afun fact is when we make
hormones, the backbone actuallybegins with cholesterol.
So cholesterol is shuttled intoour mitochondria and then that
cholesterol goes through aseries of very fancy enzymatic
(03:18):
reactions until it turns intohormones like estrogen and
progesterone.
And so sometimes when I havepatients that have a short
luteal phase or they have lowprogesterone so they might have
things like recurrent pregnancyloss.
I always want to support theirmitochondria as we work on that
hormone imbalance pattern,because inside the mitochondria
that cholesterol will turn intopregnant alone and then pregnant
(03:40):
alone is transformed by thisvery fancy enzyme called 3-beta
hydroxystero dehydrogenase intoprogesterone.
So if we're going to reallywork on helping our body make
progesterone on its own, we gotto get those mitochondria
healthy.
Speaker 1 (03:54):
Yeah, so a lot of our creation of hormones actually
happens in the mitochondria, soit's super key.
If we want hormones at all,we've got to have our
mitochondria.
Speaker 2 (04:03):
That's exactly right.
It's the rate limiting factorin hormone production, which
means we're only able to makehormones at a rate that our
mitochondria can sustain.
It's kind of a big deal.
Speaker 1 (04:14):
Yeah, and so if well, I'm maybe jumping ahead.
But if our mitochondria arelike overtaxed, then that can be
really difficult on ourhormonal health.
I often talk about hormones inlike a pyramid structure because
, just for a visual illustration, because people often associate
something like PCOS with likebeing just a purely hormonal
(04:35):
issue.
They're like well, I was justborn with too much testosterone,
like, this is just how I am,and the reality is that hormone
processes are kind of like oneof the last sort of things that
the body is going to work on.
It's almost like your hair andyour nails right.
Like if you're unhealthy, thosethings are going to suffer.
Like if you're not healthyunderneath your mitochondria,
not healthy, your hormones aregoing to suffer.
(04:56):
So it's not something that well, I guess, am I making sense?
Speaker 2 (05:00):
Yeah, yeah, You're making sense to me and I'll
bring up.
There's a hormone called thehormone conference that the IFM
offers.
That you have attended and haveworked on for years, and one of
the kind of hallmark takeawaysfrom that program is that a
hormone imbalance is often anappropriate response to
something going on elsewhere inthe body.
Right Like our hormones areconstantly trying to compensate
(05:22):
for other things.
So it makes perfect sense whatyou were saying.
It's like the last step in.
Our hormones are just trying tokeep us healthy in the context
of everything else going on inour body.
Speaker 1 (05:32):
Yeah.
So if we've got an imbalance orsignaling issue or whatever
going on with our hormones, wehave to look deeper.
We can't just say, okay, let metake the supplement that's
going to make me make more Idon't know, estrogen or whatever
.
It's not that simple.
It's like well, why are thingsout of balance in the first
place?
And oftentimes it goes backdirectly to the mitochondrial
health and the function of ourenergy makers of ourselves.
Speaker 2 (05:54):
The powerhouse of ourselves.
Speaker 1 (05:56):
Yeah, it's like a magic school bus in here.
Okay, so what kinds of thingsmight happen when our
mitochondria are working well?
You give us some examples.
Speaker 2 (06:06):
Yeah, I would love to give some examples, and what I
am about to say I'm going topreface this is that it's going
to be annoying.
But I would not say it's goingto be annoying and so I'll just
get out.
I'll just get out with it thatA mitochondrial dysfunction,
mitochondrial disease.
It can be hard to notice or todiagnose, because people
actually call mitochondrialdysfunction like the great
(06:28):
masquerader or the notoriousmasquerader, because, if you
think about it, our mitochondria, like I said, are found in most
cells of the body and so whenwe have dysfunction it can
present, like with any symptomin any organ at any age.
So how frustrating, right.
But this is actually anopportunity for us to say okay,
then what type of patient do Iwant to consider mitochondrial
(06:51):
dysfunction in?
And so I think about if someonehas an atypical presentation of
a common disease, like when wesee all the time that's a
comorbidity with PCOS, isHashimoto's right or autoimmune
thyroiditis, and it's like if Ihave an autoimmune patient and
they're not responding to mynormal stuff, I'm doing
everything I can to tone theirimmune system, I've got them on
(07:12):
thyroid hormone and they're justnot feeling better.
I'm really wondering what'sgoing on in the mitochondria.
So atypical presentations ofcommon disorders.
If someone has a lot ofrecurrent setbacks or flare ups
in their health, like we thinkwe're on a good trajectory, and
then something happens, they getan illness, some big stressor
happens, or even something likefasting that the body might
(07:35):
perceive as stressful, and nowtheir symptoms are in full flare
mode, I'm kind of wondering ifsomething is going on with their
mitochondria.
Speaker 1 (07:41):
Well, speaking of fasting, I want to pick your
brain a little bit about that,because what I recall from some
of my IFM conferences is a lotof us, different practitioners,
have sort of different opinionsabout fasting.
Right, because there can besome huge benefits to fasting,
but then there can also be somedifficulties to fasting,
depending on the person.
I've heard that a certain amountof fasting is really helpful
(08:03):
for the mitochondrial health,because if you go a certain
length of time it helps them tosort of clean up, right?
Is that true, and what shouldwe take away from that?
Speaker 2 (08:15):
Yeah, intermittent fasting can be helpful for
mitochondria, but I think wehave to look at this person as a
whole.
So, like you and I have talkedabout fasting before in the
context of cortisol If someoneis really having HPA axis
dysfunction meaning their bodyis already under such a source
of stress that it can't reallytolerate any more stressors I'm
going to be really cautiousabout using fasting Now.
(08:37):
We know that, in fact, for PCOS, the bulk of the research on
fasting is in people who areinsulin resistant specifically,
and we know that not everyonewith PCOS has a lot of trouble
with insulin.
It's common, but not everyone.
So I think we have to look at,like their whole hormonal health
, their HPA axis.
We should experiment.
If we think fasting is going tobe helpful and they feel a lot
(08:59):
worse, we should probably backoff and do some mitochondrial
support, not to say we can neverdo fasting, but let's get their
mitochondria a little bit moreresilient and then try again.
Speaker 1 (09:07):
Yes, I love that because you know, personally I
tend to recommend fasting morein my post-menopausal patients
and stuff and I myself inpost-menopausal I do
intermittent fasting.
Now I feel good when I do it.
But I've also had clients whofelt horrible and it almost
reminds me of treating otherthings like candida overgrowth
(09:28):
or something like that, where ifyou do too much, too soon and
too fast it's so overwhelmingfor the body you can almost get
this cascade reaction ofinflammation from actually
trying to do something positive.
So healing sometimes is kind ofa slow process and I always
think about the body as, likeyou know, it can't.
You can't push it too hard, toofast.
(09:49):
You have to let it heal in itsown time and each one of us is
like on a different timelinewith it.
I think fasting is kind of oneof those things that gets thrown
in there.
A lot is like well, just fastand it'll help, everything you
know, but for some people nowit's not helpful.
Speaker 2 (10:03):
Yeah, I was actually just listening to a lecture,
like kind of a tangent, but it'sadjacent, you'll see where I'm
going.
I was talking about fasting andhow.
Yeah, fasting can be great fora lot of people, but the lecture
was specific to people who havegenetic variations in the way
that they glucuronidate things.
So Gilbert syndrome was the bigexample.
It's like how you engage withenvironmental toxicants, right,
(10:25):
and like most of us don't walkaround knowing our genetic
status for things like this, andthen when we fast, we feel
terrible.
So what I'm trying to say islet's normalize a little bit of
trial and error.
You know, it's okay to trysomething that you think is
going to be helpful and then, ifit doesn't feel good, to go
back to the drawing board.
I think in medicine we doourselves a disservice when
(10:46):
we're like, well, this shouldwork, so we're just going to
stick with it.
You know what I'm saying.
It's like it's okay if it's abit of an experiment.
Speaker 1 (10:52):
I totally agree, and I think in the case of PCOS
that's really important, becauseso often in the sort of medical
community at large, pcos getskind of lumped in as like this
one type of issue.
It's like it's an insulinresistant thing, like limit your
carbs, fast, do that kind ofstuff.
It'll help whatever.
But then when you get into thePCOS sort of healthcare
community, those of us who'vespent a little bit more time
(11:15):
sort of thinking more deeplyabout the disorder, we've all
come up with our own sort ofways of dealing with this.
But there's this pervasive themeon the other side that like
fasting is horrible for you andit's terrible for your hormones.
That will never help you at alland you should never, ever try
it.
And I really think the truthlies somewhere in the middle
that for some people somethinglike fasting could be really
beneficial.
For other people it's not goingto be helpful, and for a lot of
(11:38):
people it might not be helpfulat first but might be helpful
later or vice versa.
But, like you said, a littlebit of experimentation, trial
and error, I think is soimportant to view your body as
almost a little bit of a scienceexperiment.
That's how I do it, you know,because you won't everyone's
biochemically unique right.
Speaker 2 (11:57):
So we all have different needs Individual Yep,
that's right, and I think thatkind of like oh, I think the
truth is somewhere in the middleprobably applies to a lot of
the things that we do.
There is life and general rightand general right on a lot of
things.
So I think that's true for somany different areas.
Speaker 1 (12:13):
I think the struggle comes when you know just as,
like practitioners, we're alwaystrying to find like a protocol,
right, like we want, like a setof steps that we can like put
everyone through, but we justthat's the beauty of functional
medicine and functionalnutrition is that the whole
point is we don't put peoplethrough a set of specific steps.
We, you know, take them as aunique person, exactly, and that
(12:35):
means that things may change.
Speaker 2 (12:36):
So anyway, we're not with it.
We don't treat diagnosis codes,we treat people, and that's the
beauty of it.
Speaker 1 (12:42):
Yes, love it.
Okay.
So let's talk a little bit morespecifically about mitochondria
and PCOS.
Where, like, where's theconnection there?
How might it impact PCOS?
Speaker 2 (12:54):
This is a fun question and in order to answer
this, I feel like I'm going tohave to do a little bit of
anatomy and physiology review.
So everyone, focus back.
We got to get into the A and P.
So I there's a few differentways that I can connect
mitochondria specifically forPCOS.
The first is that there's aneffect at the level of the ovary
, which I'll describe, and thenthere also is a connection to
(13:15):
insulin resistance.
So I'll talk about the ovaryfirst and then can I put you
responsible for not letting meforget about the insulin
resistance part If I get soexcited about the ovary Right
here.
Okay, so I love granulosa cellsand I just need to own how much
I love granulosa cells.
Granulosa cells are these.
They actually represent thelargest cell population in the
ovary and they're so importantfor fertility.
(13:36):
There's their specialized cells.
They're located in the ovarianfollicle, which is basically our
egg sac that surrounds ourlittle oocyte or egg cell.
People call them, like the eggcell, helper cells or nourishing
cells.
So they're really, reallyimportant and I love them.
They provide nourishment.
They support the developing eggby producing hormones like
(13:58):
estrogen, which is a big deal.
So during ovulation, a matureegg is released from the
follicle, it bursts from thefollicle and then the remaining
granulosa cells that were in theegg sac, they form a structure
called the corpus luteum andthat produces progesterone to
sustain the endometrium duringthe luteal phase or during early
pregnancy.
So that part's really important.
(14:19):
And I think I am happy to saythat the growth and the
proliferation and the divisionof the granulosa cells require
abundant and stable mitochondriato supply appropriate levels of
energy.
And the granulosa cells arereally dependent upon healthy
mitochondria.
And when we have mitochondrialdysfunction it disrupts that
(14:39):
bi-directional communicationbetween the egg cell and the
granulosa cells, which can leadto stagnant growth and
development.
And if we think about PCOS andthe cystic part of PCOS, they're
not really cysts, right?
They're all of these follicles,all of these little egg sacs
that grew a little bit butdidn't get big enough to ovulate
.
That's why we see thisanovulation happening.
(15:00):
So when you look to the studies,we see that when they have been
in the IVF setting and they'llextract some fluid from the
follicles of women with PCOS, wesee increased levels of
reactive oxidant species andwhat that means it's oxidative
stress.
So it essentially means we havemore compounds that can damage
(15:20):
DNA than we have antioxidantsthat can kind of fight those
compounds.
So we see an increased level ofreactive oxidant species in
that follicular fluid which canimpair the function of the
mitochondria.
It can lead to an abnormalshape of the granulosa cells and
then we have inadequate energysupplied to do all these things
(15:42):
that we need to do, like ovulateand mature an egg.
It's also interesting that wesee that mitochondrial
dysfunction in the follicularfluid of women with PCOS, so we
can actually make our egg cellsless effective at utilizing
energy from glucose.
So there's all of thesemetabolic components.
It's really interesting.
In in turn, as a result of allof that, we see altered egg
(16:07):
quality and this is thought tobe one of the contributors to
why we sometimes see poorpregnancy outcomes through IVF
when women with PCOS are goingthrough treatment.
And I'm bringing that up becauseI think that that can be Scary
to hear sometimes.
But the good news is we have alot of control Over those
changes.
So they're largely influencedby epigenetics and I talk about
(16:31):
so genetics are like the part ofyour story that's written in
pen, but epigenetics are thepart that's written in pencil.
We can do some editing, we canerase, we can write new things
in.
So While we do see theseconnections.
There's so much that we can doand we'll talk about this, I'm
sure nutritionally, lifestylesupplements, all of that to
power up those mitochondria andreally support that process, no
matter where you are on yourfertility journey, if you're
(16:51):
just trying to ovulate regularly, if you're ready to do IVF.
There's just so much that wecan offer.
Speaker 1 (16:57):
Well, and I think it's important to remember too
that Fertility is not just aboutgetting pregnant.
Your fertility health, yourhormonal health, your ability to
ovulate, your ability to makeenough Progesterone, is
important for your physicalhealth and can be a great
indicator of how healthy you areunderneath.
As someone with PCOS, you knowif you're ovulating more
regularly, and Especially ifyou've done lifestyle changes
(17:19):
and that's shortening yourcycles in a positive way, like
that's a good underlying signthat you are in a more healthy
state.
You know, so often we're toldwith PCOS like, oh, go away,
come back when you want to getpregnant, and so we just sort of
assume that these sort offertility or period related
issues with PCOS aren't reallythat important Until they affect
(17:41):
our ability to conceive.
But it's all connected, right.
So yeah, our fertility healthis our health, like it's our.
It's our personal health too.
But to kind of piggyback onwhat you were saying about, you
know, oxidative stress, I got aquestion just yesterday because
I'm always telling people thatmy favorite supplement for PCOS
(18:03):
is NAC.
Right, and there was a newstudy that came out this year
that sort of validated me, whichI was like yes, because,
because, what's that oh?
long, everybody's like oh youknow, a nozzetals and great, I
love them.
I love a nozzetals, but I am aNAC fan because of that
oxidative stress and that NAC it, for those who don't know, is a
.
It's a precursor to a and apowerful antioxidant called
(18:25):
glutathione, and so this stuffthat that we're talking about
here is one mechanism for howNAC might be supportive of your
PCOS health.
It doesn't just help your eggquality, but also, you know,
potentially, your insulinsensitivity or your glucose
management and stuff like that.
Tell us a little bit about themitochondria insulin resistance
connection.
Speaker 2 (18:45):
Oh, thank you for reminding me because I
definitely was, like, so excitedabout these granulosis.
Yeah, so remember how I said,there are mitochondria in all
over, in all of your differenttissue types in the body, and
it's interesting because therehave been studies that are
showing that when we see I Don'tI really despise the word
defect, but that's what theycall it in the in the research
(19:06):
right, variation, we could sayvariation Variations in
mitochondrial protein synthesisthat affect energy production in
our granulosa cells can alsoaffect energy production in our
pancreas, which is where we makeinsulin, and that can
Contribute to what they call the, the clinical phenotype of the
insulin resistance PCOS.
And so to your point earlierabout, like this isn't just
(19:28):
about fertility, right, when westart supporting our
mitochondria.
Some of the biggest users ofmitochondrial energy are our
brain like that one's prettyimportant our art, our Skeletal
muscle.
So it's not just about theovulatory piece and even the
metabolic piece, it's aboutsupporting these crucial organs
that are keeping us alive, rightand that's a look.
Speaker 1 (19:48):
When we talk about like root cause medicine or root
cause nutrition, I mean, themitochondria are like the root,
you know, of everything.
So it's it's just cool how,when there are different things,
that strategies and things thatwe can do that are supportive,
that it doesn't just help onething in the body.
It, whenever we work on themitochondria, we're helping
everywhere, right?
Speaker 2 (20:07):
So, because the my computer everywhere, Can I put a
visual out really quick?
Because you just reminded me,we learn this in functional
medicine.
That's like you, if you thinkof all of your body systems as a
web.
So the way that we do this inFunctional medicine is we have
this tool that's called thefunctional medicine matrix,
which I'm obsessed with, and itis a kind of a map of all of our
(20:27):
different body systems.
It's our Gut health, our immunesystem, inflammation,
mitochondrial energy production,our environmental toxicin
exposure, our transportmechanisms, which is like our
blood supply, our lymphaticsystem.
It's our hormones, ourneurotransmitters and then the
structural integrity of ourskeleton and our cell membranes.
And if you think about that asa spider web, like all of those
systems are connected.
(20:47):
Imagine a spider web in yourmind.
If you pull on any part of thatweb, it's gonna change all of
the other areas, and so when westart working on our
mitochondrial health, there areimplications in our hormones, in
our gut health, in Every otherpart of our body.
Speaker 1 (21:02):
So we're really building resiliency in our whole
and our self as a system if youhad to, to make a definitive
determination between what, like, the true root cause of a A lot
of issues is.
You know how, in functionalmedicine, we're always like
everything goes back to the gut,right?
Yeah, what's more important?
(21:23):
The gut and mitochondria,what's more?
Speaker 2 (21:27):
This is like asking someone to choose between french
fries and mashed potatoes.
Like what an excruciatingdecision.
But I'm gonna go mitochondria,I'm gonna go my the hard
questions, because mitochondriacan also affect Our intestinal
barrier function and so really Icould make a case that it's
like the root of the root.
Speaker 1 (21:44):
So I'm gonna go my dream actually I agree with you
because, yeah, I mean I do a lotof my work with clients
involves working on the gut,because I'm a nutrition
professional and Nutrition isdigestion.
Digestion is food, like the gutis right there, right, but but
you know the mitochondria reallywhere it's at.
(22:07):
I mean, that's that's theultimate goal of, like, getting
somebody's digestion Better isso that they can eat more
antioxidant rich foods, morepolyphenols, more of all this
stuff, and then eventually getto the cell right.
So that's right, okay, well,we're gonna talk about some
things that you guys can do tobe supportive of your
mitochondria, but before we dothat, what are some things that
might damage mitochondrialhealth?
(22:28):
I'm also going to ask you alittle bit about genetic
influences on mitochondrialhealth.
This is personal, but I've hada genetic test done and I have
some issues with my mitochondriafrom that perspective.
So I'm interested in theconnection there and I want to
hear more about it.
Speaker 2 (22:44):
Yeah, so what are some of the things that can
affect the health of ourmitochondria?
I think there's two differentpillars, two different ways.
That I think about this isthings that you have too much of
and things that you don't haveenough of.
We got to unpack that andfigure that out.
So, in the too much category,when we have too much oxidative
stress we've talked about thatwhen we have chronic
(23:04):
inflammation, which that wecould probably do a whole other
episode just on inflammation.
But inflammation might comefrom autoimmune disease or a gut
infection, periodontal disease,which people forget about all
the time food sensitivitiesthere's a whole spectrum of
inflammatory triggers that wecould talk about, but too much
(23:25):
of it is going to damage themitochondria.
When our blood sugar ischronically high, exposure to
environmental toxicants all ofthat can lead to mitochondrial
dysfunction.
Then we don't have enough ofmostly nutrients.
We don't have enough vitamin Cor CoQ10 or glutathione, which
you talked about, which is whywe're going to use enocidal
cysteine to give our glutathionea boost.
(23:45):
When we don't have enough Bvitamins or mineral co-factors
like iron and this is a big linkbetween our assimilation in our
gut and our mitochondrialhealth, because iron is one of
the most important mitochondrialsupport nutrients.
I have patients all the time.
I just saw someone recently andshe has really heavy periods
like so much blood loss, soshe's iron deficient.
(24:07):
Then she's also super fatiguedbecause her mitochondria need
the iron.
There's all these connectionsbetween if we're bleeding super
heavy or if we havehypochlorhydria, which is low
stomach acid, we can't pull theiron from our food.
We're going to start to see animpact on the mitochondria and
then we might see fatigue,depression, anxiety, migraines,
(24:28):
muscle pain, like all of thesethings that are related to the
health of our mitochondria.
Speaker 1 (24:31):
Right.
So many women struggle withthose subtle, sneaky symptoms
that are very hard todefinitively put in a diagnosis
category.
They get pushed around todifferent places.
I guess it's iron deficiency,andemia, that's all.
But I see this so much in myclients that when we look at
(24:52):
their blood work they'restruggling with all this other
stuff autoimmunity, gut healthissues, whatever.
They're also struggling tobring that iron in, even when
they're on iron support.
So when there's trouble gettingthe iron into the body, yeah,
there's something going on there.
So it's interesting that youmention inflammation and insulin
resistance and all of thesethings, because I always talk
(25:14):
about the PCOS vortex.
These are really the issuesthat make up the core of PCOS.
It's an inflammatory condition,it's an insulin resistance
condition.
Typically, there's usually someadrenal dysfunction going on.
All of those things.
Like you said, they tend toaffect each other, but they also
affect the mitochondria andvice versa.
Speaker 2 (25:33):
It sets the scene.
Isn't this a reason why, likeyou mentioned earlier, it's
really tempting for a lot ofpeople to file PCOS under a
hormonal condition?
But if we broaden that lens andlook at it as hormones,
inflammation, the metaboliccomponent, now we have all of
these other tools in our toolboxthat we can call upon, and so
(25:53):
it's shattering these limitingbelief systems that allow us to
look at the root cause, like ifwe open up our minds to the fact
that mitochondria could be atthe root of these symptoms.
Now we have a whole spectrum oftools we could use that we
didn't even consider before.
Speaker 1 (26:08):
Yeah, the cool thing about them is so many of them
are lifestyle based.
They're nutrition based tools,so we're going to talk about
that.
So how might someone with PCOSsupport their mitochondrial
health?
Speaker 2 (26:21):
There's all kinds of things, and I think this is like
every practitioner has theirfavorites, and so what?
I have my favorites, what areyour favorites?
You have your favorite, sowe'll talk about it and compare
notes.
But I think, from a lifestyleperspective, another piece that
helps on so many levels iskeeping your blood sugar stable,
because we talked about how,when you have chronically
(26:44):
elevated blood sugar, that thatcan cause some dysfunction in
the mitochondria.
So, keeping blood sugar stablewith all the nutrition stuff
that you talk about all the time, combining your carbohydrates
with that fiber protein to slowthat release of glucose into
your body, and no naked carbs,no naked carbs.
And eating your soluble fibersand all of the things that
you're always educating about.
And then with our regularmoderate exercise I love this
(27:07):
idea.
Like so many of my PCOSpatients, they're taking their
15, 20 minute walk.
I see you on Instagram, even inthe dark, like so committed
doing your glucose walk.
Speaker 1 (27:16):
Do you think it's so important?
I got it under desk treadmillso I don't have to do that
anymore.
Got to do what you got to do.
Speaker 2 (27:22):
I think that's all really important.
Meditation, even because of theway that it lowers our stress
hormones, can be super helpfulfor our mitochondria.
Speaker 1 (27:29):
Yeah, a lot of people don't realize that when you're
stressed you get like an acutestressor during the day.
It raises your blood sugarBecause you store a little sugar
in your liver and your musclesand it's there for that
emergency of when you're underattack, but like when you get a
text or a mean message on yourinner DMs, like that's going to
raise your blood sugar.
Speaker 2 (27:49):
So you're activated.
Yes, so having those stresstransformation strategies is
super important, minimizingenvironmental toxicants, which I
say that and people I think arelike.
What does that even mean?
I always say we have to live inthe world where there are toxic
exposures.
It's just you go outside andbreathe the air.
If you live in a city, even out, I live in the country and even
(28:09):
out here, you know, anywhereyou are there's going to be
toxicants, but it's fine.
Our body is inherently wise andwe have the tools that we need
to transform those.
But we can do ourselves a favorby minimizing exposures where
we can.
So I always start with personalcare products, just because
it's like what we're bathing ourskin in all the time, and I say
let's do a little productinventory.
I go to the skin deep databasefrom environmental working group
and just type in the littleproducts and gives you a
(28:31):
toxicity rating from one to 10.
I try to stick in the green,which is zero to two.
So just trying to clean upthose things like where are the
greatest sources of exposure inour cleaning products and our
personal care products andstarting there.
So that's like.
Speaker 1 (28:44):
Glass and plastics too I'm always with PCOS has a
particular connection to highlevels of BPA and difficulty in
metabolizing, I think, plasticsand stuff, when they get
ingested.
So just trying to switch overto glass and you know that kind
of thing, I mean, like you said,this is the world that we live
in, right, and I thinkoftentimes those of us who have
(29:07):
chronic health conditions orautoimmune conditions or things
like that we're just like almostlike canaries in the coal mine,
right, like our bodies are notadjusting to this new modern
sort of context that we're in,as well as maybe some other
people's bodies are.
But this is the reality thatwe're all living in.
I mean, it goes far beyond whatyou can do as an individual,
(29:31):
but, like you said, you do yourpart.
Speaker 2 (29:33):
Do what you can.
You do what we can.
And thank you for calling outglass, because people always ask
me what do you want me to cutmy raw chicken on if you don't
want me to use a plastic cuttingboard, glass, glass?
Speaker 1 (29:46):
I actually saw, and I don't actually know that this
is true, but I did see somebodyreally talking intensely about
how wood is actually a prettydecent anti-microbial
environment for cutting meat.
It's more antimicrobial thanplastic or something.
Speaker 2 (30:03):
Don't quote me on that, but I heard that.
Speaker 1 (30:05):
Well, let's all Google that, because that's
super interesting, because Ilove a black cutting board.
I would just love that to betrue, but we are not.
Yeah, I'm not an expert on themicrobial properties of bamboo
or wood, nor am I, butenvironmental toxicants.
Speaker 2 (30:17):
We'll tie that one up with a bow.
We're going to do our best.
Lower inflammation which wetalked a little bit about this
and work with a practitioner ifyou can, with a functional
medicine practitioner.
Shout out if you want to go toifmorg and find someone near you
and find a practitioner tool.
There's people, there'sthousands of certified
practitioners over the wholeworld, so the likelihood that
someone is going to be near youenough to do telemed is likely.
(30:39):
So anyway, that's an aside.
But when you go looking forchronic inflammation, we can go
inflammation hunting.
Do you go to the dentist andwhat's going on in your gut and
do you have insulin resistance,and it's a bit of an
investigation.
So just work with someone who'scomfortable doing that.
We talked a little bit aboutno-naked carbs, but I think a
nutrient-dense diet in generalis really important and the
(30:59):
easiest way to conceptualizethat is to eat the rainbow.
I know that sounds super simple, but that's actually the best
way that we can guarantee broadspectrum antioxidant coverage is
like did you actually eat red,orange, yellow, green, purple
foods today?
So just give a checklist.
Speaker 1 (31:16):
A lot of health stuff .
I mean, we've got this wholepodcast about it right, but at
the end of the day, a lot of thestuff that we're talking about
it's the simple stuff, andsomewhere along the way we have
disconnected ourselves so muchfrom our own health and
intuition that we've forgottenthat health is actually simple.
It's eating your veggies andtaking a walk.
Speaker 2 (31:39):
I don't know Work on the trauma, the implementation
part.
That's hard right.
It's like, yeah, I know thatgoing to bed before 11 PM in a
totally dark room is what Ishould be doing, but also, how
am I supposed to read myromantic novels on my Kindle at
11.30?
If that's the case, Exactly, or?
Speaker 1 (31:57):
I know that I'm supposed to eat the rainbow, but
how am I going to actuallyovercome my food sensory issues,
or how am I going to shop forall those and how am I going to
put them together?
You have a recipe that I thinkI'm going to link to on this
podcast.
Speaker 2 (32:12):
I'm so excited.
Speaker 1 (32:13):
What is it?
Isn't it like a glutathionesalad?
Glutathione salad so good.
Every time you share that, Ishare it right back because I
love the glutathione salad, butsomething like that.
One of the things that I dothat I think is really
supportive of mitochondrialhealth is I just have a matcha
latte every day.
It's like my little thing.
It's a great source ofantioxidants If you get a high
(32:34):
quality one that's notcontaminated with lead, and so,
if you can make little thingsinto habits, you have a salad
every day for lunch.
Speaker 2 (32:45):
Yeah, because you're matcha latte.
Speaker 1 (32:46):
It doesn't have to be that complicated.
You can do one thing at a time.
Speaker 2 (32:50):
OK, you've kind of opened a door to talk a little
bit about sups.
Is that OK?
Can?
Speaker 1 (32:53):
we go there the supplements, because I am a
supplement fan.
Speaker 2 (32:59):
You know, yeah, it's easy to get supplement fatigue.
I think it's like, immediately,I'm a supplement, yeah, too,
school.
But I'm also defensive becauseI think there's a perception,
which can be true at times, thatfunctional medicine is just
like a supplement for everything, right, right, because we know
what to use.
And so I'm always like, yes,I'm so happy that we have
(33:22):
supplements and I know about somany of them and I have so many
to offer.
And I think the distinction isI'm never just going to give
someone supplementrecommendations Right, it's
always in combination with thelifestyle, with all the things.
But in this case there's somerock star mitochondrial support,
of course.
Speaker 1 (33:38):
Supplements and you mentioned OK, so I thought about
what are your?
Speaker 2 (33:40):
favorites.
Ok, so this one is actually.
I've long been a lover ofvitamin D for a variety of
reasons, but I wasunderappreciating the
mitochondrial aspect of vitaminD.
I was like it's great, you knowour immune system and hormones
and all that, but vitamin D canactually directly act on
mitochondria and upregulateantioxidant enzymes.
So just another reason for usto get our vitamin D tested and
(34:03):
to supplement accordingly.
You already mentioned NAC,which is we love it for so many
reasons.
It's a mitochondrial support,it's an antioxidant, it helps
with our glucose control.
It's a mucolitic meaning ithelps to thin mucus.
So when I have patients thatare like I'm not seeing that egg
white cervical fluid or I'mtaking Clomid and my cervical
fluid is gone, nac to the rescue.
Speaker 1 (34:26):
Yep and, as an aside, with NAC and vitamin D both of
those if you've ever had COVIDor dealing with some like longer
term symptoms from COVID, itwould be very helpful.
Speaker 2 (34:36):
We love, probably because they help the
mitochondria so much and myfunction is one of the drivers
of long COVID, but that's awhole thing.
But, yeah, a lot of thesesupplements are going to work.
You mentioned matcha.
That's an excellent thing toadd.
I'm also going to give a shoutout to melatonin, and I'm going
to talk about this becausepeople are always like what
Melatonin?
I'm like there's a lot of feararound melatonin and so I think
(34:56):
people aren't using it.
But melatonin in people withPCOS significantly improves
mitochondrial function in ourgranulosa cells and people are
always really worried about, Ithink, dependency on melatonin.
But I feel really comfortablewith low doses of melatonin at
night, so I use a 0.3 dose,which is very low, some
(35:21):
interesting stuff about highdose melatonin in PCOS.
Speaker 1 (35:25):
But it's newer, right , I don't know a ton about it
yet.
Speaker 2 (35:28):
Yeah, and we've historically been using high
doses for things like lupus.
People use high doses like anautoimmune picture in general,
but I'm using like 0.3milligrams for the most part,
and people always say I'mworried about inhibiting
ovulation and I've looked intothese studies and I'm happy to
(35:53):
be proven wrong if someone wantsto forward me an article.
But it seems like this wholeidea is derived from these
studies that were done in the90s where people were given
melatonin at incredibly highdoses, like 300 milligrams,
which is so I just said.
I give 0.3 milligrams.
It's so high, and so I haven'tpersonally seen any issues with
(36:16):
ovulation at low doses and Ithink that the antioxidant
protection of melatonin, themitochondrial support aspect of
melatonin, is like if we do acost-benefit analysis, I think
that the benefit outweighs anypotential costs that I haven't
seen at that dose.
That being said, of course,always talk to your doctor and
make sure melatonin's right foryou.
Sometimes it causes people tobe more awake at night and if
(36:36):
you're that person, thenmelatonin is not for you.
Speaker 1 (36:38):
But I just wanna like give a shout out to melatonin
because it is a great option,and those people that I've
worked with before who have likea lot of the people I work with
have sleep issues right.
It's just a common thing whenyou've got other stuff going on,
and so I cannot count how manypeople have been like, yeah, I
tried melatonin.
It doesn't really make me tired.
It doesn't do anything for me,though.
So if it's not, you know, it'snot one of those things that,
(36:59):
for a lot of people, that muchevery night is gonna be
something you get like sleepdependency on.
Speaker 2 (37:03):
But Exactly, but it does give that little
mitochondrial boost.
And then some of my otherfavorites are CoQ10 is a big one
.
This is super important part ofthe electron transport chain,
which is how we produce energy.
So CoQ10, l-carnitine isanother one that's super
important.
Alpha lipoic acid is a good one.
(37:25):
And then resveratrol.
I love resveratrol but I alwaysgive a caveat that I only dose
resveratrol in the follicularphase.
So maybe, like the first 10 orso days of the cycle, I'll use
resveratrol and the studies wesee that there's a benefit, even
if it's just used for a week, aweek at a time, and then take a
break.
So I'm a fan of resveratrol.
In that context, is itreasoning for only using it
during the follicular phase?
(37:46):
Yeah, there's some evidence toshow that it affects the way
that the uterine tissue, theendometrium, changes following
implantation Interesting.
And so there's some researchfrom the IVF setting saying that
people who took resveratrolthroughout their whole cycle had
problems with the developmentafter implantation.
(38:07):
That did not result in apregnancy.
So I'm just within abundance ofcaution, I'll use it in the
first half of the cycle for themitochondrial benefits and then
we discontinue.
Speaker 1 (38:15):
No big sense.
Yeah, well, that's a reallygood one.
I mean there is I could add tothis list.
How about fish oil?
Speaker 2 (38:24):
Fish oil Love a fish oil.
Fatty acids Love a good fishoil.
Speaker 1 (38:27):
You can see what else I don't know.
Speaker 2 (38:28):
You've covered all the ones that I was probably
going to say, but then alsogoing back to B vitamins, like
those foundational things, yeah,so important for that electron
transport chain, and I'm gladyou mentioned fatty acids.
So our mitochondria have a cellmembrane that is largely it's
called the lipid bilayer and itreally incorporates a lot of
(38:49):
omega-3 fatty acids.
So if we want that cellmembrane to remain flexible and
healthy and prepare itself fromdamage, it needs to have fatty
acids.
Speaker 1 (38:58):
So from a PCOS perspective, what I have seen is
a lot of great evidence onusing vitamin D, on using NAC.
I've seen some stuff onmelatonin especially recently I
feel like I've been seeing morestuff about that CoQ10, alpha
lipoic acid and L-carnitine.
I've seen stuff there, fish oil, of course, zinc.
So all of these things.
(39:20):
If you want to go on PubMed andjust do a little searchy search
you can find a fair amount ofevidence that they're supportive
.
Of course there's differencesin quality of research and all
that, but not just for whatwe're talking about here with
mitochondria, but directly forPCOS symptoms.
So I highly recommend you don'tneed to do all of them all at
(39:44):
once, unless you're a superoverachiever, but you can start
with one and give supplements alittle time, see if you notice
any differences.
I know for me NAC was probablythe biggest thing for me.
Just regularly using NAC for afew months I noticed a big
difference.
And just having a matcha too, Imean that really changed my
skin.
It changed a lot of things forme.
(40:04):
And it's not necessarily a youdon't think of it as a
supplement, it's a food but itkind of acts in the same way
that maybe a supplement would Ilove foods like that, like a
medicinal quality, but I'm alsoenjoying myself and it's
delicious and luxurious.
Speaker 2 (40:18):
It helps me romanticize my life.
Speaker 1 (40:20):
Exactly, it's all of those things Kind of just love
matcha, I'm just obsessed withit.
I think it's because I nevergot into drinking coffee, so I
had this gap where I needed,like everyone every girl likes
their little.
I'm a beverage girl.
Speaker 2 (40:33):
A little drink yeah.
Speaker 1 (40:35):
Every little drink right and I had.
There was just such a gap there.
Now it's filled with joy.
Speaker 2 (40:41):
Well, as a Seattleite , I'm drinking my coffee, girl,
yeah.
Speaker 1 (40:45):
I know you are, and no, no hate.
Well, I mean, you were justtalking today about bitters,
right?
Speaker 2 (40:49):
Yes, so is coffee a bitter, or I mean coffee is a
bitter, coffee is a bitter.
Matcha is a bitter, I believe.
I think matcha definitely couldqualify as a bitter.
Speaker 1 (40:58):
It's when you first drink it.
Definitely, yes, it's bitter.
It's those bitter receptors.
Yeah, but the cool thing aboutbitter foods is the more you eat
of them, the more you taste thesubtle flavors that come out.
They're really quite deliciousand tell everybody about the
bitters thing that you sharedtoday about how there's
receptors.
Speaker 2 (41:19):
There's actually a PCOS connection, so I'm so
excited to talk about this, sothis sounds funny and people
commented when I shared aboutthis on Instagram.
They were like wait, am Ireading this correctly?
Yes, and let me explain.
You have bitter taste receptors.
They're on your tongue, right?
So I see you have that bittersensation.
When you eat bitter greens likearugula or Brussels sprouts, or
coffee or grapefruit, it tastesbitter and I know everybody
knows that feeling that I'mtalking about Makes you salivate
(41:41):
, it makes your stomach growl.
Well, emerging research over thelast five years or so has shown
us that we have bitter tastereceptors in our ovaries, in our
uterus, on sperm, in ourkidneys, in our genitourinary
tract.
I mean, they're everywhere andit's so, so, so interesting.
(42:01):
And it's still a little bitunclear about the mechanism
behind why we'd have all thesereceptors outside the oral
cavity.
But what's really strange andcool and exciting is that I'll
give PCOS as an example.
They found that this was amouse study.
So let me just say that whenthey gave mice who had PCOS a
(42:23):
hops-derived bitter compound,they started ovulating regularly
.
Their levels of progesteroneimproved and this was all
started because they were tryingto do these experiments on mice
where they removed or blockedthe action of their bitter
receptors and then the micecould no longer reproduce and
they were like, oh wait, maybethe bitter receptors were doing
(42:45):
something.
So it's like prompted this wholeline of research and now
they're looking at the bittertaste receptors in the granulosa
cells.
We know how much I love thoseand how it seems like when
you're younger than 36, you havemore bitter taste receptors in
your granulosa cells and thenover 36, you have a little bit
less.
And when they look at studiesof people who had UTIs, they
(43:07):
found that bitter receptors inthe genitourinary system would
detect the chemicals that wereproduced by pathogenic bacteria
that caused the UTI and thatactivated this whole immune
response which causes some ofthe pain in the urinary tract.
But it's like why your immunesystem, like, responds and
(43:27):
clears that bacteria.
So who knew that UTIs andbitter taste receptors were
related?
But there you have it andpeople saying nutrition doesn't
matter, it's everything.
Speaker 1 (43:38):
Come on, that's incredible and actually I'm
going to take that tip and I'mgoing to use that with clients,
because I have some clients withchronic UTIs that are really
hard to get a handle on andmaybe some more bitter foods in
the diet might be helpful.
Speaker 2 (43:50):
Maybe some bitters will have to have a whole other
conversation about the vaginalmicrobiome.
Have your coffee.
Yes, have your coffee.
I'll never take them away.
Speaker 1 (43:58):
Yeah, I don't know I never I get the.
I actually did that question aton where it was, especially
when I'm sharing about Mojah,Because there's this assumption
that with PCOS you can't haveany caffeine.
No, caffeine at all, Never.
And like sure.
I mean, if you've got a majoradrenal component you might want
to limit your caffeine.
But I really think we have thisweird sort of thing about
caffeine that I'm not sure isactually played out in the
(44:19):
research.
I mean, do you have thoughts oncaffeine?
Speaker 2 (44:22):
I always tell people well, my patients are all trying
to get pregnant.
And so they're like, is this OK?
And then what if I get pregnant?
And for years we were told thatup to 200 milligrams of
caffeine is probably fine.
And then there were someresearch that came under like
maybe that's a bit much.
So I say 100 milligrams ofcaffeine, which is like eight
ounces of coffee, or it's alatte, a tall latte, and I feel
pretty good about that.
(44:43):
Yeah.
Speaker 1 (44:44):
I feel fine too.
I mean so from the pregnancyperspective.
I know there's a great bookthat I loved called what is it
Expecting Better?
I don't know, it's by thestatistician who wrote a
pregnancy book and she basicallywent into the statistics of all
the different studies that havebeen done on things like deli
meat consumption, you know Right, like all that kind of stuff.
(45:06):
And she did a lot of thestudies on caffeine and found
that really kind of herconclusion was if you are used
to drinking a certain amount ofcaffeine, then you could
probably cut back slightly fromwhat you're used to drinking and
be fine.
Now I don't want to talk toyour doctor before, yeah, of
course, but that rings sort oftrue for me.
(45:27):
I just feel like there's acertain level of caffeine that
we probably can tolerate, and alot of people think caffeine is
responsible for a lot of theintellectual developments of the
last 300, 400 years.
So you know.
Speaker 2 (45:42):
I believe it's responsible for my doctoral.
There's some benefit.
And let me just I have to talkabout CYP1A2 just for two
seconds.
Oh yeah, it's a geneticvariation, it's a single
nucleotide polymorphism.
It's the way that youmetabolize caffeine is your
CYP1A2.
And so that variation can makeyou metabolize caffeine quickly
(46:04):
or more slowly, right, and so ifyou're that person, like I am,
that can have a coffee at 6 pmand then still go to sleep,
perfectly, you're probably afast metabolizer.
Where we know we have ourfriends and they take a sip of
caffeine and they are wired,you're probably kind of a slow
metabolizer.
So, just to tie it all up,every human has the biochemical
individuality that makes thesethings more or less appropriate
(46:25):
for them.
Speaker 1 (46:26):
Yes, exactly, and I am a slow metabolizer and you
know, what's funny is that I'vealways sort of known that,
because you know I have to stopby 2 pm or I won't be sleeping.
And then I did my genetic testand what do you know, there it
came up and I'm like, yes,confirmation.
So, okay, let's talk aboutbefore, because I know we're
(46:47):
running short on time.
So if anyone is trying toconceive with PCOS, are there
some specific reasons why wewant to?
Oh, you know what we talkedabout that already.
I'm gonna.
Speaker 2 (46:55):
I think we've made the case.
Speaker 1 (46:56):
Like there's so many reasons I did that Okay so,
before we close up for the day,tell us where we can find you,
tell us if you have anythingthat you want to let us know
about.
Speaker 2 (47:06):
Yes, the best place to find me is on Instagram at
Functional Fertility, becauseI'm there most days having fun
and just doing my thing.
You can head to my website,drcaliawattlescom, to learn
about my clinical services,including my upcoming online
program, which I'm super excitedabout.
It's called the FunctionalFertility Blueprint and it walks
through all of the steps that Inormally take with my patients.
(47:27):
There's a lab testing involved.
It's all of your supplements,your modifiable lifestyle
factors.
We create your own functionalmedicine matrix together so that
you can identify your uniquearea of clinical imbalances.
I'm super proud of it and Ithink it's gonna be really
helpful and just allows me toreach this audience that is
larger than the people who livein Washington, which is who I
normally work with.
So very excited for theFunctional Fertility Blueprint
(47:49):
to come out.
The kind of page describing allof the curriculum is open at Dr
Caliawattles If anyone wants togo check it out and join the
list.
20 people are invited to be myfounders round, so spots are
limited, that's gonna be so cool.
Speaker 1 (48:04):
That would be such an incredible opportunity.
Hopefully, yeah, when thispodcast comes out, we can send
people that way and I think itis gonna be great.
I can already tell I know, if Iknow Calia, there would be a
lot in there.
She jam.
She's like me in that way.
I think we're both very similarin that we love to jam pack our
(48:24):
courses with lots ofinformation Once you get your
money's worth.
So I know it's gonna be great,so I will link to that and then
follow her on Instagram.
While you're at it, follow meon Instagram if you're not
already, and thank you forlistening today.
Calia, thank you for being onthe show.
I really appreciate it.
(48:45):
Thank you so much.
All right, talk to y'all later.
Bye.
Hello everyone, welcome back to an Amber a day,
the functional nutrition podcast.
I'm your host, amber Fisher,and today I am here with a
fabulous guest.
She has been a guest on ourpodcast before.
This is Dr Kalia Waddles, whoruns functional fertility and,
as I was just telling her, Ihave long admired her work.
Just look up to her, thinkshe's a fantastic, fabulous
(00:22):
person and it's incrediblyintelligent.
Love to learn from her.
So today, her and I are goingto be discussing mitochondrial
health, pcos and a little bitabout fertility, since that is
her specialty.
So, yeah, thank you for beinghere, kalia.
Speaker 2 (00:37):
Thank you so much for having me.
We're reunited and it feels sogood.
Speaker 1 (00:41):
And, yes, we, we have known each other virtually for
a few years now.
Speaker 2 (00:47):
And a few years we've had a virtual friendship.
Speaker 1 (00:49):
Yes, a lot, a lot has happened in those years, so
it's wonderful, okay, so what Iwant to do first is I'd love for
you to just introduce yourselfto everybody.
Tell us what you do, you know.
Speaker 2 (01:00):
Yeah, great.
So I am Kalia Waddles.
I'm a naturopathic doctor bytraining and then I have some
post doctoral certificationthrough the Institute for
Functional Medicine.
So I'm also an IFM certifiedpractitioner.
I am the founder of my practice, functional fertility where I
really take a root cause,evidence based, patient centered
approach to fertility using abody systems approach, which is
(01:21):
what IFM teaches us.
So I'm looking at all theaspects of someone's health to
really identify the underlyingdrivers of their fertility
struggles, and we're cultivatingresilient health that sets them
up for a healthy pregnancy, ahealthy baby and longevity in
their health so that they canenjoy this family they work so
hard for we love it.
Speaker 1 (01:39):
We love to see it.
Is she not so well spoken?
Everyone, just I, just she is.
So what we're going to kind oftalk about today is a topic that
you and I are both verypassionate about, and that is
mitochondrial health.
And when I say mitochondria,people sometimes when I look
like a deer in headlights arelike okay, this is over my head,
Like we're talking aboutsomething like really you know
(01:59):
intense here what the heck is amitochondria?
So for those of us who haveforgotten our biology, can you
explain to us what themitochondria are and why they
are important, just for ourhealth in general, but also for
our hormones specifically?
Speaker 2 (02:13):
Yes, I would love to.
Mitochondria are a beloved tome and if anyone's been on my
social media, you'll see like30% of the posts are about
mitochondrial health, becauseit's so important.
Mitochondria are tinystructures that are found in
both cells of the body and Ithink the mitochondria have an
excellent PR team, becauseeverybody knows their
catchphrase.
People always tell me I canstill hear my 10th grade biology
(02:34):
teacher say mitochondria arethe powerhouse of the cell, like
that's their thing, and peopleremember that.
What that means is thatmitochondria are responsible for
generating energy, and I say wecan think of them like cellular
batteries, because theyessentially convert energy from
things like the food we eat intoa form that our cells can use.
And this comes up in myfertility practice all the time
(02:55):
because I say ovulation,fertilization, implantation
these are energeticallyexpensive processes.
So we need really healthymitochondria to power those.
And when we look at hormones, afun fact is when we make
hormones, the backbone actuallybegins with cholesterol.
So cholesterol is shuttled intoour mitochondria and then that
cholesterol goes through aseries of very fancy enzymatic
(03:18):
reactions until it turns intohormones like estrogen and
progesterone.
And so sometimes when I havepatients that have a short
luteal phase or they have lowprogesterone so they might have
things like recurrent pregnancyloss.
I always want to support theirmitochondria as we work on that
hormone imbalance pattern,because inside the mitochondria
that cholesterol will turn intopregnant alone and then pregnant
(03:40):
alone is transformed by thisvery fancy enzyme called 3-beta
hydroxystero dehydrogenase intoprogesterone.
So if we're going to reallywork on helping our body make
progesterone on its own, we gotto get those mitochondria
healthy.
Speaker 1 (03:54):
Yeah, so a lot of our creation of hormones actually
happens in the mitochondria, soit's super key.
If we want hormones at all,we've got to have our
mitochondria.
Speaker 2 (04:03):
That's exactly right.
It's the rate limiting factorin hormone production, which
means we're only able to makehormones at a rate that our
mitochondria can sustain.
It's kind of a big deal.
Speaker 1 (04:14):
Yeah, and so if well, I'm maybe jumping ahead.
But if our mitochondria arelike overtaxed, then that can be
really difficult on ourhormonal health.
I often talk about hormones inlike a pyramid structure because
, just for a visual illustration, because people often associate
something like PCOS with likebeing just a purely hormonal
(04:35):
issue.
They're like well, I was justborn with too much testosterone,
like, this is just how I am,and the reality is that hormone
processes are kind of like oneof the last sort of things that
the body is going to work on.
It's almost like your hair andyour nails right.
Like if you're unhealthy, thosethings are going to suffer.
Like if you're not healthyunderneath your mitochondria,
not healthy, your hormones aregoing to suffer.
(04:56):
So it's not something that well, I guess, am I making sense?
Speaker 2 (05:00):
Yeah, yeah, You're making sense to me and I'll
bring up.
There's a hormone called thehormone conference that the IFM
offers.
That you have attended and haveworked on for years, and one of
the kind of hallmark takeawaysfrom that program is that a
hormone imbalance is often anappropriate response to
something going on elsewhere inthe body.
Right Like our hormones areconstantly trying to compensate
(05:22):
for other things.
So it makes perfect sense whatyou were saying.
It's like the last step in.
Our hormones are just trying tokeep us healthy in the context
of everything else going on inour body.
Speaker 1 (05:32):
Yeah.
So if we've got an imbalance orsignaling issue or whatever
going on with our hormones, wehave to look deeper.
We can't just say, okay, let metake the supplement that's
going to make me make more Idon't know, estrogen or whatever
.
It's not that simple.
It's like well, why are thingsout of balance in the first
place?
And oftentimes it goes backdirectly to the mitochondrial
health and the function of ourenergy makers of ourselves.
Speaker 2 (05:54):
The powerhouse of ourselves.
Speaker 1 (05:56):
Yeah, it's like a magic school bus in here.
Okay, so what kinds of thingsmight happen when our
mitochondria are working well?
You give us some examples.
Speaker 2 (06:06):
Yeah, I would love to give some examples, and what I
am about to say I'm going topreface this is that it's going
to be annoying.
But I would not say it's goingto be annoying and so I'll just
get out.
I'll just get out with it thatA mitochondrial dysfunction,
mitochondrial disease.
It can be hard to notice or todiagnose, because people
actually call mitochondrialdysfunction like the great
(06:28):
masquerader or the notoriousmasquerader, because, if you
think about it, our mitochondria, like I said, are found in most
cells of the body and so whenwe have dysfunction it can
present, like with any symptomin any organ at any age.
So how frustrating, right.
But this is actually anopportunity for us to say okay,
then what type of patient do Iwant to consider mitochondrial
(06:51):
dysfunction in?
And so I think about if someonehas an atypical presentation of
a common disease, like when wesee all the time that's a
comorbidity with PCOS, isHashimoto's right or autoimmune
thyroiditis, and it's like if Ihave an autoimmune patient and
they're not responding to mynormal stuff, I'm doing
everything I can to tone theirimmune system, I've got them on
(07:12):
thyroid hormone and they're justnot feeling better.
I'm really wondering what'sgoing on in the mitochondria.
So atypical presentations ofcommon disorders.
If someone has a lot ofrecurrent setbacks or flare ups
in their health, like we thinkwe're on a good trajectory, and
then something happens, they getan illness, some big stressor
happens, or even something likefasting that the body might
(07:35):
perceive as stressful, and nowtheir symptoms are in full flare
mode, I'm kind of wondering ifsomething is going on with their
mitochondria.
Speaker 1 (07:41):
Well, speaking of fasting, I want to pick your
brain a little bit about that,because what I recall from some
of my IFM conferences is a lotof us, different practitioners,
have sort of different opinionsabout fasting.
Right, because there can besome huge benefits to fasting,
but then there can also be somedifficulties to fasting,
depending on the person.
I've heard that a certain amountof fasting is really helpful
(08:03):
for the mitochondrial health,because if you go a certain
length of time it helps them tosort of clean up, right?
Is that true, and what shouldwe take away from that?
Speaker 2 (08:15):
Yeah, intermittent fasting can be helpful for
mitochondria, but I think wehave to look at this person as a
whole.
So, like you and I have talkedabout fasting before in the
context of cortisol If someoneis really having HPA axis
dysfunction meaning their bodyis already under such a source
of stress that it can't reallytolerate any more stressors I'm
going to be really cautiousabout using fasting Now.
(08:37):
We know that, in fact, for PCOS, the bulk of the research on
fasting is in people who areinsulin resistant specifically,
and we know that not everyonewith PCOS has a lot of trouble
with insulin.
It's common, but not everyone.
So I think we have to look at,like their whole hormonal health
, their HPA axis.
We should experiment.
If we think fasting is going tobe helpful and they feel a lot
(08:59):
worse, we should probably backoff and do some mitochondrial
support, not to say we can neverdo fasting, but let's get their
mitochondria a little bit moreresilient and then try again.
Speaker 1 (09:07):
Yes, I love that because you know, personally I
tend to recommend fasting morein my post-menopausal patients
and stuff and I myself inpost-menopausal I do
intermittent fasting.
Now I feel good when I do it.
But I've also had clients whofelt horrible and it almost
reminds me of treating otherthings like candida overgrowth
(09:28):
or something like that, where ifyou do too much, too soon and
too fast it's so overwhelmingfor the body you can almost get
this cascade reaction ofinflammation from actually
trying to do something positive.
So healing sometimes is kind ofa slow process and I always
think about the body as, likeyou know, it can't.
You can't push it too hard, toofast.
(09:49):
You have to let it heal in itsown time and each one of us is
like on a different timelinewith it.
I think fasting is kind of oneof those things that gets thrown
in there.
A lot is like well, just fastand it'll help, everything you
know, but for some people nowit's not helpful.
Speaker 2 (10:03):
Yeah, I was actually just listening to a lecture,
like kind of a tangent, but it'sadjacent, you'll see where I'm
going.
I was talking about fasting andhow.
Yeah, fasting can be great fora lot of people, but the lecture
was specific to people who havegenetic variations in the way
that they glucuronidate things.
So Gilbert syndrome was the bigexample.
It's like how you engage withenvironmental toxicants, right,
(10:25):
and like most of us don't walkaround knowing our genetic
status for things like this, andthen when we fast, we feel
terrible.
So what I'm trying to say islet's normalize a little bit of
trial and error.
You know, it's okay to trysomething that you think is
going to be helpful and then, ifit doesn't feel good, to go
back to the drawing board.
I think in medicine we doourselves a disservice when
(10:46):
we're like, well, this shouldwork, so we're just going to
stick with it.
You know what I'm saying.
It's like it's okay if it's abit of an experiment.
Speaker 1 (10:52):
I totally agree, and I think in the case of PCOS
that's really important, becauseso often in the sort of medical
community at large, pcos getskind of lumped in as like this
one type of issue.
It's like it's an insulinresistant thing, like limit your
carbs, fast, do that kind ofstuff.
It'll help whatever.
But then when you get into thePCOS sort of healthcare
community, those of us who'vespent a little bit more time
(11:15):
sort of thinking more deeplyabout the disorder, we've all
come up with our own sort ofways of dealing with this.
But there's this pervasive themeon the other side that like
fasting is horrible for you andit's terrible for your hormones.
That will never help you at alland you should never, ever try
it.
And I really think the truthlies somewhere in the middle
that for some people somethinglike fasting could be really
beneficial.
For other people it's not goingto be helpful, and for a lot of
(11:38):
people it might not be helpfulat first but might be helpful
later or vice versa.
But, like you said, a littlebit of experimentation, trial
and error, I think is soimportant to view your body as
almost a little bit of a scienceexperiment.
That's how I do it, you know,because you won't everyone's
biochemically unique right.
Speaker 2 (11:57):
So we all have different needs Individual Yep,
that's right, and I think thatkind of like oh, I think the
truth is somewhere in the middleprobably applies to a lot of
the things that we do.
There is life and general rightand general right on a lot of
things.
So I think that's true for somany different areas.
Speaker 1 (12:13):
I think the struggle comes when you know just as,
like practitioners, we're alwaystrying to find like a protocol,
right, like we want, like a setof steps that we can like put
everyone through, but we justthat's the beauty of functional
medicine and functionalnutrition is that the whole
point is we don't put peoplethrough a set of specific steps.
We, you know, take them as aunique person, exactly, and that
(12:35):
means that things may change.
Speaker 2 (12:36):
So anyway, we're not with it.
We don't treat diagnosis codes,we treat people, and that's the
beauty of it.
Speaker 1 (12:42):
Yes, love it.
Okay.
So let's talk a little bit morespecifically about mitochondria
and PCOS.
Where, like, where's theconnection there?
How might it impact PCOS?
Speaker 2 (12:54):
This is a fun question and in order to answer
this, I feel like I'm going tohave to do a little bit of
anatomy and physiology review.
So everyone, focus back.
We got to get into the A and P.
So I there's a few differentways that I can connect
mitochondria specifically forPCOS.
The first is that there's aneffect at the level of the ovary
, which I'll describe, and thenthere also is a connection to
(13:15):
insulin resistance.
So I'll talk about the ovaryfirst and then can I put you
responsible for not letting meforget about the insulin
resistance part If I get soexcited about the ovary Right
here.
Okay, so I love granulosa cellsand I just need to own how much
I love granulosa cells.
Granulosa cells are these.
They actually represent thelargest cell population in the
ovary and they're so importantfor fertility.
(13:36):
There's their specialized cells.
They're located in the ovarianfollicle, which is basically our
egg sac that surrounds ourlittle oocyte or egg cell.
People call them, like the eggcell, helper cells or nourishing
cells.
So they're really, reallyimportant and I love them.
They provide nourishment.
They support the developing eggby producing hormones like
(13:58):
estrogen, which is a big deal.
So during ovulation, a matureegg is released from the
follicle, it bursts from thefollicle and then the remaining
granulosa cells that were in theegg sac, they form a structure
called the corpus luteum andthat produces progesterone to
sustain the endometrium duringthe luteal phase or during early
pregnancy.
So that part's really important.
(14:19):
And I think I am happy to saythat the growth and the
proliferation and the divisionof the granulosa cells require
abundant and stable mitochondriato supply appropriate levels of
energy.
And the granulosa cells arereally dependent upon healthy
mitochondria.
And when we have mitochondrialdysfunction it disrupts that
(14:39):
bi-directional communicationbetween the egg cell and the
granulosa cells, which can leadto stagnant growth and
development.
And if we think about PCOS andthe cystic part of PCOS, they're
not really cysts, right?
They're all of these follicles,all of these little egg sacs
that grew a little bit butdidn't get big enough to ovulate
.
That's why we see thisanovulation happening.
(15:00):
So when you look to the studies,we see that when they have been
in the IVF setting and they'llextract some fluid from the
follicles of women with PCOS, wesee increased levels of
reactive oxidant species andwhat that means it's oxidative
stress.
So it essentially means we havemore compounds that can damage
(15:20):
DNA than we have antioxidantsthat can kind of fight those
compounds.
So we see an increased level ofreactive oxidant species in
that follicular fluid which canimpair the function of the
mitochondria.
It can lead to an abnormalshape of the granulosa cells and
then we have inadequate energysupplied to do all these things
(15:42):
that we need to do, like ovulateand mature an egg.
It's also interesting that wesee that mitochondrial
dysfunction in the follicularfluid of women with PCOS, so we
can actually make our egg cellsless effective at utilizing
energy from glucose.
So there's all of thesemetabolic components.
It's really interesting.
In in turn, as a result of allof that, we see altered egg
(16:07):
quality and this is thought tobe one of the contributors to
why we sometimes see poorpregnancy outcomes through IVF
when women with PCOS are goingthrough treatment.
And I'm bringing that up becauseI think that that can be Scary
to hear sometimes.
But the good news is we have alot of control Over those
changes.
So they're largely influencedby epigenetics and I talk about
(16:31):
so genetics are like the part ofyour story that's written in
pen, but epigenetics are thepart that's written in pencil.
We can do some editing, we canerase, we can write new things
in.
So While we do see theseconnections.
There's so much that we can doand we'll talk about this, I'm
sure nutritionally, lifestylesupplements, all of that to
power up those mitochondria andreally support that process, no
matter where you are on yourfertility journey, if you're
(16:51):
just trying to ovulate regularly, if you're ready to do IVF.
There's just so much that wecan offer.
Speaker 1 (16:57):
Well, and I think it's important to remember too
that Fertility is not just aboutgetting pregnant.
Your fertility health, yourhormonal health, your ability to
ovulate, your ability to makeenough Progesterone, is
important for your physicalhealth and can be a great
indicator of how healthy you areunderneath.
As someone with PCOS, you knowif you're ovulating more
regularly, and Especially ifyou've done lifestyle changes
(17:19):
and that's shortening yourcycles in a positive way, like
that's a good underlying signthat you are in a more healthy
state.
You know, so often we're toldwith PCOS like, oh, go away,
come back when you want to getpregnant, and so we just sort of
assume that these sort offertility or period related
issues with PCOS aren't reallythat important Until they affect
(17:41):
our ability to conceive.
But it's all connected, right.
So yeah, our fertility healthis our health, like it's our.
It's our personal health too.
But to kind of piggyback onwhat you were saying about, you
know, oxidative stress, I got aquestion just yesterday because
I'm always telling people thatmy favorite supplement for PCOS
(18:03):
is NAC.
Right, and there was a newstudy that came out this year
that sort of validated me, whichI was like yes, because,
because, what's that oh?
long, everybody's like oh youknow, a nozzetals and great, I
love them.
I love a nozzetals, but I am aNAC fan because of that
oxidative stress and that NAC it, for those who don't know, is a
.
It's a precursor to a and apowerful antioxidant called
(18:25):
glutathione, and so this stuffthat that we're talking about
here is one mechanism for howNAC might be supportive of your
PCOS health.
It doesn't just help your eggquality, but also, you know,
potentially, your insulinsensitivity or your glucose
management and stuff like that.
Tell us a little bit about themitochondria insulin resistance
connection.
Speaker 2 (18:45):
Oh, thank you for reminding me because I
definitely was, like, so excitedabout these granulosis.
Yeah, so remember how I said,there are mitochondria in all
over, in all of your differenttissue types in the body, and
it's interesting because therehave been studies that are
showing that when we see I Don'tI really despise the word
defect, but that's what theycall it in the in the research
(19:06):
right, variation, we could sayvariation Variations in
mitochondrial protein synthesisthat affect energy production in
our granulosa cells can alsoaffect energy production in our
pancreas, which is where we makeinsulin, and that can
Contribute to what they call the, the clinical phenotype of the
insulin resistance PCOS.
And so to your point earlierabout, like this isn't just
(19:28):
about fertility, right, when westart supporting our
mitochondria.
Some of the biggest users ofmitochondrial energy are our
brain like that one's prettyimportant our art, our Skeletal
muscle.
So it's not just about theovulatory piece and even the
metabolic piece, it's aboutsupporting these crucial organs
that are keeping us alive, rightand that's a look.
Speaker 1 (19:48):
When we talk about like root cause medicine or root
cause nutrition, I mean, themitochondria are like the root,
you know, of everything.
So it's it's just cool how,when there are different things,
that strategies and things thatwe can do that are supportive,
that it doesn't just help onething in the body.
It, whenever we work on themitochondria, we're helping
everywhere, right?
Speaker 2 (20:07):
So, because the my computer everywhere, Can I put a
visual out really quick?
Because you just reminded me,we learn this in functional
medicine.
That's like you, if you thinkof all of your body systems as a
web.
So the way that we do this inFunctional medicine is we have
this tool that's called thefunctional medicine matrix,
which I'm obsessed with, and itis a kind of a map of all of our
(20:27):
different body systems.
It's our Gut health, our immunesystem, inflammation,
mitochondrial energy production,our environmental toxicin
exposure, our transportmechanisms, which is like our
blood supply, our lymphaticsystem.
It's our hormones, ourneurotransmitters and then the
structural integrity of ourskeleton and our cell membranes.
And if you think about that asa spider web, like all of those
systems are connected.
(20:47):
Imagine a spider web in yourmind.
If you pull on any part of thatweb, it's gonna change all of
the other areas, and so when westart working on our
mitochondrial health, there areimplications in our hormones, in
our gut health, in Every otherpart of our body.
Speaker 1 (21:02):
So we're really building resiliency in our whole
and our self as a system if youhad to, to make a definitive
determination between what, like, the true root cause of a A lot
of issues is.
You know how, in functionalmedicine, we're always like
everything goes back to the gut,right?
Yeah, what's more important?
(21:23):
The gut and mitochondria,what's more?
Speaker 2 (21:27):
This is like asking someone to choose between french
fries and mashed potatoes.
Like what an excruciatingdecision.
But I'm gonna go mitochondria,I'm gonna go my the hard
questions, because mitochondriacan also affect Our intestinal
barrier function and so really Icould make a case that it's
like the root of the root.
Speaker 1 (21:44):
So I'm gonna go my dream actually I agree with you
because, yeah, I mean I do a lotof my work with clients
involves working on the gut,because I'm a nutrition
professional and Nutrition isdigestion.
Digestion is food, like the gutis right there, right, but but
you know the mitochondria reallywhere it's at.
(22:07):
I mean, that's that's theultimate goal of, like, getting
somebody's digestion Better isso that they can eat more
antioxidant rich foods, morepolyphenols, more of all this
stuff, and then eventually getto the cell right.
So that's right, okay, well,we're gonna talk about some
things that you guys can do tobe supportive of your
mitochondria, but before we dothat, what are some things that
might damage mitochondrialhealth?
(22:28):
I'm also going to ask you alittle bit about genetic
influences on mitochondrialhealth.
This is personal, but I've hada genetic test done and I have
some issues with my mitochondriafrom that perspective.
So I'm interested in theconnection there and I want to
hear more about it.
Speaker 2 (22:44):
Yeah, so what are some of the things that can
affect the health of ourmitochondria?
I think there's two differentpillars, two different ways.
That I think about this isthings that you have too much of
and things that you don't haveenough of.
We got to unpack that andfigure that out.
So, in the too much category,when we have too much oxidative
stress we've talked about thatwhen we have chronic
(23:04):
inflammation, which that wecould probably do a whole other
episode just on inflammation.
But inflammation might comefrom autoimmune disease or a gut
infection, periodontal disease,which people forget about all
the time food sensitivitiesthere's a whole spectrum of
inflammatory triggers that wecould talk about, but too much
(23:25):
of it is going to damage themitochondria.
When our blood sugar ischronically high, exposure to
environmental toxicants all ofthat can lead to mitochondrial
dysfunction.
Then we don't have enough ofmostly nutrients.
We don't have enough vitamin Cor CoQ10 or glutathione, which
you talked about, which is whywe're going to use enocidal
cysteine to give our glutathionea boost.
(23:45):
When we don't have enough Bvitamins or mineral co-factors
like iron and this is a big linkbetween our assimilation in our
gut and our mitochondrialhealth, because iron is one of
the most important mitochondrialsupport nutrients.
I have patients all the time.
I just saw someone recently andshe has really heavy periods
like so much blood loss, soshe's iron deficient.
(24:07):
Then she's also super fatiguedbecause her mitochondria need
the iron.
There's all these connectionsbetween if we're bleeding super
heavy or if we havehypochlorhydria, which is low
stomach acid, we can't pull theiron from our food.
We're going to start to see animpact on the mitochondria and
then we might see fatigue,depression, anxiety, migraines,
(24:28):
muscle pain, like all of thesethings that are related to the
health of our mitochondria.
Speaker 1 (24:31):
Right.
So many women struggle withthose subtle, sneaky symptoms
that are very hard todefinitively put in a diagnosis
category.
They get pushed around todifferent places.
I guess it's iron deficiency,andemia, that's all.
But I see this so much in myclients that when we look at
(24:52):
their blood work they'restruggling with all this other
stuff autoimmunity, gut healthissues, whatever.
They're also struggling tobring that iron in, even when
they're on iron support.
So when there's trouble gettingthe iron into the body, yeah,
there's something going on there.
So it's interesting that youmention inflammation and insulin
resistance and all of thesethings, because I always talk
(25:14):
about the PCOS vortex.
These are really the issuesthat make up the core of PCOS.
It's an inflammatory condition,it's an insulin resistance
condition.
Typically, there's usually someadrenal dysfunction going on.
All of those things.
Like you said, they tend toaffect each other, but they also
affect the mitochondria andvice versa.
Speaker 2 (25:33):
It sets the scene.
Isn't this a reason why, likeyou mentioned earlier, it's
really tempting for a lot ofpeople to file PCOS under a
hormonal condition?
But if we broaden that lens andlook at it as hormones,
inflammation, the metaboliccomponent, now we have all of
these other tools in our toolboxthat we can call upon, and so
(25:53):
it's shattering these limitingbelief systems that allow us to
look at the root cause, like ifwe open up our minds to the fact
that mitochondria could be atthe root of these symptoms.
Now we have a whole spectrum oftools we could use that we
didn't even consider before.
Speaker 1 (26:08):
Yeah, the cool thing about them is so many of them
are lifestyle based.
They're nutrition based tools,so we're going to talk about
that.
So how might someone with PCOSsupport their mitochondrial
health?
Speaker 2 (26:21):
There's all kinds of things, and I think this is like
every practitioner has theirfavorites, and so what?
I have my favorites, what areyour favorites?
You have your favorite, sowe'll talk about it and compare
notes.
But I think, from a lifestyleperspective, another piece that
helps on so many levels iskeeping your blood sugar stable,
because we talked about how,when you have chronically
(26:44):
elevated blood sugar, that thatcan cause some dysfunction in
the mitochondria.
So, keeping blood sugar stablewith all the nutrition stuff
that you talk about all the time, combining your carbohydrates
with that fiber protein to slowthat release of glucose into
your body, and no naked carbs,no naked carbs.
And eating your soluble fibersand all of the things that
you're always educating about.
And then with our regularmoderate exercise I love this
(27:07):
idea.
Like so many of my PCOSpatients, they're taking their
15, 20 minute walk.
I see you on Instagram, even inthe dark, like so committed
doing your glucose walk.
Speaker 1 (27:16):
Do you think it's so important?
I got it under desk treadmillso I don't have to do that
anymore.
Got to do what you got to do.
Speaker 2 (27:22):
I think that's all really important.
Meditation, even because of theway that it lowers our stress
hormones, can be super helpfulfor our mitochondria.
Speaker 1 (27:29):
Yeah, a lot of people don't realize that when you're
stressed you get like an acutestressor during the day.
It raises your blood sugarBecause you store a little sugar
in your liver and your musclesand it's there for that
emergency of when you're underattack, but like when you get a
text or a mean message on yourinner DMs, like that's going to
raise your blood sugar.
Speaker 2 (27:49):
So you're activated.
Yes, so having those stresstransformation strategies is
super important, minimizingenvironmental toxicants, which I
say that and people I think arelike.
What does that even mean?
I always say we have to live inthe world where there are toxic
exposures.
It's just you go outside andbreathe the air.
If you live in a city, even out, I live in the country and even
(28:09):
out here, you know, anywhereyou are there's going to be
toxicants, but it's fine.
Our body is inherently wise andwe have the tools that we need
to transform those.
But we can do ourselves a favorby minimizing exposures where
we can.
So I always start with personalcare products, just because
it's like what we're bathing ourskin in all the time, and I say
let's do a little productinventory.
I go to the skin deep databasefrom environmental working group
and just type in the littleproducts and gives you a
(28:31):
toxicity rating from one to 10.
I try to stick in the green,which is zero to two.
So just trying to clean upthose things like where are the
greatest sources of exposure inour cleaning products and our
personal care products andstarting there.
So that's like.
Speaker 1 (28:44):
Glass and plastics too I'm always with PCOS has a
particular connection to highlevels of BPA and difficulty in
metabolizing, I think, plasticsand stuff, when they get
ingested.
So just trying to switch overto glass and you know that kind
of thing, I mean, like you said,this is the world that we live
in, right, and I thinkoftentimes those of us who have
(29:07):
chronic health conditions orautoimmune conditions or things
like that we're just like almostlike canaries in the coal mine,
right, like our bodies are notadjusting to this new modern
sort of context that we're in,as well as maybe some other
people's bodies are.
But this is the reality thatwe're all living in.
I mean, it goes far beyond whatyou can do as an individual,
(29:31):
but, like you said, you do yourpart.
Speaker 2 (29:33):
Do what you can.
You do what we can.
And thank you for calling outglass, because people always ask
me what do you want me to cutmy raw chicken on if you don't
want me to use a plastic cuttingboard, glass, glass?
Speaker 1 (29:46):
I actually saw, and I don't actually know that this
is true, but I did see somebodyreally talking intensely about
how wood is actually a prettydecent anti-microbial
environment for cutting meat.
It's more antimicrobial thanplastic or something.
Speaker 2 (30:03):
Don't quote me on that, but I heard that.
Speaker 1 (30:05):
Well, let's all Google that, because that's
super interesting, because Ilove a black cutting board.
I would just love that to betrue, but we are not.
Yeah, I'm not an expert on themicrobial properties of bamboo
or wood, nor am I, butenvironmental toxicants.
Speaker 2 (30:17):
We'll tie that one up with a bow.
We're going to do our best.
Lower inflammation which wetalked a little bit about this
and work with a practitioner ifyou can, with a functional
medicine practitioner.
Shout out if you want to go toifmorg and find someone near you
and find a practitioner tool.
There's people, there'sthousands of certified
practitioners over the wholeworld, so the likelihood that
someone is going to be near youenough to do telemed is likely.
(30:39):
So anyway, that's an aside.
But when you go looking forchronic inflammation, we can go
inflammation hunting.
Do you go to the dentist andwhat's going on in your gut and
do you have insulin resistance,and it's a bit of an
investigation.
So just work with someone who'scomfortable doing that.
We talked a little bit aboutno-naked carbs, but I think a
nutrient-dense diet in generalis really important and the
(30:59):
easiest way to conceptualizethat is to eat the rainbow.
I know that sounds super simple, but that's actually the best
way that we can guarantee broadspectrum antioxidant coverage is
like did you actually eat red,orange, yellow, green, purple
foods today?
So just give a checklist.
Speaker 1 (31:16):
A lot of health stuff .
I mean, we've got this wholepodcast about it right, but at
the end of the day, a lot of thestuff that we're talking about
it's the simple stuff, andsomewhere along the way we have
disconnected ourselves so muchfrom our own health and
intuition that we've forgottenthat health is actually simple.
It's eating your veggies andtaking a walk.
Speaker 2 (31:39):
I don't know Work on the trauma, the implementation
part.
That's hard right.
It's like, yeah, I know thatgoing to bed before 11 PM in a
totally dark room is what Ishould be doing, but also, how
am I supposed to read myromantic novels on my Kindle at
11.30?
If that's the case, Exactly, or?
Speaker 1 (31:57):
I know that I'm supposed to eat the rainbow, but
how am I going to actuallyovercome my food sensory issues,
or how am I going to shop forall those and how am I going to
put them together?
You have a recipe that I thinkI'm going to link to on this
podcast.
Speaker 2 (32:12):
I'm so excited.
Speaker 1 (32:13):
What is it?
Isn't it like a glutathionesalad?
Glutathione salad so good.
Every time you share that, Ishare it right back because I
love the glutathione salad, butsomething like that.
One of the things that I dothat I think is really
supportive of mitochondrialhealth is I just have a matcha
latte every day.
It's like my little thing.
It's a great source ofantioxidants If you get a high
(32:34):
quality one that's notcontaminated with lead, and so,
if you can make little thingsinto habits, you have a salad
every day for lunch.
Speaker 2 (32:45):
Yeah, because you're matcha latte.
Speaker 1 (32:46):
It doesn't have to be that complicated.
You can do one thing at a time.
Speaker 2 (32:50):
OK, you've kind of opened a door to talk a little
bit about sups.
Is that OK?
Can?
Speaker 1 (32:53):
we go there the supplements, because I am a
supplement fan.
Speaker 2 (32:59):
You know, yeah, it's easy to get supplement fatigue.
I think it's like, immediately,I'm a supplement, yeah, too,
school.
But I'm also defensive becauseI think there's a perception,
which can be true at times, thatfunctional medicine is just
like a supplement for everything, right, right, because we know
what to use.
And so I'm always like, yes,I'm so happy that we have
(33:22):
supplements and I know about somany of them and I have so many
to offer.
And I think the distinction isI'm never just going to give
someone supplementrecommendations Right, it's
always in combination with thelifestyle, with all the things.
But in this case there's somerock star mitochondrial support,
of course.
Speaker 1 (33:38):
Supplements and you mentioned OK, so I thought about
what are your?
Speaker 2 (33:40):
favorites.
Ok, so this one is actually.
I've long been a lover ofvitamin D for a variety of
reasons, but I wasunderappreciating the
mitochondrial aspect of vitaminD.
I was like it's great, you knowour immune system and hormones
and all that, but vitamin D canactually directly act on
mitochondria and upregulateantioxidant enzymes.
So just another reason for usto get our vitamin D tested and
(34:03):
to supplement accordingly.
You already mentioned NAC,which is we love it for so many
reasons.
It's a mitochondrial support,it's an antioxidant, it helps
with our glucose control.
It's a mucolitic meaning ithelps to thin mucus.
So when I have patients thatare like I'm not seeing that egg
white cervical fluid or I'mtaking Clomid and my cervical
fluid is gone, nac to the rescue.
Speaker 1 (34:26):
Yep and, as an aside, with NAC and vitamin D both of
those if you've ever had COVIDor dealing with some like longer
term symptoms from COVID, itwould be very helpful.
Speaker 2 (34:36):
We love, probably because they help the
mitochondria so much and myfunction is one of the drivers
of long COVID, but that's awhole thing.
But, yeah, a lot of thesesupplements are going to work.
You mentioned matcha.
That's an excellent thing toadd.
I'm also going to give a shoutout to melatonin, and I'm going
to talk about this becausepeople are always like what
Melatonin?
I'm like there's a lot of feararound melatonin and so I think
(34:56):
people aren't using it.
But melatonin in people withPCOS significantly improves
mitochondrial function in ourgranulosa cells and people are
always really worried about, Ithink, dependency on melatonin.
But I feel really comfortablewith low doses of melatonin at
night, so I use a 0.3 dose,which is very low, some
(35:21):
interesting stuff about highdose melatonin in PCOS.
Speaker 1 (35:25):
But it's newer, right , I don't know a ton about it
yet.
Speaker 2 (35:28):
Yeah, and we've historically been using high
doses for things like lupus.
People use high doses like anautoimmune picture in general,
but I'm using like 0.3milligrams for the most part,
and people always say I'mworried about inhibiting
ovulation and I've looked intothese studies and I'm happy to
(35:53):
be proven wrong if someone wantsto forward me an article.
But it seems like this wholeidea is derived from these
studies that were done in the90s where people were given
melatonin at incredibly highdoses, like 300 milligrams,
which is so I just said.
I give 0.3 milligrams.
It's so high, and so I haven'tpersonally seen any issues with
(36:16):
ovulation at low doses and Ithink that the antioxidant
protection of melatonin, themitochondrial support aspect of
melatonin, is like if we do acost-benefit analysis, I think
that the benefit outweighs anypotential costs that I haven't
seen at that dose.
That being said, of course,always talk to your doctor and
make sure melatonin's right foryou.
Sometimes it causes people tobe more awake at night and if
(36:36):
you're that person, thenmelatonin is not for you.
Speaker 1 (36:38):
But I just wanna like give a shout out to melatonin
because it is a great option,and those people that I've
worked with before who have likea lot of the people I work with
have sleep issues right.
It's just a common thing whenyou've got other stuff going on,
and so I cannot count how manypeople have been like, yeah, I
tried melatonin.
It doesn't really make me tired.
It doesn't do anything for me,though.
So if it's not, you know, it'snot one of those things that,
(36:59):
for a lot of people, that muchevery night is gonna be
something you get like sleepdependency on.
Speaker 2 (37:03):
But Exactly, but it does give that little
mitochondrial boost.
And then some of my otherfavorites are CoQ10 is a big one
.
This is super important part ofthe electron transport chain,
which is how we produce energy.
So CoQ10, l-carnitine isanother one that's super
important.
Alpha lipoic acid is a good one.
(37:25):
And then resveratrol.
I love resveratrol but I alwaysgive a caveat that I only dose
resveratrol in the follicularphase.
So maybe, like the first 10 orso days of the cycle, I'll use
resveratrol and the studies wesee that there's a benefit, even
if it's just used for a week, aweek at a time, and then take a
break.
So I'm a fan of resveratrol.
In that context, is itreasoning for only using it
during the follicular phase?
(37:46):
Yeah, there's some evidence toshow that it affects the way
that the uterine tissue, theendometrium, changes following
implantation Interesting.
And so there's some researchfrom the IVF setting saying that
people who took resveratrolthroughout their whole cycle had
problems with the developmentafter implantation.
(38:07):
That did not result in apregnancy.
So I'm just within abundance ofcaution, I'll use it in the
first half of the cycle for themitochondrial benefits and then
we discontinue.
Speaker 1 (38:15):
No big sense.
Yeah, well, that's a reallygood one.
I mean there is I could add tothis list.
How about fish oil?
Speaker 2 (38:24):
Fish oil Love a fish oil.
Fatty acids Love a good fishoil.
Speaker 1 (38:27):
You can see what else I don't know.
Speaker 2 (38:28):
You've covered all the ones that I was probably
going to say, but then alsogoing back to B vitamins, like
those foundational things, yeah,so important for that electron
transport chain, and I'm gladyou mentioned fatty acids.
So our mitochondria have a cellmembrane that is largely it's
called the lipid bilayer and itreally incorporates a lot of
(38:49):
omega-3 fatty acids.
So if we want that cellmembrane to remain flexible and
healthy and prepare itself fromdamage, it needs to have fatty
acids.
Speaker 1 (38:58):
So from a PCOS perspective, what I have seen is
a lot of great evidence onusing vitamin D, on using NAC.
I've seen some stuff onmelatonin especially recently I
feel like I've been seeing morestuff about that CoQ10, alpha
lipoic acid and L-carnitine.
I've seen stuff there, fish oil, of course, zinc.
So all of these things.
(39:20):
If you want to go on PubMed andjust do a little searchy search
you can find a fair amount ofevidence that they're supportive
.
Of course there's differencesin quality of research and all
that, but not just for whatwe're talking about here with
mitochondria, but directly forPCOS symptoms.
So I highly recommend you don'tneed to do all of them all at
(39:44):
once, unless you're a superoverachiever, but you can start
with one and give supplements alittle time, see if you notice
any differences.
I know for me NAC was probablythe biggest thing for me.
Just regularly using NAC for afew months I noticed a big
difference.
And just having a matcha too, Imean that really changed my
skin.
It changed a lot of things forme.
(40:04):
And it's not necessarily a youdon't think of it as a
supplement, it's a food but itkind of acts in the same way
that maybe a supplement would Ilove foods like that, like a
medicinal quality, but I'm alsoenjoying myself and it's
delicious and luxurious.
Speaker 2 (40:18):
It helps me romanticize my life.
Speaker 1 (40:20):
Exactly, it's all of those things Kind of just love
matcha, I'm just obsessed withit.
I think it's because I nevergot into drinking coffee, so I
had this gap where I needed,like everyone every girl likes
their little.
I'm a beverage girl.
Speaker 2 (40:33):
A little drink yeah.
Speaker 1 (40:35):
Every little drink right and I had.
There was just such a gap there.
Now it's filled with joy.
Speaker 2 (40:41):
Well, as a Seattleite , I'm drinking my coffee, girl,
yeah.
Speaker 1 (40:45):
I know you are, and no, no hate.
Well, I mean, you were justtalking today about bitters,
right?
Speaker 2 (40:49):
Yes, so is coffee a bitter, or I mean coffee is a
bitter, coffee is a bitter.
Matcha is a bitter, I believe.
I think matcha definitely couldqualify as a bitter.
Speaker 1 (40:58):
It's when you first drink it.
Definitely, yes, it's bitter.
It's those bitter receptors.
Yeah, but the cool thing aboutbitter foods is the more you eat
of them, the more you taste thesubtle flavors that come out.
They're really quite deliciousand tell everybody about the
bitters thing that you sharedtoday about how there's
receptors.
Speaker 2 (41:19):
There's actually a PCOS connection, so I'm so
excited to talk about this, sothis sounds funny and people
commented when I shared aboutthis on Instagram.
They were like wait, am Ireading this correctly?
Yes, and let me explain.
You have bitter taste receptors.
They're on your tongue, right?
So I see you have that bittersensation.
When you eat bitter greens likearugula or Brussels sprouts, or
coffee or grapefruit, it tastesbitter and I know everybody
knows that feeling that I'mtalking about Makes you salivate
(41:41):
, it makes your stomach growl.
Well, emerging research over thelast five years or so has shown
us that we have bitter tastereceptors in our ovaries, in our
uterus, on sperm, in ourkidneys, in our genitourinary
tract.
I mean, they're everywhere andit's so, so, so interesting.
(42:01):
And it's still a little bitunclear about the mechanism
behind why we'd have all thesereceptors outside the oral
cavity.
But what's really strange andcool and exciting is that I'll
give PCOS as an example.
They found that this was amouse study.
So let me just say that whenthey gave mice who had PCOS a
(42:23):
hops-derived bitter compound,they started ovulating regularly
.
Their levels of progesteroneimproved and this was all
started because they were tryingto do these experiments on mice
where they removed or blockedthe action of their bitter
receptors and then the micecould no longer reproduce and
they were like, oh wait, maybethe bitter receptors were doing
(42:45):
something.
So it's like prompted this wholeline of research and now
they're looking at the bittertaste receptors in the granulosa
cells.
We know how much I love thoseand how it seems like when
you're younger than 36, you havemore bitter taste receptors in
your granulosa cells and thenover 36, you have a little bit
less.
And when they look at studiesof people who had UTIs, they
(43:07):
found that bitter receptors inthe genitourinary system would
detect the chemicals that wereproduced by pathogenic bacteria
that caused the UTI and thatactivated this whole immune
response which causes some ofthe pain in the urinary tract.
But it's like why your immunesystem, like, responds and
(43:27):
clears that bacteria.
So who knew that UTIs andbitter taste receptors were
related?
But there you have it andpeople saying nutrition doesn't
matter, it's everything.
Speaker 1 (43:38):
Come on, that's incredible and actually I'm
going to take that tip and I'mgoing to use that with clients,
because I have some clients withchronic UTIs that are really
hard to get a handle on andmaybe some more bitter foods in
the diet might be helpful.
Speaker 2 (43:50):
Maybe some bitters will have to have a whole other
conversation about the vaginalmicrobiome.
Have your coffee.
Yes, have your coffee.
I'll never take them away.
Speaker 1 (43:58):
Yeah, I don't know I never I get the.
I actually did that question aton where it was, especially
when I'm sharing about Mojah,Because there's this assumption
that with PCOS you can't haveany caffeine.
No, caffeine at all, Never.
And like sure.
I mean, if you've got a majoradrenal component you might want
to limit your caffeine.
But I really think we have thisweird sort of thing about
caffeine that I'm not sure isactually played out in the
(44:19):
research.
I mean, do you have thoughts oncaffeine?
Speaker 2 (44:22):
I always tell people well, my patients are all trying
to get pregnant.
And so they're like, is this OK?
And then what if I get pregnant?
And for years we were told thatup to 200 milligrams of
caffeine is probably fine.
And then there were someresearch that came under like
maybe that's a bit much.
So I say 100 milligrams ofcaffeine, which is like eight
ounces of coffee, or it's alatte, a tall latte, and I feel
pretty good about that.
(44:43):
Yeah.
Speaker 1 (44:44):
I feel fine too.
I mean so from the pregnancyperspective.
I know there's a great bookthat I loved called what is it
Expecting Better?
I don't know, it's by thestatistician who wrote a
pregnancy book and she basicallywent into the statistics of all
the different studies that havebeen done on things like deli
meat consumption, you know Right, like all that kind of stuff.
(45:06):
And she did a lot of thestudies on caffeine and found
that really kind of herconclusion was if you are used
to drinking a certain amount ofcaffeine, then you could
probably cut back slightly fromwhat you're used to drinking and
be fine.
Now I don't want to talk toyour doctor before, yeah, of
course, but that rings sort oftrue for me.
(45:27):
I just feel like there's acertain level of caffeine that
we probably can tolerate, and alot of people think caffeine is
responsible for a lot of theintellectual developments of the
last 300, 400 years.
So you know.
Speaker 2 (45:42):
I believe it's responsible for my doctoral.
There's some benefit.
And let me just I have to talkabout CYP1A2 just for two
seconds.
Oh yeah, it's a geneticvariation, it's a single
nucleotide polymorphism.
It's the way that youmetabolize caffeine is your
CYP1A2.
And so that variation can makeyou metabolize caffeine quickly
(46:04):
or more slowly, right, and so ifyou're that person, like I am,
that can have a coffee at 6 pmand then still go to sleep,
perfectly, you're probably afast metabolizer.
Where we know we have ourfriends and they take a sip of
caffeine and they are wired,you're probably kind of a slow
metabolizer.
So, just to tie it all up,every human has the biochemical
individuality that makes thesethings more or less appropriate
(46:25):
for them.
Speaker 1 (46:26):
Yes, exactly, and I am a slow metabolizer and you
know, what's funny is that I'vealways sort of known that,
because you know I have to stopby 2 pm or I won't be sleeping.
And then I did my genetic testand what do you know, there it
came up and I'm like, yes,confirmation.
So, okay, let's talk aboutbefore, because I know we're
(46:47):
running short on time.
So if anyone is trying toconceive with PCOS, are there
some specific reasons why wewant to?
Oh, you know what we talkedabout that already.
I'm gonna.
Speaker 2 (46:55):
I think we've made the case.
Speaker 1 (46:56):
Like there's so many reasons I did that Okay so,
before we close up for the day,tell us where we can find you,
tell us if you have anythingthat you want to let us know
about.
Speaker 2 (47:06):
Yes, the best place to find me is on Instagram at
Functional Fertility, becauseI'm there most days having fun
and just doing my thing.
You can head to my website,drcaliawattlescom, to learn
about my clinical services,including my upcoming online
program, which I'm super excitedabout.
It's called the FunctionalFertility Blueprint and it walks
through all of the steps that Inormally take with my patients.
(47:27):
There's a lab testing involved.
It's all of your supplements,your modifiable lifestyle
factors.
We create your own functionalmedicine matrix together so that
you can identify your uniquearea of clinical imbalances.
I'm super proud of it and Ithink it's gonna be really
helpful and just allows me toreach this audience that is
larger than the people who livein Washington, which is who I
normally work with.
So very excited for theFunctional Fertility Blueprint
(47:49):
to come out.
The kind of page describing allof the curriculum is open at Dr
Caliawattles If anyone wants togo check it out and join the
list.
20 people are invited to be myfounders round, so spots are
limited, that's gonna be so cool.
Speaker 1 (48:04):
That would be such an incredible opportunity.
Hopefully, yeah, when thispodcast comes out, we can send
people that way and I think itis gonna be great.
I can already tell I know, if Iknow Calia, there would be a
lot in there.
She jam.
She's like me in that way.
I think we're both very similarin that we love to jam pack our
(48:24):
courses with lots ofinformation Once you get your
money's worth.
So I know it's gonna be great,so I will link to that and then
follow her on Instagram.
While you're at it, follow meon Instagram if you're not
already, and thank you forlistening today.
Calia, thank you for being onthe show.
I really appreciate it.
(48:45):
Thank you so much.
All right, talk to y'all later.
Bye.
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