Well with Arielle Lorre - 20: JUSTIN JANOSKA - All About PCOS

Episode Date: August 28, 2019

In this episode Arielle talks to clinician and founder of The Autoimmune Revolution, Justin Janoska, about all things PCOS (Polycystic Ovary Syndrome). They cover everything from what exactly it is, how it happens, its effects on other systems of our bodies, managing symptoms like weight gain and acne, and various options of treatment. Justin also answers many audience questions.  Follow Justin on Instagram: http://www.instagram.com/justinjanoska Visit Justin's Website: http://www.theautoimmunerevolution.com Buy Justin's book: https://amzn.to/2ZuZW29 Follow Arielle on Instagram: http://www.instagram.com/ariellelorre    See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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Go to your rise-adviseur or sunnycars. combe. I'm Aria-Lori, and this is the Blondeffile podcast where I talk to experts, influencers, and inspirational people in the world of wellness and beyond.

My guest today is Justin Janoska. If you haven't listened to Justin's other episode on my podcast, he was one of my first guests, and we talked all about flexible dieting, macros. He has a book out called The Flexible Dieting Disaster, and it is really fascinating. so I highly recommend going back and checking that out. A little bit about Justin. He is a clinician and the founder of the autoimmune revolution, an emerging company that guides women in their healing journey to reverse their autoimmune disease and reproductive disorder naturally with specific attention on Hashimoto's, Lupus, PCOS, and endometriosis. He holds a master's in human nutrition from the University of Bridgeport, but he has a very different and unique approach

that emphasizes mind-body medicine, including childhood trauma and early adult stress. Through his work with clients, he helps them acquire a deeper understanding of how they got here, supports them to be with their pain, and embrace their truth. Justin and his team are committed to revolutionizing how we address and heal autoimmune disease in women. And I can attest to that. I have been working with Justin, and it is unlike any other practitioner I've worked with before. So, guys, this topic was highly, highly requested. PCOS just seems to be so pervasive.

I was really shocked by how many women reached out on my Instagram with questions about this. It's important to keep in mind that you're going to hear different opinions from different people. The thing that Justin really wanted me to emphasize in this intro that we talked about after we had stopped recording was that we can recover from PCOS. So many women get this diagnosis and think that it implies that they won't be able to have children. They'll have trouble conceiving. They'll be plagued with these health issues and hormone imbalances their whole life. and he really wanted me to emphasize that that is not the case. So it is a dense episode.

It is fascinating. It is filled with information. And I hope you guys enjoy it. All right. I have Justin here. Welcome. Hey. Nice to see you again.

How are you? You too. I'm good. How are you? I'm psyched to be here. Yeah. La La Land. Kennedy is on the mic too.

Hello. Hello, Miss Kennedy. We'll see if she has anything to add today. I will attempt. So today we're going to be talking about PCOS. This is a really hot topic. When I posted it on my Instagram, I got hundreds and hundreds of questions. And it's something that I've been diagnosed with myself.

I think it's kind of up in the air, whether I actually have it or not. Justin is giving me a look. He's shaking his head right now. And I think that might be common. I think a lot of people, now he's nodding his head. Yes. Okay. I think a lot of people are diagnosed with it and don't necessarily have it.

We might have some of the symptoms. But so I'm really interested to learn as well. I am going to start by just talking about PCOS, establishing what it is a little bit. And then I'm just going to go into listener questions because there were so many. Totally. So why don't we just start with the beginning, PCOS, polycystic ovarian syndrome? What exactly is it? Yeah, I mean, the nuts and bolts of it is simply, it's this, you know, confluence of genetic, environmental, hormonal factors that basically cause all host of symptoms that a lot of women listening probably have, which is related to, you know, skin tags and, you know, maybe hair loss, hair growth, amenorrhea, menorrhasia, heavy periods.

Okay, back up amenorrhea and what, let's, for a lot of. Laman's ones. Like no ovulation. Yeah. In ovulation. No period. Not ovulating, I guess. And men are so heavy flow, maybe painful periods.

And dark hyperpigmentation of the skin maybe. Usually depression. Sometimes I hear a lot as well. Brain fog waking. And infertility, obviously, is a very, very common one as well. So, I mean, that's generally with a diagnosis, doctors will say, You need to have two out of the three criteria, which is need to have antivulation or some sort of menstrual cyclicity. You need to have hyperandigogenism, which I should have mentioned as well, which causes hair loss and or hair growth.

And what exactly is that? Just so high testosterone. Okay. You know, and other precursors. High androgen. Right. D. D.

H.E.A. D. S, things like that, which, you know, are predominantly what men have, but women have been greater than normal quantities. So hyperandrogenism in ovulation or period and also ovarian cysts, which is one of these things that a lot of women will say, or the doctors will say you have PCUS because you have multiple cysts. But technically they are follicles. So it's a misnomer. It shouldn't be called polycystic anyway. It should be called polyfellicular, if anything.

Okay. So aside from that, they are normal for a young woman to have. have you have cysts or follicles right um so one of the biggest misconceptions is that you need to have multiple cysts in order to have PCS which isn't true at all so you could technically have and i've had women as clients who have had only high androgens in a normal period or just a dysregulated period and normal angriens and there's a weird set of combination of things so we get very uh i guess set on following a strict criteria, which is maybe one of the shortcomings with conventional medicine because a lot of times, for that reason, then, a lot of women get misdiagnosed because

their doctors are saying that, well, you don't really have it because you don't have these other issues. You see what I mean? Yeah, like for me, I was diagnosed because I have cystic ovaries. And we're not talking like a, like in ovarian cysts, like one. It's multiple. They call it like a string of pearls, right? Right. And irregular periods. So that was, and my hormones, my hormones are always normal when we test them. And I don't really have any of the other markers.

But I was diagnosed in my early 20s, I believe, and just put on birth control. Yeah. That's kind of the protocol. Standard. So I want to rewind a little bit, though. Are people, people who do have it, are they born with it? Or is it something that they develop over their life? Yeah, it's a lifestyle sort of condition.

Syndrome is the appropriate term, not a disease, really. So yeah, it's definitely related to environment and a lot of other things. But there are definitely genetic, what we call polymorphisms or genetic variants that can get you on the spectrum, right? Increase a risk for it, but doesn't mean you're going to get it. Just like an autoimmune disease, right? So the certain genes that are responsible for metabolizing and detoxifying estrogens, for example. We know a lot of women have estrogen dominance. So if that's going on in the liver, for example, where you do that, then maybe that's one way for women to end up with PCOS or even endometriosis, which kind of falls in that same sort of path.

And what exactly is endometriosis too? Let's define it so that we can separate the time. Yeah, and a lot of women will have both, actually, because there's a lot of overlap between the two. but estrogen, I'm sorry, endometriosis is simply just this condition where the endometrium, right, that's the lining of the uterus, that tissue is growing in other areas in the body where it shouldn't. So it's generally just transferring over, I'm trying to think of the best term. It's basically just like, you know, channeling into your Philippine tombs, your ovaries, your pancreas, maybe, your stomach. it can get in your lungs, it's crazy. The stuff can migrate in different areas of the body.

So that can get pretty nasty. And that's also driven a lot by estrogen dominance. Not only that, but we find that there are genetic, you know, variants and issues that are kind of priming that mechanism. But, again, it doesn't mean you're going to get either of those conditions just because of the bright genes, right? Okay. So I feel like we kind of have to separate this into like people who are misdiagnosed with PCOS or have symptoms that. mimic PCOS or similar and then actual PCOS, right? Yeah.

So let me think of how to phrase this. How does, so people who truly do have PCOS, you're saying that it's something that develops as a result of lifestyle. And what does that look like? Yeah, out of lifestyle. So let's take a step back and say that we could probably categorize PCOS into two different phenotypes. We have the lean PCOS type.

We have the obese type. Some might go to say there is the sort of inflammatory type and insulin resistant type, but they kind of all like mishmash and mix together. But if you look at the lean women out there, especially in the fitness and competition world, a lot of them end up having it and they don't realize they have it. And I've had a lot of women come to me

and I've been able to see that. And that's all stress induced because they have high introgens and DHEA and sometimes insulin resistance and issues with that. But yeah, that's strictly because you beat your body to the ground for months on end. And voila, here's where you end up. Or you have hypothalic menorrhea, which simply just means you have, you know, low progesterone and estrogen and all the sex hormones. So we can kind of go in out of those directions. With the obese type, though, yeah, I mean, that's largely lifestyle as well, right?

because if obesity is lifestyle, then that can easily cause PCS for some people who have the right genes again. Okay. So for somebody who is doing competitions or something or is like on a really strict diet and they're beating themselves up, like you said, and they develop this, do they also develop cystic ovaries or just the other symptoms? They can. The thing with this is that, and you can tell by their period, I think, what's kind of happening because if it's irregular or non-existent, if it's not existent, which is actually not that common. Most women, I think, with PCOS I've seen from my experience, that is, have a cycle, but it's just very skewed.

It's a very drawn-out, you know, mencies and heavy bleeding, but they do ovulate here and there, not all of them, though. But really what's driving all this dysfunction is up top, right? Think about if you have a lot of stress, for example, or high insulin from diet and lifestyle, which, you know, actually is stemming from stress too. And testosterone and environmental estrogens, right? All these things kind of come together and they can really skew the luninizing hormone and the follicle stimulating hormone that comes out of the pituitary, right?

And when that happens, you end up really to keep it simple to understand why this, you know, the cysts happen, you end up stopping the follicle from maturing it to you know, it's late stage graphene follicle where then it, you know, that's where the egg gets released, right? So it goes through a number of series, which I won't really get into, but it basically stops midstage and you end up having a lot of these antrial preantial follicles. And when you have high levels of luteinized hormone from high estrogen or insulin, for example, then they start responding to that hormone. And then they start to multiply. And then that's where you start to create a lot of androgens out of that as well. So it's a really complicated series of events that happens,

but you can see where it comes from, where it stems from, right? And then does that stress that the body, so stress can cause all of that or exacerbate it? And then does all of that kind of exacerbate stress back? Is it like a cycle? Yeah. Oh yeah. Yeah. It's one vicious cycle because we can see that people who have high antigens, they will have high insulin because we know antigens increases insulin resistance and insulin resistance increases and worsens high antrogens. And you've inflammation, and that can worsen estrogen dominance as well because of the aromatization. So, you know, it's just a lot of mechanisms and things like that. But, yeah, it's all interconnected like this.

So once you really fix one thing, you know, you really fix all of it. It's like a domino effect. So when somebody goes to the doctor and the doctor sees whatever symptoms, they see fit to diagnose somebody with PCOS, it seems like the most common thing, the most common protocol, like we said earlier, is to put somebody on birth control. Yeah. How does that, why is that the solution, do you think? And how does that affect everything?

Yeah. So to be fair, birth control is not, quote unquote, bad, right? Definitely has this utility and need. I think it's a huge mistake. And I'll hear not a lot, but I hear people in the alternative space say like, yeah, birth control. control is bad and we need to get off of it and not use it. That's really interesting because for years I didn't go on it and you know all of my issues probably more than anybody because we've been working together.

But I and I did, I have tried to stay away from birth control just because I felt like I didn't absolutely need it anyway. But I kind of had this like fear about going on it because there is so much noise in I guess like you said the alternative space, but it just seems to be every. everywhere now that birth control is like evil and it's going to fuck your body up and don't take it. Well, the thing is that, yes, it is a band-aid if we're going to use it for PCOS or any hormonal issues like acne, for example, or even a missing period or a heavy period rather, not a missing period.

And so it's important in certain situations, but, right, like if you have a lot of heavy flow, you're probably going to need it until we get to the root cause, you know, so there is that sort of angle I take. But yeah, for sure, like, there is an issue with it because we're not getting to the underlying problem, right? And we actually can find in research is kind of ridiculous because a lot of women out there don't know that. Not all birth control is created equal.

And we know that some can have sort of antigen effects, estrogen effects, which simply means that it can actually increase antigens and increase estrogens, and some can do vice versa, the opposite. So, no one really knows this because doctors are probably just getting, you know, hearing it from the rep, the drug rep, being like, here, just use this and give it to your patients, right? And we need to be informed about this because this is really important. In fact, my friend Dr. J. Tita, he's really good with this and he'll, he can shed more light on this. But that's where you can start to see how, if you're on the wrong type of birth control, if you decide to take it, you might be actually doing more damage than you want. So, just for example, we know that, you know, ortho-tricyclin, which is a common one, that has a sort of low angiogen impact.

And that's probably one that you may want to use, recommend or ask your physician for your OB, I guess, right? If it's possible. But the ones that may be a problem and worsen angrient nitrogen levels are, you know, Plan B, for example, you know, which is a lot of, you know, synthetic progester. right. So leaving Nordgestrel, technically speaking. And there's some other ones. Norgestrel is the other one that probably has a high antigen impact as well that maybe is not helpful. And desogestrel is the other one. So these are just like the overall names for it, but they have specific brand names that underlie, or I'm sorry, are underneath all those. So it's hard. What about progester and only birth control? Because that was something that was recommended to me for

years. I mean, as and how it relates to PCOS. Is it helpful at all? Which one are you talking about? Do you know? I don't remember the name of it, no, but I know it was progesterone only. Yeah. I didn't take it. Yeah. I think again that I don't know. I mean, honestly, a lot of women I talk to and seen are not using progester, project and only. A lot of them are just combos, right? And so, But I think, again, the same thing. The whole purpose of it is to stop your cycle. It's really all it's doing. You're not normalizing anything with birth control.

Hormonal birth control, that is. Let's be clear. And so you're just shutting things down because it's just creating a lot of havoc with what you're going through. So, again, you make your own informed decision. If that's what you want to do things and live your life, that's fine. But it's really important for me to say to women who have PCUS, like you still have the underlying dysfunction at a deep level. And it has a long list of negative health outcomes and consequences, types of diabetes, cardiovascular issues, endometrial hyperplasia, I mean, maybe all those things, just depending on what you're doing and how everything else looks in your health, right?

Yeah, so can we unpack that a little bit? Like, what are the short-term ramifications of dealing with this and maybe putting a band-aid on it and not getting to the root cause? And what are the long-term implications? Yeah, to be fair, I think that PCS is the short-term, if you do, just got diagnosed and you're just kind of, you know, managing away through life and taking band-aids and you want to do that because you just want to avoid it and actually put in the work, for example, I guess. You can probably get away for a bit, honestly, I think. You know, everyone's is different. Don't quote me on that, but it's really when this goes on for years and years and years.

And we just really ignore everything else. And that's where I think it gets really treacherous because I've spoken to plenty of women who try to then to get pregnant and I'm not surprised, but they end up having three, two, three, four miscarriages or just suffering even more and don't get pregnant at all. And so there's a reason for this. And it's because of all the hormonal dysfunction inflammation that's going on that's inside the body, right? So I want to talk a little bit about how all of the dysfunction and inflammation affects other functions of the body. So we know that like one of the simple, symptoms with PCOS is acne, skin problems. Is that from the androgens? Yeah. Okay. Can we talk about that a little bit? Yeah. So we know that

there are, whatever, there are receptors for testosterone in the hair follicles, right? And so we, we know that if you have a lot of that going on, you eat a lot of animal products or dairy, for example, that can increase seabom. And that's that oil, right? That's on our skin that it's normal to have, that causes a lot of this sort of feeding for the bacteria, Pachnus, which kind of feeds on that, right? And that's how you develop acne because it just snowballs like that, but guess what? It's the testosterone. It's the IGF1. It's the insulin, the hormones that are in food. Not just that, but like that's a lot of, that's a big source for a lot of people and that just drives more oil production. That's how you get acne, really. I mean, it's more two than that, but like that's one of the biggest things. And you'll be surprised. I mean, you cut gluten and dairy out for a month and acne goes away most of the time. That was somebody's

question. So there's the answer. But I cut out gluten and dairy and I've been having skin problems. Again, it's more than just that. I know. It's not that simple. I'm saying for a lot of people, some people it can be really helpful and be the only thing they need. For others, no, it's driven by more things and, you know, again, that come, it can come back to, like, your skin health and your skin microbiome and what sort of species you have on your skin that can be contributing to acne and maybe your gut and if there are infections in there, or if you have liver inflammation and you have toxins that are getting, or, you know, not getting out of the body, but they're coming out through the skin because their skin gelargus organ. It's a detoxification organ, right?

Yeah. So think about all those things as well. So what about the gut? How does, how is PCOS and hormone dysfunction and the gut related. Yeah. Well, think about this. So if we're taking birth control, for example, we know that's almost like a, I'll put it like this, like a nuclear bomb going off in your gut, kind of like antibiotics in a way. I'm not trying to scare you or discourage you from taking it, but it's important to understand that.

We know that it can really do a lot of damage with long-term use in the gut. it can deplete like a dozen or so nutrients in the body, and it can cause leaky gut and do all these things. And so if you have dysbiosis from birth control, it's not just that, but that's one of the things that can cause it, but again, stress can do that as well, right? And so, and who knows if you were exposed to, you know,

candida, fungus maybe, or some other microbe. And so these things can, we actually know in the research that women, mostly, I would say, the obese type have dyspliosis or some sort of overgrowth of bad things that can contribute to, again, feeds into the cycle of inflammation and all that stuff. And so we know that they have dysbiosis and that's something that, again, is a hidden miscause for, you know, really resolving PCOS and we have to address that.

Not everybody has that, you know, but it's one of the things I found. And I think especially for the lean women who are in the competition or fitness world because they're under a lot of stress and I find a lot of them do have some sort of sebo, small intestinal bacterial overgrowth

or candida or fungus even like vaginal les infections maybe may not be related but it's all this stuff I see and it's you know it doesn't really surprise me you know

what about energy levels and mood yeah yeah a lot of women Women with PCOS have depression all the time. You know, energy fatigue is huge. I mean, I've never met a woman who doesn't have fatigue.

And if you think about it, you're, so mitochondria, if you know what that is, it's an organelle in your cell. It creates, like, pretty much it's your energy powerhouse, right? So we already know in the research that PCOS can cause mitochondrial dysfunction. I was actually looking at a study ironically today about this. And so that's really important because if you have inflammation and oxidative stress, and if you're radicals floating around because of your condition and your PCOS, then that's going to contribute to your fatigue, right?

And if you have insulin resistance, that's also going to do that because guess what? You can't get calories into your, you know, your muscle cells or, and they can't generate energy that way. And so it's a convergence of a lot of things. And this is also important for fertility. Your oocytes, you know, the cells and the ovaries have a lot of mitochondria. they're damaged, how do you expect to get pregnant, right? So it affects things in a lot of ways. And then with the mood stuff, I'm not really sure.

I think it probably relates to inflammation because that can be systemic. And I know that depression is, well, as a whole, is largely inflammatory based, not some like, quote unquote, serotonin deficiency as, you know, medicine has kind of indoctrinated us to believe. But I was telling Kennedy, you're such a contrarian. I know. I like it. Shake things up. And so I see depression a lot and I think it's probably related to inflammation and potentially energy as well.

The deficit is related to what I said before about mitochondria stuff. It's hard to know. But I generally will say, I'll tell you clinical parole here, L. carnitine is something that I use a lot. And that seems to be helpful with depression. What is it again? L. carnitine. It's just a supplement you can take. But bear in mind that it's still likely a band-aid because you need to heal everything else.

Right. But it can be useful. It's like an and, like something therapy. Mm-hmm. And. Mm-hmm. Yeah. Okay.

Well, this is all very bleak. Is it curable? Okay, so we should... And then we'll get to questions where we can talk about specifics, but like, is this something that we have to live with forever? Yeah. Well, the short answer is no. It is if lifestyle, I got you in here, lifestyle can get you out, plain and simple. I don't care where your doctor says, like, you need to, you know, understand the truth of it.

And a lot of times we think that we're doomed. This is our fate and destiny because that's what the doctor said. And we just look at him as the, you know, he or she as the... leader and the authority and we just trust that. But we know that, and I've done this so many times with women that you can completely reversing in remission and that's really what it is. So no, we're not curing anything. That's a bad term to use because it implies that you're never going to get it back again.

Yes, you can get it back if you can manage it. Right. It's all about managing it because we, and it's really, honestly, I think it's very easy to manage. If you understand your body and you really honor that and listen to you to your and you know what got you here and you know what can get you out of it and you maintain that. And so it's really reversing PCOS, I would say. That's the correct term.

I want to rewind a little bit. You said if lifestyle got you in, lifestyle can get you out. And maybe you said this before and I just missed it. But are there any cases where lifestyle doesn't get you there and it just happens? It's just how your body's made. I can only speak from my experience. I've never seen anything that suggests that now. Okay.

And just out of curiosity, I don't know if you have an exact number, but I mean, how many people do you think are misdiagnosed with this? You know what? I'd be lying if I said I knew and actually looked into that. I have no idea. It's hard to know that because we speculate that with other conditions like, you know, even Lyme disease. I can tell you Lyme if you want, but like PCOS, I actually don't know. I think that because we don't spend a lot of time looking into the. fitness population and what I said before about kind of how the doctors are looking for,

you know, ovarian cysts and other biomarkers that need to be elevated or high, luteinized hormone, which doesn't have to be high, right? I think honestly a lot of women are getting misdiagnosed or undiagnosed rather. So hard to say, but I think what's more important is you being aware that, you know, if you have these symptoms and you're listening to this and it makes sense to you, that you know, really consider it despite what your doctor says. You know, if he says he or she says you don't have it, what is your body saying to you, right? You got to honor that because you might just be, you know, hurting yourself down the road and not knowing it.

Yeah, I mean, I said it before and I'll say it again. I was like kind of astonished by how many people rode in in the last 24 hours with questions. and the people that follow me are mostly like healthy, young, young-ish, vibrant women. And I was like, wow, all these people have or have been diagnosed with PCOS. It's just like kind of shocking. So let's get to audience questions because there were so many. Sure. I tried to kind of compile them in an organized manner, but we might jump all over the place.

So why don't we start with the most common one, which is, is not? there a diet or a specific way of eating to best manage symptoms or like you said to reverse it. Yeah. So the first thing I'll say is diet is important, but that alone probably, for my experience, will not get you, you know, the full results you want in intermission. So a lot of women will do keto and just think that, okay, well, low carbs, low insulin, you know, that sort of logic, I guess. And you're not wrong for thinking that. Keto's the rage these days and all that stuff. And so it can be helpful.

And we know in studies, there's like one study, I think, that shows that keto is actually really good for reversing PCOS and obese people. I don't know. Actually, it's not helpful at all from what I found in lean type because it's more stressful to the body to create ketones. And that's a very, you know, energy draining process. And so that can actually be kind of counterproductive. So anyway, the point is that the food type, quality probably matters more to me.

You know, you want to control your carbon intake. You don't want to be eating like 400 grams of carbs and pounding, you know, cheesecake every day. But like that's, you know, an obvious thing, I think. But aside from that, dairy. and animal products probably need to go. That's the first thing I look for. Like meat? Red meat.

Okay. You have some leo with poultry and fish. What about fish? Specifically salmon. Yeah. Gee, I wonder why you asked that. So, yeah, seafood, you've, yeah, you're okay with that for the most part. But it's definitely the red meat that has the more concerning things.

because of the hormones in it, that can just fuel the fire for you. So I would say cutting out gluten and dairy, maybe gluten, actually. Not always. It's hit or miss. Depends on the person. But dairy and meat are the first two for me. And I kind of go from there. I don't really do much else after that because I don't only have to.

But that's kind of how I've seen it. What about soy products? Yeah, right? That's a good question. So I hear a lot of people kind of go back and forth. Some saying it's, you know, worse for estrogen. It's, you know, it's an endocrine disruptor, all this stuff. From what I found in the research, actually, by the way, it's a mild sort of endocrine disruptor.

It's really, unless you're eating, you're pounding like, you know, two pounds of, you know, tempe a day, then I didn't mean to make that rhyme, by the way. Then that might be a concern. But actually, I tell my clients to consume soy because we know that it actually helps with reducing lutenized hormone. So and androgen is actually a little bit. So that's why I like to use it. And I, you know, I tell them to integrate a little bit of it if they're willing. But, you know, again, it's not going to magically fix your problems. You have to do other things.

But that's probably kind of where I go with diet. That makes sense. Speaking of endocrine disruptors, what about like beauty products, home products? Is that a major factor? Yeah. I think it can be. And I will definitely recommend to women to check and access their personal care products and see if they're loaded with parabins and phallates and dioxins and other things like that.

Because that could, you know, at a low level, just contribute to the problem. So I'm like, I like to try to cover all the bases, you know, but you don't need to like completely revamp your entire sort of set up at home in your bathroom. I'm more concerned about like stress, honestly, psychological stress and emotional stress and physical stress more than that stuff. But that's kind of how I hear in my see it in my head, like it's hierarchy of stuff. But yeah, I mean, it's something to consider, but it wouldn't be the top priority for me. Just that's my bias, I think. So something that I was kind of surprised by was that you are a proponent of intermittent fasting for PCOS, right? I am.

Yes. Sounds like there's a butt. coming well the thing yeah the one the one the one sort of uh potential issue is that if you're hypoglycemic which you may most or not um that can definitely be a bad idea right but generally speaking though for PCOS yes i like using your men fasting again if women are willing to do that because we know that when you don't you know eat for extended periods of time you you you reduce insulin, right, glucose levels go down. And guess what?

That's what we want, right? So you develop greater insulin sensitivity, which is why resistance training is more helpful than cardio, for example. You know, you're improving that sensitivity so that when you eat foods that are creating a lot of insulin, you can get it in your muscle cells and start to burn it instead of it floating around. So I like intermittent fasting for a number of reasons, but like, yeah, it's definitely for the insulin sort of,

stuff and it will help with basically inflammation, I would say, at a really broad way of explaining it. But isn't there always kind of a risk that it can be another stress around your body and it can react that way? Yeah, and that's, it's tricky, right? So I'm not going to say that everyone needs to do it. Really, again, it comes down to like assessing your tolerance to it and whether or not you feel like it's appropriate for you and how you feel with it. initially, yes, when you first do it, it's not really going to be fun.

You're going to have to bite the bowl and deal with the hunger pains and stuff. But after that, I was doing for three years at one point. So, like, it's pretty manageable, but, you know, a 16-hour fast is pretty, like, standard as a protocol that a lot of people follow. And that can, you know, honestly, you don't even need to follow that. It's like, okay, if you eat, your feeding window is, say, nine hours out of the day. okay then um then why don't and say for example you wake up and you eat at 8 a.m. So why don't you push it back to like say 10 a.m. Like even that a little shift can be quite beneficial right.

So you don't need to wait till like three o'clock in the afternoon if that makes sense. Right. Yeah. Um, I had a few specific questions from people about kind of diet and weight and all that. So what is, how can someone manage weight gain with PCOS? Yeah, I know. It's a million dollar question, right? Everyone wants to know that.

Yeah. I think what's really, I'll just make a comment on this. A lot of times I hear women say that their physician says that you will lose weight and you'll quote unquote fix your PCOS. Do you know how assigne that sounds? Like how about the other way around? around, right? Right.

Reverse and heal your PCOS and you can lose weight. And that's really what we need to do. So with that being said, if you've understood what we've set up to this point and you're listening, you can see that, okay, we have potentially high antigen issues depending on my symptoms if I've hair loss or hair growth, skin tags. Okay, that's a sign of high antigens. It's really common. You can pretty much tell somebody has that without doing a lab test for testosterone or

DHEA or DHAAS, for example. And then considering that with the typical insulin resistance issues, and it's difficult to know, and I'm just going to say this because you can run a fasting insulin test. You can do all these, you know, HBA1C maybe, fasting glucose. It's difficult because different cells in the body can be insulin resistant compared to others. And so you can't measure that. We're looking at a broad spectrum, like, sort of idea of what your insulin sensitivity might be like. And so from the research, I think it's, like, pretty much clear that somewhere between

60, maybe 50 to 80 percent of women, PCOs have insulin resistance. So you should just assume, and I like to assume women have it. And so we need to address that. And so you can't just cut calories and cut your carbs and expect those weight. It'll help. But over and over, I hear women do that, and they don't get results. I don't lose any weight at all. Maybe lose a pound a month and something ridiculous like that.

So it's really, really frustrating, and I hear you. I really do. But you have to get the hormones imbalance. You know, thermodynamics is really important. We know that, you know, calories in versus calories out. But guess what? Hormones matter just as much, if not more in this context. Yeah, somebody asked if calories in and calories out are kind of irrelevant at this point.

You know, I mean, it matters. but don't expect to lose weight, or don't be surprised, rather, that you can lose weight if you're literally eating 1,100 calories. And it's because your hormones are out of balance. I mean, we could even get into, like, thyroid. Maybe there's a lot of thyroid issues with this, too, because I see a lot of women with PCOS also have hypothyroidism for Hashimoto's, which is autoimmunity. And so that just complicates things even further.

And so we really ought to get the hormones in check. Progestrone, testosterone, estrogen, estrogen, thyroid potentially. And when you do that, that really makes the biggest difference in weight loss. What are your thoughts on Metformin? Another Band-Aid? Not can it help? Sure.

It is a Band-Aid, but guess what? Burberine is just as, no, it's crazy, but like it's a natural, you know, sort of remedy, but it is as effective as Burbrine and it doesn't have the same, it doesn't have any side effects. It's phenomenal. It is one of nature's best sort of therapies for this stuff. with getting insulin down and improving sensitivity. So I really like using that.

Generally, like 1,000 milligrams. No, actually, they'll use 500 milligrams like three times a day. Yeah, it's great. Again, not a panacea, you know, but it can definitely help a lot. What about VITACs? Again, VITACs is a superstar sort of supplement as well because it, you know, it works on the hypothalamus and changing how, the hormones, the hormonal output, rather.

So we can, we find that it's actually hit or miss. It's hard to know. Everyone's a different response differently. So a lot of women have estrogen issues that are higher relative to progesterone. And so we need to get progesterone up. And this is actually quite useful for women who have amenorrhea or no period, right? Or have maybe ludial phased defect. So we know that VITAC could help modulate the hypothalamus in a way where it reduces

lutinized a hormone and thereby increases progesterone through a downstream effect. So it does, I'll tell you what, it does take time. So don't expect to sort of work and see a magical shift happen in a month. It can probably take at least three months before the kick-in. But I like using that for sure. And that's what I'll use around maybe a thousand milligrams a day. So it is really good for sure. Okay, so what about exercise and the best kind of exercise to manage symptoms?

and the best kind of exercise, I guess, overall for balancing hormones. So, again, we got to talk about the type. If you're obese, you have a lot of weight to lose. Resistance training, weightlifting to some degree, and some cardio probably would be really good. And I recommend that. Most of my clients are lean type. In fact, like 90% of them are. So I work on usually resistance training, but not too much because,

guess what? That's probably what got them into this mess, right? He's lifting too much, spending two hours in the gym. And also doing a lot of cardio, which is actually just worsened the whole problem because you're increasing cortisol and that increases glucose and that increases insulin resistance, right? So I don't program cardio at all. Actually, I really don't recommend it because, again, it's a stress to the body. It's, you know, cortisol is a great stress reducer as much as they great stress inducer, right? So it's my recommendation is to do like short maybe half hour resistance training workouts Maybe three four times a week two to four you know somewhere that range again depends on people's

Symptoms and how they're responding how they feel like we have to go off that So I can't really nail it down to one thing but that's my broad recommendation Okay, well that's good to know so I'll stop doing cardio today What was the eye roll for? Listen, I wasn't sure about a lot of things with that, but for you. Okay, let's see. Where are we? Okay, so you said in the hierarchy, stress would be the most important factor.

Did I hear that, right? Yeah, but that's honestly my bias because I've just spoken to so many women, and I know that they're physically stressed because they're the lean type. competition they were dieting for like two year three years whatever two three years um and yeah there's emotional stress too maybe they had trauma in the past i mean it's just stuff patterns i've seen and so we need to get that under control because it'll just literally derail your hormones even further and you can't diet and slump in your way out of pcs if you have that going on so i'm i'm i'm very very focused on emotional stress physical stress and yeah everything else

underneath that which would include gut health and hormones and detoxification liver health right and ultimately managing inflammation which will happen when you do all the other things you with me I'm trying yeah so I'm just trying to figure out because there are so many different things that are affected like how do you decide where to start I mean I feel like you can't like even with your gut you can't it's difficult to to treat gut issues if you if your stress is out of control right and and if you have gut issues and hormone issues you can't treat the hormones until the gut is under control so how do you it just seems like such a maze like how do you decide where to start what is the best place to start yeah and it can

get really confusing because a lot of women will feel overwhelmed to think that they need to all these 12 things that once because their coach or practitioner whoever they hired is telling them to do all these things but then if you're stressed out about doing all those things how is that the cause. My whole thing is keeping it simple, right, and integrating or introducing new small things like every week or two depending on how they're dealing with it and how they're doing. So honestly, it's making those diet changes that we spoke about before. It's seeing what stressors are going on in their life and how we can heal that, manage it.

And that's just very, very case dependent. I don't, it depends on what they're really going through. So once we do that, then we give it some time. and see what, you know, we use subjective scales to see, like, what their fatigue is like and what their gut issues are like and other symptoms that may be improving or not. And then we go from there, I make outcome-based decisions. And if they're getting better, cool, we maintain that and not going to add more to it. There's no point.

I see no point. And then if they're not getting better, if there's still lingering issues, okay, they don't start to navigate and see if there's any issues with, you know, liver and complications. and labs will sometimes be helpful to see, and they'll show that, and sometimes I get that. But then I'll start to look into infections and see if there are, especially if they have like IBS, bloating, constipation gas, like that type of stuff.

And I kind of, you know, just go through that, and then we'll see. If we really need to go further than that, then we will. But a lot of times, it's sort of like a domino effect. You do these couple of things and you give it some time, and you're patient, and you trust the process, then you, you, you just, you just a process, then you, you, you, you, you let unfold and the body gets, you know, really back to its normal state again. It's really quite surprising to see.

But again, it's hard because we want to do all these things. But you don't need to, I mean, I can't say for sure, but most people do need to take 15 supplements to or in cut out all these calories to get results. You know, it can be counterproductive and maybe not needed at all. What if somebody is on birth control and then they decide to make all these life? lifestyle changes is the goal to get off birth control. Yeah, and that'll actually happen because, I mean, I can't tell anybody to get off birth control. It's on my job.

And so what we want to do is do all these root cause things while they're on birth control if they need to be on it. And yeah, we start to have that conversation. And I can be like, hey, so you're starting to improve in these areas. So why don't you have that conversation with your OB and see about jumping off it or weaning off of it? or if you just want to stop on your own, I mean, that's your call, right? Balls in your court.

You make your own informed decision. But, yeah, I mean, that would be ideally the outcome we want because, you know, we know that if you do everything right, you don't need birth control anymore. Is there a thing called post-birth control PCOS? Somebody asked about that. Yeah. Yeah, that's actually quite common. And what I can say, though, is that it can mimic PCOS doesn't mean you really always have it.

But yeah, you can see a lot of acne and weight gain and gut issues maybe. And that is something you can to think about. But you'll know if you have PCOS, if you have these other sort of issues with hair, you know, hair growth, hair loss, skin tags, maybe, depression. And then you can confirm it probably with, you know, some lab markers. And that's what I would say to really, you know, cement that. to see if you have it. But not everybody has PCOS coming out of, coming off of birth control. But you can because what happens a lot of times is there's sort of like a boomerang effect

where you suppress all your hormones, testosterone's really low, and then all of a sudden your body's trying to regulate and get it back up again. Then we have this sort of like overcompensation and you create a lot of testosterone. And I guess what happens to acne, right? That's what we see a lot. What about for people who have been diagnosed with PCOS or they are experiencing these symptoms and they want to conceive. Yeah.

So you really want to, I could say this a million times, but you really want to make sure you get your health and check and get this under control because, yeah, it's not a surprise that I hear this literally every month it seems like, you know, somebody tries to get pregnant and it doesn't happen though they get a miscarriage and they're really frustrated and they do chlomaphene and, you know, IVF and they're trying to do all these sort of loopholes to get pregnant, but you can do that. Honestly, if you get pregnant, great. But understand that, you still have PCOS.

And if you're not getting pregnant, it's because you have PCOS. That's not been managed, right? So you can't heal. I mean, you can't get pregnant in an unhealthy environment. It's that simple. So I hate to be blunt like this, but you're really doing a disservice

for a lot of people in your life. And to yourself, if you're trying to be like, I need to get pregnant because I want to and I'm anxious and I just like, it's been my goal my whole life. Like, great, you will do that and you'll get there, but you have a greater chance if you get your body where it needs to be to do that optimally, right? Okay, we kind of covered this before, but the other most common question that I had was about PCOS and acne and how to manage acne. So you mentioned before animal products. Yeah. So it depends on what else is going on.

If you have disaster and issues, like, yeah, we have to control that and work that out. But there are definitely issues with the animal and animal products and the food. So that can, if you just do that alone, that can make, you know, it can really take you really far. But beyond that, actually, if, um, I'm trying to think for a minute. If you, I did a whole whiteboard Wednesday on this, actually. I just don't remember exactly what I covered in that. But yeah, so you want to heal the gut for sure because, again, these infections like Cibbo or Candida can definitely exacerbate acne, maybe.

But aside from diet as well, you can, you also want to look at your stress because, I mean, I think women know that if they're stressed out, they can definitely develop acne for a period of. at time. So that's definitely an important area to focus on. Aside from that, though, we can do things at the skin microbiome level. So we know, again, that some bacteria and fungus can maybe contribute to this sort of acne issue. And again, that may not be related to PCOS. That could be related to women who just have acne. They don't know why. But a lot of times it's related to the gut, right? So the skin is a reflection. of your gut health a lot of times. So I really think of it that way, but again, you can do things for your skin.

And there are some probiotics that you can use topically that I know are helpful. Mother Dirt is a product I've used actually with clients. And that's basically like live bacteria for your skin. That can be helpful, right? T.T.R.O.O. That sort of stuff. Which some of you may have used already before. But I really think about detoxification, seeing what sort of environmental toxins may be, women might be exposed to because that could really be feeling the whole problem, right?

And that's hard to know, but you have to see like your lifestyle and what you've been exposed to in your environment, whether it's you work in a very toxic place, maybe at the nuclear power plan or I don't know, who does what, in a coal mine or you're in a very like in the, you're in the garage, right, working on cars. I don't know, just throwing out random things. But you want to think about these things and like where you've been. Yeah. Because maybe you've harbored a lot of toxins and it's hard to know unless you really decide to test for that stuff, which I don't really like to do.

But if you improve your liver health and your gut and you do like infrared sauna, for example, in sweat therapy, contrast hydrotherapy that can take you. And what that means is you're going back and forth between hot and cold, cold shower. I'm sorry, hot shower, cold bath, jumping back and forth. Dry skin brushing, those sort of things can help with mobilizing toxins and things out of body, which is helpful because we know that a lot of these toxins are stored in your fat cells. So if we get that out, maybe that can increase your chances of reversing or really, you know, getting rid of your acne.

Lymphatic drainage? Yeah, exactly. Yeah. So what supplements have you found are helpful with managing symptoms and reversing? Okay. So we talked about berberina vitex. Aside from that, I will sometimes use. use, you know, an acetylcystine. I will use curcumin because of its anti-inflammatory benefits.

Sometimes inocidol, myoanacidol, which is really helpful for oocyte quality match and quality. So if you have infertility issues, that can be really helpful. Diodyl methane, DIM, which is a popular one, I think, and calcium degluterate and broccoli seed extract. And those are things that are going to help with liver detoxification. So I'm really a proponent for that because I can could maybe help you in a lot of ways. And again, getting and mobilizing these toxins out of the body, which is a good thing, right? Aside from that, though, you can,

if you have high androgens and testosterone, what I like to use a lot is Chinese peony. That's a really good one. And Chinese white peony, that is. And spearmint, those are two that I like a lot. So, yeah, just some things that can, be helpful, but bear in mind that you got to probably do more than just take these things, you know, but from a natural standpoint, they do have a lot of utility.

So I know this is very complicated, but since we're coming to a close, if somebody thinks they might have PCOS or they've just been diagnosed with it, I know it can be very overwhelming. So do you have any recommendation? What would you say? Where would you say? say to start or what would you recommend? Yeah. I would definitely go to an OB and see what their input is and confirm it from that point and see if they have any sort of evidence from lab testing to see if you have it. And again, they're going to check, you know, hopefully they do like a, you know,

ultrasound of your ovaries and check that out. Again, maybe not necessary. And you don't need to have PCS like we've talked up before. or you don't need to have cysts, rather, to have PCOS I meant. And aside from that, though, if we check DHA, DHEA, DHEA, DHEAS levels,

17 hydroxy progesterone, freestosterone, and then lutenizing hormone and FSAH, those can, those are a lot of the common biomarkers that you want to get tested. And that will point you in the direction as to whether or not you're on the spectrum of PCOS.

But you look at that coupled with their symptoms, and that's what you have to do. If your doctor saying, no, you don't have anything, yet you have hair loss, hair growth, depression, waking and acne and skin tags and like infertility issues and everything we just talked about, what do you think the truth is? Your doctor's word or your intuition, right? I mean, that's kind of how I look at it, but you really got to listen to your body. And if you think you have it, you probably do. We know our body is best. Right.

Okay. Well, we covered a lot of ground, I feel like. a short amount of time. Thank you so much for coming. And your Instagram is a wealth of knowledge, as is your website and people can work with you. So where can everybody find you? Yeah, sure. So my website is the autoimmune revolution. And just so it's clear, we work with women who have endometriosis and PCOS and reproductive dysfunction. So aside from autoimmune disease. But outside of that, on Instagram, it's at Justin

Janoska, J-U-S-T-I-N-J-A-N-O-S-K-A. And actually I do a lot of these, what I call Whiteboard Wednesdays, and it's all related to this sort of stuff. I have plenty, I think, on my IGTV and even my YouTube. But it's all on my page, and you can find the trainings. I have done a lot of free trainings on PCOS and talking about these different pathways

and how it all unfold like this in a more in a more detailed way if you're interested in that. And even acne. So that's where you can find that information if that piques your interest. And that will all be linked in the show description as well. Cool. And that's, you're my first guest that I've had on twice. So if you guys didn't listen to his other episode, go back.

I think it was like episode three or four. Yeah. Because you were one of my first ones when it was just me and my laptop and a mic. Look at that. So maybe we'll have you on next time you're here. Thank you so much. You bet. Anytime.

Bye. As always, thank you. for tuning in. I appreciate you guys sharing, sharing on social media, sharing with people in your lives. Please rate, review, subscribe if you haven't already, and do all of the things. I'll talk to you next week.