March 19, 2024 • 65 mins
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Ever wonder why your body behaves the way it does, especially when it comes to complex conditions like PCOS? Today I'll explain a concept called the Priority Pyramid, something I came up with early in my journey to becoming a practitioner that has helped me really look deeper into hormone issues to find the root cause. I also discuss some philosophical things and fun stuff happening in my life in the first 20 minutes or so.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hello, welcome back to An Amber Day, the Functional
Nutrition Podcast.
I'm your host, amber Fisher,and I'm so excited you're here.
Today we're going to be talkingabout one of my favorite
illustrative topics the prioritypyramid.
So if you don't know what thatis, priority pyramid is a
concept that I came up with whenI was early on in my nutrition
practice and I was trying toexplain to people why their
(00:20):
hormone symptoms were not reallyabout their hormones and why
they should care about thingslike their adrenal health or
their gut health or their bloodsugar balance, instead of just
trying to figure out like whatfood can I eat to get better
progesterone levels, or whateverit may be.
So it works really really well,especially in cases related to
(00:40):
PCOS, because so much of whatdrives our PCOS hormone
imbalances are deeperphysiological processes,
metabolic issues and things likethat.
So I'm going to kind of explainhow that works today and buckle
up, because it's going to be afun ride.
Well, actually I don't know ifyou'll think that or not, but I
think it's interesting andactually what the kind of cool
(01:03):
thing about priority pyramid is.
I sort of like came up withthis concept on my own, but then
, as I've taken more training inthe functional medicine world.
I see different iterations ofthe same concept around in lots
of different forms and I thinkit's really cool because I think
a lot of us who are meant to dothis sort of systemic health
(01:26):
and healing work where we'relooking outside the box, we're
looking deeper, we'reinvestigating, we're getting to
the core of issues and kind ofrebuilding we're just sort of
born with this kind of mind thatlikes to do that kind of thing
and since that's fun for us, wespend more time doing it and
then we end up helping people inthat way and we all kind of
have this same concept that'salmost built into who we are as
(01:48):
people.
I think that's really cool.
I really do believe thateverybody is kind of meant for
something and I believe that ifyou really are excited about
something or something seemsreally wonderful to you, there's
a good chance that you wouldprobably be really good at that
and there might be a place foryou, whether that's like a
career or a hobby or whatever.
(02:08):
And I think a lot of peoplehold themselves back from even
trying because they just assumeback in the day.
Okay, let me give you a littlepersonal example, back in the
day when I was really interestedin nutrition.
I was researching it all thetime, reading every book, like
going on every blog.
I thought, man, wouldn't it becool to be like a nutrition
(02:29):
podcaster and have a blog?
Okay, keep in mind, guys, thiswas like 2012, 2013.
So the social media world waslandscape was very different.
There was no Instagraminfluencer types, health
influencer stuff going on.
That kind of thing didn't exist.
But there were blogs and therewere starting to be podcasts,
(02:49):
like the age of the podcast hadbegun, and I followed this
podcast shout out to the Paleofor Women podcast.
I think it's called theEmpowered Women podcast.
Now They've rebranded along theway because they kind of both
of them got out of the wholePaleo sphere anyway, but I was
really into that at the time.
So I'm listening to thispodcast all the time,
obsessively listening to it.
(03:10):
I'm just like man, that is thejob that would be the coolest
thing to get, to be working fromhome, getting to do podcasts,
getting to research the stuffthat you're so interested in and
talk about it all day and writeabout it, because I love to
write.
But I just thought that's a onein a million thing to be able
to be successful in some sort ofonline career and not have to
(03:32):
go to a nine to five job orwhatever.
That's impossible, that's notgoing to happen for me, it
doesn't happen for but maybe oneor two people, or maybe not one
or two, but it doesn't happenvery often, and so I told myself
there's really no point intrying because it's impossible,
(03:54):
and then fast forward and that'sessentially my career.
I'll be honest that the grindof the whole podcasting, making
Instagram reels like TikToks,reading blogs, writing
newsletters like seeing clients,all that kind of stuff is a lot
more work than I.
It's a lot more of a job than Ioriginally figured.
(04:18):
And making consistent money atit to where you can support your
family and stuff Just amoderate income is a lot harder
than it looks.
I remember thinking back when Ifirst started my Instagram.
I thought, man, if I ever havelike 100,000 Instagram followers
, I'm going to have it made.
Those people must have so muchmoney.
They probably can just workwhen they want to and they get
(04:43):
to work being creative and it'snot so amazing.
And then now that I'm there Imean I have, I think somewhere
in the 80s 80,000 or sofollowers I realized like, oh
actually, no, actually no, Imean I don't want to complain or
anything, because I know I'mvery lucky and I do make you
(05:05):
know I can support my familymost months, but it's a lot more
of a grind than it looks likefrom the outside, which I think
is good.
It's like not supposed to looklike a grind from the outside,
but anyway it is still my dreamjob in a lot of ways and I just
sometimes, when I think back onthat, I feel really grateful and
it also helps me appreciate,like, when I'm going through
(05:26):
like a hard month.
Like you know, the last year orso the economy has been kind of
weird and it has been more of agrind than it was previously,
and so sometimes I can get alittle down or start feeling,
you know, like maybe I, maybeI'm not saying anything
important anymore, like maybemaybe you know I've done
everything I can do, or or whathave you.
(05:46):
And when I start feeling likethat, I like to think back on.
You know me back then thinking,wow, wouldn't it be cool to be
like a blogger or a podcaster?
And like here I am, I'm doingit.
So anyway, that is a veryroundabout story in which to
illustrate my point, which isthat I really do think that if
there's something that you areexcited about, it might be meant
(06:08):
for you, and certainly thiskind of work was meant for me,
because I was just born withthis sort of way of thinking
about health.
That was a little countercultural, at least for the time.
It's interesting to watch theevolution of our beliefs and our
opinions about health andnutrition, even since I've
(06:28):
excuse me hopefully you couldn'thear me burping there.
I don't know what it is aboutlike recording a podcast, but I
get like a nervous throat.
Do you guys know what I mean?
Like if you're going to have togive a speech or something and
suddenly, like you've had,you've been normal all day, but
then suddenly your throat islike itchy, like you're getting
like a scratch in it and you'relike then you start clearing it
and then, anyway, my, it's likean anxiety throat response.
(06:51):
I don't know, but it's veryannoying.
I'll tell you that much.
So apologies, especially withthis new microphone, I'm sure
you can hear like every smackingsound my mouth makes, which is,
for those of you who don't likethose kinds of sounds is not
going to be very fun.
Anyway, it's been so interestingto watch the change in opinions
about health and nutrition,even since I started working in
(07:14):
this field.
Because back when I was likeearly on in my excitement about
nutrition days, the concepts offunctional health, nutrition,
holistic health, like combiningconventional and alternative
methods, like Eastern andWestern medicine all that kind
of stuff was really kind ofscoffed at.
(07:36):
Like there are some things thatnow are just a given, like, for
example, testing for vitamin Ddeficiency.
Back when I started innutrition, I had the hardest
time getting doctors to run avitamin D test and because they
were like, oh, that's one ofthose woo, woo things, like
that's one of those alternativethings.
Well, now it's like they do itautomatically.
(07:57):
It's like almost part of regularblood work for a lot of doctors
because, especially since COVIDand the connection between
COVID's symptom severity andvitamin D deficiency, like now
it's like a standard thing,right.
Same thing with, like somethinglike fish oil.
You know fish oil used to bereally scoffed at, but then
there were, you know, severalstudies that came out that
showed, you know, benefits forheart health and things like
(08:17):
that from fish oil.
So now I have a lot of myclients be like, oh, I'm on a
fish oil because my doctor saidtoo, because, for you know, to
help with my cholesterol orwhatever.
So it's like some of thesethings just become standard,
they become part of a vernacularand they used to be seen as
like super cuckoo, cuckoobananas.
Oh, another example intestinalpermeability or leaky gut.
(08:38):
Even when I started in practicea lot of people still were like
leaky gut, that's fake, likethat's fake news, like that's
not a real thing.
And then you know, now we haveso much evidence on the gut
immune connection, the gut brainconnection I'm looking at a
book right now called the gutimmune connection on my shelf
over there.
We have so much research onthat and that's really where a
(09:00):
lot of the oomph for currentresearch is going.
And you know as well,established now that this is a
real thing.
So it's just funny, you know, Ijust think like and that's not
to say that I've never beenwrong, because I certainly have
I have made some recommendationsthat I'm like, ooh, I cringe
thinking about.
In fact, I'm going through thearchives of my TikTok right now
because I'm looking for oldvideos that I've never reposted,
(09:22):
to kind of do like from thearchives series, give myself a
break from content creation, andsome of them I'm having to skip
over because I'm like, yeah, no, I don't know if that I believe
that 100% or I'd have to putcaveats on it now that I didn't
back then.
So that's not to say that I'mlike that myself or people in
functional medicine are notwrong sometimes or don't
(09:43):
exaggerate things sometimes orwhatever.
It certainly happens.
But I do think there's likethis kind of newer generation of
health professionals that thinkdifferently about stuff, that
think a little bit moreexpansively about certain topics
, and that's good.
That's a good thing becauseprogress is a good thing.
(10:04):
Sometimes with progress comes alittle bit of fumbling around.
I'm not gonna wait.
Who did I hear talk about thisrecently?
Somebody said recently they'relike I'm not gonna wait for
research to catch up to what Iknow to be true, and that
mindset can get dangerous.
Like I could definitely see away where that would not go in a
(10:24):
positive direction.
But for people on the cuttingedge there is some truth to that
.
It takes like 25 years ofbuildup of research studies for
things to get like reallysolidified in the conventional
world.
So it's kind of nice to be overhere on the edge where you can
try some stuff out and see howit works in real people and use
your intuition a little bit moreand stuff like that.
(10:46):
Obviously, always by being safe, consult your doctor before
anything, before taking anythingon this podcast to heart.
So anyway, this disclaimer,we're gonna get into the topic
today, I promise.
But, as I said, I may or maynot have said this in the last
podcast or I might have editedit out, but I'm freeing myself
(11:09):
up a little bit with thestructure of these podcasts for
this year.
For the last couple of yearsI've been so like, let me follow
this set list of things I'mgonna talk about.
It's gonna be very educational.
Not a lot about me, not a lotabout my opinions.
It's gonna be facts andevidence and whatever.
And that served me for a time.
But I'm kind of a little bitsick of that.
I wanna just talk a little bitmore about different stuff and
(11:32):
go where my mind takes me.
So we will get into today'stopic.
But that is a little bit about.
That's a little bit ofinformation on my opinions,
about career choices and hobbychoices, et cetera.
Speaking of that, this lastweekend I had my dance team
(11:54):
performance.
I'm not sure if I've mentionedit yet on the podcast, but I
have mentioned that I have beentaking salsa lessons for the
last eight or nine months and acouple of months into that I
decided to join a salsa danceteam at my dance school and this
is like they have levels ofdance teams or performance teams
(12:16):
.
So they have the freshman level, the sophomore level, the JV
varsity level and then the allstars level, and I joined the
freshman team obviously becauseI'm very new at this, but we
have been practicing likehardcore practicing for months
now and we had our bigperformance on Saturday night.
I might insert a video of thisin the YouTube version if you
(12:36):
guys wanna see.
Definitely it's not perfect andany of you who are salsa
dancers that are more advancedare gonna see all the mistakes,
but I'm so proud of myself andof all the people on my team who
have become good friends overthese months.
You know it reminds me so muchof summer camp or when I was
growing up.
I was really involved in achurch youth group like super
involved.
(12:56):
I was there like four days aweek and it reminds me so much
of that.
Those were some of the besttimes in my life and so it's so
exciting to be part of a grouplike this again.
Anyway, we had our bigperformance.
There was this whole crew.
It was like a week-end-er eventwhere there were all these
special lessons being taught bythis dance group from New York
City, empire Mambo.
So these are some of the mostfamous dancers of the style of
(13:19):
dancing that I do, which iscalled onto salsa.
Anyway, these are some of themost famous dancers in the world
.
Apparently.
I don't know anything aboutthis stuff, but this is what I
hear from people in the know.
Anyway, they were here.
They taught workshops whichwere incredibly hard, really fun
, but nothing will make you feelmore like a beginner than going
to some of these workshops.
I'm like, okay, I can hang alittle bit with.
Like I mean, I can hang for awhile, but at some point I'm
(13:42):
just like, okay, I'm so tired,anyway.
So they did this week-end-erevent and then there was a
social dance in the evening andwe performed during that social
dance.
My mom and dad came to watch,but I am so proud of myself that
I did that and it was such afulfilling experience, because
(14:04):
dance is something that I havealways wanted to do.
It's one of those things that Ialways felt would be so fun, but
wasn't for me, and a lot of itstemmed from body confidence
issues and just feeling like Iwas bigger than other people.
And so because I was biggerthan other people, I wasn't.
I wouldn't be welcome in aspace where it's traditionally
(14:26):
very feminine or the dancers arevery petite or they are very
pretty or whatever.
I just didn't feel like I fitin in that kind of environment
or that I would be welcome there.
And when I was younger, Ireally wanted to join the dance
team at my high school but youhad to go through pep squad
first and in order to do allthat, you had to try out.
And so I was just too scared toeven try out for pep squad
(14:50):
because I thought I am too bigfor this.
They don't want they're notgonna want a big girl on their
pep squad.
And looking back, that is sosad.
It really is, because I reallyheld myself back from doing that
and I do think I would havereally enjoyed it.
I would have gotten a lot outof it and I'm sorry that I never
(15:11):
did that.
But those body confidence issueswere real.
Some of it was from the timesthese were the early aughts.
I think I would have had to tryout for Pep Squad in 2002, 2003
, something like that, and atthat time, for those of you who
were teens at that time, youremember anybody that was bigger
than a size gosh, who evenknows a size four that was
(15:32):
considered fat in the publicsphere.
And there was this element ofif you were considered fat, then
you were not welcome in publicspaces.
You certainly weren't welcometo show your body off in some
sort of sensual performanceenvironment like dance.
Some teams might have had girlsthat were a little bit bigger,
(15:52):
but it was almost like this sortof embarrassment thing, like oh
, there's the girl on the team.
So I was very aware of thosestandards at the time and I
didn't want to rock the boat, Ididn't want to be the token
bigger girl and yeah, I don'tknow.
Honestly, I wasn't even thatbig and it shouldn't have
mattered anyway.
Even if I was, wherever I fell,I should have been able to feel
(16:15):
comfortable doing that, justbecause I wanted to do it and
because it seemed fun and Icould have been good at it.
You know what I mean.
So the whole thing is sad, butthere's a redemption arc because
as I grew up I got morecomfortable with myself and
especially as I kind of madepeace with my PCOS and my
insulin resistance and, to someextent, my weight, although I
(16:37):
still struggle in thatdepartment, like I think many of
us do.
As I made more peace with thatstuff and more peace with my
body, I realized this wassomething that I could have done
, I could have enjoyed and beengood at.
And then the thing that I lethold me back for a while was my
age, because I thought I'm tooold to do all that.
(16:59):
And it's so funny looking back.
I remember when I went back toschool to get my nutrition
degree, I thought I was too old.
Then I was like 25, and Ithought I thought I'm too old to
switch paths.
It's so silly, looking back onit now that I'm 35 now and I
realized at any point I could goback to school tomorrow,
totally switch careers and havea very fulfilling career in a
(17:23):
different field probably inmultiple different fields if I
wanted to.
I don't want to go back toschool because I'm sick of
school, but you know what I mean.
Time is on my side.
I'm still very young.
You can always change.
You can always change direction.
So I let my age hold me back fora while and then, finally, this
last year, when I was going tobe turning 35, I would say
(17:45):
probably since I turned 30, I'vebeen on this kind of kick where
I'm like okay, things that Iwanted to do when I was younger,
things that were scary for me,things that I have fears around,
I'm going to push myself to dothem.
I don't know why I'm like that.
I just am.
If I feel, if I'm afraid ofsomething, I'm like well, I
better do it.
I better do it so I'm notafraid of it anymore.
I like challenging myself, likethat Like is the wrong word.
(18:06):
I just I feel a need to do itanyway.
So that's why I started doingthe pole dancing for a while.
I did that for a few years.
I really loved that andsometimes I really miss it.
But once I got involved indance, I just didn't have time
or space.
Like my muscles could nothandle anything else and I'm
really focused on this now.
So, anyway, I turned 35.
(18:28):
I'm like okay, this is it, thisis the year I'm going to learn
to dance, I'm going to do it andI'm going to have fun.
And I didn't even know thatdance performance teams were
like a thing, but they are kindof a big deal.
Like every dance school hasperformance teams and you know a
lot of adults of all ages areon these performance teams and
it's really fun and so I joinedand anyway, the rest is history
(18:51):
and performance on Saturdaynight went really well.
So yeah, I don't know, I'm in avery good mood today, just
coasting off the high from thatexperience still.
But yeah, let's see how longhave I been talking?
Probably a while.
So let's get into today's topic,the priority pyramid.
So to start off with, we tendto think about health in a
(19:12):
certain way and I alluded tothis earlier but we do tend to
think about health as like acollection of separate
experiences or separate systems.
So, for example, we think thehormones are just about the
hormones or we think that hearthealth is just about heart
health.
Like I had a lot of people youknow come into my practice and
(19:33):
say like, oh well,cardiovascular disease runs in
my family, or type two diabetesruns in my family.
And what people don't tend torealize is that just because
something genetically runs inyour family doesn't mean that
you're fated to experience thatthing.
It does mean you're geneticallymore predisposed, but your
environment and your lifestyleplay the biggest role in
determining how your geneticsactually express.
(19:54):
And some of that is out of yourcontrol.
Because if you were raised foryou know however many years in
the type of home that iscontributing towards the
development of insulinresistance and you're raised on
that diet and stuff, yeah, Imean you're like the odds are
stacked against you early on,but there is so much that can be
done to sort of reverse thosethings and genetics are not set
(20:15):
in stone.
They can express differentlybased on how well you take care
of yourself.
So when we think about thingslike hormones, you know you're
born with PCOS right, you havethis genetic predisposition
towards PCOS.
But it's not just that you'reborn with extra testosterone or
that you're born with cysticovaries or something it develops
with time because of acombination of factors that are
(20:41):
not really hormonal at all.
It's not like you just wake upone day you know you go through
puberty.
You wake up one day and youjust have, like, high
testosterone just because you'reunlucky or because you're you
know what have you?
There's a combination of deeperfactors, systemic issues that
are happening, that are buildingup into this experience where
(21:02):
your body is making moretestosterone and then it is the
testosterone, or, you know, highDHEA or whatever that are
driving the cystic ovaries andthen from there a lot of that
stuff is a cascade effect, right?
So once we have cystic ovaries,we end up making too much
estrogen because we're notovulating, and those little
cysts are producing estrogenBecause we're not ovulating,
we're not making progesterone.
So you know that contributes tothe whole cycle of us not
(21:26):
ovulating again and anyway, etcetera, et cetera.
We know, if you've listened to afew podcasts, you probably know
the mechanics of how PCOS works.
Thank you.
A lot of the symptoms that wehave are seem hormonal, right,
like, so we'll have facial hairand so we think, okay, facial
hair, that's something that menhave, that's a testosterone
(21:47):
thing, right?
Hair loss, that's somethingthat men deal with.
That's probably a testosteronething and, to a lesser extent,
things like weight gain andstuff.
Testosterone can cause peopleto hold weight in the middle.
So, yes, that is what's goingon, but also why.
The question to always ask iswhy is this happening?
(22:09):
Why are my hormones out ofbalance in the first place?
Because, as I said before, itdoesn't just happen out of
nowhere.
So, to kind of illustrate thispoint to people, I explain this
concept of the priority pyramid.
And if you imagine a pyramid,think about it as like a levels
of priority thing.
(22:30):
It doesn't necessarily have tobe a pyramid structure.
It could be a different thing,but you know, it could be ladder
rungs or whatever.
But there is a top and a bottomto this.
There's a accessory and afoundation.
So on this pyramid we havethree main levels and the top
level is gonna be our sexhormones.
(22:51):
So this is gonna be things likeestrogen, progesterone,
testosterone, all that kind ofstuff, the kind of thing that we
usually point to when we seePCOS symptoms and we say like,
okay, these are out of balance,these are out of balance and
that's why I have so manysymptoms.
But beneath that there are twoother rungs that actually are
the reason why these hormones onthe top are out of whack in the
(23:14):
first place.
So in the middle I tend to lookat things like blood sugar
balance.
I tend to look at things likeadrenal dysfunction.
So the HPA axis, even thethyroid, can function here as
well.
Well, these are things that arenot necessarily root cause
(23:35):
issues, but they are drivingsymptoms.
So they are both drivers ofsymptoms and also driven by
other things.
They're in the middle, they'rekind of like they're the
middleman.
They are part of what directsthe sex hormones to be out of
balance, but they're also thingsthat get out of balance
(23:56):
themselves because of the deeperstuff.
And insulin could be argued,depending on who you talk to,
that it might actually be downon this bottom rung that I'm
about to talk about.
I usually put it in the middle,though, because I find that a
lot of insulin resistance.
There's a genetic component toit, for sure, but that genetic
component really can vary basedon a lot of the factors deeper
(24:18):
in the body.
So what's the deepest rung?
The deepest rung is gonna beour mitochondrial health, the
health of our cells, our cellenergy makers, and the health of
our gut, the bacteria in ourgut and the mitochondria
themselves, which are kind oflike the energy makers of our
cells.
Both of these things actuallyare connected to the way that
(24:39):
our genetics express.
So a lot of times we thinkabout the gut as just being
about our digestion or maybejust playing a role in like how
inflamed we are or something,but gut health is actually
really critical to the way thatour genetics express as well,
and so we have some researchstudies that show that if your
gut health is out of balance,for example, you might be more
(25:01):
insulin resistant or it mightdrive adrenal dysfunction or
something like that, because itcreates sort of an inflammation
or an inflammatory environmentthe mitochondria.
If you go back and listen to acouple episodes ago, I did an
interview with one of my friends, dr Kalia Waddles, who is a
functional medicine physician.
She is incredibly brilliant,really passionate and excited
(25:22):
and she loves to talk about themitochondria.
So we did an episode on themitochondria in PCOS, so I
highly highly recommendlistening to it.
I know it sounds a little bitlike boring, but I promise you
it's not a boring interview,it's actually really cool.
So, but the mitochondria are incharge of a lot of that
inflammation that gets producedas well, and in genetic
transcription, so like in howour genes reproduce.
(25:44):
And yeah, there's just, andthen also it's just like the
energy that each organ that wehave has the function to do its
job correctly.
So, for a mitochondria are likereally damaged or they're
really sluggish or there's justnot enough cleanup work
happening for those, then thatfeeds into every area of our
body, including potentially ourgut health, some might argue.
I asked Kalia this.
(26:04):
I'm like what would you say isreally like the true root of
everything?
You know, at least as far as weknow in this current time, is
it the mitochondria or is it thegut?
Because a lot of people talkabout the gut, and I certainly
do a lot.
I mean, I'm sure there'spodcasts on heroin, like the gut
is the foundation of everything.
But you know, there's somethingto be said on both ends, like,
(26:24):
and actually I think after I'vekind of given it some thought
and I think she said the samething that probably it's
actually mitochondrial health,that really is the true root of
everything, because I mean,that's yeah, that's where the
energy comes from for everything.
So, anyway, that's the pyramidstructure.
So why is it in a pyramid?
You know what's the purpose ofthe pyramid format here?
(26:46):
Well, the idea is to show youalso that, along with kind of
each rung, sort of causingissues in the rung, on top of it
there's also this concept of,like, the body has certain
things that it cares more aboutthan others.
So if our gut health and ourmitochondrial health are not in
(27:06):
balance, then the body can'tlike keep track of and manage
and do a great job with thethings on the middle rung.
So, like our thyroid healthmight suffer here, our adrenal
health might suffer here,because you know, this kind of
inflammatory environment thatgets created by issues on the
deepest rung is not reallyconducive to great blood sugar
(27:27):
balance or to great adrenalhealth, and so if those things
by extension are out of balance,then it's really hard for the
body to keep the hormones inbalance.
I mean, just anyone who's had athyroid issue can tell you that
your thyroid's out of whack.
It obviously is going to messup your blood sugar balance, is
(27:48):
going to mess up your hormones.
I mean this is one reason why alot of women with thyroid
issues, they get on thyroidmedication and suddenly their
fertility returns and they'reable to actually get pregnant
and maintain a pregnancy.
They're actually able to loseweight again or do this or that.
So there's a lot that is drivenby that middle rung that then
(28:08):
impacts that top rung with thesex hormones and in PCOS.
A good example here would beblood sugar balance and adrenal
dysfunction.
Both of these things can createmore testosterone in the body.
The insulin does this bydirectly driving testosterone
production in the ovary.
When insulin is a hormone, sowhen it's high it sends signals
(28:32):
to the ovaries to make moretestosterone, and then the
adrenals can do this in moresubtle ways but they can raise
an androgen called DHEA whichthen can sort of create that
cascade effect of cystic ovariesand those other.
Dhea is an androgen, so itfunctions in much the same way
as testosterone and the adrenalscan also throw off blood sugar
(28:54):
balance even more, creating amore insulin resistant
environment which raisestestosterone.
So there are different methodsthere.
I've also seen too that theadrenals being out of balance
can of course contribute toovaries or to egg health that's
poorer, or to premature ovarianinsufficiency, that kind of
(29:15):
stuff.
So it all plays a role and itcan drive issues at the top and
there might be something to besaid, for example, with
something like estrogen kind ofcreating issues down at the base
of the pyramid with gut healthor with mitochondrial health,
like, for example, a veryestrogenic environment can
(29:35):
contribute to high histamineproduction or it can also create
imbalanced gut bacteria.
But it's like a chicken or anegg situation and in this case I
don't see a very many pathwaysfor the estrogen to actually be
the starter thing that thendrives the gut health
(29:59):
mitochondrial issue.
I see it the other way around.
Now I could be proven wrong onthat, and I'm willing to be
proven wrong.
Maybe it's a circle, maybe it'snot a pyramid, maybe it's like
one of those little circularflow charts.
I could see maybe a potentialfor high levels of plastic kind
of exposures or endocrinedisruptors, and then liver
(30:20):
health issues, detoxificationissues kind of playing a role
there.
But again, then that kind ofconnects back to the gut,
because the gut is a big part ofdetoxification.
Anyway, I'm going off on alittle rabbit trail here where
I'm working things out in my ownmind, but for the purposes of
today's podcast we'll call it apyramid.
And for this pyramid we have tounderstand that in order for us
(30:40):
to really fix what's wrong atthe top, we have to fix what's
wrong at the bottom.
It's just not going to work theother way around.
I can't put you on.
Here's an example Vitex.
Vitex is an herb that can helpyou create a little bit more
estrogen at the beginning ofyour cycle and then contribute
(31:03):
to you ovulating earlier, whichthen can help you make more
progesterone and can kind of besupportive of more regular
cycles.
It tends to work fairly well inPCOS.
I use it a lot with my clients.
I like Vitex a lot, but if Idon't have balance going on or
at least improvement going on onthe two bottom rungs of the
pyramid and I try to put you onVitex, it's not going to do
(31:25):
anything.
A similar concept here would bebirth control right, like yeah,
we could put you on birthcontrol and kind of artificially
alter the hormones and yoursymptoms might reduce while
you're on it, but go off yourbirth control and what happens?
Right, any of you who have donethis know it all comes rushing
back.
And this is something thatreally bothered me a lot in the
(31:48):
early days of managing my PCOS,because I really wanted there to
be something prescription thatI could take that would help.
And I really did believe,because I felt like I was led to
believe this, but maybe Imisinterpreted.
But I felt like a lot of myhealth care professionals were
like, ok, take birth control andit'll fix the issue.
It'll like fix your hormones.
(32:08):
And you know, I vaguelyremember one of my doctors being
like yeah, and then when, ifyou get off of it later, your
hormones will probably like bebalanced again, like they'll
probably just adjust because ofthe birth control.
That's not how it works at all.
It certainly didn't work thatway for me and I think because
of that I placed so much focusfor so long on the hormones
themselves that I reallyneglected those deeper issues,
(32:31):
and so every time I would getoff birth control I would create
more issues for myself, becausethat kind of going on and off
of birth control is really hardon the hormones of somebody who,
like me, has, you know, someliver, sluggish liver issues.
I had the MTHFR gene mutation,like there's some stuff going on
that makes detoxification moredifficult for me, not to mention
(32:52):
like a lifelong struggle withlike irritable bowel which,
thank God is like actually hasbeen under control for quite a
while now, but you know itwasn't certainly at that point.
And so to go on and off ofbirth control like that was
essentially to put a lot ofpressure on my detoxification
(33:12):
systems, and you know thatcontributed to more and more
estrogen dominance etc, etc.
Eventually I developedendometrial cancer from this
kind of high estrogenenvironment.
I find it funny too that thetreatment for the endometrial
cancer was like high doseprogesterone, you know, because
that sort of balanced everythingout.
But anyway, that's neither herenor there.
(33:33):
What I'm saying is, if you hyperfocus on your testosterone
levels or your DHEA levels orwhatever, and miss the bigger
picture, the deeper stuff, thenwe can do that dance all day.
It's not going to end in youhaving a more balanced hormone
(33:54):
profile, and I think that'sprobably why, like there really
isn't anything besides hormonalbirth control, there's really no
, like no doctors areprescribing I don't know like
well, I guess they are kind ofprescribing testosterone
blockers now that I say thatlike spironolactone, right, but
these things just kind ofvaguely work.
They don't really take care ofthe root and point being that
(34:17):
there's really no good solutionsfor the hormone issues.
That last right.
And so that's where I think isreally one of the big proofs or
indicators that PCOS is so muchmore than just hormone
imbalances.
Because if it were just hormoneimbalances, you know they'd put
us all on, like we'd all be onspironolactone, hormonal birth
(34:38):
control and maybe progesterone,on that combo for life and all
would be well, right, we wouldbe like perfectly fine, but no,
we still have these sort of longterm consequences and we have
these issues where we get off ofthis stuff and it all comes
raging back.
But what I think is the mostconcerning is the fact that,
like, pcos stays with you evenpost menopause.
You still have PCOS.
(34:59):
You may not even have ovariesanymore.
I don't have ovaries anymore.
I had a total hysterectomy in2020, but I still have PCOS.
Because PCOS is really miss.
It's not named well, I mean, youdon't even need polycystic
ovaries to be diagnosed withPCOS.
You can actually be diagnosedwith it without polycystic
ovaries.
Look up the Rotterdam criteriafor diagnosis.
(35:20):
You only need two of the three.
One of those three things ispolycystic ovaries, but if you
have the other two, you can havePCOS and not have PCO, not have
polycystic ovaries, which is,you know, the disorder is
misnamed or it's what is theword I'm looking for here.
There's a better name.
Misnamed is not the right word.
Those of you who are intovocabulary, let me know what
(35:45):
word I'm looking for here.
But the name it's namedincorrectly or inappropriately
and I do think I thought I thinkI've heard talk about this, but
I do think that, like,eventually, they were going to
change the name of it.
But all that to say it followsyou through life and, untreated,
can result in higher risks of alot of different stuff we
(36:06):
talked last week about thehigher risks of depression,
anxiety.
Even ADHD is more common inPCOS.
Bipolar disorder is more commonin PCOS.
So there's mental health things.
There's also cardiovasculardisease, diabetes risk, you know
, infertility like.
There's just a lot of thingsthat are risk factors beyond
(36:27):
just oh, I have hightestosterone so I have irregular
periods and I grow facial hairso I just need to go get laser.
You know what I mean.
And the mistake that I thinkconventional medicine makes is
just looking at those hormonesand being like, okay, what can I
do to manipulate these?
And then you know, there's somemovement to manipulate the
(36:47):
deeper issues, right?
So metformin, of course, isgoing to manage insulin a bit
better and that's a very commonrecommendation.
On the supplement side,inositols work just as well as
metformin, sometimes better, andthose are typically recommended
.
Fish oils have some goodresearch for PCOS.
(37:09):
Inesidyl cysteine is myfavorite supplement for PCOS.
I mean, these things all workkind of on deeper issues and are
a little bit more well known,but they're all just either
band-aid approaches or they'rehelpful, but they're not going
to really fix those deep, deepmitochondrial and gut health
(37:30):
issues unless there's afundamental change to the way
we're nourishing ourselves.
Gut health can get out ofbalance for a lot of different
reasons.
Medications can contribute tothat Shoot, even things like
sedentary lifestyle and traumacan contribute to that, but the
biggest contributor is going tobe our diet, because the diet is
(37:50):
what directly feeds thebeneficial bacteria.
So if we're not feeding those,then over time we're creating an
environment in there that ispro more negative bacteria or
that's just pro theproliferation of specific kinds
of bacteria at the expense ofothers, and it's really about
the balance between those, andthat balance is created by fiber
(38:16):
.
Same thing with ourdetoxification systems, the gut
being one of the major sites ofdetoxification for hormones.
If we're not taking care of ourmitochondrial health and we're
not taking care of our guthealth, then our body's going to
really struggle withdetoxification and elimination.
This is why sometimes, if yourcholesterol is high, eating more
(38:39):
fiber can help.
It can also help with yourestrogen dominance issues.
It's fundamentally aboutnourishment of those two areas.
When we're not taking care ofmitochondria, which is also
something that is done primarilythrough the ways that we
nourish ourselves, then we getthis increase in inflammation
(39:02):
that's being created and aninability to clean that
inflammation up because we'renot feeding ourselves with
things like antioxidants, whichare going to clean up oxidants,
we get reduced ATP production.
Atp is like we talk aboutglucose being the food for the
cells.
Glucose eventually breaks downinto ATP.
Atp is the real food foreverything.
(39:24):
It gets a little bit technicalthere.
This is where the Krebs cyclecomes in.
Just think about that.
If you were to hear that yourbody runs on fuel.
If you are not able to createthe fuel that you need, what's
going to happen?
(39:44):
You can't maintain everything.
Some stuff is going to fall bythe wayside.
Your body, at its core, wantsto keep you alive.
That's priority one stay alive.
Priority, like 857 or whatever,is reproduce.
If your body feels that it isin a state where it can barely
manage itself, where it canbarely keep itself going, it's
(40:08):
not going to have the energy orthe resources to promote
reproduction.
There's some argument too forcertain things like PCOS being
evolutionary alterations to helpthe body reproduce during times
when there was struggle.
Some people think that PCOSbecause it is this insulin
(40:31):
environment, it's all thesehormonal structures to get you
to hold on to fat.
A lot of people think that thismight come from genetics of
people who lived through famines, because, end of the day, yes,
number one priority is keepyourself alive, but it is also
important to maintain.
The race must continue.
People must continue to be born.
(40:53):
It is very primal to want topass on your genetics.
Some people think these areadaptations for those kinds of
environments, which means thatwhen we're in an environment
where we're not in a famine,then suddenly we have all the
stuff at our fingertips and itall goes haywire.
Now we have access to too muchstuff.
There's a lot going on here,but at its core, we have to
(41:15):
manage our mitochondrial healthand our gut health in order to
have actual results with ourhormones.
I think the point that I'mtrying to make with this podcast
besides just explaining thisconcept to you so that you can
think more critically aboutnutrition recommendations that
you see on the internet is thatwhen you are managing your PCOS,
don't just look at yourhormones to determine if you're
(41:39):
making progress.
The thing about hormones isthat they can take a very long
time to respond to deeperchanges.
The deeper changes take a lotlonger to really take hold than
you would expect.
When I'm working with clients,I'm not really expecting to see
(42:00):
regulated periods, major hormonechanges, major changes to
facial hair production, thingslike that, until I've been
working with a person for atleast six months, but usually
longer.
It depends a lot on where theperson is starting from.
Sometimes I'll have people comein who are freshly diagnosed
with PCOS and it develops later.
They developed it in theirmid-20s but they always had
(42:22):
regular periods.
As a teenager, let's say.
Maybe they gained some weightor they've been struggling in
that department and they wentand got tested and then they get
diagnosed with PCOS.
Those people tend to have theeasiest time, relatively, with
getting back to regular cyclesbecause their body has that
memory of having regular,balanced hormones before.
Really, what I do with them isI help balance their insulin
(42:42):
levels out, because usually it'sthe insulin that's triggering
this wonkiness with thetestosterone, and then they're
off with their cycles.
Regular cycles can vary.
It can vary from anywhere fromupwards of 35 days to months and
months and months and months.
It's my people who are like oh,I have a cycle.
(43:03):
Some months it's 35 days, somemonths it's 45 days, some months
it's always around a month toevery couple of months.
But it's very irregular in thesense that they don't know
exactly when it's coming.
It's not really on a scheduleand the ovulation date gets
pushed around.
That's usually the influence ofinsulin.
If we can manage the bloodsugar better, suddenly their
(43:25):
body's like okay, we know therhythm, and it can go back to
its rhythm again.
Those tend to be the people whohave resolution of their
symptoms the fastest.
If you've been living with neverhaving periods or having a
period once every 10 months foryour whole adult life and now
you're in your 30s and you'retrying to get pregnant and it's
(43:45):
not working and you're justcoming from a place where a lot
more has built up, a lot moredamage has occurred and it's
going to take longer to regulate, if, if and this is just being
totally honest here if we canregulate you fully at all.
I don't say this to bedefeating, but there is a
collection of people, myselfincluded, I believe.
(44:07):
I don't know, because a lothappened to me Not to go into it
, but a lot happened to me towhere I wasn't.
I really didn't have time toreally test things, but I do
think that there is a collectionof people with the most severe
PCOS symptoms who probably willnever get like fully regular
periods back.
Their hormones will probablyalways be a little bit wonky.
(44:28):
But but that's not to say thatthey can't make major changes.
I think they can make a lot ofchanges to how inflamed they are
, to how insulin resistant theyare, to how well they nourish
themselves, to how well theircells are functioning, to how
well the detoxification systemsare functioning and getting a
much better place with theirhormone balance.
But there may not be timebefore they hit menopause for
(44:48):
them to actually like fully fixit, get to the point where
they're having like 30 daycycles.
I just think I like to berealistic and I think, with the
way that we live now, the waythat our world works, the way
that our food system works,there's a lot stacked against us
that is outside of our control.
Think about things like soilquality.
How much zinc are we gettingfrom our fruits and vegetables
(45:13):
that we were getting like twiceof or three times as much back
when our grandparents wereeating fruits and vegetables?
So we have to do a lot more nowto get the same benefit.
The impact of endocrinedisruptors is something that I
think we're going to see moreand more information on over the
years, and that's somethingthat's really in a lot of ways,
outside of our control plasticsin our environment and that is
(45:36):
something thatdisproportionately impacts those
with PCOS.
So there's a lot of things thatbuild up that we can't do much
about.
And if you are coming from aplace where you've had a lot of
years built up with these thingswithout really knowing about
the need to work on yournutrition because some of us are
just we're not educated on that, just didn't know, or we knew
(45:58):
but we didn't want to doanything about it at the time
then it may not be the mostfeasible thing to get everything
sorted out perfectly like somepeople can, and a lot just
really depends on where you'recoming from with that severity.
I mean it's interesting becauseI've worked with a lot of
people over the years.
(46:18):
I've been in practice almost adecade now and mostly with those
with PCOS.
That's mostly what I've done.
I've done some other stuff,like I'll do some stuff with
autoimmunity.
I do a lot.
I have like kind of a littleword of mouth thing going with
like upper digestive stuff, likenausea and GERD.
I do a lot with that foodsensitivity, that kind of thing.
But most of the work that I'vedone is with PCOS and it's
(46:42):
usually my clients who haven'tdealt with PCOS symptoms as long
that have a better chance ofgetting them fully resolved.
No-transcript.
So yeah, that it is what it is,and I say that from a place of
love because I believe I'm oneof those people as well.
I mean, I ended up gettingcancer at 25.
So I don't think we were in, Idon't think there were like
(47:03):
great odds that I was gonna getlike perfect 30-day cycles, but
I didn't even really get thechance to try.
You know, knowing what I knownow, I would love to see what
would happen, knowing what Iknow now, if I also didn't have
the fear of getting cancer againand I could like try out stuff.
I'd love to see what I could do.
But I'm not gonna get thatchoice anymore because, you know
(47:24):
, at this point I'mpost-menopausal.
It is what it is and for some ofus, some of you I know some of
you listen to me you are alreadypost-menopause as well, or
you're in your early 40s, or youknow you're at a place where
it's like it's kind of it iswhat it is situation, and now
we're just doing cleanup work.
We're doing what we can right.
That's okay too.
There's still a lot of value inthat because, like I said
(47:45):
before, this is something thatis gonna affect you.
Pcos stays with you throughoutyour whole life.
So at that point when we're notlooking at, let's try to get
totally regular periods.
Now the goal post changes andit's let's have a better quality
of life as we age, let's reduceour risk of long-term health
complications, let's keep ourhearts healthy, let's keep our
(48:07):
bone density, you know, in agood space.
So our goals change.
But at the end of the day, todo any of that stuff whether
it's regulate periods or reduceour risk of chronic health
issues as we age it starts bytaking care of the mitochondria
(48:30):
and the gut.
Now, how do we do that?
There's a lot to that.
I may have to make a part two tothis podcast, because I'm
looking at the time and I'vebeen recording now for like an
over an hour.
Obviously, I'm gonna edit it,so it's not gonna be an hour
long that you're listening, butstill, I've been recording a
long time and I think this isgonna be a long one.
So I'm not gonna go too muchinto depth today on like what we
can do.
I might make a part two, butwhat I would suggest and I'll
(48:52):
try to link to some of these inthe show notes is go back and
listen to my podcasts that arespecific to gut health.
Listen to that one with me andKalea that talks about
mitochondrial health, listen tothe one about gut health and
then I may do another onespecifically about supporting
your mitochondria.
I actually already havesomething like that.
I'll look.
Anyway, you will see.
You'll see in the next fewepisodes if I end up doing that
(49:13):
or not.
But big things more fiber,that's for your gut.
More antioxidants, that's foryour mitochondria.
Exercise for both.
So antioxidants are gonna belike your PCOS superfoods I do
have a podcast on the PCOSsuperfoods, so highly recommend
listening to that.
Your leafy greens, your veggies, your even things like dark
(49:36):
chocolate stuff that's highmagnesium, like peanut butter,
all that kind of stuff, mostlyyour veggies and your fruits,
right, like your berries allthat kind of stuff, the stuff
you know is healthy for you.
That's gonna support yourmitochondrial health.
With mitochondrial health wealways say eat the rainbow.
So eat lots of different colorsof fruits and veggies For gut
health.
We're talking fiber, so thatmeans more obviously vegetables
(49:58):
are gonna contribute to that.
But also we're looking atthings like legumes, so beans in
your diet being things likewhole grains in your diet.
Being careful with grains,obviously, because too many
grains or an imbalance betweengrains and protein and fats can
create more of an insulinresponse, which could be
negative here.
So being careful with grains.
However, whole grains are, andparticularly legumes are where
(50:20):
we're gonna get a lot of ourfiber, but it doesn't have to be
a lot Like.
I would definitely look at howmuch fiber are you getting from
these different things and planaccordingly.
So we're looking to get atleast 30 grams of fiber a day.
But honestly, if I'm beingtotally honest, I think with
PCOS we'd probably benefit frommore.
But work your way up.
(50:40):
If you're gonna try it, workyour way up, because if you do
too much fiber too fast you'llmake yourself constipated and
miserable.
Even things like psyllium huska little psyllium husk to bridge
the gap can be helpful here,but it should mostly come from
whole foods, because then you'regonna get those mitochondrial
benefits as well.
So you're kind of like killingtwo birds with one stone.
Exercise for both.
Exercise, because exercisehelps with mitochondrial repair.
(51:02):
It also helps with bacterialbalance in the gut.
Really cool.
There was a study done thatshowed that exercise on its own,
with no diet changes alteredthe gut bacteria balance.
So exercise for both, becauseit's gonna help with not only
with repair for mitochondria,gut health balance, but it's
(51:22):
also gonna help with insulin,which is then gonna help with
the amount of cleanup work thathas to be done.
It's gonna reduce that.
So exercise is key for both.
I do have planned to do anexercise and PCOS podcast very
soon.
It's in my little notebook hereand I wrote it down so I have
to do the planning for it andpull studies and things like
(51:42):
that.
But that is coming.
So, yeah, those are the bigthings and I hope this was
interesting for you.
Hope it helps.
Thanks for listening to mythoughts at the beginning about
dance and all that kind of stuff.
I hope you enjoyed this.
But definitely reach out if youhave questions.
There's a form you can find inthe link tree.
That's questions for thepodcast and I love to answer
(52:03):
questions from you guys and I'mplanning to do more of that this
year.
And if you have not left areview on iTunes, but you've
reached this point in thepodcast, I know that you are a
solid listener.
You are a person who is veryclose to my heart, because not
many people make it to the endof these.
So please, please, please,please, please, do me a favor,
(52:24):
leave me a review.
I don't know Reviews.
Everybody's entitled to leavethe review that they want, but
I'm really trying to get morefive-star reviews, because
lately I've got a couple ofone-stars which has made me sad.
So, anyway, you know I'm notfor everyone, but if you are a
(52:44):
listener and you've gottenanything out of this podcast,
please do me a favor.
The way it helps the most is ifyou rate it on iTunes.
So it's kind of annoyingbecause you have to like go find
me on iTunes and then rate itfrom there.
You can also rate me on Spotify, but I think it matters more if
you rate me on iTunes, fromwhat I've read.
Anyway, thank you guys.
Talk to you soon.
Bye.
Hello, welcome back to An Amber Day, the Functional
Nutrition Podcast.
I'm your host, amber Fisher,and I'm so excited you're here.
Today we're going to be talkingabout one of my favorite
illustrative topics the prioritypyramid.
So if you don't know what thatis, priority pyramid is a
concept that I came up with whenI was early on in my nutrition
practice and I was trying toexplain to people why their
(00:20):
hormone symptoms were not reallyabout their hormones and why
they should care about thingslike their adrenal health or
their gut health or their bloodsugar balance, instead of just
trying to figure out like whatfood can I eat to get better
progesterone levels, or whateverit may be.
So it works really really well,especially in cases related to
(00:40):
PCOS, because so much of whatdrives our PCOS hormone
imbalances are deeperphysiological processes,
metabolic issues and things likethat.
So I'm going to kind of explainhow that works today and buckle
up, because it's going to be afun ride.
Well, actually I don't know ifyou'll think that or not, but I
think it's interesting andactually what the kind of cool
(01:03):
thing about priority pyramid is.
I sort of like came up withthis concept on my own, but then
, as I've taken more training inthe functional medicine world.
I see different iterations ofthe same concept around in lots
of different forms and I thinkit's really cool because I think
a lot of us who are meant to dothis sort of systemic health
(01:26):
and healing work where we'relooking outside the box, we're
looking deeper, we'reinvestigating, we're getting to
the core of issues and kind ofrebuilding we're just sort of
born with this kind of mind thatlikes to do that kind of thing
and since that's fun for us, wespend more time doing it and
then we end up helping people inthat way and we all kind of
have this same concept that'salmost built into who we are as
(01:48):
people.
I think that's really cool.
I really do believe thateverybody is kind of meant for
something and I believe that ifyou really are excited about
something or something seemsreally wonderful to you, there's
a good chance that you wouldprobably be really good at that
and there might be a place foryou, whether that's like a
career or a hobby or whatever.
(02:08):
And I think a lot of peoplehold themselves back from even
trying because they just assumeback in the day.
Okay, let me give you a littlepersonal example, back in the
day when I was really interestedin nutrition.
I was researching it all thetime, reading every book, like
going on every blog.
I thought, man, wouldn't it becool to be like a nutrition
(02:29):
podcaster and have a blog?
Okay, keep in mind, guys, thiswas like 2012, 2013.
So the social media world waslandscape was very different.
There was no Instagraminfluencer types, health
influencer stuff going on.
That kind of thing didn't exist.
But there were blogs and therewere starting to be podcasts,
(02:49):
like the age of the podcast hadbegun, and I followed this
podcast shout out to the Paleofor Women podcast.
I think it's called theEmpowered Women podcast.
Now They've rebranded along theway because they kind of both
of them got out of the wholePaleo sphere anyway, but I was
really into that at the time.
So I'm listening to thispodcast all the time,
obsessively listening to it.
(03:10):
I'm just like man, that is thejob that would be the coolest
thing to get, to be working fromhome, getting to do podcasts,
getting to research the stuffthat you're so interested in and
talk about it all day and writeabout it, because I love to
write.
But I just thought that's a onein a million thing to be able
to be successful in some sort ofonline career and not have to
(03:32):
go to a nine to five job orwhatever.
That's impossible, that's notgoing to happen for me, it
doesn't happen for but maybe oneor two people, or maybe not one
or two, but it doesn't happenvery often, and so I told myself
there's really no point intrying because it's impossible,
(03:54):
and then fast forward and that'sessentially my career.
I'll be honest that the grindof the whole podcasting, making
Instagram reels like TikToks,reading blogs, writing
newsletters like seeing clients,all that kind of stuff is a lot
more work than I.
It's a lot more of a job than Ioriginally figured.
(04:18):
And making consistent money atit to where you can support your
family and stuff Just amoderate income is a lot harder
than it looks.
I remember thinking back when Ifirst started my Instagram.
I thought, man, if I ever havelike 100,000 Instagram followers
, I'm going to have it made.
Those people must have so muchmoney.
They probably can just workwhen they want to and they get
(04:43):
to work being creative and it'snot so amazing.
And then now that I'm there Imean I have, I think somewhere
in the 80s 80,000 or sofollowers I realized like, oh
actually, no, actually no, Imean I don't want to complain or
anything, because I know I'mvery lucky and I do make you
(05:05):
know I can support my familymost months, but it's a lot more
of a grind than it looks likefrom the outside, which I think
is good.
It's like not supposed to looklike a grind from the outside,
but anyway it is still my dreamjob in a lot of ways and I just
sometimes, when I think back onthat, I feel really grateful and
it also helps me appreciate,like, when I'm going through
(05:26):
like a hard month.
Like you know, the last year orso the economy has been kind of
weird and it has been more of agrind than it was previously,
and so sometimes I can get alittle down or start feeling,
you know, like maybe I, maybeI'm not saying anything
important anymore, like maybemaybe you know I've done
everything I can do, or or whathave you.
(05:46):
And when I start feeling likethat, I like to think back on.
You know me back then thinking,wow, wouldn't it be cool to be
like a blogger or a podcaster?
And like here I am, I'm doingit.
So anyway, that is a veryroundabout story in which to
illustrate my point, which isthat I really do think that if
there's something that you areexcited about, it might be meant
(06:08):
for you, and certainly thiskind of work was meant for me,
because I was just born withthis sort of way of thinking
about health.
That was a little countercultural, at least for the time.
It's interesting to watch theevolution of our beliefs and our
opinions about health andnutrition, even since I've
(06:28):
excuse me hopefully you couldn'thear me burping there.
I don't know what it is aboutlike recording a podcast, but I
get like a nervous throat.
Do you guys know what I mean?
Like if you're going to have togive a speech or something and
suddenly, like you've had,you've been normal all day, but
then suddenly your throat islike itchy, like you're getting
like a scratch in it and you'relike then you start clearing it
and then, anyway, my, it's likean anxiety throat response.
(06:51):
I don't know, but it's veryannoying.
I'll tell you that much.
So apologies, especially withthis new microphone, I'm sure
you can hear like every smackingsound my mouth makes, which is,
for those of you who don't likethose kinds of sounds is not
going to be very fun.
Anyway, it's been so interestingto watch the change in opinions
about health and nutrition,even since I started working in
(07:14):
this field.
Because back when I was likeearly on in my excitement about
nutrition days, the concepts offunctional health, nutrition,
holistic health, like combiningconventional and alternative
methods, like Eastern andWestern medicine all that kind
of stuff was really kind ofscoffed at.
(07:36):
Like there are some things thatnow are just a given, like, for
example, testing for vitamin Ddeficiency.
Back when I started innutrition, I had the hardest
time getting doctors to run avitamin D test and because they
were like, oh, that's one ofthose woo, woo things, like
that's one of those alternativethings.
Well, now it's like they do itautomatically.
(07:57):
It's like almost part of regularblood work for a lot of doctors
because, especially since COVIDand the connection between
COVID's symptom severity andvitamin D deficiency, like now
it's like a standard thing,right.
Same thing with, like somethinglike fish oil.
You know fish oil used to bereally scoffed at, but then
there were, you know, severalstudies that came out that
showed, you know, benefits forheart health and things like
(08:17):
that from fish oil.
So now I have a lot of myclients be like, oh, I'm on a
fish oil because my doctor saidtoo, because, for you know, to
help with my cholesterol orwhatever.
So it's like some of thesethings just become standard,
they become part of a vernacularand they used to be seen as
like super cuckoo, cuckoobananas.
Oh, another example intestinalpermeability or leaky gut.
(08:38):
Even when I started in practicea lot of people still were like
leaky gut, that's fake, likethat's fake news, like that's
not a real thing.
And then you know, now we haveso much evidence on the gut
immune connection, the gut brainconnection I'm looking at a
book right now called the gutimmune connection on my shelf
over there.
We have so much research onthat and that's really where a
(09:00):
lot of the oomph for currentresearch is going.
And you know as well,established now that this is a
real thing.
So it's just funny, you know, Ijust think like and that's not
to say that I've never beenwrong, because I certainly have
I have made some recommendationsthat I'm like, ooh, I cringe
thinking about.
In fact, I'm going through thearchives of my TikTok right now
because I'm looking for oldvideos that I've never reposted,
(09:22):
to kind of do like from thearchives series, give myself a
break from content creation, andsome of them I'm having to skip
over because I'm like, yeah, no, I don't know if that I believe
that 100% or I'd have to putcaveats on it now that I didn't
back then.
So that's not to say that I'mlike that myself or people in
functional medicine are notwrong sometimes or don't
(09:43):
exaggerate things sometimes orwhatever.
It certainly happens.
But I do think there's likethis kind of newer generation of
health professionals that thinkdifferently about stuff, that
think a little bit moreexpansively about certain topics
, and that's good.
That's a good thing becauseprogress is a good thing.
(10:04):
Sometimes with progress comes alittle bit of fumbling around.
I'm not gonna wait.
Who did I hear talk about thisrecently?
Somebody said recently they'relike I'm not gonna wait for
research to catch up to what Iknow to be true, and that
mindset can get dangerous.
Like I could definitely see away where that would not go in a
(10:24):
positive direction.
But for people on the cuttingedge there is some truth to that
.
It takes like 25 years ofbuildup of research studies for
things to get like reallysolidified in the conventional
world.
So it's kind of nice to be overhere on the edge where you can
try some stuff out and see howit works in real people and use
your intuition a little bit moreand stuff like that.
(10:46):
Obviously, always by being safe, consult your doctor before
anything, before taking anythingon this podcast to heart.
So anyway, this disclaimer,we're gonna get into the topic
today, I promise.
But, as I said, I may or maynot have said this in the last
podcast or I might have editedit out, but I'm freeing myself
(11:09):
up a little bit with thestructure of these podcasts for
this year.
For the last couple of yearsI've been so like, let me follow
this set list of things I'mgonna talk about.
It's gonna be very educational.
Not a lot about me, not a lotabout my opinions.
It's gonna be facts andevidence and whatever.
And that served me for a time.
But I'm kind of a little bitsick of that.
I wanna just talk a little bitmore about different stuff and
(11:32):
go where my mind takes me.
So we will get into today'stopic.
But that is a little bit about.
That's a little bit ofinformation on my opinions,
about career choices and hobbychoices, et cetera.
Speaking of that, this lastweekend I had my dance team
(11:54):
performance.
I'm not sure if I've mentionedit yet on the podcast, but I
have mentioned that I have beentaking salsa lessons for the
last eight or nine months and acouple of months into that I
decided to join a salsa danceteam at my dance school and this
is like they have levels ofdance teams or performance teams
(12:16):
.
So they have the freshman level, the sophomore level, the JV
varsity level and then the allstars level, and I joined the
freshman team obviously becauseI'm very new at this, but we
have been practicing likehardcore practicing for months
now and we had our bigperformance on Saturday night.
I might insert a video of thisin the YouTube version if you
(12:36):
guys wanna see.
Definitely it's not perfect andany of you who are salsa
dancers that are more advancedare gonna see all the mistakes,
but I'm so proud of myself andof all the people on my team who
have become good friends overthese months.
You know it reminds me so muchof summer camp or when I was
growing up.
I was really involved in achurch youth group like super
involved.
(12:56):
I was there like four days aweek and it reminds me so much
of that.
Those were some of the besttimes in my life and so it's so
exciting to be part of a grouplike this again.
Anyway, we had our bigperformance.
There was this whole crew.
It was like a week-end-er eventwhere there were all these
special lessons being taught bythis dance group from New York
City, empire Mambo.
So these are some of the mostfamous dancers of the style of
(13:19):
dancing that I do, which iscalled onto salsa.
Anyway, these are some of themost famous dancers in the world
.
Apparently.
I don't know anything aboutthis stuff, but this is what I
hear from people in the know.
Anyway, they were here.
They taught workshops whichwere incredibly hard, really fun
, but nothing will make you feelmore like a beginner than going
to some of these workshops.
I'm like, okay, I can hang alittle bit with.
Like I mean, I can hang for awhile, but at some point I'm
(13:42):
just like, okay, I'm so tired,anyway.
So they did this week-end-erevent and then there was a
social dance in the evening andwe performed during that social
dance.
My mom and dad came to watch,but I am so proud of myself that
I did that and it was such afulfilling experience, because
(14:04):
dance is something that I havealways wanted to do.
It's one of those things that Ialways felt would be so fun, but
wasn't for me, and a lot of itstemmed from body confidence
issues and just feeling like Iwas bigger than other people.
And so because I was biggerthan other people, I wasn't.
I wouldn't be welcome in aspace where it's traditionally
(14:26):
very feminine or the dancers arevery petite or they are very
pretty or whatever.
I just didn't feel like I fitin in that kind of environment
or that I would be welcome there.
And when I was younger, Ireally wanted to join the dance
team at my high school but youhad to go through pep squad
first and in order to do allthat, you had to try out.
And so I was just too scared toeven try out for pep squad
(14:50):
because I thought I am too bigfor this.
They don't want they're notgonna want a big girl on their
pep squad.
And looking back, that is sosad.
It really is, because I reallyheld myself back from doing that
and I do think I would havereally enjoyed it.
I would have gotten a lot outof it and I'm sorry that I never
(15:11):
did that.
But those body confidence issueswere real.
Some of it was from the timesthese were the early aughts.
I think I would have had to tryout for Pep Squad in 2002, 2003
, something like that, and atthat time, for those of you who
were teens at that time, youremember anybody that was bigger
than a size gosh, who evenknows a size four that was
(15:32):
considered fat in the publicsphere.
And there was this element ofif you were considered fat, then
you were not welcome in publicspaces.
You certainly weren't welcometo show your body off in some
sort of sensual performanceenvironment like dance.
Some teams might have had girlsthat were a little bit bigger,
(15:52):
but it was almost like this sortof embarrassment thing, like oh
, there's the girl on the team.
So I was very aware of thosestandards at the time and I
didn't want to rock the boat, Ididn't want to be the token
bigger girl and yeah, I don'tknow.
Honestly, I wasn't even thatbig and it shouldn't have
mattered anyway.
Even if I was, wherever I fell,I should have been able to feel
(16:15):
comfortable doing that, justbecause I wanted to do it and
because it seemed fun and Icould have been good at it.
You know what I mean.
So the whole thing is sad, butthere's a redemption arc because
as I grew up I got morecomfortable with myself and
especially as I kind of madepeace with my PCOS and my
insulin resistance and, to someextent, my weight, although I
(16:37):
still struggle in thatdepartment, like I think many of
us do.
As I made more peace with thatstuff and more peace with my
body, I realized this wassomething that I could have done
, I could have enjoyed and beengood at.
And then the thing that I lethold me back for a while was my
age, because I thought I'm tooold to do all that.
(16:59):
And it's so funny looking back.
I remember when I went back toschool to get my nutrition
degree, I thought I was too old.
Then I was like 25, and Ithought I thought I'm too old to
switch paths.
It's so silly, looking back onit now that I'm 35 now and I
realized at any point I could goback to school tomorrow,
totally switch careers and havea very fulfilling career in a
(17:23):
different field probably inmultiple different fields if I
wanted to.
I don't want to go back toschool because I'm sick of
school, but you know what I mean.
Time is on my side.
I'm still very young.
You can always change.
You can always change direction.
So I let my age hold me back fora while and then, finally, this
last year, when I was going tobe turning 35, I would say
(17:45):
probably since I turned 30, I'vebeen on this kind of kick where
I'm like okay, things that Iwanted to do when I was younger,
things that were scary for me,things that I have fears around,
I'm going to push myself to dothem.
I don't know why I'm like that.
I just am.
If I feel, if I'm afraid ofsomething, I'm like well, I
better do it.
I better do it so I'm notafraid of it anymore.
I like challenging myself, likethat Like is the wrong word.
(18:06):
I just I feel a need to do itanyway.
So that's why I started doingthe pole dancing for a while.
I did that for a few years.
I really loved that andsometimes I really miss it.
But once I got involved indance, I just didn't have time
or space.
Like my muscles could nothandle anything else and I'm
really focused on this now.
So, anyway, I turned 35.
(18:28):
I'm like okay, this is it, thisis the year I'm going to learn
to dance, I'm going to do it andI'm going to have fun.
And I didn't even know thatdance performance teams were
like a thing, but they are kindof a big deal.
Like every dance school hasperformance teams and you know a
lot of adults of all ages areon these performance teams and
it's really fun and so I joinedand anyway, the rest is history
(18:51):
and performance on Saturdaynight went really well.
So yeah, I don't know, I'm in avery good mood today, just
coasting off the high from thatexperience still.
But yeah, let's see how longhave I been talking?
Probably a while.
So let's get into today's topic,the priority pyramid.
So to start off with, we tendto think about health in a
(19:12):
certain way and I alluded tothis earlier but we do tend to
think about health as like acollection of separate
experiences or separate systems.
So, for example, we think thehormones are just about the
hormones or we think that hearthealth is just about heart
health.
Like I had a lot of people youknow come into my practice and
(19:33):
say like, oh well,cardiovascular disease runs in
my family, or type two diabetesruns in my family.
And what people don't tend torealize is that just because
something genetically runs inyour family doesn't mean that
you're fated to experience thatthing.
It does mean you're geneticallymore predisposed, but your
environment and your lifestyleplay the biggest role in
determining how your geneticsactually express.
(19:54):
And some of that is out of yourcontrol.
Because if you were raised foryou know however many years in
the type of home that iscontributing towards the
development of insulinresistance and you're raised on
that diet and stuff, yeah, Imean you're like the odds are
stacked against you early on,but there is so much that can be
done to sort of reverse thosethings and genetics are not set
(20:15):
in stone.
They can express differentlybased on how well you take care
of yourself.
So when we think about thingslike hormones, you know you're
born with PCOS right, you havethis genetic predisposition
towards PCOS.
But it's not just that you'reborn with extra testosterone or
that you're born with cysticovaries or something it develops
with time because of acombination of factors that are
(20:41):
not really hormonal at all.
It's not like you just wake upone day you know you go through
puberty.
You wake up one day and youjust have, like, high
testosterone just because you'reunlucky or because you're you
know what have you?
There's a combination of deeperfactors, systemic issues that
are happening, that are buildingup into this experience where
(21:02):
your body is making moretestosterone and then it is the
testosterone, or, you know, highDHEA or whatever that are
driving the cystic ovaries andthen from there a lot of that
stuff is a cascade effect, right?
So once we have cystic ovaries,we end up making too much
estrogen because we're notovulating, and those little
cysts are producing estrogenBecause we're not ovulating,
we're not making progesterone.
So you know that contributes tothe whole cycle of us not
(21:26):
ovulating again and anyway, etcetera, et cetera.
We know, if you've listened to afew podcasts, you probably know
the mechanics of how PCOS works.
Thank you.
A lot of the symptoms that wehave are seem hormonal, right,
like, so we'll have facial hairand so we think, okay, facial
hair, that's something that menhave, that's a testosterone
(21:47):
thing, right?
Hair loss, that's somethingthat men deal with.
That's probably a testosteronething and, to a lesser extent,
things like weight gain andstuff.
Testosterone can cause peopleto hold weight in the middle.
So, yes, that is what's goingon, but also why.
The question to always ask iswhy is this happening?
(22:09):
Why are my hormones out ofbalance in the first place?
Because, as I said before, itdoesn't just happen out of
nowhere.
So, to kind of illustrate thispoint to people, I explain this
concept of the priority pyramid.
And if you imagine a pyramid,think about it as like a levels
of priority thing.
(22:30):
It doesn't necessarily have tobe a pyramid structure.
It could be a different thing,but you know, it could be ladder
rungs or whatever.
But there is a top and a bottomto this.
There's a accessory and afoundation.
So on this pyramid we havethree main levels and the top
level is gonna be our sexhormones.
(22:51):
So this is gonna be things likeestrogen, progesterone,
testosterone, all that kind ofstuff, the kind of thing that we
usually point to when we seePCOS symptoms and we say like,
okay, these are out of balance,these are out of balance and
that's why I have so manysymptoms.
But beneath that there are twoother rungs that actually are
the reason why these hormones onthe top are out of whack in the
(23:14):
first place.
So in the middle I tend to lookat things like blood sugar
balance.
I tend to look at things likeadrenal dysfunction.
So the HPA axis, even thethyroid, can function here as
well.
Well, these are things that arenot necessarily root cause
(23:35):
issues, but they are drivingsymptoms.
So they are both drivers ofsymptoms and also driven by
other things.
They're in the middle, they'rekind of like they're the
middleman.
They are part of what directsthe sex hormones to be out of
balance, but they're also thingsthat get out of balance
(23:56):
themselves because of the deeperstuff.
And insulin could be argued,depending on who you talk to,
that it might actually be downon this bottom rung that I'm
about to talk about.
I usually put it in the middle,though, because I find that a
lot of insulin resistance.
There's a genetic component toit, for sure, but that genetic
component really can vary basedon a lot of the factors deeper
(24:18):
in the body.
So what's the deepest rung?
The deepest rung is gonna beour mitochondrial health, the
health of our cells, our cellenergy makers, and the health of
our gut, the bacteria in ourgut and the mitochondria
themselves, which are kind oflike the energy makers of our
cells.
Both of these things actuallyare connected to the way that
(24:39):
our genetics express.
So a lot of times we thinkabout the gut as just being
about our digestion or maybejust playing a role in like how
inflamed we are or something,but gut health is actually
really critical to the way thatour genetics express as well,
and so we have some researchstudies that show that if your
gut health is out of balance,for example, you might be more
(25:01):
insulin resistant or it mightdrive adrenal dysfunction or
something like that, because itcreates sort of an inflammation
or an inflammatory environmentthe mitochondria.
If you go back and listen to acouple episodes ago, I did an
interview with one of my friends, dr Kalia Waddles, who is a
functional medicine physician.
She is incredibly brilliant,really passionate and excited
(25:22):
and she loves to talk about themitochondria.
So we did an episode on themitochondria in PCOS, so I
highly highly recommendlistening to it.
I know it sounds a little bitlike boring, but I promise you
it's not a boring interview,it's actually really cool.
So, but the mitochondria are incharge of a lot of that
inflammation that gets producedas well, and in genetic
transcription, so like in howour genes reproduce.
(25:44):
And yeah, there's just, andthen also it's just like the
energy that each organ that wehave has the function to do its
job correctly.
So, for a mitochondria are likereally damaged or they're
really sluggish or there's justnot enough cleanup work
happening for those, then thatfeeds into every area of our
body, including potentially ourgut health, some might argue.
I asked Kalia this.
(26:04):
I'm like what would you say isreally like the true root of
everything?
You know, at least as far as weknow in this current time, is
it the mitochondria or is it thegut?
Because a lot of people talkabout the gut, and I certainly
do a lot.
I mean, I'm sure there'spodcasts on heroin, like the gut
is the foundation of everything.
But you know, there's somethingto be said on both ends, like,
(26:24):
and actually I think after I'vekind of given it some thought
and I think she said the samething that probably it's
actually mitochondrial health,that really is the true root of
everything, because I mean,that's yeah, that's where the
energy comes from for everything.
So, anyway, that's the pyramidstructure.
So why is it in a pyramid?
You know what's the purpose ofthe pyramid format here?
(26:46):
Well, the idea is to show youalso that, along with kind of
each rung, sort of causingissues in the rung, on top of it
there's also this concept of,like, the body has certain
things that it cares more aboutthan others.
So if our gut health and ourmitochondrial health are not in
(27:06):
balance, then the body can'tlike keep track of and manage
and do a great job with thethings on the middle rung.
So, like our thyroid healthmight suffer here, our adrenal
health might suffer here,because you know, this kind of
inflammatory environment thatgets created by issues on the
deepest rung is not reallyconducive to great blood sugar
(27:27):
balance or to great adrenalhealth, and so if those things
by extension are out of balance,then it's really hard for the
body to keep the hormones inbalance.
I mean, just anyone who's had athyroid issue can tell you that
your thyroid's out of whack.
It obviously is going to messup your blood sugar balance, is
(27:48):
going to mess up your hormones.
I mean this is one reason why alot of women with thyroid
issues, they get on thyroidmedication and suddenly their
fertility returns and they'reable to actually get pregnant
and maintain a pregnancy.
They're actually able to loseweight again or do this or that.
So there's a lot that is drivenby that middle rung that then
(28:08):
impacts that top rung with thesex hormones and in PCOS.
A good example here would beblood sugar balance and adrenal
dysfunction.
Both of these things can createmore testosterone in the body.
The insulin does this bydirectly driving testosterone
production in the ovary.
When insulin is a hormone, sowhen it's high it sends signals
(28:32):
to the ovaries to make moretestosterone, and then the
adrenals can do this in moresubtle ways but they can raise
an androgen called DHEA whichthen can sort of create that
cascade effect of cystic ovariesand those other.
Dhea is an androgen, so itfunctions in much the same way
as testosterone and the adrenalscan also throw off blood sugar
(28:54):
balance even more, creating amore insulin resistant
environment which raisestestosterone.
So there are different methodsthere.
I've also seen too that theadrenals being out of balance
can of course contribute toovaries or to egg health that's
poorer, or to premature ovarianinsufficiency, that kind of
(29:15):
stuff.
So it all plays a role and itcan drive issues at the top and
there might be something to besaid, for example, with
something like estrogen kind ofcreating issues down at the base
of the pyramid with gut healthor with mitochondrial health,
like, for example, a veryestrogenic environment can
(29:35):
contribute to high histamineproduction or it can also create
imbalanced gut bacteria.
But it's like a chicken or anegg situation and in this case I
don't see a very many pathwaysfor the estrogen to actually be
the starter thing that thendrives the gut health
(29:59):
mitochondrial issue.
I see it the other way around.
Now I could be proven wrong onthat, and I'm willing to be
proven wrong.
Maybe it's a circle, maybe it'snot a pyramid, maybe it's like
one of those little circularflow charts.
I could see maybe a potentialfor high levels of plastic kind
of exposures or endocrinedisruptors, and then liver
(30:20):
health issues, detoxificationissues kind of playing a role
there.
But again, then that kind ofconnects back to the gut,
because the gut is a big part ofdetoxification.
Anyway, I'm going off on alittle rabbit trail here where
I'm working things out in my ownmind, but for the purposes of
today's podcast we'll call it apyramid.
And for this pyramid we have tounderstand that in order for us
(30:40):
to really fix what's wrong atthe top, we have to fix what's
wrong at the bottom.
It's just not going to work theother way around.
I can't put you on.
Here's an example Vitex.
Vitex is an herb that can helpyou create a little bit more
estrogen at the beginning ofyour cycle and then contribute
(31:03):
to you ovulating earlier, whichthen can help you make more
progesterone and can kind of besupportive of more regular
cycles.
It tends to work fairly well inPCOS.
I use it a lot with my clients.
I like Vitex a lot, but if Idon't have balance going on or
at least improvement going on onthe two bottom rungs of the
pyramid and I try to put you onVitex, it's not going to do
(31:25):
anything.
A similar concept here would bebirth control right, like yeah,
we could put you on birthcontrol and kind of artificially
alter the hormones and yoursymptoms might reduce while
you're on it, but go off yourbirth control and what happens?
Right, any of you who have donethis know it all comes rushing
back.
And this is something thatreally bothered me a lot in the
(31:48):
early days of managing my PCOS,because I really wanted there to
be something prescription thatI could take that would help.
And I really did believe,because I felt like I was led to
believe this, but maybe Imisinterpreted.
But I felt like a lot of myhealth care professionals were
like, ok, take birth control andit'll fix the issue.
It'll like fix your hormones.
(32:08):
And you know, I vaguelyremember one of my doctors being
like yeah, and then when, ifyou get off of it later, your
hormones will probably like bebalanced again, like they'll
probably just adjust because ofthe birth control.
That's not how it works at all.
It certainly didn't work thatway for me and I think because
of that I placed so much focusfor so long on the hormones
themselves that I reallyneglected those deeper issues,
(32:31):
and so every time I would getoff birth control I would create
more issues for myself, becausethat kind of going on and off
of birth control is really hardon the hormones of somebody who,
like me, has, you know, someliver, sluggish liver issues.
I had the MTHFR gene mutation,like there's some stuff going on
that makes detoxification moredifficult for me, not to mention
(32:52):
like a lifelong struggle withlike irritable bowel which,
thank God is like actually hasbeen under control for quite a
while now, but you know itwasn't certainly at that point.
And so to go on and off ofbirth control like that was
essentially to put a lot ofpressure on my detoxification
(33:12):
systems, and you know thatcontributed to more and more
estrogen dominance etc, etc.
Eventually I developedendometrial cancer from this
kind of high estrogenenvironment.
I find it funny too that thetreatment for the endometrial
cancer was like high doseprogesterone, you know, because
that sort of balanced everythingout.
But anyway, that's neither herenor there.
(33:33):
What I'm saying is, if you hyperfocus on your testosterone
levels or your DHEA levels orwhatever, and miss the bigger
picture, the deeper stuff, thenwe can do that dance all day.
It's not going to end in youhaving a more balanced hormone
(33:54):
profile, and I think that'sprobably why, like there really
isn't anything besides hormonalbirth control, there's really no
, like no doctors areprescribing I don't know like
well, I guess they are kind ofprescribing testosterone
blockers now that I say thatlike spironolactone, right, but
these things just kind ofvaguely work.
They don't really take care ofthe root and point being that
(34:17):
there's really no good solutionsfor the hormone issues.
That last right.
And so that's where I think isreally one of the big proofs or
indicators that PCOS is so muchmore than just hormone
imbalances.
Because if it were just hormoneimbalances, you know they'd put
us all on, like we'd all be onspironolactone, hormonal birth
(34:38):
control and maybe progesterone,on that combo for life and all
would be well, right, we wouldbe like perfectly fine, but no,
we still have these sort of longterm consequences and we have
these issues where we get off ofthis stuff and it all comes
raging back.
But what I think is the mostconcerning is the fact that,
like, pcos stays with you evenpost menopause.
You still have PCOS.
(34:59):
You may not even have ovariesanymore.
I don't have ovaries anymore.
I had a total hysterectomy in2020, but I still have PCOS.
Because PCOS is really miss.
It's not named well, I mean, youdon't even need polycystic
ovaries to be diagnosed withPCOS.
You can actually be diagnosedwith it without polycystic
ovaries.
Look up the Rotterdam criteriafor diagnosis.
(35:20):
You only need two of the three.
One of those three things ispolycystic ovaries, but if you
have the other two, you can havePCOS and not have PCO, not have
polycystic ovaries, which is,you know, the disorder is
misnamed or it's what is theword I'm looking for here.
There's a better name.
Misnamed is not the right word.
Those of you who are intovocabulary, let me know what
(35:45):
word I'm looking for here.
But the name it's namedincorrectly or inappropriately
and I do think I thought I thinkI've heard talk about this, but
I do think that, like,eventually, they were going to
change the name of it.
But all that to say it followsyou through life and, untreated,
can result in higher risks of alot of different stuff we
(36:06):
talked last week about thehigher risks of depression,
anxiety.
Even ADHD is more common inPCOS.
Bipolar disorder is more commonin PCOS.
So there's mental health things.
There's also cardiovasculardisease, diabetes risk, you know
, infertility like.
There's just a lot of thingsthat are risk factors beyond
(36:27):
just oh, I have hightestosterone so I have irregular
periods and I grow facial hairso I just need to go get laser.
You know what I mean.
And the mistake that I thinkconventional medicine makes is
just looking at those hormonesand being like, okay, what can I
do to manipulate these?
And then you know, there's somemovement to manipulate the
(36:47):
deeper issues, right?
So metformin, of course, isgoing to manage insulin a bit
better and that's a very commonrecommendation.
On the supplement side,inositols work just as well as
metformin, sometimes better, andthose are typically recommended
.
Fish oils have some goodresearch for PCOS.
(37:09):
Inesidyl cysteine is myfavorite supplement for PCOS.
I mean, these things all workkind of on deeper issues and are
a little bit more well known,but they're all just either
band-aid approaches or they'rehelpful, but they're not going
to really fix those deep, deepmitochondrial and gut health
(37:30):
issues unless there's afundamental change to the way
we're nourishing ourselves.
Gut health can get out ofbalance for a lot of different
reasons.
Medications can contribute tothat Shoot, even things like
sedentary lifestyle and traumacan contribute to that, but the
biggest contributor is going tobe our diet, because the diet is
(37:50):
what directly feeds thebeneficial bacteria.
So if we're not feeding those,then over time we're creating an
environment in there that ispro more negative bacteria or
that's just pro theproliferation of specific kinds
of bacteria at the expense ofothers, and it's really about
the balance between those, andthat balance is created by fiber
(38:16):
.
Same thing with ourdetoxification systems, the gut
being one of the major sites ofdetoxification for hormones.
If we're not taking care of ourmitochondrial health and we're
not taking care of our guthealth, then our body's going to
really struggle withdetoxification and elimination.
This is why sometimes, if yourcholesterol is high, eating more
(38:39):
fiber can help.
It can also help with yourestrogen dominance issues.
It's fundamentally aboutnourishment of those two areas.
When we're not taking care ofmitochondria, which is also
something that is done primarilythrough the ways that we
nourish ourselves, then we getthis increase in inflammation
(39:02):
that's being created and aninability to clean that
inflammation up because we'renot feeding ourselves with
things like antioxidants, whichare going to clean up oxidants,
we get reduced ATP production.
Atp is like we talk aboutglucose being the food for the
cells.
Glucose eventually breaks downinto ATP.
Atp is the real food foreverything.
(39:24):
It gets a little bit technicalthere.
This is where the Krebs cyclecomes in.
Just think about that.
If you were to hear that yourbody runs on fuel.
If you are not able to createthe fuel that you need, what's
going to happen?
(39:44):
You can't maintain everything.
Some stuff is going to fall bythe wayside.
Your body, at its core, wantsto keep you alive.
That's priority one stay alive.
Priority, like 857 or whatever,is reproduce.
If your body feels that it isin a state where it can barely
manage itself, where it canbarely keep itself going, it's
(40:08):
not going to have the energy orthe resources to promote
reproduction.
There's some argument too forcertain things like PCOS being
evolutionary alterations to helpthe body reproduce during times
when there was struggle.
Some people think that PCOSbecause it is this insulin
(40:31):
environment, it's all thesehormonal structures to get you
to hold on to fat.
A lot of people think that thismight come from genetics of
people who lived through famines, because, end of the day, yes,
number one priority is keepyourself alive, but it is also
important to maintain.
The race must continue.
People must continue to be born.
(40:53):
It is very primal to want topass on your genetics.
Some people think these areadaptations for those kinds of
environments, which means thatwhen we're in an environment
where we're not in a famine,then suddenly we have all the
stuff at our fingertips and itall goes haywire.
Now we have access to too muchstuff.
There's a lot going on here,but at its core, we have to
(41:15):
manage our mitochondrial healthand our gut health in order to
have actual results with ourhormones.
I think the point that I'mtrying to make with this podcast
besides just explaining thisconcept to you so that you can
think more critically aboutnutrition recommendations that
you see on the internet is thatwhen you are managing your PCOS,
don't just look at yourhormones to determine if you're
(41:39):
making progress.
The thing about hormones isthat they can take a very long
time to respond to deeperchanges.
The deeper changes take a lotlonger to really take hold than
you would expect.
When I'm working with clients,I'm not really expecting to see
(42:00):
regulated periods, major hormonechanges, major changes to
facial hair production, thingslike that, until I've been
working with a person for atleast six months, but usually
longer.
It depends a lot on where theperson is starting from.
Sometimes I'll have people comein who are freshly diagnosed
with PCOS and it develops later.
They developed it in theirmid-20s but they always had
(42:22):
regular periods.
As a teenager, let's say.
Maybe they gained some weightor they've been struggling in
that department and they wentand got tested and then they get
diagnosed with PCOS.
Those people tend to have theeasiest time, relatively, with
getting back to regular cyclesbecause their body has that
memory of having regular,balanced hormones before.
Really, what I do with them isI help balance their insulin
(42:42):
levels out, because usually it'sthe insulin that's triggering
this wonkiness with thetestosterone, and then they're
off with their cycles.
Regular cycles can vary.
It can vary from anywhere fromupwards of 35 days to months and
months and months and months.
It's my people who are like oh,I have a cycle.
(43:03):
Some months it's 35 days, somemonths it's 45 days, some months
it's always around a month toevery couple of months.
But it's very irregular in thesense that they don't know
exactly when it's coming.
It's not really on a scheduleand the ovulation date gets
pushed around.
That's usually the influence ofinsulin.
If we can manage the bloodsugar better, suddenly their
(43:25):
body's like okay, we know therhythm, and it can go back to
its rhythm again.
Those tend to be the people whohave resolution of their
symptoms the fastest.
If you've been living with neverhaving periods or having a
period once every 10 months foryour whole adult life and now
you're in your 30s and you'retrying to get pregnant and it's
(43:45):
not working and you're justcoming from a place where a lot
more has built up, a lot moredamage has occurred and it's
going to take longer to regulate, if, if and this is just being
totally honest here if we canregulate you fully at all.
I don't say this to bedefeating, but there is a
collection of people, myselfincluded, I believe.
(44:07):
I don't know, because a lothappened to me Not to go into it
, but a lot happened to me towhere I wasn't.
I really didn't have time toreally test things, but I do
think that there is a collectionof people with the most severe
PCOS symptoms who probably willnever get like fully regular
periods back.
Their hormones will probablyalways be a little bit wonky.
(44:28):
But but that's not to say thatthey can't make major changes.
I think they can make a lot ofchanges to how inflamed they are
, to how insulin resistant theyare, to how well they nourish
themselves, to how well theircells are functioning, to how
well the detoxification systemsare functioning and getting a
much better place with theirhormone balance.
But there may not be timebefore they hit menopause for
(44:48):
them to actually like fully fixit, get to the point where
they're having like 30 daycycles.
I just think I like to berealistic and I think, with the
way that we live now, the waythat our world works, the way
that our food system works,there's a lot stacked against us
that is outside of our control.
Think about things like soilquality.
How much zinc are we gettingfrom our fruits and vegetables
(45:13):
that we were getting like twiceof or three times as much back
when our grandparents wereeating fruits and vegetables?
So we have to do a lot more nowto get the same benefit.
The impact of endocrinedisruptors is something that I
think we're going to see moreand more information on over the
years, and that's somethingthat's really in a lot of ways,
outside of our control plasticsin our environment and that is
(45:36):
something thatdisproportionately impacts those
with PCOS.
So there's a lot of things thatbuild up that we can't do much
about.
And if you are coming from aplace where you've had a lot of
years built up with these thingswithout really knowing about
the need to work on yournutrition because some of us are
just we're not educated on that, just didn't know, or we knew
(45:58):
but we didn't want to doanything about it at the time
then it may not be the mostfeasible thing to get everything
sorted out perfectly like somepeople can, and a lot just
really depends on where you'recoming from with that severity.
I mean it's interesting becauseI've worked with a lot of
people over the years.
(46:18):
I've been in practice almost adecade now and mostly with those
with PCOS.
That's mostly what I've done.
I've done some other stuff,like I'll do some stuff with
autoimmunity.
I do a lot.
I have like kind of a littleword of mouth thing going with
like upper digestive stuff, likenausea and GERD.
I do a lot with that foodsensitivity, that kind of thing.
But most of the work that I'vedone is with PCOS and it's
(46:42):
usually my clients who haven'tdealt with PCOS symptoms as long
that have a better chance ofgetting them fully resolved.
No-transcript.
So yeah, that it is what it is,and I say that from a place of
love because I believe I'm oneof those people as well.
I mean, I ended up gettingcancer at 25.
So I don't think we were in, Idon't think there were like
(47:03):
great odds that I was gonna getlike perfect 30-day cycles, but
I didn't even really get thechance to try.
You know, knowing what I knownow, I would love to see what
would happen, knowing what Iknow now, if I also didn't have
the fear of getting cancer againand I could like try out stuff.
I'd love to see what I could do.
But I'm not gonna get thatchoice anymore because, you know
(47:24):
, at this point I'mpost-menopausal.
It is what it is and for some ofus, some of you I know some of
you listen to me you are alreadypost-menopause as well, or
you're in your early 40s, or youknow you're at a place where
it's like it's kind of it iswhat it is situation, and now
we're just doing cleanup work.
We're doing what we can right.
That's okay too.
There's still a lot of value inthat because, like I said
(47:45):
before, this is something thatis gonna affect you.
Pcos stays with you throughoutyour whole life.
So at that point when we're notlooking at, let's try to get
totally regular periods.
Now the goal post changes andit's let's have a better quality
of life as we age, let's reduceour risk of long-term health
complications, let's keep ourhearts healthy, let's keep our
(48:07):
bone density, you know, in agood space.
So our goals change.
But at the end of the day, todo any of that stuff whether
it's regulate periods or reduceour risk of chronic health
issues as we age it starts bytaking care of the mitochondria
(48:30):
and the gut.
Now, how do we do that?
There's a lot to that.
I may have to make a part two tothis podcast, because I'm
looking at the time and I'vebeen recording now for like an
over an hour.
Obviously, I'm gonna edit it,so it's not gonna be an hour
long that you're listening, butstill, I've been recording a
long time and I think this isgonna be a long one.
So I'm not gonna go too muchinto depth today on like what we
can do.
I might make a part two, butwhat I would suggest and I'll
(48:52):
try to link to some of these inthe show notes is go back and
listen to my podcasts that arespecific to gut health.
Listen to that one with me andKalea that talks about
mitochondrial health, listen tothe one about gut health and
then I may do another onespecifically about supporting
your mitochondria.
I actually already havesomething like that.
I'll look.
Anyway, you will see.
You'll see in the next fewepisodes if I end up doing that
(49:13):
or not.
But big things more fiber,that's for your gut.
More antioxidants, that's foryour mitochondria.
Exercise for both.
So antioxidants are gonna belike your PCOS superfoods I do
have a podcast on the PCOSsuperfoods, so highly recommend
listening to that.
Your leafy greens, your veggies, your even things like dark
(49:36):
chocolate stuff that's highmagnesium, like peanut butter,
all that kind of stuff, mostlyyour veggies and your fruits,
right, like your berries allthat kind of stuff, the stuff
you know is healthy for you.
That's gonna support yourmitochondrial health.
With mitochondrial health wealways say eat the rainbow.
So eat lots of different colorsof fruits and veggies For gut
health.
We're talking fiber, so thatmeans more obviously vegetables
(49:58):
are gonna contribute to that.
But also we're looking atthings like legumes, so beans in
your diet being things likewhole grains in your diet.
Being careful with grains,obviously, because too many
grains or an imbalance betweengrains and protein and fats can
create more of an insulinresponse, which could be
negative here.
So being careful with grains.
However, whole grains are, andparticularly legumes are where
(50:20):
we're gonna get a lot of ourfiber, but it doesn't have to be
a lot Like.
I would definitely look at howmuch fiber are you getting from
these different things and planaccordingly.
So we're looking to get atleast 30 grams of fiber a day.
But honestly, if I'm beingtotally honest, I think with
PCOS we'd probably benefit frommore.
But work your way up.
(50:40):
If you're gonna try it, workyour way up, because if you do
too much fiber too fast you'llmake yourself constipated and
miserable.
Even things like psyllium huska little psyllium husk to bridge
the gap can be helpful here,but it should mostly come from
whole foods, because then you'regonna get those mitochondrial
benefits as well.
So you're kind of like killingtwo birds with one stone.
Exercise for both.
Exercise, because exercisehelps with mitochondrial repair.
(51:02):
It also helps with bacterialbalance in the gut.
Really cool.
There was a study done thatshowed that exercise on its own,
with no diet changes alteredthe gut bacteria balance.
So exercise for both, becauseit's gonna help with not only
with repair for mitochondria,gut health balance, but it's
(51:22):
also gonna help with insulin,which is then gonna help with
the amount of cleanup work thathas to be done.
It's gonna reduce that.
So exercise is key for both.
I do have planned to do anexercise and PCOS podcast very
soon.
It's in my little notebook hereand I wrote it down so I have
to do the planning for it andpull studies and things like
(51:42):
that.
But that is coming.
So, yeah, those are the bigthings and I hope this was
interesting for you.
Hope it helps.
Thanks for listening to mythoughts at the beginning about
dance and all that kind of stuff.
I hope you enjoyed this.
But definitely reach out if youhave questions.
There's a form you can find inthe link tree.
That's questions for thepodcast and I love to answer
(52:03):
questions from you guys and I'mplanning to do more of that this
year.
And if you have not left areview on iTunes, but you've
reached this point in thepodcast, I know that you are a
solid listener.
You are a person who is veryclose to my heart, because not
many people make it to the endof these.
So please, please, please,please, please, do me a favor,
(52:24):
leave me a review.
I don't know Reviews.
Everybody's entitled to leavethe review that they want, but
I'm really trying to get morefive-star reviews, because
lately I've got a couple ofone-stars which has made me sad.
So, anyway, you know I'm notfor everyone, but if you are a
(52:44):
listener and you've gottenanything out of this podcast,
please do me a favor.
The way it helps the most is ifyou rate it on iTunes.
So it's kind of annoyingbecause you have to like go find
me on iTunes and then rate itfrom there.
You can also rate me on Spotify, but I think it matters more if
you rate me on iTunes, fromwhat I've read.
Anyway, thank you guys.
Talk to you soon.
Bye.
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