Pursuit of Wellness - Hormone & Fertility Tips (+ PCOS & Birth Control From Experts)

Episode Date: August 12, 2024

Ep. # 123 Welcome to another episode of Monday Mashups on POW! This week, we’re bringing you an insightful collection of episodes on hormone health featuring experts Dr. Jolene Brighten, Sara Gottfried, and Dr. Mindy Pelz. We'll explore topics such as fertility awareness, navigating post-pill recovery, and the benefits of seed cycling. From understanding PCOS and insulin resistance to lifestyle redesign and individualized supplements, we’ve got the essential information to help you optimize your hormonal health. Join us for expert advice and empowering conversations to support your wellness journey! Leave Me a Message - click here! For Mari’s Instagram click here! For Pursuit of Wellness Podcast’s Instagram click here! For Mari’s Newsletter click here! For Dr. Brighten’s Instagram click here! For Sara Gottfried instagram click here! For Dr. Pelz’s instagram click here! For POW Brand Promo Codes click here! Sponsored By:  Visit BetterHelp.com/POW  today to get 10% off your first month. Visit clearstemskincare.com and use code POW at checkout for 20% off your first purchase. Again, that’s code POW for 20% off your first purchase on clearstemskincare.com. Head to moshlife.com/POW to save 20% off plus FREE shipping on either the Best Sellers Trial Pack or the new Plant Based Trial Pack. That’s 20% off PLUS free shipping on either the Best Sellers or Plant Based Trial Pack at moshlife.com/pow.  Stop wasting money on things you don’t use. Cancel your unwanted subscriptions by going to RocketMoney.com/pow  Show Links: Ep. 41 - Signs Your Hormones Are Imbalanced w/ Dr. Jolene Brighten: Coming Off The Pill, Periods, Medical Gaslighting, IVF & Infertility, Endocrine Disruptors, Seed Cycling & Becoming Your Own Advocate. Ep. 80 - Fix Your Hormones: PCOS, Fertility, Pregnancy &  Autoimmune Conditions w/ Dr. Sara Gottfried  Ep. 11 - Dr. Mindy Pelz On The Truth About Birth Control, Hormones, Cortisol, Fasting & Cycle Syncing. Natural Cycles App Oura Ring What To Expect When You’re Expecting  Is This Normal By Dr. Brighten Beyond The Pill By Dr. Brighten Fast Like A Girl App Dr. Mindy’s Books Topics Discussed Dr. Jolene Brighten 02:14 - Fertility awareness methods 07:06 - Empowering conversations with your children  12:01 - Navigating post-pill recovery  22:46 - Seed Cycling Dr. Sara Gottfried  30:10 - Genetic and environmental drivers  32:40 - PCOS deep dive 36:10 - PCOS and conceiving  37:35 - Insulin resistance  40:36 - Carb tolerance, weight lifting, and fertility   44:47 - Lifestyle redesign 46:23 - Individualized supplements 48:17 - Sugar suggestions 50:05 - Progesterone  53:58 - Testing for ovulation  Dr. Mindy Pelz 59:10 - The DUTCH test 01:00:51 - Hormone breakdown  01:02:07 - Birth control awareness  01:06:46 - Testosterone in women  1:08:01 - Cortisol patterns  12:55 - Fasting and hormones  01:14:40 - Fasting frequency and exercise  01:17:46 - Nutrition suggestions  01:20:03 - PMS nutrition suggestions  01:21:41 - Fasting length  01:22:40 - Breaking your fast  01:23:24 - Building muscle while fasting  01:25:47 - Toxins and fasting  01:27:19 - Fasting protocols and simplifying your routine  01:30:01 - Improving your DUTCH test results  01:34:02 - Doing health in a women’s way 

This is the Pursuit of Wellness podcast, and I'm your host, Mari Lele. What is up, guys? Welcome back to the Pursuit of Wellness podcast. I'm so excited for today's mashup episode. We are talking top hormone and fertility tips. We're talking about things like PCOS, birth control, endometriosis, etc. I think this is such an important topic and one that needs to be discussed more. So I have some of my favorite top guests coming back to give us the tips and advice. Before I hop in, I want to let you guys know we are doing a giveaway for the whole month of August. Every single Monday, we will be picking a listener to

win a Bloom Sparkling Energy PR box. If you've seen it, it's stunning. You don't want to miss out. A pow tote bag and a Healing Era hat. To enter, all you have to do is follow or subscribe to the Pursuit of Wellness show on Spotify or Apple. Leave a review. Follow us on the Pursuit of Wellness podcast Instagram. It is US is us based only and we will be closing the following sunday each week and one winner will be announced so keep that in mind and you don't want to miss that giveaway today we are talking to dr jolene brighton who is a board certified naturopathic endocrinologist clinical sexologist and prominent leader in women's medicine she is going to give us advice on fertility awareness, navigating post birth control, recovery and wellness, seed cycling

and hormone health. We are also talking to Dr. Sarah Gottfried, doctor, wife, mother, scientist, researcher, speaker, connector, scholar, Harvard educated doctor with 25 years of experience. She was absolutely amazing to talk to. And she's talking about PCOS deep dive, insulin resistance, lifestyle redesign, progesterone, sugar, ovulation, and more. We are also talking to Dr. Mindy Pelz, a fan favorite. She's a world renowned women's health expert on a mission to empower women to believe in their bodies. We are going to be talking about hormone health and birth control awareness, optimizing hormones through fasting and nutrition, and lifestyle optimization. I know you guys are going to love this episode, so grab a pen and paper.

You're going to want to take notes. And without further ado, let's hop right in. If someone wants to prevent pregnancy or even monitor symptoms they may be having, but want to take a more natural route, what do you recommend? Because I've seen women lately using Natural Cycles app with their aura ring. I saw that the second you walked in. I have one too. So what do you recommend for a natural birth control? Yeah. So it's not going to work for everyone. The best birth control is the one that achieves your goals, works for you, and has

the least amount of side effects. If you do not do fertility awareness correctly, the side effect is getting pregnant. You've got to be okay with that. And so that's what the aura with natural cycles integration is, is one component of fertility awareness method. So for fertility awareness method to work, you need not just the temperature, and this is the thing to understand for anyone who wants to do this, same time every day, understand that if you travel, if you get sick, like these kinds of temperature changes can affect your cycle and that data tracking. So we want to look at temperature and we want to look at symptoms. So in is this normal? So beyond the pill, I talk through FAM, in is this normal? I actually go through like I talk through FAM. In, is this normal?

I actually go through like checkpoints of like, am I ovulating? That can help you with FAM. It also can help you get pregnant. And I basically say like, if you want to dodge pregnancy or you want to get pregnant, this is good to know. So looking for fertile cervical mucus, am I in the mood? Am I interested in my partner? That's a pretty good sign that we're nearing ovulation. And so we can take these collections of signs that we have that we are going to ovulate along with the temperature data to dial that in and then understand that while you only ovulate one day and you've got 24 hours for sperm and egg to meet, that's it for you. Your uterus will tend. So your anatomy is set up to tend to sperm

and keep them alive for about five days. So that means you've got a six-day fertile window. Now, whenever I hear people say like, well, I used FAM and I got pregnant, I ask more questions. And it usually comes down to, I used FAM, but then I used a pullout method when I knew I was in my fertile window. The pullout method, it's about 20% failure. So that's huge. That's a lot of people getting pregnant. About one in five will get pregnant. So you weren't really using FAM. You were actually using the pullout method with like a little hack to know that you had to pull out during that window. But still, that is not what FAM is. So with fertility awareness method, that's what FAM is. I was like, I just started using FAM and I didn't

define it. My face was like, what is FAM? Yeah, it's okay. Yeah. And you always clarify if I start doing that. So with that, you have to abstain from sex in any kind of sex where sperm could be introduced into the vagina. Is This Normal has a whole lot of other things that you can do that are still considered sex and a good time, and you can orgasm or have pleasure. But if you do want to have penetrative sex, you need to use a condom. You need to have a barrier. You need to have some kind of backup method. Otherwise, this is not truly using FAM. So that's just important to know. The other non-hormonal option that we have is the copper IUD. It's like 99.9% effective, hugely effective.

Someone will comment, I got pregnant, or I know someone who did. I actually have a colleague of mine that his wife, he's like, we got that copper IUD, like we're done. And then his wife got pregnant. And he's like, who gets pregnant with the copper IUD? I'm like, it's's like, we got the Cabra IUD, like we're done. And then his wife got pregnant and he's like, who gets pregnant with the Cabra IUD? I'm like, it's always like, you know, Jurassic Park moment where they're like, life finds a way. It does sometimes. So just know that if you're messing around with sperm and you are a fertile individual, every single method has failure rates. And so that's important to be aware of. So we have the copper IUD, we have fertility awareness method, which I think is just great for getting to know your body, even if you have a copper IUD. And then we have barrier methods. So condoms, diaphragm, if you can get a diaphragm, they're hard to come by these days. But

barrier methods are for everyone who's in a new relationship who hasn't had STI testing or is in a non-monogamous relationship as well. So growing up, I personally never had the period talk, the sex talk. So that created a lot of shame for me. When I did eventually get my period, I was embarrassed, confused. I was like stealing tampons from my mom. Smuggling them up your sleeve. Literally, I felt like what's wrong with me? And I was super ashamed even through puberty. And that rolled over into my adult life.

I really only learned about my cycles within the past year. And I think a lot of women can relate to that. Do you have advice for anyone listening who wants to have a conversation with their daughter, their sister, whoever it may be, and empower that person? Yeah, so that's exactly why I wrote Is This Normal? Is that these questions like that are coming up, these are the things we all should have been taught

before we even got our period. And so what I've told moms, because they asked me like, I have a 10-year year old, I think she's going to start a period, you know, in a year or two. So if you see breast buds, odds are period's coming in the next two years. Like, should I just give her your book? No, you should read the book. You should be the expert in your household. You should take ownership of that knowledge and teach her that. And you can give her the book and you guys

can do a little read party. I do know several people who are like, I'm reading your book to my daughter at night as she's going to bed and like we're having conversations. That's a great way to use the tool. But I want you to be the authority in your house. Why that's important is because if you're not, Google, they're friends. Some random TV show is going to teach them the things that, I mean, the incorrect things a lot of the time that you could have had an opportunity to teach them. And it is a way to build trust so that if something goes wrong, they'll immediately come to you. That's really the goal. I mean, I'm a parent. I'm a parent to boys. And yet, I mean, my boy who's 10, he can tell you all about the menstrual cycle. Like he can tell you he's very body literate

about all bodies. And I my goal is always like, if there is anything, I'm the one to come to come to me first. Like you're never going to be in trouble. You're not going to be shamed. If I do ever make you feel bad in a response, you tell me. You make me own it. Like, I'm trying to cultivate that kind of relationship because in four years, he's going to be 14. And as they become teenagers, that is when it is time to experiment. It is time to try things. And you want them to be, they are inherently little scientists. You want them to be in that controlled environment where it's safe. Like they're in the lab doing their experiment instead of a field blowing stuff up, right? Like,

so we've got the controlled environment, not that I'm trying to control him, but that it is, there is a net there to catch him. So if he makes the wrong decision, if, you know, he does something that he thought was a wise choice, and in retrospect, it's not. I'm the person that he can come to. And that's what I want to see for parents when it comes to reproductive health, because that is part of sexual health. And if we look to the research out of Amsterdam and Germany, they changed their sex ed. It is required. They start with talking about consent at a very young age.

They are just very sex positive, body positive, and not shaming. These children are, well, I mean, they're teens. This is how you know I'm old because I'm like these children. I'm like, well, they're young adults, really. They actually delay sex. So their first encounter is delaying. They tend to be monogamous. They report their first time as being fun. They tell their parents about it. In the U.S., most of the time you ask somebody about their first time, they regret it. They felt pressured into it. They didn't understand like the nuances. You ask them about sex ed, they're like, banana and condom, period, suck. Like, I don't really know anything about it.

And yet we have these countries that have changed everything. We've had an entire cohort where now young adults go through it. And less STIs, less teen pregnancies. I mean, all the good stuff that we want. But also, back to your question, very positive relationship with their parents when it comes to sex, their reproductive health, their periods, their bodies, all the things that they experience through those pubescent years and into adulthood. I think I was given the American Girl doll book. Do you remember that one? No, I was never given any, but my parents gave me

What to Expect When You're you're expecting which had like this short and by parents I mean mom and by gave me I mean I found it on my book when on my bed one day um and there was like this like this is how breasts form like the yeah and I'm like okay yeah weird I don't know where I'm like in the mirror I'm like where am I and will they get that big or is there you know and this is I talk about, there's a whole breast chapter in Is This Normal of like growing up in the age of Pam Anderson. And like, honey, you do you, no judges, but like, oh my God, Baywatch, did you mess with my mind? Like, I'm like, oh my God, that? What is, why am I not there? I'm just waiting. Like, when are they coming in?

Yeah. The book I was given was the same thing. and i love the fact that you're encouraging parents to read it first because just being given a book as a 12 year old you're like yeah what is this it makes you feel more weird if anything yeah so i love that and i love that you have this new book now is this normal because i think that's going to be so helpful for so many people i want to talk about coming off the pill yeah yeah because i think a lot of people are in that phase right now, myself included. And there's a lot of negative bounce back that comes with coming off. Oh, yeah. What can we do to help with that process? Yeah. You know what's crazy is

there's like the negative bounce back in your body and then there's the negative bounce back of anyone you tell where doctors are like, oh, I'll see you when you're pregnant. Or other people are like, this is like, women like fought for this. And this is our right. And you are not a feminist unless you're on the pill. And I'm like, this is so weird. Can people just like make their individual choice and it be theirs? And we'd be like, good job. You made a decision for yourself. How can I support you? So let's talk about coming off the pill because this is the information that I never got when I was on it, when I told my doctor I wanted to come off of it. I don't think a lot of us, I mean, we're just told you'll come off and it'll be fine and then it's not fine.

So I have definitely, it just does, I'm not saying this lightly, it feels like some pill PTSD. So I'm going through IVF. And I shared this on YouTube that I had to go on the pill. And I only did it for 10 days. But my God, my mood completely tanked. I was crying, depressed, but also raging and gaslighting myself being like, it can't happen this fast. This is just because and I'm like, I can already hear haters online being like, oh, this is just because you like wrote a book about it. And I'm like doing this to myself. And then I'm like, am I gaslighting myself? And like going through all of this. And my husband's like, dude, you got to get off that pill because you are not happy. You are not yourself. And I'm like, thank you. Okay. Like needed to hear that because I was wondering. So, and then I developed cystic

acne again. So when I came off the pill initially, and everyone can see my skin, I do not struggle with acne. It's beautiful. Thank you. Yes, I do a lot to take care of it. But I came off the pill. I lost my period for the first time in my life. My period had gone missing, besides from being on the pill. And I developed cystic acne, and it was getting really bad. People had asked me before, like, oh, do you have any pictures from that time? I'm like, literally none. Because why would you take a photo? I would not allow people to take photos. This time around, I've been so open on social media that I just showed people. So I had to go on the pill twice with IVF, and times cystic acne along my jawline. And what I was told

when I came off the pill is that I just had PCOS. So my doctor's like, oh, you had PCOS. I'm like, no. And he's like, yeah, that's why you have acne and your period's gone. I'm like, no, but I never had acne and I always had a period. So no. And I've done lots of testing. I don't have elevated androgen. I do not have these PCOS pictures. And yet even now with the pill, I experienced those coming off and having that rebound of androgen. So that is usually why I bring that up. That is one of the top things that will drive women back on the pill. Because when your skin starts to freak out and you're getting acne, that is so horrific. Like, in terms of your self-esteem, in terms of like, you start trying everything, you are devoting so

much mental energy to it. And I'm fortunate that being in my 40s now and knowing what I know, I see cystic acne and I'm like, I got you. I know. I know what we're going to do here and we're prepped for that. So there's the acne component. There is the missing period. So on average, women will come off the pill and not see their period return for like three months. And that's considered normal. It could take three months. If you have PCOS or you went on the pill because you had irregular periods, we can expect six months until your period comes back. Something like the Depo-Provera shot could be 18 months. So that's just important to know if you want to plan a baby in the future. And so for me, though, as a doctor, if somebody's period hasn't come back, I'm like, let's just start working on that now. Let's just start

working on those components now. So we've got the missing periods. We've got the acne. We've got new emotions. Or maybe you were depressed on the pill and that now. So we've got the missing periods. We've got the acne. We've got, you know, new emotions. Or maybe you were depressed on the pill and that continues. So there's a lot of systems that are affected by the pill. It's so funny to me how doctors are like, no, it just affects your reproductive system. I'm like, except your hormones affect every system in your body. But somehow the pill is magical and isolated. It just is baffling to me. No, it could never affect your mood, really, because it actually operates at the brain level.

And natural cycling hormones affect your mood. And you'll prescribe it when their cyclical mood changes to affect their mood. And I just want to say, not everybody's experience is going to be the same. But what I experienced, I thought I was alone. I thought I was a freak. I thought there was something wrong with me.

My period did come back. It was so horrific. It was so heavy. I had the wildest PMS. And I just kept feeling like my doctor isn't helping me. They're not believing me. And it must just be me. Fortunately, I was in naturopathic medical school.

I already had a background in nutrition science. I was like, let me hack this. Let me figure this out. And it was once I got into practicing with patients that so many women had a similar story. And there were women who would call my office and be like, okay, I want to schedule an appointment because I heard this is the doctor who believes women about their birth control. And I was like, what a bizarre thing. And we would actually have, and we do have like patient intakes that they would say, like, I think when I'm like, how do you think I can help you? I think you'll actually believe me when I tell you about my birth control experience. And I'm like, the fact that so many doctors were not believing women and

still are not believing women. So what do we do? So I've talked a lot about like, okay, what can happen? And this is what a lot of experts have termed post-birth control syndrome, which is just like this collection of signs and symptoms. Now, it can be brand new things or it can be things that you are covering up. So if you had acne, it's coming back. If you had horrible periods, they're coming back unless you do things to prep. So if you went on the pill for symptoms, like 58% of women do, let's give us three months to really prep your body. And that's the whole protocol. Everything is in Beyond the Pill. Some people have been like, oh, I have to get your 30-day

program now. I'm like, no, no, it's all in the book. Literally everything you need, you can do that. So we want to prep your body for three months. And if you're someone who's like, no, I just started it for pregnancy, like prevention, I have no problems. I don't think I'll have problems. Let's have you come off and go right into the program. And so what the program encompasses is looking at the different systems, the different ways the pill affects your body, and then working on that.

So number one is if you're going to stay on the pill, get on a prenatal or a multivitamin because you are depleting nutrients by taking that medication it is one of many medications that deplete nutrients out there and if you're on any of those other medications your doctor would be like yes yeah if you're on statins let's take coq10 if you're on metformin let's get you some b12 if you're on the pill doctors are like just eat a standard diet i'm like the standard american diet the one that's devoid of nutrients the one that you have absolutely no education in whatsoever like send them to a dietician, please. Like somebody who's actually an expert in nutrition because it is not you. So nutrient-dense diet, prenatal or

multivitamin on top of that because it is very hard to out-eat what is happening while you are on the pill. So losing B vitamins like folate, B12, magnesium. You're magnesium deficient. Here come the headaches. Here comes the twitching eye. Here comes painful periods when those come back. So we want to make sure that we're replenishing nutrient stores. We got to work on the metabolic health. So for some women, they take the pill, their C-reactive protein inflammatory marker goes up. They can be inflamed and it can also affect insulin. So we want to, again, go back to nutrition, eating an anti-inflammatory diet and making sure that we're eating protein, fiber, fat at every single meal.

There's not a book I have that doesn't talk about that because it's so essential for maintaining our blood sugar. So that's the metabolic component. We've got to take care of gut health and the liver. So these two systems are how we process estrogen we no longer need, whether it's exogenous, so outside of us, or the stuff we make. And then we move it out of our body. Also through via the kidneys. So we got to drink water.

But the pill has been shown to mess with our microbiome. And some research has compared it to antibiotics in terms of its ability to disrupt the microbiome. So that is because, well, you take this pill and it's a big dose of hormones. It's not like a huge dose compared to the early iterations, but it's big enough that it shuts down brain ovarian communication. That has to be processed by the liver. That's going to, and the nutrients that are being depleted, the liver also needs to be able to detoxify.

And this is not that like, oh, you have to do like this radical detox to get the pill out. You have to support the system that is already set up in your body to do that. But even as you digest that pill, absorb it, not all of it is going to end up absorbed. So it's going to make its way to the large intestine. And we have not done extensive research to understand what is the impact of these hormones and their metabolites on the microbiome that lives there. So we, again, going back to the fiber,

we want to consider probiotics. We want to make sure that we are eating in a way that nourishes our gut, supplies our liver with the ability to detox, and is also going to be something that works with our system. So I say that because if somebody jumps to like 25 grams of fiber right now, that might not work for them. That's the ideal, the goal, what we want to work towards, but you have to start slow, usually. And so while I'm like, eat more cruciferous vegetables, that might be like, cook your cruciferous vegetables, make sure that you can get them digestible and working your way up with those so that it's not an abrupt change. I think like, do you have a dog? Of course.

Yeah, of course. We can hear it right now. I'm not a psycho. I have a dog. Yeah course. Yeah, of course. We can hear it right now. I'm not a psycho. I have a dog. Yeah. So like I explain to people, like whenever they have pets, I'm like, you know how like you can't just switch your dog's food? Yeah. And they're like, yeah, yeah. Okay.

So it's same with you. Like if you've been eating like, you know, three to five grams of fiber every day, I can't just be like, okay, now now i'm gonna have you eat nothing but plants like and i it's always something like people will be like oh i went plant-based and i felt awful but they said that's part of the process i'm detoxing like you switch the system too fast like your body needs time to adapt to that so i've given a few tips but i want to make sure like if you have questions because it's a huge topic and i could i mean i wrote a whole book on it i could talk about it i want to ask you specifically about seed cycling oh yeah

because I know you speak about this and I've heard mixed reviews some people love it some people hate it why do they hate it I've just heard people say it didn't do anything for them and I've kind of been looking into it for myself yeah um I'd love to understand how it works and how you think it impacts the hormones. Yeah. Okay. So I have been seed cycling forever. Gosh, I think for like 12 years now, I love seed cycling. It's a great way to be very aware and bring awareness to your cycle, but it's also like bringing in fiber, bringing in nutrients and just working with you where you're at. So whenever people say it didn't work for me, this is why. It is not a cure or a fix or the one thing. It is something that is beneficial that can be an adjunctive

therapy that you can bring in. But, you know, for example, if you have polycystic ovarian syndrome and you're not exercising and you're not, you know, you don't even have to have a condition. You're not exercising. You're not sleeping. You are, you know, abusing your body in terms of what I call metabolic obscenities, where you're like, I'm binging on sugar for breakfast and then like just guzzling black coffee. it's like you're literally cussing at your body and your whole metabolism. Like you can't seed cycle your way out of that. It has to be added in addition. It's just like supplements. Like you can't just out supplement a poor diet and lifestyle. They have to be in addition to the foundation that's already there. So with seed cycling though, I will say that like I say that and then somebody is going

to comment like, oh, no, but like I added that and then my acne went away. I have had so many patients who are like, I added that and I got pregnant. And I'm like, that's not supposed to be possible. They were already doing all of the things. So I'm a big fan of seed cycling. It was actually my mentor who taught me about it in medical school so long ago. And he wrote a book about it like 20 plus years ago. His name is Dr. Dixon Tom. And that's where I learned about seed cycling. So because I've talked about it so much, people are like, oh, she created seed cycling. I'm like, no. You are the queen of seed cycling i do talk about it a lot and i have been doing it forever

so what we should what is seed cycling okay so seed cycling is you're going to track your cycle eat certain seeds at certain times a month so when it comes to menstruation through ovulation and if you don't have a period or you're like post-menausal, you know, whatever reason you don't have a period, you go new moon to full moon because the moon cycle is roughly about 29 days. And our cycles are roughly like 20 to 29, 30 days, like somewhere in that range. So what we do is we eat fresh ground flax seeds. And we are going to eat pumpkin seeds at the beginning, one to two tablespoons of each. And I say fresh ground, but I honestly just like pre-grind like a week's worth and stick it in the freezer and blend them together and then just do two tablespoons of each so I don't have to think

about it. And then once you ovulate, we switch over and that's going to be sesame and sunflower seeds. Now the sesame and the flax seeds both have to be ground because you're not a cow and you can't digest them. And so that's the way we're going to get at those nutrients. And so those are going to provide you nutrients. And I go into detail of the science we have and the science we don't have around this on my website at drbrayton.com. But at the beginning of your cycle, we're supporting estrogen levels. But we also have fibers in there that are going

to make it so that your estrogen is not spiking. People are always like, flaxseed will make my estrogen so high. It will not, in fact, do that. It is all working with your system to help encourage the balance of those. We're going to get omega-3 fatty acids. We're going to be in minerals and nutrients that are specific to supporting estrogen in the follicular phase and progesterone in the luteal phase. And the whole time we are supporting testosterone levels, which is why I think that is in part why it can help women with PCOS so much. And we actually are seeing new research coming out showing, and there's been several studies showing that PCOS is one of those conditions

that can be affected positively from seed cycling. Now, again, it's not going to be the only thing you do with PCOS, but it is one of the many things that we can employ outside of pharmaceuticals or with pharmaceuticals, which is what I always love is like, let's take the buffet and let's figure out what works for you. Okay, amazing. I think I want to try that actually. I've done the ground pumpkin seeds, but I haven't tried the others or in a cycle. So good to know. This show is sponsored by BetterHelp. I feel like throughout my healing journey, the thing that stayed consistent for me is therapy. It has just been the number one thing that I turn to when I'm going through any different type of stressor,

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POW at checkout for 20% off your first purchase. I come from a family of very high stress, high strung women. And I feel like I'm that way. I'm very, you know, type A, I'm very anxious all the time. It takes a lot of work for me to calm down. And I lean on the side of having higher testosterone. And I struggle with acne and a little bit more of PCOS like symptoms. Is that connected in some way? So you're asking about kind of the genetic environmental drivers of polycystic ovary syndrome or whatever phenotype of PCOS you might have. So, yes, we know that there are genetic drivers. And, you know, it'd be so easy if there was just one gene that we could identify and we could test you for the gene. Yes or no, you have it. It's more complex than that because there's a lot of different genes that kind of work in a pathway to affect your metabolism, to affect your, you know, kind of the state of balance

between estrogen, progesterone, and testosterone because PCOS is not just testosterone. And so, yes, I feel like it definitely runs in families. I don't have PCOS, but I certainly have insulin resistance. And I've got a lot of people in my family with PCOS. And I feel like, you know, for some of us, I'm a higher testosterone person as well. You know, there's a gift in that. And then there's also a way that it creates vulnerability. And so on the one hand, I think my higher testosterone levels helped me achieve. I wouldn't say I'm a type A anymore.

I'm more like an A minus. But I was a type A certainly. I'm more like an A minus, but I was a type A certainly through college and through medical school. And I think that higher testosterone was helpful. It builds confidence and agency and it helps you just kind of put yourself out in the world in a way that you may not be able to if testosterone levels are lower. So there is a gift side and then there's more shadow side. I agree. I feel like I'm very driven and I think a lot of that comes from my high testosterone, but I have the acne on the jawline and that's where it gets frustrating. I want to dive into PCOS. I'm sure you've heard this from a few interviewers, but PCOS is by far the most

asked question I get every time. And truthfully, I'm a little bit confused about PCOS. I have some symptoms of it, but don't have cysts on my ovaries. Like I'm not even, it's a weird diagnosis because I feel like it's kind of just a cluster of symptoms. And it's like, is the diagnosis even really helpful? Like, should we just focus on the symptoms? Like, how do you define PCOS? You're asking just kind of the most brilliant question when it comes to PCOS because it's polycystic ovary syndrome, not a disease. And syndromes tend to be this constellation of symptoms where you might have one or two, but not like all five. So it can be tricky to diagnose.

You know, the average woman with PCOS can go to a lot of different clinicians and suffer for like seven years before she gets any clear answers. So the way that I diagnose it is to look at a woman's history. You know, if she tells me and she's got acne and she's got maybe some increased hair growth in places where she doesn't want it, like on her chin or nipples. And you put that together with sometimes some irregular menstrual cycles, but not always. You put it together with cysts on the ovaries, but not always. You put it together with a particular blood panel, like biomarker panel with higher testosterone levels, but not always. Maybe some insulin resistance, but not always. Like there's a way that it's maddening and frustrating that you don't get a yes, no answer. There's more like, oh, you have a touch of PCOS. Okay,

what am I supposed to do with that? And the problem there is that in conventional medicine, they ask one question, which is, okay, we think you've got PCOS. Do you want to get pregnant? Yes or no? Yeah. And if you want to get pregnant, then typically they give metformin, maybe some clomid, try to get you ovulating so that you can get pregnant. If you don't want to get pregnant, you get told, here's a birth control pill. It'll give you a cycle, which is a total myth. And so to me, that really is the problem. So the diagnosis is a problem. The treatment approach is a problem because there's so many things that you can do to go upstream and look at the root causes and work with them there. Yeah. I feel like it's almost more helpful to ignore the PCOS diagnosis and just focus on the symptoms at hand. Yes.

That's how I like to approach it. Yes. It's a good way to approach it. You mentioned the fertility piece. I'm trying to get pregnant right now. So I'm very interested in this topic. Well, it has been a emotional rollercoaster. I did not anticipate how obsessive I would be four months in. It's crazy how it takes over your whole... It does take over your life. I did not anticipate that.

I really thought that I would be very chill about the whole thing and I'm not. So that's nice. If you have a PCOS diagnosis or you have the symptoms of PCOS, is it just a for sure thing that you're having, you're going to have a hard time conceiving? No. Okay. How does that work? Well, it depends on ovulation. It depends on a lot of different factors. I mean, when you look at PCOS, I wish it were simpler in some ways, but it's one of the most complex conditions that women face. And if you take away the hormonal imbalance that the birth control pill causes, PCOS is the number one hormone imbalance that women face. So not everyone with PCOS struggles with fertility. But if you're not ovulating every cycle or if there's some irregularity to how you ovulate, that's what tends to make it more difficult to get pregnant. And then for women like us who've got higher testosterone levels, the higher testosterone can be directly sometimes toxic to the ovarian tissue.

And you combine that maybe with some insulin resistance, which is something I also have. And it can make it harder for the normal healthy processes to be happening in the ovary. Okay. Now that typically shows up as cysts in the ovaries, but not always. How do you know if you're insulin resistant? The main way you know is to look at your insulin levels and your glucose levels. So for some of my patients, I put a continuous glucose monitor in pretty much everyone. And so sometimes you can tell just from their glucose levels that someone is insulin resistant. But we also know from studies in the UK, like the Whitehall study, that problems with insulin can predate problems with glucose by 7 to 13 years. So the way that I like to look at it is I like to do a two-hour

glucose challenge test where I'm looking at fasting glucose and insulin, and then we give a specific amount of carbohydrates, so usually a 75 or 100 gram load. And then you look at your glucose and insulin at intervals after that, like every 30 minutes, every hour. And then you look a total of two hours out. I like to do that with a continuous glucose monitor, but you still have to draw the insulin. Because typically what happens with insulin resistance,

what's happening on a cellular level is that your cells become numb to the insulin signal. So you can think of it as insulin is like the lock on the door of your cells and it goes in, opens, unlocks the door, lets glucose inside of your cells. So if you're someone who's insulin resistant, it's like the lock in the door is jammed. So you can try with insulin to open the lock to the door to get glucose to go inside the cell, and it's just not happening. And so in that situation, your insulin levels in your blood stream are getting higher and higher, trying to drive that glucose inside your cells, and it's not working. So typically, you want to look at the postprandial insulin first, like what happens in response to food, because that's what changes first in the sequence. Can you feel that physically? I feel it because I'm pretty sensitive to it.

Yeah. So I started, I was insulin resistant when I left that doctor's office in my 30s. And I went to the lab and I checked my cortisol, which was like three times what it should have been. I checked testosterone. I looked at estrogen, progesterone, thyroid, and I looked at insulin and glucose. And I remember my fasting insulin was like in the 20s and my glucose was in the prediabetes range. It was like 105. And I was like, what is that?

Did I eat some food or like, was that my mouthwash or my toothpaste? Like, why is that? And I checked it again and it was still elevated. So I was insulin resistant probably through my pregnancy. Like I had a borderline glucose test in my pregnancy. I find that when I eat, so I eat very high fat, high protein, low carb. I don't feel good when I have a lot of carbs. I've noticed I'm very sensitive to sugars. I don't know what that means about insulin resistance.

I don't think it's ever been. I do a lot of lab work and it's never been mentioned to me. So I don't know. Oh, you have some lab work there. Listen, I printed it out. I wasn't gonna ask, but I was like,

let me just see if she notices it on the table. Okay. Yes. I can't wait to show you. Happy to look. Yeah, because I'm really just trying to hone in on this and figure out my situation. I mean, I've improved my lab work since the beginning of last year, but now I'm on this fertility journey and I'm kind of looking at it from a new lens. When it comes to PCOS or symptoms of PCOS, how can we live in the most optimal way? Live,

eat, supplement, what do you recommend? So generally for women who are trying to get pregnant, the recommendation is a little bit different than someone who's not trying to get pregnant. So what I talk about in the hormone cure is that a low carb diet reduces testosterone within seven days, reduces acne within seven days. So low carb can be super helpful. The thing that's a little bit tricky is that when you're trying to get pregnant,

carbs can sometimes be your friend. I know. And I find this somewhat frustrating because I'm pretty carb intolerant. Like I just can't tolerate that much in the way of carbs. And I know you have been lifting heavy for quite a long time. There are ways to work around that. So you can do carb cycling. You can work on kind of both sides of the equation. If you think about the input side, which is the amount of carbs that you consume, how you combine them with protein and with fats. And then you look on the output side, you look at

how much you exercise, how much you lift, how much muscle mass you have. So there's ways to become more carb tolerant. But generally, when you're trying to get pregnant, what I've found taking care of patients is that low carb, even, you know, almost like a ketogenic diet can be kind of stressful on the female body. I know. I love my keto lifestyle. I know. I hear you. I'm the same. But I'm eating more. Okay. So here's what I do. I have more potato. I feel good on potato. So I do sweet potato, Japanese, and I'll do them at night. So I kind of like backload my carbs at dinner. How do you feel about that? So I think you can debate that.

I mean, part of, if I were taking care of you, I would want to see continuous glucose data to see what happens when you have carbs at night. I actually wore one kind of recently. The only time I saw it spike was when I had two dark cherries. Yeah, so certain fruits can really spike you. So it sounds like Japanese sweet potato, white potatoes, sweet potatoes were not spiking you. Is that right?

No, I felt fine. So that's good news. And it might be related to the lifting that you do. It might allow you to be more carb tolerant. When I have sweet potatoes or white potatoes, my glucose goes through the roof. Interesting. So it's really individualized. It's important to recognize that. So then the question is also, you know, one of the consequences of a ketogenic diet or low carb diet is that you might be feeding your benevolent bacteria in your gut less of the prebiotic fibers that they need. So that's another thing that I like to test in my patients just to see if, you know, is there some optimization that we could do here? With PCOS, the symptoms, the hair growth, the acne, is the diet helpful

for those symptoms? Or do you feel like there's certain supplements that need to be introduced? I think diet can go a long way. And I've got a food first philosophy. So I definitely think lifestyle redesign, starting with food, is the place to begin. For most women who've got PCOS, I would say they need more than just a dietary change. But that said, you know, it's pretty impressive to me. I think it's pretty empowering that inside of seven days, you can significantly change the biochemistry of your body. You can significantly change your testosterone. So there's a lot that you can do. It's a heavy lift with food, but you also have to be really consistent about it. And it's one of those behavior change changes that's not that easy for

people. So I would say start there. The thing about supplements is that they can give you kind of more dynamic range. They can give you, you know, like I'm down in Los Angeles, I'm away from my kitchen, I'm not weighing my protein, I'm not getting my 30 grams five times a day. Like I'm not on my game the way that I usually am. And so supplements kind of let me have a little more buffer. And I think the same is true with PCOS. What specific supplements do you like for PCOS? So this is where I individualize.

And I love that you sort of said, you know, why do we think of it as PCOS? Maybe we should just look at the individual components that someone is facing and address those. So that's how I work with patients. And so I do genetic testing and I'm looking, you know, not just at your PCO pathways, I'm looking at your cellular processes, like how well do you detoxify? What's going on with your methylation? What's happening with your inflammatory tone? What about oxidative stress, kind of the rust in the body from aging? How are those pathways doing? What's going on with your blood vessels and your lipids and also nutrigenomics? How do you do with vitamin D? What's going on with choline?

Sounds like you probably get enough from the way that you eat. So I like to look at genetics. I like to look at biomarkers to guide the recommendations of supplements. But there are certain supplements that have been shown to be really helpful. So that includes the myonositol, d-chironositol, those are probably the most proven. But vitamin D also has a huge role with PCOS, things that help as insulin sensitizers, like berberine, chromium, those things can be helpful alpha lipoic acid and so with my patients i'm doing the genetic testing i'm doing biomarker testing i'm doing hormone testing dutch plus with the biomarker

testing i'm looking at micronutrients like what is your level of alpha lipoic acid? What's going on in your gut? Do you have the right levels of, you know, short chain fatty acids? So I'm, I'm treating, I'm personalizing based on what's in front of me with the patient that I'm working with. And with diet, with PCOS, is the recommendation whole foods, lower carb? Should we be avoiding sugar completely? That's where I start. So I like to meet people where they are. You know, someone like you sounds like you've been off of sugar for a fair amount of time. Yeah. I'm not really a good example. You're not the best example. Yeah. So a more normal human who is maybe having dessert a couple times a week and has, you know, often there's a layer of some emotional eating with PCOS.

And I say that as someone who's recovered from emotional eating. So I have a lot of compassion for people who, and I think this often relates to trauma, that the way that we eat and the soothing that we experience with food, the serotonin increase that we experience with eating carbohydrates, that can sometimes set up these pathways that can become dysfunctional. And so, yes, my preference is to get a continuous glucose monitor in my patients to start tracking their food intake to see what are the healthy foods that are really a good fit for them.

How does some macronutrient modulation, how does that help them? But generally, I'm starting with a low carb approach and we're trying to get rid of refined carbohydrates. We're trying to reduce sugars significantly, but I like to meet someone where they are. I'm not going to tell them, okay, no more sugar ever again, or else I'm not going to talk to you. Like that's, that's no way to take care of somebody. I want to ask you about progesterone. I see a lot of questions about progesterone.

I discovered that I had extremely low progesterone. It was at like a 0.1. Yes. And as I mentioned, I run very stressed, a little bit more on the kind of negative side. So I introduced bioidentical progesterone. I take slow release progesterone every day. And when I was researching it before I started taking it, there's kind of like a little bit of bad PR around progesterone. Why is that? And like, do you think that

hormone replacement therapy can be useful? So this is somewhat complex, this particular topic. What we know is that if your ovaries are not producing an egg and going through the cycle that raises your progesterone level so that on, you know, ideally day 21 or 22, you've got a progesterone in your serum of 10 to 15. If that's not happening, then what we want to do is try to nudge your body into ovulating and producing those progesterone levels on their own. So typically the place that I start is with Chase Tree. So Chase Tree, I don't know if you've taken it before, but it's been shown to raise serum progesterone levels.

There was a randomized trial that was published at Stanford a while ago showing this. So back when I was working at McMedicine, I had this woman who came in and she was trying to get pregnant. She was like 34, 35, and she had really low progesterone levels. And so she was starting to go down this path toward reproductive endocrinology, you know, where they were going to start using increasingly stronger medications

to try to get her to ovulate and to get her pregnant. Meaning like metformin, Clomid? Metformin, Clomid. And she somehow found out about Chase Tree. And so she started taking it. It's also called Vitex, Chaseberry. She started taking it and she got pregnant. So it raised her progesterone levels. She got pregnant. And this is what we call in medicine an anecdotal report. Like it's not the best evidence, but she told me this.

And I was like, that's really interesting. Like I was never taught about that. And I'm board certified as Snow Beach UIN. So I go and I look at the data and lo and behold, it's shown to be like this gentle nudge to the ovary and to the endocrine system that helps women ovulate and helps to raise their progesterone level. So that would be my preference as a way of, you know, kind of managing ovulation and maybe, you know, working on insulin resistance and some other things. The thing about bioidentical progesterone is that in some women, it can block ovulation. So that's where you have to be kind of careful. So what I sometimes do with patients is if they need progesterone,

I'm going to try to have them make their own endogenous progesterone by whatever means necessary. And they might need metformin. You know, Chase Tree might not do it. But I'm pretty reluctant to start bioidentical progesterone. If I've got someone in whom metformin or clomid doesn't work or Chase Tree doesn't work, then at that point I'm going to refer

them to a reproductive endocrinologist. Sometimes I'll use bioidentical progesterone after someone ovulates, but I really want to do everything I can so that your ovaries can do that for you. What do you feel like is the best way to test if we're ovulating. I'm using the strips, the pee sticks, but the lines are a little confusing. And my temperature with my aura ring. Yeah. And do you use an app together, like Natural Cycles with Aura? Yeah. And it says confirmed ovulation based on the temperature, but can I trust that or should I be doing double checks? Double checks I think are helpful when you're trying to get pregnant. Yeah. So I really, I mean, I wear an aura as well.

I think their data is really accurate. So I like a backup method such as the pee sticks where you're looking for luteinizing hormone. Are you ovulating when you expect to? Like is it, what day is it? Day 21, around day 21. So a little late, a longer cycle. Wait, no. I tested progesterone on day 21. So that was after ovulation. Yes.

I don't exactly know the day, but I do know that my luteal phase is too short. Yes. So it was around the six day mark. And on this past cycle, it was actually closer to 12. So it's starting to increase. Gotcha. Yeah. So luteal phase and a shortened luteal phase is something that we see really commonly. Oh, okay. And one of the kind of easy solutions for that is vitamin C. So vitamin C at small doses, like 750 to a thousand milligrams has been shown in women with shortened luteal phase to normalize their luteal phase and to increase their progesterone levels. So I'm always looking for what are some of the natural ways? Are there any micronutrients that might be low that we could adjust and get to the Goldilocks

position so that we allow the intelligence of your body to come through? Yeah. Do you think bioidentical progesterone is something that I could like wean myself off of? Yes. Okay. That's good to know. Because now I'm not, am I stuck on it? You're not stuck on it. You're not stuck on it. And it's, you know,

let me first say that it makes sense that you tried it. Yeah. It totally makes sense. You saw low progesterone. You're thinking, well, it's over the counter. Like you can get progesterone from whole foods. So it makes sense to try it. What I've seen, again, anecdotally, is that it blocks ovulation and pregnancy in women. Got it. Okay. I'm glad I asked about that. I'm glad you did too. If you're anything like me, you have a ton of subscriptions to various apps on your phone that you may or may not use. I discovered that I had so many subscriptions that I wasn't actually using,

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at moshlife.com. Thank you, Mosh, for sponsoring this episode. I have recently been on a deep dive with my own hormones and I actually brought in my own Dutch test results here today for Dr. Mindy to look at and advise on. Thank you, Dr. Mindy, for agreeing to do that. And I can't wait to learn more from you today. Welcome to the show. Oh, thank you for having me. I can't wait to dive into your Dutch. There's so much to say here.

Should we start there since we already have it out? Yeah, for sure. I mean, I don't know if your audience knows why the Dutch is so amazing too. We might want to... Let's talk about that because I think a lot of women believe that blood tests are the best way to test hormones, but they're not. Yeah. And I also on that want to say that what we have when we go into our doctor's office and they do a blood test is it's a... It can often be the moment that a woman becomes disempowered.

Because we're not often looking at the day of her cycle that they're being tested at. It's, as we talked beforehand, hormones pulse in. So if the hormone was pulsing at that particular moment, it may show up as a certain level. So it's such a weak test, which is why I love the Dutch because you did, what, four or five urine tests? And spit all day. Yeah. I brought it to the gym. I brought it with me wherever I was going. I was like, guys, don't ask questions.

I'm doing a Dutch test. And now I'm the biggest fan of this test. Yes, yes. I run one on myself every year. And I think I actually the first time I ran a Dutch test, I was like, oh, my gosh, I think we could end breast cancer if every woman ran a Dutch test every single year. And I have no financial ties to them. I literally just think it's that great of a test. Awesome. So mine look a little bit off balance here. So let's start with

this. What it does is the first three categories it gives you are the major categories of your hormones. So estrogen, progesterone, and testosterone. Now, estradiol, you're 28. So estradiol would be the most, it's like the functional part piece of estrogen. So it's one slant of estrogen. So that's why you'll see that it says estradiol. The first thing I did when I picked up this Dutch test is look at the age and go, okay, you can see that your estradiol, your progesterone are that they're actually look like mine and I'm 53. Oh, wow. So that gives you a little like you shouldn't look like me, a menopausal woman. You're in that

menopausal range, which means you're not ovulating. And if you don't have enough progesterone, you don't have enough of the hormone that's going to let that uterine lining shed. So the teaching moment that most women should know is that estrogen has to peak for the egg to be released from our ovaries. So we take you and we go, you don't even have enough estrogen to allow that egg to be released out of the ovaries. And is this because I was on birth control for such a long time? Birth control really messes up the whole hormonal system. And what age were you when you went on it? I would say I was around 20 and I'm 28 now. Yeah. And so, and when did you start your period?

I was actually older. So I was around 16, 17. Okay. So this is what happens is that it, we have to form like a path between the brain and the ovaries. There's, there's communication that's going to happen. So when you start your period, let's say at 16, 15, it takes, they say, up to 12 years for that path to just get reestablished. So when you come in with a birth control, what you've done is you've taken the job out of the hypothalamus pituitary and ovaries to communicate. And you've added a synthetic hormone into the body. And so the body's never had to do it naturally. So this whole system is super messed up. We can get into that later, but that just makes me angry. And it should make you angry.

And I please don't want you like walking because anger is not going to help you here. We're going to get into your cortisol in a moment. That's for sure. But the teaching moment that I don't want women to miss is that there's so much that we are exposed to from the medications to birth control to our beauty products to, you know, our foods that are disrupting our hormones and it's affecting us more than men. And we are in such a hormonal mess. You are not, your story is not unique. But when we look at just birth control, you know, why is it our job to have the birth control? Why is it, you know, they're coming up with some really interesting new versions of male birth control beyond just a condom. But the actual birth control pill itself is a major disruptor of a natural cycle. And millions of women have what

are going through what you're going through. They get off the pill, but they now don't know how to get their cycles back. I'm starting to see stories pop up more and more because women around my age are wanting to have kids and are not able to because they're not getting their periods back. I'm starting to see stories pop up more and more because women around my age are wanting to have kids and are not able to because they're not getting their periods back. Yeah. And so this is where I think collectively as women, we need to stand up and demand something different. And that starts with hormonal knowledge. We have to understand, like we have to know that the birth control is going to have this

long-term effect. And I'll give you the best example that I can give you is I have a 23-year-old daughter. And when we went to, you know, we have a great relationship and we made the decision of birth control together, you know, she asked me what I thought. I looked at it all and I decided that an IUD, we both decided, I mean, it was ultimately her choice, that an IUD, the long-term consequence was so much less than the pill because the pill has this manipulation of your own natural hormones, and then your body never finds its normal cycle. Right. Now, there's no perfect birth control, but there is the aftermath of the birth control pill

is greater than any other version that we have out there. Which is just not a conversation that ever happens. I mean, I didn't have that conversation. It wasn't even brought up that this would have implications on my health down the line. I didn't even think about it. I mean, when you're 20 years old or younger, that's not something that you think of.

That's right. That's right. But shame on the doctors for not something that you think of. That's right. That's right. But shame on the doctors for not bringing that to your attention. Yeah. And why are we not having a collaborative conversation with our patient? You know, again, I don't mean to go after the system,

but the system is not supporting women. And the way that most doctors have been trained is that there's a superiority complex. They're up here, we're down there. We should, whatever I tell you, you should do. And they're not used to this collaborative connection that should happen between a doctor and a patient. And the reason I'm coming in strong is that I want all women to like let's stop that let's if we understand our hormones then we can walk into the doctor's office already armed with knowledge to have a more

educated conversation with the doctor now the doctor is forced to have to talk to us differently yeah and that's why conversations like this exactly so important and for everyone listening now you know and now you can be armed with this knowledge yeah so looking at this if my estrogen is super low is my testosterone high your testosterone is high but but good for you like like like i wouldn't be concerned about that i mean it's on the higher end but let's talk about what testosterone does for women. Of course, we always think of it as libido. And definitely there's a piece of that. But it's also motivation and drive. So we're going to get into your cortisol pattern here in a moment. But the first, just to fill everybody else in, the first thing I asked you was, man, you've been stressed. But here's what I'm now

diving into this, looking at it at a different level is with all that testosterone you have a lot of motivation and drive you're an entrepreneur you want to take over the world like most of us do and so that testosterone has pushed been able to neurochemically propel you into these spaces where now the stress load is high because anytime you're trying to create something you you know, on your own is, or it sounds like you do it with your husband, but it's a big endeavor. And so you had the hormone

that could move you in the right direction, but at the consequence of things like cortisol. So the cortisol confused me because going into this test, I expected to see really high cortisol because I feel like I am stressed a lot. And then looking at it, it's super low. Yeah. Why would that happen? So when we move down to the next category, it's your cortisol pattern. So let's talk about the difference between just

cortisol itself and the pattern. Okay. So when we wake up in the morning, our cortisol should be at pretty decent levels. I mean, I'm looking at yours and yours is a little bit on the low end. So do you drink coffee? I do decaf usually. Okay. Do you wake up slowly or are you pretty good? I kind of wake up and roll into the gym. Ah, good for you. Like 6am I wake up and then I'm at the gym by 6.30 usually. Is that a time? Is that because of the most efficient for your... Yes 6 a.m i wake up and then i'm at the gym by 6 30 usually is that a time is that because of the most efficient for your yes yes okay so let me throw out some possibilities here for you um most people with this low cortisol will will definitely go for the cup of coffee first

thing in the morning because they need that to bring cortisol up yours isn't completely low but it's on the lower side within about 90 minutes of awakening your cortisol peaks which is this one right here and to you know it's the highest actually the highest cortisol we'll ever get is within 90 minutes of us waking up so actually your best time to go to the gym is 90 minutes after you wake up. Interesting. Because cortisol was made to make us move. So if you don't use cortisol, often we will store cortisol. So for women that are trying to lose weight, when we see these cortisol spikes, it's like you go use it, go use it because your body is otherwise going to put it in your tissues and it'll put it in fat. So you have a, you know, a pretty good spike it's still i

mean i want you in the middle of this of this graph here and you're on the lower end um but you would be best to work out 90 minutes in just i mean fyi um now the rest of the day it just tanks what's your energy as the day goes on i would say it kind of gets a bit lower in the afternoon, for sure. So we're supposed to go lower as the day goes on, which is why one of the things that I try to preach is, can we, as women, front load our day? Like, literally, if you look at your cortisol pattern by four o'clock, if you could like just chill out,

that would be the time to just turn everything off and move into a more of a, what we call a parasympathetic place where you're, you're just a little more relaxed. Now that's everybody's cortisol pattern. Um, but yours, I mean, you, by the end of the day, you have no cortisol. So I don't know what gets you. I mean, maybe it's just a good mindset, but. I think a lot of it's mindset. By five, I generally stop doing what I'm doing. And I think I struggle with anxiety in a big way. So I think it's the anxiety that kind of keeps me going, if I'm being honest. Okay. So this is the catch 2222 you've got progesterone

being low progesterone is a precursor for a beautiful neurotransmitter called gaba okay so if you don't have enough progesterone you're not going to have enough gaba and you're not going to be able to calm yourself so when you can't calm yourself down, usually in that scenario, you'll maybe reach for wine or you reach for something to relax you. But also it leads to these high anxious states. Okay. And here's the catch-22 is that what tanks progesterone, because yours is really low, is cortisol.

So back to your question of why is it unusual if I've had so much stress, why is my cortisol so low? Because you've been chronically under stress for a long time. If you were acutely under stress, we would actually see it really, really high. But without even knowing your lifestyle, I can tell you you've been chronically going at it for a long time. And if there was one piece of advice I'd give you so far, it's to really learn how to relax, learn what downtime means for you. But without that progesterone, downtime in the beginning could be a little torturous. Because sitting down without the neurochemical reserves, your brain is going to go, get up, go, what are you doing?

And it's going to want to keep moving you and you've got testosterone, especially during, we'll kind of go into, you know, where you may be, I know you probably don't know where you're ovulating right now, but during the, you know, more of an ovulatory time, your testosterone is going to be like, go do something, go do something. But without progesterone, what ends up happening is you are just doing but not relaxing. Yes, this is me. I'm relating to everything you're saying. Excellent. So with fasting, why is fasting beneficial for the hormones? So let's use estrogen as an example.

When estrogen likes insulin to be low, likes glucose to be low. So when we fast, we clean up that system. So let's go back to you. You've got, when I go over to this metabolite picture, you are, you're good estrogen. Well, let me explain. An estrogen metabolite is what your estrogen is breaking down into. And it usually breaks down into three metabolites.

One is called 2-OH, 4-OH, and 16-OH. 2-OH is the healthy estrogen. You want a lot of that for the situation you're in. So one of the ways you can get that is by fasting. Because as insulin comes down, the good estrogen will go up. Okay. Now, when I look at your other metabolites, you've got 4-OH is at 12.7%. We don't want it higher than 11% of the breakdown of estrogen. So there's a toxic piece here where you've got a little bit of some

toxins that we all do have toxins in our body so if i can teach you how to fast to 17 hours that's where those cells start to mobilize and detox so now i can use you know a 13 14 15 hour fast for you on a fairly regular basis and i I can throw in a 17, 18, 19 hour fast, something around that on a periodic, like once in every once in a while basis. And I'm maximizing the good estrogen and I'm helping to get rid of the bad estrogen. So when you say a once in a while fast, like how frequently? Roughly. So typically, because you don't have a period right now. No. So do you have any sense of ovulation? I do. Oh, good. Through my skin. My skin tells all the stories that are going on. So the last period I got, I had a slight one

around November 23rd of last year. Okay. So around the 23rd, I noticed my skin kind of gets dull right before and then it looks really good at a certain point. So I think I have a general idea of what's going on. Okay. So what I would say is use your skin and track it on a tracker. Okay. We actually have, we have a Fast Like a Girl app. You can track it on that. Yeah. Awesome. We just launched it. And so it'll tell you kind of different length fasts and different foods. Okay. Awesome. So track it. So you see what your patterning is and what I would, what the typical way that you would do is day one, which typically would be the day that you have fully bleed, but you're not bleeding. You're just going to see it on your app. one to day 10 i would have you just start

by going into some longer fast so or some or do like a 15 hour fast okay so let me give you a range 13 to 15 hours and generally people would do that overnight and then into the morning that's right okay just the way you're just pushing breakfast back a couple hours you can have your coffee in the morning or your decaf. That's fine. Okay. Can you exercise? You can exercise. Totally fine. It might even move you there a little bit quicker into the fat burning place. So yeah, that's fine. And then, so I would have you do that for one month. I would have you the first 10 days. I would have you just do this 13 to 15 hour fast every single day.

Every day. Yeah. Okay. Now on day 11, you're moving into ovulation. So this is where testosterone comes high. You've got a lot of great testosterone. We'll talk about her in a second. But you don't have a lot of estrogen.

We're trying to get an egg to release. But you have a little bit of progesterone and progesterone doesn't like fasting. So I like to keep women, you know, under 13 hours. I don't like in a situation like yours, I don't want you to go more than 13 hours in that, in that ovulation window. And I want you to focus on your microbiome. So we talked before going on, you have this microbiome test and you're missing two key bacteria that at least the test couldn't detect it. One is called L. rhamnos,

the other one's called L. ruderi. Both of these bacteria are key bacteria, a part of a whole set of bacteria called the strobilome. And the strobilome are a set of microbes that break estrogen down. So during ovulation, I want you doing everything you can for your microbiome, more probiotic foods, more prebiotic foods, more polyphenol foods. Fasting will not be your tool during that time. You used it in the first half of the cycle. That was your tool. But now we're in ovulation.

It's not your tool. What kind of foods would you recommend within those categories? Yeah. So do you like sauerkraut? You know, yeah. I can do a spoonful. I can do it. So sauerkraut's making a comeback.

You know, artisan sauerkraut. Love that raw kefir. Okay. And it has to be raw. The pasteurized kills all the bacteria. Okay. So raw kefir is great. You know, there's a lot of drinks out there.

Like people ask me about kombucha. It's kind of a weak probiotic. But sauerkraut, kimchi, kefirs, anything fermented is going to add good bacteria in. I called it in the book, three Ps. So that's, that's one piece of it is we're adding in, you know, these probiotic rich foods, but then we have polyphenol foods and polyphenol foods are like all of the vegetables. So as many, and one of the things for estrogen, estrogen loves when you give her a ton of salads so if we want to break her down i would say eight to ten cups of vegetables every single day mostly green vegetables a lot of leafy greens during

ovulation and now we're going to start to break down that the estrogen that we hopefully created more of in the front half of the cycle using fasting as your tool. Okay. And then the last piece of that is prebiotic, which is nuts and seeds. So hemp seeds, you know, I put hemp seeds on all my salads. I'll actually take sauerkraut and like put it in a salad with a ton of like bitter greens, like arugula, maybe some radicchio. It's really good for the liver. I'll put some, I love nuts. I'll put some raw almonds in there and just take a bunch of hemp seeds and pour it in there. And that's like estrogen's heaven.

It'll really help you break down estrogen. Okay, so that's what I will be eating every day then. I do love a salad. So that's good. I eat salad every day, but I think I could add more vegetables and more variety in there probably. Yeah, so from day 11 to 15, day 10, let's just say day 10 to 15. And the reason I'm kind of giving you some fluidity with the dates is everybody's cycle is different.

So it's not like every woman ovulates on day 10. Okay. And what about that pre that PMS moment where everyone's having the cravings and the mood swings? Like what do you recommend during that time? Right. So when you come out of ovulation, you're going to have another dip where your hormones go low. So from day 16 to day 19, you can go, I would encourage you to throw in a little longer fast. So I would say, could we get you now to that 17 hour mark where we're getting rid of some of the toxins that have accumulated in your body? Now, the reason that I'm picking that part of the cycle to get rid of some toxic estrogen is during ovulation, we just, your body makes all this estrogen, but now we got to

get rid of it. So if we can throw a 17 hour fast in at least one of those days, you can do, you know, there's, it's a four or five day window. You could do 13, 13 to 15 hours most of those days, but one of them, I want you going above 17. I hope I didn't lose you on that. No. So at most days, I'll do 13 to 15, which is just pushing breakfast a little bit. 17 hours. Just one time.

What time would that take me to into the morning? Like noon. Okay. Well, that doesn't sound too difficult. And so here's the crazy thing. This is why I love fasting. The more you do it, the easier it gets. I think the word fasting sounds really intimidating And so here's the crazy thing. This is why I love fasting. The more you do it, the easier it gets.

I think the word fasting sounds really intimidating because when I was going to, you know, when I was planning my questions for you, I was like, well, how am I going to make it through a whole day of not eating? Right. Do you ever do a full day of no eating? Oh, yeah. We do multiple full days of no eating.

Oh, my gosh. Okay, so what's the longest fast that you would recommend? Well, it's so funny. I just had this conversation with some colleagues last night. The longest fast I've ever done is five days. Woo! Yeah, but it's a, we can chat.

I mean, it's the most incredible spiritual experience. Really? Like when you think about, like if you ever get overwhelmed with the noise of the day and like your brain is just chatting at you, when you start to go longer and longer without food, the brain stops talking. And GABA goes up.

And all of a sudden, you get really calm. And the insights that come in are so deep. So I've actually started to use three- to five-day water fast now. If I have any challenges in my life i can't quite solve i'll just throw it put in a three to five day water fast just to kind of quiet the noise so i can get really clear on what i need to do it there's a reason every religion's used it so yeah but then you would have to do it the right time of your cycle and what is the best way to break a fast like that yeah and how do you not eat everything in sight?

Yeah. Yeah. And so there's, I have a five-step process that I explain in the book. You start with broth, and then you go into like some, like one of my favorite meals to break a fast with is like avocado with some sauerkraut. And so you'll go into like some good fat with a little bit of a probiotic.

And if you're doing okay, then you would go into some vegetables and we just watch your digestion and see how it's doing. And if everything's good with those steps, then you can start to go in more into some of the meats. And depending on each meat's gonna be a little different. I usually have people start with eggs and then they can go into the grass fed meats.

How do we handle building muscle while fasting? Yeah. So this was also a big, like the media took it and went with like, if you fast, you'll break down muscle. Okay. How you do it is that when you break your fast, you want to break it with protein and you want to make sure you get at least 30 grams of protein. The reason that you go after 30 grams, you can get more if you want to make sure you get at least 30 grams of protein. The reason that you go after

30 grams, you can get more if you want in that first meal, is it'll trigger an amino acid receptor site in your muscles that will build your muscles stronger. So when you're fasting, your body is going to get rid of any of the stored glucose that it put years ago. It'll burn fat, it'll take it from the liver, or it could start to pull it from the muscle, especially if you're working out in a fasted state, you're going to lose a lot of that glucose from the muscle. Totally fine. We just want to make sure we repower that muscle up. So they're on the other side of the fasting healing effect of what we call autophagy, which is where the cells are getting stronger. Glucose is exiting out of the fasting healing effect of what we call autophagy, which is where the cells are getting stronger,

glucose is exiting out of the system, lives this incredible cellular growth mechanism or pathway called mTOR. And mTOR is how we build muscle. So when we pair a fast, we have to think about fasting as it's getting rid of what no longer serves us. That's the best way I can explain it. And then when we add protein back in,

we're giving the muscle what it needs, which is amino acids. So if you are a vegetarian, are you vegetarian? No. Okay. Yeah. So yes, I was for 10 years. I was like the sickest version of me. Yeah. So yes, agreed. I love meat too. So you want to go in with at least 30 grams of protein in that first meal, because now think from your muscles perspective. Your muscles like, okay, we just got rid of the bad. Oh, here comes all these nutrients. Let's build ourselves stronger." And one of my favorite fasting hacks is to go into a workout in a fasted state, push your muscles, do a lot of muscle building, and then follow that, come home and power up on protein.

And now you're building lean, strong muscle. Love it. And so that's the part of the conversation that didn't get out into the world. Speaking of getting rid of the bad, let's say someone has candida, a parasite, something of that nature. Is a fast going to get rid of that toxin?

Yeah, so the interesting thing about fasting for any gut problem is that the research shows that at 24 hours of fasting, we actually see intestinal stem cells produced. So what a stem cell is, is it is a cell that can go and repair any, it's basically any problem in there. So it will go in and repair the whole internal lining of your gut. The other thing that happens at 24 hours is we see the microbes start to relocate. So they're not clumped together. So they start to spread out, which can allow you to start to pull more nutrients in from your foods. And then the last thing that we see is things like candida things like parasites they don't like an environment where the mucosal lining is repaired where the microbes have spread out like

you're literally changing the garden in there and so they're like we're out we're like there's this isn't a a great place for us to live anymore and so you naturally will start to see candida die off. You'll see parasites go away. If you dip into these 24-hour fasts, thinking of them like you would any supplement, but you're doing it from the inside, putting yourself periodically into these fasted states. So is fasting going to be individual for everyone? It sounds like it is. Yes. You got it. yes. You got it. Yeah, you got it. And especially for women.

Okay. Especially for women. Like in the book, in the back, I put my favorite protocols where I show like how, you know, if you're listening to this and you're like, wow, I didn't really know there was so much to fasting. I show you some of the protocols that I know have worked. And this is why we created an app. This is why I love conversations like this,

because we're all going to find our own rhythm with it. And that gives us an opportunity to get out of this one-size-fits-all diet, health care system we've been in, and start to understand that there's my way, not my way could be completely different than anybody else. I also love the fact that this is a way to improve your health. It doesn't cost anything. It's like, it's just about simplifying. You're not adding anything crazy. It's not about some fancy program with soups and whatever. You're just quite literally not eating for a certain window of time.

That's right. Well, that part to me is so important because if we make every healthcare solution have to be expensive or cost money, what do you do with the single mom who's working two jobs and trying to raise her kids and is living paycheck to paycheck? She... So is she at a disadvantage?

She's walking into her grocery store with those bad oils and the bad toxins, and is living paycheck to paycheck. So is she at a disadvantage? She's walking into her grocery store with those bad oils and the bad toxins, and that's the cheaper food she's going to eat. But what if we teach her how to fast for 16 hours? What the research shows is that we will be able to help her body repair from the damage of that food. So now we've got a tool that everybody can use, and it levels the healthcare playing field in my eyes. And everything here is connected. I think that's the kind of, you know, I kind of knew that, but to actually see the numbers and understand it is so crazy. Like our gut is fully

impacting our hormones and there's things we can do to improve the gut, which will then improve the hormones. That's right. That's right. They're like a big team, right? And it's like, you need your liver, you need your gut, you need your brain. And then we've got to learn how to cycle with these hormones, which is why like my huge message is lifestyle. When hormones have gone awry, stop looking for the magic pill. That's been why we're in this hormonal mess is that we keep searching for the magic pill. Let's look at our lifestyle and try to balance that first. So thank you so much for looking at the Dutch test results for me. It means a lot. And this is definitely a big focus for me right now, kind of a somber question,

but do you feel like this is repairable? A thousand percent. So two things I want to tell you, the microbiome, you can change the microbiome in three days. Wow. Those bacteria are turning over really quickly. These hormones,

I would say my experience has been 30 to 90 days is what I see. The one piece we should discuss is progesterone because when we come around day 20 of your cycle, you want to avoid all fasting and you actually want to bring your glucose up. So you want to go into more of the root vegetables. In the book, i call it hormone feasting foods so it's your squashes it's your sweet potatoes it's your potatoes in general it's tropical fruits citrus fruits these are not keto foods i do not want you in keto during that time and here's what's fascinating this is this is like the liberating moment I want to give all women.

And I wish I had known this at 16. That week before our periods, there is a reason we crave carbs. You are not undisciplined. Your body, your progesterone is saying, give me more glucose so I can make my appearance. And so your story about you were in keto for so many years, the biggest challenge you did is you didn't give progesterone enough carbs. Now, I'm not giving women free reign to sit on the couch

and eat a box of pizza and a tub of ice cream. I'm asking you to switch over to nature's carbs, which is why, like, bring the fruits in, bring the squashes, the potatoes. If you increase that, and we're talking 150, 200 grams of net carbs. It's a lot of carbs. If you bring those in the week before your period and you really work on your stress, that's the biggest time.

Just like ovulation is the time I want you to work on your gut microbiome the most. The week before your period, I want you to work on your gut microbiome the most. The week before your period, I want you to work on your stress the most. So you add in these vegetables and the root vegetables, and then you start saying no that week. And how do we feel about dark chocolate? Oh, that's the other amazing piece is that dark chocolate is incredible because it has magnesium in it.

So what, I mean, think about it, like, what have we said for years? Like, I don't want to go out. I don't feel like working out. I'm just hungry. And I just want to eat chocolate and sit on the couch. It's the week before my period. Yep. Yep. That's progesterone. That's what she wants. Yeah. So it's time to like, actually sit back and chill a little bit. That's right. Okay. So yes, given your profile, give yourself permission. It's funny because that is really the hardest part for me. Yeah, I know. Which we can literally see.

And I live a pretty healthy lifestyle, which I think it's good we're talking about this. And I'm telling people that there are issues in my blood work because as healthy as I am, my stress levels are not. Yeah. And I still have things I need to work on clearly with my gut health. And that's why I'm so grateful to have you here. So what is the date today? It's the 24th. So it's a day after I would have technically have started my period. So right now I should be... Day two. Day two, I should be fasting. Yeah. Yep. You should start fasting. Yep. And you should go keto. You should go low carb.

So let's bring glucose and insulin down. A great thing if you haven't put a CGM on. Do you know what a CGM is? Oh, no. Glucose monitor? Yeah. Put a continuous glucose monitor on because then you can start to see the patterns of your glucose. It's really interesting. So you want to keep glucose low, like around 100, and a little under 100 pretty consistently throughout the day. Okay. Now, you'll eat and there'll be spikes,

but as long as it comes back to around 100 most of the day, you're good. Under 100 is great. 70, 90 is optimal. Okay. So... If you could give an overall message for all the women listening about this topic what would you say oh god i have so much i want to say as you can tell um for starters um stop give stop shaming yourself stop guilting yourself stop telling yourself horrible things we have been living in a patriarchal world and I don't mean this as like a rally feminist cry.

I mean this as we have to start to demand that we do health in a woman's way. This is why I named it Fast Like a Girl. So you have to eat like a girl. We have to socialize like a girl. We got to do all things according to our body. And so, so much of the suffering that women have from the mood disorders to the weight gain to the lethargy is coming because we're living out of accordance with our hormones. So learn your hormones, get to know them, and then understand the lifestyle to match

it to that. And you will never fall out of love with your body again. Awesome. Thank you so much. Thank you. Loved this. to receive my favorites at marilowelland.com. It will be linked in the show notes. This is a Wellness Out Loud production produced by Drake Peterson, Fiona Attucks, and Kelly Kyle. This show is edited by Mike Fry

and our video is recorded by Luis Vargas. You can also watch the full video of each episode on our YouTube channel at Maritowners. Love you, Power Girls and Power Boys. See you next time. The content of this show is for educational and informational purposes only it is not a substitute for individual medical and mental health advice

and does not constitute a provider patient relationship as always talk to your doctor or health team