Podcast Episode #364: Healing PCOS with Amy Medling

Topics

1. Introducing our guest, Amy Medling from the PCOS Diva [1:55]
2. Creating the PCOS Diva [5:33]
3. Amy's book, Healing PCOS [11:03]
4. Lean PCOS [16:00]
5. PCOS and skin, seed cycling, and natural progesterone cream [25:18]
6. Balancing PCOS without birth control pills [37:19]
7. PCOS and keto [41:11]

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You’re listening to the Balanced Bites podcast episode 364.

Liz Wolfe: Welcome to the Balanced Bites podcast. I’m Liz; a nutritional therapy practitioner, and author of the Wall Street Journal bestseller Eat the Yolks; The Purely Primal Skincare Guide; and the online program Baby Making and Beyond. I live on a lake in the mystical land of the Midwest, outside of Kansas City.

I’m the co-creator of the Balanced Bites Master Class, with my podcast partner in crime, Diane. And together we’ve been bringing you this award-winning podcast for almost 7 years. We’re here to share our take on modern healthy living, answer your questions, and chat with leading health and wellness experts. Enjoy this week’s episode, and submit your questions at http://blog.balancedbites.com or watch the Balanced Bites podcast Instagram account or Facebook group for our weekly calls for questions. You can ask us anything in the comments.

Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment. Before we get started, let’s hear from one of our sponsors.

Diane Sanfilippo: Today’s podcast is sponsored by Kettle and Fire bone broth and soups. We’ve talked about bone broth before and the many benefits, but to name a few, it’s been shown to reduce inflammation, improve digestion, and improve the quality of your skin. While I do like to make my own bone broth, I especially like making it in an Instant Pot; there’s not always time for that. Kettle and Fire is the next best thing. They use organic chicken bones, and a slow simmer time to extract as much protein as possible. Not to mention that they use chicken feet; yay! Which increases the collagen and gelatin. And you can store it directly on your shelf for up to two years. Which is pretty cool, considering they’re a fresh, never frozen broth with no added preservatives or additives. Check them out at www.KettleandFire.com/BalancedBites and use coupon code BalancedBites for 10% off, plus free shipping when you get six cartons or more. That’s one per customer. It’s 10% off, and free shipping on six cartons or more.

1. Introducing our guest, Amy Medling from the PCOS Diva [1:55]

Liz Wolfe: My guest today is Amy Medling, and I’m really excited to have her on the show to chat about PCOS. We get a ton of questions on this topic all the time, so we’re really thrilled to have Amy here today to talk about this.

And I’ll give you a quick background on Amy. Amy Medling is a certified health coach who specializes in working with women with PCOS; polycystic ovarian syndrome. She’s the founder of PCOS Diva, and has developed a proven protocol of diet and lifestyle programs that offer women tools to help gain control of their PCOS, and regain their fertility, femininity, health, and happiness. She lives in Nashua, New Hampshire, with her husband and three children. And you can find her at PCOSDiva.com.

So, welcome to the show, Amy!

Amy Medling: Oh, thank you! I’m so happy to be here.

Liz Wolfe: We’re excited that you're here. Before we get into these really meaty questions that we had submitted through Instagram and through our social media for you, let’s do something fun. Let’s do something new I’m digging. Is there anything new you're digging these days?

Amy Medling: Yeah! I went through a little life crisis. My 18-year-old, right after prom, was diagnosed with a tumor on his pancreas.

Liz Wolfe: Oh my gosh!

Amy Medling: Yeah. Two and a half; three weeks ago now, he had to have major, major surgery at Mass General Hospital. And I was with him for a week at the hospital. And three things that really got me; well, four things that really got me through. Because I wasn’t able to get to the cafeteria. And the cafeteria food, honestly, at the hospital was the worst. But there was a juicery nearby. So between smoothies, green juice, and Go Macro bars. I know they’re not paleo; but they really worked for me as kind of a mini meal replacement.

And then this really fantastic supplement that I discovered called Tranquility by Natura Health Products. Because I was kind of stuck in that fight or flight mode. And this sort of helped me kind of get relaxed a little bit into rest and digest. It helped to calm the nervous system. It promotes relaxation, and really worked for me like a charm. And I’m still taking it, and still really loving it.

And then finally, the other thing that I really enjoyed during this time that was very stressful was Rob Bell’s Robcast. It was just really some great spiritual food for me during this difficult time. So happy to say my son is recovering really well. And he’s expected to have a full recovery.

Liz Wolfe: Well that’s wonderful to hear. And we will all be thinking about you guys and hoping that everything continues to go well.

Amy Medling: Thank you.

Liz Wolfe: What is the name of that supplement one more time?

Amy Medling: It’s called Tranquility, and it’s distributed by Natura Health Products. It was formulated by Donald Yance. He has a whole line of really great natural supplements. And I’m actually using some of them for my son. He has a digest mend that’s really good. And a whole food based powdered multivitamin and mineral formula that I’m putting in his smoothies. But really I’m digging this Tranquility formula for kind of stress. It can bring me back into that sort of rest and digest mode.

Liz Wolfe: Awesome.

Amy Medling: It calms the nervous system. Yeah.

2. Creating the PCOS Diva [5:33]

Liz Wolfe: Ok. So before we dive into our listener questions today, I’d love to hear just a little bit more about your story, and how you came to create PCOS Diva.

Amy Medling: Sure. I often hear from women with PCOS, who were like me. Frustrated. Had lost all hope, because the only advice their doctors offer is to lose weight; take a pill, whether that’s the birth control pill or the diabetic drug metformin. And basically just kind of suck it up and live with their symptoms.

As early as age 14, I started wrestling with some of the common PCOS symptoms. And it felt like it was going to be the fate of my life. Because many of the women in my family also had hormonal issues. My mother, my grandmother. Well, actually both grandmothers. And one day, when I was 17 or 18 in college, I was at the clinic, because I hadn’t gotten my period. I was sort of trying to figure out what was going on with my body. The doctor basically told me that they were going to have to jump through hoops to get me pregnant one day. She renewed my prescription for the pill, and sent me on my way.

I just felt like I wasn’t getting the answers that I needed through mainstream medical community. And this continued through my 20s, when in my late 20s I was trying to get pregnant. And with the help of fertility drugs, and a reproductive endocrinologist, I was able to get pregnant. And it was after the birth of my second son; and I hear from a lot of women with PCOS that they feel worse than ever. It’s like; you just don’t bounce back after pregnancy.

At the time, I had these two little guys. And I have this wonderful husband. But I was exhausted all the time. My PCOS symptoms were at the worst. I wasn’t able to be the wife or mother that I wanted to be. And after years of following mainstream advice from countless doctors, I realized that nothing was helping. The drugs that they offered me made me feel sicker and more miserable. And at age, I think it was 31 or 32 at the time, I felt way too young to feel so old. And sick and tired of feeling sick and tired. And I just couldn’t go on living this way.

That’s when I realized that I could no longer play the victim card. And continue to think and act like a victim. No one was going to help me unless I really helped myself, and changed the way that I was living my life. I was, at the time, kind of on the standard American diet. I was taking care of everybody else but me. And I really began changing my diet and lifestyle. I had gone to see a naturopath at the time. I started trying some nutritional supplements. And after really tons of hours of trial and error, I developed a protocol that helped me to thrive. I changed my diet and lifestyle, but most importantly, I changed my mindset. I really started taking extreme care of myself.

My husband started noticing this shift. And one night when we were out to dinner, and I was being very particular about what I wanted to eat, and how I was ordering my meal at the restaurant. The waitress walked away from the table, and my husband said; gosh, when have you become such a diva?

And at first I was offended, until I realized that in order to be my best self, and give my best to my family, I did have to be a diva. And after that, my doctor started seeing the improvements in my lab results. I was feeling better. My lab results were improving. My hormones were shifting to become more balanced.

She started sending women to me that were also not able to tolerate the traditional protocol; the birth control pill and metformin. Metformin can make women very sick with GI distress.

So when I saw that my protocol was helping other women, I realized that there were thousands of women out there like me, struggling against their symptoms with medicine and advice that didn’t help. And I could break what I had learned into small, manageable steps to help women take control of their symptoms. And that’s what I ended up doing. I started PCOS Diva back in 2009. And I’ve had thousands, I think at this point 6000 women go through my online programs. And then really put all of my best advice and protocols and recipes and info into my book, Healing PCOS, so that it could really reach more women that need help. Because, between 10 and 20% of the female population has PCOS.

3. Amy’s book, Healing PCOS [11:03]

Liz Wolfe: Wow. Ok. So, as far as your book, Healing PCOS. And the program that you created to help with those symptoms. This is; how does your book, and the content in your book, fit into your overall approach. What you have on your website, and what you provide for people on the internet.

Amy Medling: So the book is broken down into really three main sections. It all begins with thinking like a diva. Shifting that mindset from that victim mentality to one where you’re really in control. And you're partnering with your body. It’s no much about waging a war against PCOS, or fighting PCOS. It’s really about learning to read your body’s cues. Because your body is sending you cues to bring it back into balance. So it’s partnering with your body.

And then, once you can really partner and learn to love your body as it is right now, in this moment. Not when you lose 20 pounds. Or the acne goes away. Or the facial hair subsides. It’s like loving it and taking care of it right now. That’s when you can really start making sustainable lifestyle change to help manage your PCOS.

We move into eating like a diva, and moving like a diva. I sort of bring it all together in a 21-day protocol and program with a meal plan and recipes. But it really all begins with shifting your mindset.

Liz Wolfe: So I feel like sometimes you have to tell people; don’t skip this part. People hear “mindset”. And they’re like; oh, ok. But you're like; no, seriously. Don’t skip this part. Can you just emphasize a little bit more how important that is?

Amy Medling: Oh my gosh. Even in the book, I say, “I know you're going to be tempted to go right to the 21-day program. And even in the 21-day program, I said, “Don’t start this until you’ve read the Think like a Diva chapter.” Because you're absolutely right. We kind of want to bypass that. Because I think sometimes that’s the hardest work.

I think for many women; we have this adversarial relationship with our bodies. I know that I did. And when I was really suffering with PCOS, I was in this place. I call it diet, deprivation, and denial. I was always depriving myself of things that brought me pleasure. And it wasn’t until I started allowing pleasurable food and experiences. Loving myself more. That I really, my body started; I don’t know if cooperating is the right word. Just relaxing, and easing into healing.

Liz Wolfe: Mm-hmm. I don’t have PCOS, but I would like to corroborate your feelings about mindset with my recent journey, I guess. I really did not find myself mentally capable of sustainably taking care of my body. For me, that’s been going to the gym three times a week. Working with a trainer. Making nourishing food choices a good proportion of the time. But for the most part, incorporating physical activity. Which has really been lacking in my life for several years, since my daughter was born, really. And until I did this exact work that you're talking about; for some reason, it was just a really rocky road to sustainably taking care of myself. So I couldn’t agree with you more.

Doing that work; all of a sudden, something shifts and your commitment, and your ability to follow through on taking care of yourself just becomes so much stronger.

Amy Medling: Yeah. And I think a key to that is figuring out; I call it what your big why is. And I talk about that in the book. I think when we become mothers, too, we have to take care of ourselves in order to be the best for our children. And to be good role models.

I have a daughter, as well. At age 37, I had my third child, after doctors told me I would never get pregnant without fertility treatments. And now I have this little girl. She’s 9, and she’s looking to me as her role model about how to treat her body. So that’s such a motivating factor for me to make sure that I’m taking extra good care. Because I know she’s watching.

4. Lean PCOS [16:00]

Liz Wolfe: Yes. Love that. Are you ready to jump into a few listener questions?

Amy Medling: Yeah, absolutely.

Liz Wolfe: Perfect. So this is a question, kind of a general question, that we actually get from people from time to time. “For many years, doctors didn’t think I had PCOS because I’m very thin and athletic, and I look healthy. Can you speak to women who don’t look the part, but who also suffer?”

Amy Medling: Yeah. And that’s a great question. I think that was one of the issues for me. It took me until I was age 31 to get a PCOS diagnosis. And I had mentioned that at age 14 I started wrestling with some symptoms. But I’m tall, and thin; a thin build. When I was having the most difficult time with my symptoms, I was probably about 70 pounds heavier. But still, at 6 feet tall, you can have 70 pounds on you and you're not obese.

Liz Wolfe: Yeah.

Amy Medling: So I had a very hard time getting a diagnosis. So I really empathize with women out there who are thin. And doctor’s just say; you don’t fit the PCOS phenotype. And doctors, when they think about women with PCOS, they think about women who have higher than average BMIs. They carry their weight around the middle. You're losing hair, and growing it where you don’t want it. There’s sort of this typical look of PCOS.

But, what I think a lot of people don’t realize is that 20 to 30% of women with PCOS are of average weight, or lean. And 5% of all lean women have PCOS. So women with lean PCOS do often go undiagnosed. And when you think of the fact that up to 50% of all women with PCOS are undiagnosed; the women that are thin are definitely on the higher end of that.

The thing about lean PCOS is that there still is very much an insulin resistance component. Most women with lean PCOS have insulin resistant markers. But it’s harder to measure them, because they don’t always show up by testing your A1c. Or just fasting glucose. And that’s because your resting markers are normal. It’s not until after you eat that lean women tend to have big drops in their blood sugar after eating. And that’s actually how I started healing myself. I got a glucometer, and I started really figuring out what food was doing to my body.

If I had a high carbohydrate meal; say I had some pizza for lunch, about an hour and a half later I would have a huge dip in my blood sugar which would send me to the couch for a nap. But if I went into the doctor’s office, he wouldn’t see that. Because if he’s just testing my A1c, it was normal.

So, I think it’s really helpful if there’s a lean woman listening, to get a glucometer and start monitoring your blood sugar before and after you eat. And take those numbers in with you to the doctor’s office. But it’s very important that lean women with PCOS; even if you're not having weight issues, that you really need to be very mindful of the way that you're eating. You also have higher risk of inflammation. A big driving factor of PCOS is inflammation, and I write about that in my book.

So you really need to be on an anti-inflammatory diet that helps to keep your blood sugar regulated by pairing your carbohydrates with protein and fat. And to keep your blood sugar stable.

A couple of other sort of interesting things with lean women with PCOS that have come out in studies, that women that are lean may have poor circulation and have poor capillary function. So that’s something that I actually have. I have poor circulation in my extremities, and I can probably chalk that up to PCOS.

They also have a higher LH to FSH ratio than classic PCOS. And the other interesting thing is that when lean women with PCOS have a high pain threshold compared to women without PCOS. They seem to have higher beta endorphins, which is interesting.

And the other thing that I just wanted to make a note of, is that often times women with PCOS will have; and if you read, there’s an excellent book by Dr. Fiona McCullough called The Eight Steps to Reverse Your PCOS, and she talks about this. It’s a phenotype of PCOS called adrenal androgen excess PCOS. And I think a lot of lean women have this version. You have high levels of DHEAS, and you're kind of more susceptible to stress and elevated cortisol. So it’s really important for lean women with PCOS to manage your stress, keep your blood sugar stable. I think that when you don’t have the degrees of insulin resistance that the non-lean women with PCOS have, you tend to do better with not a lot of cardio. Just constant cardio exercise. More strength training. Like yoga, Pilates, barre. It’s just not as stressful on your adrenals.

And then the other thing that I would mention, too. Myo-inositol. I use a supplement called Ovasitol, which is a combination of myo-inositol and d-chiro-inositol supplement. And that supplement can help in lots of ways for lean women. It can help reduce your LH. It can help reduce inflammation markers and androgens. Which is the male hormone that kind of tends to be out of balance in PCOS. It’s elevated. And then can also help with insulin.

Liz Wolfe: Really interesting. I’ve actually done some research; or, my research team for Baby Making and Beyond, which is a program I’m working on, has done some research on inositol and neural tube defects. We have looked a little into how it works with insulin, and how that then kind of has a downstream effect on physiology in pregnancy. Which is really interesting. But I’m very, very interested in inositol right now, so that is super interesting to know.

Amy Medling: Yeah. And if you want more information, too. I’ve done a lot of research about it on my website. One thing that I will make a note of. A lot of women with PCOS; I think they go online, and they get on different chat boards. And people recommend vitex for PCOS. And for lean women with PCOS who already have higher levels of LH; vitex can raise LH. And for lean women with PCOS, it can worse PCOS.

Liz Wolfe: Ok.

Amy Medling: So if you're listening, and you're on vitex, and you're lean; you may want to get off of it and see how you fee.

Liz Wolfe: The Balanced Bites podcast is sponsored in part by the Nutritional Therapy Association. The NTA trains and certifies nutritional therapy practitioners and consultants (including me; Liz, I’m an NTP), emphasizing bio-individuality and the range of dietary strategies that support wellness. The NTA emphasizes local, whole, properly prepared nutrient dense foods as the key to restoring balance and enhancing the body’s ability to heal.

The NTA’s nutritional therapy practitioner program and fully online nutritional therapy consultant program empower graduates with the education and skills needed to launch successful, fulfilling careers in holistic nutrition. If you're interested in learning about holistic nutrition but don’t necessarily want to become a practitioner, check out their new Foundational Wellness course. To learn more about the NTA’s nutritional therapy programs, resources, and to enroll in their free course, Nutritional Therapy 101, visit http://www.NutritionalTherapy.com.

5. PCOS and skin, seed cycling, and natural progesterone cream [25:18]

Liz Wolfe: With that in mind, I will jump into the next question, if you're ready for it.

Amy Medling: Sure.

Liz Wolfe: OK, this one is about PCOS and skin. “I’ve been seeing an acupuncturist and an integrative doctor for almost a year now to resolve my PCOS. I’ve come very far, from having no periods whatsoever to two consecutive cycles. While this is great, I’m still struggling with acne around my mouth and jawline. It was much worse, but after removing peanut butter, it dramatically decreased. However, I still have new breakouts.”

Amy Medling: Yeah, so peanuts are kind of a high androgen food. As women with PCOS, if we’re working to try to lower our androgens, one thing that can really help this; like a natural thing to do, is to drink spearmint tea. That’s been shown to reduce hirsutism in women with PCOS. Because it’s lowering the DHT and androgens in your system.

But foods like peanuts, and any peanut byproducts. Peanut oil, peanut butter. Corn oil, wheat germ, shellfish. They all are sort of high androgen foods, so you want to reduce those. I don’t recall; did the reader say that she’s eliminated dairy?

Liz Wolfe: She says, let’s see. “However, I still have new breakouts; not cystic or on my jaw and mouth, right after my period. She says she eats paleo, sleeps well, drinks tons of water, exercises. Takes high quality supplements including evening primrose oil, vitex, vitamin C and D, calcium, methylated B vitamins, Ovasitol, selenium, fish oil, probiotic.”

Amy Medling: Ok. A lot of times, with acne, you have to really look at your gut. So, the probiotic maybe consider switching that up, or adding some fermented foods, like sauerkraut. I think a couple of forkfuls of sauerkraut in a medicinal way can really help rebuild your gut with good bacteria.

So if you are doing dairy, I would definitely ditch the dairy for hormones, for one reason. But also, cows lick iodized salt licks. And iodine is really aggravating to acne. So, that’s something to think about.

And then finally; women with PCOS often have non-alcoholic fatty liver disorder. And have kind of compromised livers. And you know that we need to cleanse our livers, and it really shows up in our skin, too. So, I know I do three to four liver cleanses a year. And that has helped my skin tremendously. So I would consider doing a good liver cleanse, at least twice a year.

And don’t underestimate the benefit of finding a good esthetician. Because they can really work wonders with PCOS acne. So that would kind of be my final tip.

Liz Wolfe: I like that final tip. And I have some good friends who are medical estheticians. I think you look for the; any esthetician is wonderful, can be wonderful. But medical estheticians sometimes have access, I think, to tools that perhaps estheticians maybe don’t have. I’m going to get murdered if I’m wrong about that.

Amy Medling: {laughs}

Liz Wolfe: But I’ve had some friends who have had some really good success with medical estheticians. And acne.

Amy Medling: Yeah, and there are things that you can use like blue light therapy. They’re so knowledgeable. And a good esthetician is also going to be looking at what you're eating, as well. What kind of supplements you're taking. And it sounds like this reader has a good diet. And looking at making sure she’s got a lot of vegetables that sort of helping to detox the estrogen too.

Liz Wolfe: Some extension of her question; she also asked about seed cycling and PCOS. Do you have any opinion on that?

Amy Medling: Yeah, so one of my good things, Magdalena Wszelaki, I don’t know if you’ve had her on your show.

Liz Wolfe: I don’t believe so.

Amy Medling: She wrote a new book called Cooking for Hormone Balance. And she’s sort of the guru on seed cycling. She actually wrote an article for my PCOS Diva site about seed cycling.

The thing about it; I don’t think you can seed cycle your way out of a sluggish liver. I really think, it sounds to me; I mean, just intuitively, that this woman that wrote in probably needs some liver support and to cleanse her liver. But I do think that it can be somewhat helpful. The whole concept of seed rotation is to support from day 1 to 14 the estrogen phase of your cycle with seeds like flax seeds and pumpkin seeds. And then from day 14 through the first day of your cycle; and for women with PCOS, our cycles are kind of wonky and tend to be a lot longer. But you want that progesterone boost, which would be like sesame seeds and sunflower seeds.

Liz Wolfe: Gotcha. Ok. So, finally, she asks; “Due to my PCOS, I have low progesterone. All other hormones show as normal on blood work. I’m really scared about using natural progesterone cream, even though my integrative doc and acupuncturist recommend it.” Do you have any thoughts on the cream? And specifically related to acne breakouts, but any thoughts you might have.

Amy Medling: Yeah, so women with PCOS, low progesterone is one of the classic symptoms. It’s like; low progesterone, estrogen dominance, and excess androgen. So low progesterone, I think, I don’t have a problem with natural progesterone cream. I think it can be really helpful, in the short term. It’s not something that you want to slather on without being monitored by a doctor and in knowing that you have low progesterone.

And I know that about a year ago, I had the DUTCH test, and thought that my progesterone was low. And I was all ready to start using progesterone cream; but when it came back, my progesterone was fine. And I would have been exacerbating issues if I started adding the progesterone cream. So I guess my caveat would be; make sure you get a good hormonal panel so you know for sure your progesterone is low. It would be something that you would use short term in conjunction with a doctor monitoring.

And I think from using it short term, you could also be adding some foods that can help increase your progesterone naturally. So foods that are rich in zinc. Zinc, magnesium, B6 are critical building blocks of progesterone. So foods that are rich in zinc are pumpkin seeds. Pumpkin seeds in general are great for women with PCOS. Grass-fed beef. Flax seeds, as we already mentioned. Spinach.

Women with PCOS tend to be 19 times more likely to be deficient in magnesium. So when taking a magnesium supplement along with lots of leafy greens, avocado, dark organic chocolate. Most nuts and seeds.

And then foods that are rich in B6; wild salmon; great for women with PCOS. Sweet potatoes, organic free range chicken breasts, garlic. So I’d be working on your diet, too, to try to support progesterone. As well as working on reducing stress. Because in order to make progesterone, we need pregnenolone. And when we’re stressed, that hormonal precursor is stolen in order to produce more stress hormone. So it’s really important for women with PCOS to have some type of stress reduction practice and meditation or walking. Or something to reduce the levels of stress.

6. Balancing PCOS without birth control pills [34:31]

Liz Wolfe: Ok. Next question. “My question is more elementary than some of the others. With PCOS, it seems hard and confusing to navigate finding other options than using the pill to regulate hormones. How does one go about finding other options to begin the process? Especially if your doctor insists on more conventional methods, like using the pill. I’ve had PCOS my entire life, and have never fully understood how to navigate my options.”

Amy Medling: Yeah, that’s really a great question. You heard in my story, that was my frustration as well. But there’s a lot of practitioners who are out there that are looking at getting to the root cause of your PCOS. And whether that’s inflammation driven, or insulin resistance driven. If you're having hormonal balances. They’re not just going to stick a Band-Aid, like the birth control pill, or metformin. They’re going to really work with you to get to the root cause.

And I find that doctors that are willing to do that, have more the integrative/functional medicine backgrounds or are naturopathic. Sometimes, you can find a chiropractor that’s also a clinical nutritionist. Or an acupuncturist that also has other specialties. But looking at trying to find a doctor that’s willing to look at your diet and supplements; lifestyle, testing your gut. Doing a really good, complete hormone panel. Looking at your thyroid; not just TSH. You have to be a diva, and you have to kind of dig around.

But the Institute of Functional Medicine has a good doctor finder, as well as the American Naturopathic Association. They also have a finder on their website. And you're just talking to friends and family members, as well.

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7. Coming off of birth control pills [37:19]

Liz Wolfe: OK, next question. “I’m wanting to get off the pill in the next couple of months in order to hopefully start a family really soon with my hubby. Do you have any advice or wisdom on ways I could prepare my body for the massive hormonal change that’s about to happen? I want to prepare my body the healthiest way possible to attempt to have a seamless transition and promote healthy hormonal balance. I’m fearful of all my horrible PCOS symptoms attacking me ferociously as soon as I quit the pill, as well as infertility down the road.” Any thoughts?

Amy Medling: Yeah. Well I think first, working with your mindset. That fearful kind of mindset; I want you to shift that. You will be able to come off of the pill, and you will be able to rebalance your hormones again. I just think that making that shift is the first place to start. Yes, the pill depletes a lot of our nutrient stores. And women with PCOS, I think are already kind of undernourished. Because of the PCOS.

So really restoring nutrients in your body with like a really good multivitamin with methylated B. With selenium. Good vitamin C supplement. And just making sure your diet is as varied as possible with lots of vegetables and low glycemic fruits, quality fats, organic grass-fed meats. That is really important. And I think making sure you're doing that now, before you come off of the pill.

And then the pill actually adds to PCOS symptoms. One thing it does is it increases insulin resistance. I had mentioned earlier when we were talking about thin PCOS, that insulin resistance is kind of at the root of a lot of people’s PCOS. So we need to work on kind of repairing that metabolic issue. And birth control also causes inflammation. So following that anti-inflammatory diet that really helps to balance your blood sugar is going to be really important.

And then detoxification. The birth control you need to kind of detox those hormonal pathways, and the detoxification pathways. Make sure your liver is really able to kind of reduce all that excess estrogen. So loving up your liver, and doing some type of a healthy liver cleanse. Eating liver supportive foods, like beets and dandelion root, and all of your cruciferous vegetables are really important. Maybe doing some juicing as well for the nutrients to the detoxification properties.

The other thing that I’ll mention; I’m going to give a shout out to another one of my favorite experts. Dr. Jolene Brighton; I don’t know if you're familiar with her work.

Liz Wolfe: Yeah; we’ve had her on the podcast.

Amy Medling: Yeah. So she’s kind of becoming the birth control syndrome expert. So she has a lot of resources to kind of help you come off the birth control, as well. She’s actually writing a book about this right now. So that will be coming out soon, I think. And she’s a great resource, as well.

8. PCOS and keto [41:11]

Liz Wolfe: Alright. One final question for you. “I have infertility/PCOS, and my blood sugar is a mess. Can you tell me if keto would help more than a strict paleo diet? I would say I’m semi-paleo. If we eat out, I’ll have gluten a couple of times a week. But I try to eat cleaner at home. I have red wine most nights. I don’t take any supplements. I CrossFit two to three times a week. I sleep 6-8 hours. We adopted our 9-month-old.”

Amy Medling: Ok, yeah. So a couple of things. The first thing that kind of jumped out at me was the red wine.

Liz Wolfe: Yeah, me too.

Amy Medling: There are good properties to red wine for PCOS, and that resveratrol. If you go to my site and search for resveratrol, there has been some nice studies that have come out that it helps with many different factors of PCOS. And I actually take a resveratrol supplement. But the amount of wine that you would have to take in order to get the resveratrol in one supplement is a ridiculous amount. And alcohol really affects our blood sugar. And it also affects our ability; it compromises our liver and our ability to detox estrogen. But it also contributes to estrogen dominance, which is one of those hormonal imbalances of PCOS.

So I would really suggest limiting yourself to a glass of wine a week. I think that will make a big, big difference in your blood sugar regulation. Just an easy fix.

I will say that, you probably have been able to discern through the podcast, that there is really no one type of PCOS. There are women that are thin with PCOS, overweight, have adrenal-androgen excess PCOS, have insulin or inflammation driven. So PCOS affects us all in a different way. And I’m not a big subscriber to one size fits all type of diet. I do think that women with PCOS need lots of nutrients from vegetables. And that’s my one concern about a keto plan. That you're not going to get enough nutrients from plant-based food, unless you're maybe a little bit more flexible keto.

But with that being said, I know there’s a lot of women that are having a lot of success with it. It can be something that can sort of help jump start weight loss. I question the sustainability of a keto diet over the long haul. And it’s certainly something that you can experiment with as long as you're doing it in a healthy way.

She also said that she doesn’t take supplements; was that correct.

Liz Wolfe: Yes. “I don’t take any supplements.”

Amy Medling: Yeah. So I do think that you need to be on some key supplements. Vitamin D; get your vitamin D level checked and make sure that you get that optimized. Your B12; women with PCOS tend to be really low in B12, and that can affect fertility and energy, blood sugar. And make sure that you're taking a good omega 3 supplement. I think that you need to have some type of fish oil based with a good amount of DHA and EPA, rather than just a vegetarian form. Because women with PCOS, we don’t convert the plant-based ALA to EPA and DHA very well.

Fish oil, vitamin D, and a really good supplement with methylated B would be my absolute bare-bone supplement regimen. And then maybe adding Ovasitol on top of that. That can really help with egg quality, blood sugar, and fertility.

Liz Wolfe: So the wine thing, is real sad for a lot of us. But, I had read something fairly interesting and sad recently about how a lot of the positive hype around red wine is vastly overblown, and the downsides of nightly glasses of red wine would much outweigh the benefits for almost everyone. And I did find; I was trying to kind of enjoy life a little bit more, and relax, and whatever. And I kind of upped my alcohol consumption. Maybe was having a drink a day. A gluten free beer, or a glass of wine. And I really did find that it was making quite a difference in a negative way. So giving that up was actually one of the very simplest and best things that I have done.

Amy Medling: Yeah. And I think it’s something that you think is a mindful indulgence. And that’s something that I really encourage in my book. To make space for these mindful indulgences. And if you love a glass of red wine. And I love a glass of red wine. But make it a Friday night or a Saturday night where you sit down and have a delicious meal with your partner, and have a glass of wine. When you drink it with a meal, it lessens the blood sugar effect as well.

It’s not like you have to completely deny yourself, but you're getting out of that nightly habit. You're going to notice a difference in your energy and sleep. And I think your blood sugar control and your hormonal; especially the estrogen dominance.

Liz Wolfe: Absolutely. Alright, well that’s all that we have for you today, Amy. Is there anything else you want to make sure people know?

Amy Medling: I just want women with PCOS listening or if you suspect that you might have PCOS, that there is so much hope. There’s so much that you can do beyond the birth control pills and metformin. And most women with PCOS can get pregnant. We actually maintain our fertility longer. So their clock isn’t ticking at the same sort of rate as women without PCOS. So I think if you want to get pregnant, you want to feel better, if you want to live a full, and healthy life, you absolutely can with PCOS. I hope that my book is kind of a bright spot and can really bring you hoe and healing.

Liz Wolfe: And where can folks find you if they want to learn more?

Amy Medling: I’m available at PCOSDiva.com. And I have several free guides there. I have a PCOS 101 guide, if you’ve just gotten diagnosed. I have a lab guide, supplement guides. And then I’m available on social media. It’s pretty much anywhere, #PCOSDiva.

Liz Wolfe: Perfect. Well thank you so much for coming on the show with me today.

Amy Medling: It was a pleasure. Thanks for inviting me.

Liz Wolfe: So, folks, you can find me, Liz, at http://realfoodliz.com/ Join my email list for free goodies and updates that you don’t find anywhere else on our website or on the podcast. While you’re on the internet, leave us an iTunes review. See you next week.