Learn more about PCOS, the types, genetic links & effective solutions in our audio transcript.

Cracking the PCOS Code: Types, Genetic Links, and Effective Solutions

Dawn (00:00):

Hello and welcome to the Gastric Health Show. My name is Dawn Boxell, Registered Dietitian, and this week’s topic is cracking the PCOS code types, genetic links, and effective solutions. And I’ve been wanting to talk about PCOS for actually quite a while. I see this frequently in bariatric patients especially, and I really want to just provide kind of like a foundation of understanding, but then also let you realize that PCOS truly does go undiagnosed. Actually, some of the stats say up to 75% of females go undiagnosed with PCOS. So you could have PCOS one type of the PCOS or a combination of types and not even know it. So you’re dealing with the symptom, but you’re not dealing with the big root of the problem. And that’s where, yes, maybe you have insulin resistance, but really what you have is PCOS, the insulin resistant PCOS, and maybe inflammatory PCOS.

PCOS just stands for polycystic ovary syndrome

(01:20):

We’re going to get into all the types, but in the end, I want you to understand that sometimes you might only be dealing with one piece of what your condition is, and it’s dealing with the symptom, you’re not dealing with the problem. And when you approach it as the whole problem, then it really helps you, one, have a better understanding of your health, but then two, helps you get better outcomes because you are actually addressing the real problem. So let’s kind of dig into this because I don’t know how many people realize. How big of a deal PCOS is in our world and how many people are actually are diagnosed with this. But it’s about 15% of females at reproductive age do suffer from PCOS, which PCOS just stands for polycystic ovary syndrome. And actually PCOS has been recognized for decades, but the prevalence has actually increased millions of women worldwide.

What is PCOS?

(02:39):

So there are a variety of factors that contribute to the development and progression of PCOS, and it does affect many body systems and can be classified as a reproductive disorder. And that’s when some females actually actually learned that they have PCOS are actually diagnosed with it is when they’re having fertility issues. But the big thing is it not only impacts your reproductive health, but it also really impacts your metabolic function and overall health. There’s so many things that are connected to PCOS that truly disrupt your ability to have health balance. So what is P PCOS? Polycystic ovary syndrome is characterized by irregular or absent menstrual cycles, excessive androgen production, and the formation of small cysts on the ovaries. And again, like we’ve said, infertility, metabolic disturbances, even cardiovascular disease are actual risks or side effects that come from having PCOS.

Types of PCOS

(04:06):

There are different types, types of PCOS. So it’s not like there’s only just saying you have PCOS isn’t enough information. What type of PCOS do you have? And the first type is insulin-resistant, PCOS. And actually this is the most common type. So you could, like I said earlier, you could have a combination of a couple of these, but it’s the one that’s the most dominant, is the one that you truly would have. So insulin resistant PCOS is really just having high levels of insulin that prevent ovulation, that then trigger your ovaries to create more testosterone. And then number two is the pill induced PCOS. And this is the second most common type of PCOS. This is a result from the suppression of ovulation by taking birth control pills.

Inflammatory PCOS

(05:19):

So if your periods were regular before you started taking the birth control pill. But then after you stopped taking the pill, you maybe never really restarted your period. This could be part of the puzzle. This you could have developed PCOS because of that. So because remember we’re saying that PCOS is when you’re having irregular menstrual cycles, you’re having excess production of the testosterone and androgens, any of those male type hormones that females have as well, and then having lots of cysts on your ovaries. So once, if you get off the pill and you never really start your menstrual cycle, this could be a red flag that PCOS may have developed during that time when you were on the pill. The next one is inflammatory PCOS. And what this really is, is when the inflammation levels are so high, it creates hormone imbalances and produces more androgens and those maleo hormones, the like testosterone, and this is all caused by too much inflammation.

Adrenal PCOS

(06:46):

And then the last one is adrenal PCOS. And most women with P C os have elevated androgens, but typically when it comes to adrenal PCOS, you’re only going to have elevated dhes to qualify for adreno adrenal PCOS. So those are all the of the four types that you could have. And again, you could have a combination of these, but one of these is going to be more dominant in the main driver of your cause of PCOS. Now, different symptoms that can come with PCOS outside of irregular periods, too many androgens and testosterone and too many cysts on your ovaries. This look at the bigger picture where you might be dealing with some of these outliers at a 30 out, a 30,000 foot view.

Complications of PCOS

Causes of PCOS

(08:55):

Behaviors. And this is mostly going to be binge eating. Binge eating disorder is very common in individuals with PCOS and then also endometrial cancer, so which is cancer of the uterus lining. So again, you might be going to your doctor for these types of symptoms and. Problems that you’re struggling with when at the root it is really PCOS. So what causes some one to have PCOS? Again,

High insulin level

(10:38):

We need more insulin. Come on, body, send to us more insulin. And so now we have a high insulin level and having this high insulin level can tell your body to overproduce the androgen testosterone. And then this would make your body believe that you shouldn’t release an egg during this ovulation cycle. So that’s where your body is getting confused because the insulin levels are remaining elevated for too long. And some signs that are very common common with insulin resistance is having dark velvety patches of skin underneath your breasts, your armpits, your groin, and on the lower part of your neck, very common to see right in there are all signs of insulin resistance. You can also have an increase in your appetite. You just feel hungry, you eat a whole meal and you’re like an hour later, two hours later, you’re hungry. So this is why I would check out, I’ve written several posts on insulin resistance and that connection and what are healthy levels.

Low-grade inflammation

And I’ve also shared that I have struggled with some pre-diabetes numbers and. My insulin kind of creeping up outside of that optimal reference range and me menopause kicked this up for me. And it is very common in menopause to have for your body to migrate more towards insulin resistance. This is just a natural process as those estrogen levels and progesterone levels decline. So it kind of sets you up for higher insulin levels. So you have to kind of combat that with getting your insulin levels under better control. And that’s where you may be struggling saying, oh my gosh, I’m hungry all the time, I’ve had bariatric surgery, but yet I’m hungry all the time. And I would just say, stop, pause and reflect because this is where you truly need a practitioner like myself who can help you look through the numbers and say, okay, do you have an elevated insulin?

Do you have an elevated cortisol?

(13:13):

Do you have an elevated cortisol? Do you have an elevated a1c? What’s your fasting blood sugars? Where are you at with all of this? And maybe we can identify why you’re so hungry all the time. Has nothing to do with your bariatric surgery. I guarantee you if we fuel your body appropriately, you are not going to struggle with your appetite and you will improve your issues with weight loss resistance and can start losing weight again. Some other causes, again, low grade inflammation. This, I mean, and I’ve talked about this recently. I did a whole post on inflammation and how inflammation has a direct connecting that inflammation is directly connected to chronic disease and there is no benefit of having chronic inflammation, acute inflammation, nothing wrong with that. That is your body’s natural process of healing and is a great thing. It’s just if it continues and continues and it never gets resolved, that’s when we have problems.

Heredity or Genetic Factors:  

 (14:28):

Studies have shown that long-term low grade inflammation leads to androgen production in polycystic ovaries in people with PCOS and can lead to problems with heart and blood vessels. So it’s important to get your inflammation under control and really follow more of an anti-inflammatory lifestyle, which I again recently talked about. Just look for anti-inflammatory diet and lifestyle fight inflammation naturally so that post and video you can find and get more details on inflammation and how can you change an inflammatory process in your body. Number three is hereditary or genetic factors. So there is some very evident genetic connections, and I have talked about this connection with insulin resistance, the genes that are involved in setting you up for blood sugar dysregulation and insulin balance issues. So some people are more pro to having these conditions. PCOS is part of that picture.

Insulin signaling

(15:49):

So if you already have a family member who has PCOS, then that could be a red flag that maybe you do know that this is part of your heritage studies. Studies have shown that PCOS  has a strong genetic component and there are many genes that are involved in hormone regulation, insulin signaling and ovarian function which may contribute to PCOS. And really identifying if you have these genetic SNPs can really help you be informed with how you move forward with your diet and lifestyle and in being realistic in your expectations of how your body is going to look. You can’t expect someone with several genetic pathways that are stacked against them and expect them to have a model body and be able to sustain that. I think that’s where diet culture has given us this idea that we’re all supposed to look a certain way and this is where you have to step back and say, that’s not possible.

Exercise all the time

(17:24):

I my I would never be able to eat and I would have to exercise all the time and I would still not look like that. So there’s no value in pursuing that when you know that this is your what you were given and setting realistic expectations that is important. And this is where I feel like the messaging with health at every size is confusing for people and where I don’t track and follow with them completely, I am a believer in there is health at every size because I really don’t believe there is one standard body shape that we should all be achieving. I just don’t believe that’s possible. So I think if you can get diet culture out of your head and quit thinking that you’re supposed to attain a certain shape or figure or wear a certain size or weigh a certain number on the scale, this can be very freeing and life-changing.

Insulin signaling genes

(18:42):

When you can truly look and evaluate yourself and say, you know what? Great for them, but great for me. I can live a healthy life. I can be strong, I can have a strong body and I can do the things I want and feel fabulous without being restrictive because I’m trying to attain something unrealistic that I can never sustain. So again, you have to understanding that sometimes that understanding your genetics can truly help you cross that line and say, okay, there’s no need for me to continue to strive for this goal that’s unrealistic and unsustainable. So I want to cover just a few of these genes. The insulin signaling genes. We know that PCOS is DA definitely impacts your ability to maintain a stable and optimal level of insulin. And this can be part of it. Maybe you have some of these genetic SNPs that influence insulin signaling and glucose metabolism.

Steroid biosynthesis genes

(19:59):

There are variations in the INSR gene insulin receptor genes and the IRS-1 gene have been linked to insulin resistance, commonly observed in women with PCOS. So again, if you know, Hey, I have IRS-1, then maybe we have to work extra hard at getting that insulin into optimal ranges and optimal for you may not be the same number as someone else who doesn’t have this gene. So your ability to get at the tight reference ranges may be impossible. And to me, these are the type of people that may need medication support and they may need GLP one medications to support this or some other types of medications that can help support this and get their numbers so that they really decrease their risks for heart disease and stroke and other chronic conditions because their body will not allow them to do this sustainably, if that makes sense.

Metabolizing steroid hormones

(21:22):

There are also steroid biosynthesis genes and these are responsible for producing and metabolizing steroid hormones including androgens and estrogen. And they have also been implicated in PCOS and one of these is the CYP1A one gene, which is a cytochrome P four 50, which encodes an enzyme responsible for androgen synthesis. So this is kind of one of those genes that can really set you up for having higher hormone levels. So of course you would have to look at other genes because sometimes just having this one, it has to be an impact at a high or very high impact because remember, just having this gene doesn’t mean that it is genetically affecting you negatively. It can have absolutely no impact. It can actually be a beneficial gene in actually supporting you. But if you have PCOS, more than likely you have that in a high or very high impact and would need to maybe approach your diet and lifestyle a little bit differently and know the things that come with that.

Gonadotropin signaling genes

(22:55):

The next one is gonadotropin signaling genes and they contribute to PCOS development because of the follicle stimulating hormone or FSH and the luteinizing hor hormone or lh. And these follicle stimulating hormone receptor genes and the luteinizing hormone receptor gene have been found to alter the signaling and disrupt the follicular development in PCOS PAT in patients. So again, it’s setting the stage, it’s making your ability to manage these hormones harder and it’s setting you up for that PCOS. And then there’s also the obesity related genes. You think of the F T O, the P P A R are all connected to fat mass and how your body metabolizes fat and regulates your body weight. So these are playing a role and when you have your genetic test results, you’ll know where the deck is stacked and it can help you really be intentional about your choices to shift those genes in the right direction as much as possible.

Hormonal imbalances

(24:22):

Personally, I think there are limits and you have to understand that you’re going to get so far with where your genes will allow you to go hormonal imbalances. PCOS is characterized by an imbalance in sex hormones, particularly elevated levels of androgens such as testosterone and high levels of androgen produced by the ovaries. And PCOS is associated with having high levels of androgen produced by the ovaries. And as a result, this excess androgen creates irregular egg development and also acne and also facial hair. This is something, this is kind of one of those signs that, hey, my hormones are out of balance. The next is an obesity connection. This is really a complex relationship because you can put PCOS in remission, you can get your inflammation, your adrenals, your insulin, everything flowing and in great range, but that doesn’t always mean that you’re going to be skinny.

The Obesity Connection

(25:45):

So it just means that you have got your levels normal and as maybe as good as it’s going to be. So again, you would have to weave in those obesity genes to see if this is connecting and this is part of the picture. You also have to think about your gut microbiome being involved, and researchers have found that women with PCOS may have a different gut microbiome, which influences your metabolic function and hormone regulation. And then lastly, we want to talk about environmental factors exposure to endocrine disrupting chemicals. And these have been found as potential contributors to PCOS and can interfere with hormonal regulation and disrupt your reproductive function. So these are those obesogens or those chemicals that mimic estrogen. So it truly confuses your body because they’ll attach to your receptors and now you have excess of certain hormones.

Gut Microbiome Involvement

(27:06):

So it’s very complex. And I would say probably the biggest one is the BPAs that truly disrupt hormones that has consistently be shown in research to be problematic, especially for females but even males because it mimics the same structure as our female sex hormones. So that’s where your body gets confused and that’s why when you hear people talk about remove toxins and you’re thinking what toxin and what type of chemicals am I supposed to use then? And I think to me the plastics seem one, there’s so much evidence around them, but those seem to be the ones that we could attack the easiest. When you start going into skincare, body care, cleaning products, laundry products, things you use in your vehicles, air fresheners, I mean it’s overwhelming and one can get in a rabbit hole and get kind of overwhelmed by the thought process of, oh my gosh, everything is a toxin and I’m going to cause me to die.

Environmental factors

(28:37):

I think that’s where you have to step back and be real and say, okay. Let’s just minimize as much as possible and say, okay, one, I can try to avoid as much plastic as possible. I can definitely not reheat my food in plastic. So if you get a styrofoam container or any of those plastic containers, even the harder ones, don’t reheat your food in it. Those that definitely has been shown, the water bottles sitting and getting hot have been shown to leach into the water. So again, I don’t think we’re ever going to be perfect. I think this is something that we all can strive to do our best, but there’s times when that’s all that’s available and I’m going to drink water, and if I need to buy a plastic water bottle to drink my water, I’m going to buy a plastic water bottle.

Solutions to treating PCOS ?

(29:38):

And I think you should too, I don’t think should be a deterrent, but try to drink out of glass or stainless steel or other types of delivery systems so that you minimize your exposure to the plastics that can then help not create confusion in your body with the hormones. So what are some solutions to treating PCOS? One of them is lifestyle, and that is moving your body more, but especially strength training. And this can really help improve insulin sensitivity, can promote weight loss and regulate your hormones better. So yes, staying active is key for all of us, for our health in general. But really adding and strength training can really turn the dial up just a little bit more in helping you accomplish your goal at keeping your insulin level at a more stable place. A study published in 2022 lifestyle interventions effectively treat polycystic ovary syndrome, ovary syndrome.

Lifestyle Modifications: 

(30:56):

Researchers found that lifestyle interventions such as diet and exercise could improve PCOS symptoms such as irregular menstrual cycles and excess hair growth. The study concluded 120 PCOS women randomly assigned to either a lifestyle intervention or a control group. Diet exercise and weight loss counseling were provided to the lifestyle intervention group. The control group received no intervention and after 12 months, the lifestyle intervention group significantly improved menstrual cycles, decreased excess hair growth and improved insulin resistance compared with the control group. So the researchers concluded that lifestyle interventions may effectively treat PCOS. The next one is medications and hormone therapy. And some providers may prescribe medications for PCOS and the use of oral contraceptives or birth control pills can dramatically reduce androgen levels. Kind of alleviate those acne related symptoms and reduce excessive hair growth.

Medications and Hormonal Therapy:

(32:08):

But then also remember on the flip side, if you go into a birth control pill with normal cycles and you come out with abnormal cycles and it doesn’t change, you go not like a few months without a cycle, but you go like a whole year without a cycle, then that could be a red flag that maybe the pill has created this hormone imbalance for you. The next thing is a low glycemic or low carb diet. And I’m even going to say in some instances, maybe even a ketogenic diet, but this is going to be, again, very individual. And for me, I would like to see genetics before I would truly want someone to be that restrictive with their carbohydrates because I mean, for one, for me, I struggle to see that people can sustain this. I’m not saying it’s not possible, I’m just saying it’s not for every person.

Low-Glycemic

(33:14):

And to me, those genes would really need to be stacked against you and your brain, your mindset would need to be in the right place for me to want to go to a ketogenic diet. There’s tons of evidence behind it and there are tons of people who utilize it for optimizing their health. I recognize that, but I’m also real in the aspect that it needs to be sustainable. You can’t do it for a few months and then go back to eating how you normally did prior and expect to sustain the results that you got following a ketogenic diet. And some people may even do it for a year or a few years and then get off. I think I always try to ask myself if I’m 90 years old, am I going to want to do this? Am I going to want to continue doing this?

Low-Carb Diet

(34:18):

And that’s where I do like with exercise and stuff and really challenging myself with that strength training More recently that I started, I’m really appreciating this and especially I would say the gem that I chose. It’s definitely not your standard gem. And even when my provider, when I told my provider where I was going and she kind of chuckled and she pulled up their website and it is more geared for the geriatric population, I just laughed with her and just said, but they’re doing it right. They are setting me up so that when I’m 90, I can get in and out of bed by myself. I can go to the bathroom by myself and I can do all these things that I will want to do. So to me that’s important. And when you can see yourself doing that when you are 90 years old or it’s setting you up so that you can do that, then that makes sense.

ketogenic diet

(35:31):

And I know I’ve said this before about the ketogenic diet. There is some evidence when it comes to Parkinson’s and Alzheimer’s and dementia. And I’ll tell you, if with my mom having dementia. If although I don’t have those dementia genes, thank God, that doesn’t mean I’m still not at risk. And if I started having cognitive decline soon in these early years of midlife, I would definitely consider it. I would definitely, that would be something I would consider and I would know that this is what I need to prevent future problems. And I guess another thing I can share is I have a patient. He’s doing a CGM with me and he has diabetes in his family. He has that, I don’t have his genetics. We’ve made good progress with getting his blood sugars under control, his uric acid’s a little elevated, so we’re working on that.

kidney stones or gout

(36:40):

We don’t want to create kidney stones or gout. But also there’s some trends in some of his blood work that are renal indicators or your kidney function that are compromised and long term these can turn into something. And so to me, I, I’m going to address this with him. This is something that we need to consider to prevent and protect his kidneys long term. So I can’t go crazy and do high amounts of protein with him. Because this could tip him into more kidney problems and set him up in a place he’s not going to want to be. So again, I think you have to take this perspective of one, is this sustainable and can I do it? And two, do I need to do it? What is the value in it? And sometimes knowing the value and the importance for you personally is all you need to make it sustainable.

Dietary interventions are a crucial piece of PCO

(37:49):

So all of that to say that dietary interventions are a crucial piece of PCO OS management and. It really can help with getting the right amount of carbohydrates when you have PCOS. But to me the key is you don’t want to restrict at a ketogenic level carb intake. Not everybody needs this so that you’re talking 20 to 50 grams. Usually you start at less than 20 grams for a little while and then you’ll kind of ramp up to 20 to 50 grams and you’ll kind of stabilize there. But anything 50 and under is considered ketogenic. Most people do not need to be that low in carbohydrates. In fact, most people are going to find that they feel their best and do best somewhere between 75 and 125 grams of carbohydrates a day and maybe even up to 150. Or you could cross over that potentially if activity is high enough.

No one magic number that fits all of us

(38:55):

So again, there’s no one magic number that fits all of us. And that’s really we’re working with somebody like myself who can truly help you get dialed into what you should do. And then you take it from there. You say, okay, this is what I need. How can I make this happen? And how can I make this occur on a daily basis that’s sustainable? How can I do this? And some of this, you have to work on your mindset. You have to work on, oh my gosh, I’m afraid to eat this many carbs. Everybody gets afraid of carbohydrates. And I understand my goal with having carbohydrates somewhere in that 75 to 125 grams is it’s not going to spike your glucose and stabilize it at a high number. It’s going to be able to come right back down, even if it spikes. I don’t want to say even significantly. But if it went higher but comes back down and it’s kind of more of a nice rolling hill and not a big mountain peak and valley, that’s what we’re looking for.

Metabolic health

(40:09):

We don’t want those spikes. So you want to do low glycemic food choices that are going to fall in that less than 150 low carb range, but probably not ketogenic carb levels. So one study on a low glycemic index diet reduced PCOS. Women’s insulin resistance in androgen levels following these types of diets can help you minimize the consumption of high sugar and high carbohydrate foods. Promoting more of a stable blood sugar level overall and just having better metabolic health. And again, I think where this comes in play is the standard American diet. A lot of people are doing like 300, 400 grams of carbs a day and that’s where it’s problematic. So that’s where you have to truly track it. You need to follow or you need to find some accountability to what you’re truly doing. Sometimes you have to do a food log just to really understand what you’re taking in on a regular basis.

what the gastric health membership does

(41:31):

So again, work with a practitioner that can help you dial in these numbers and give you the time and the space and. I guess the love that you need to get there because you’re not going to do this and maintain it perfectly in the first month. And that’s okay. And that’s I would say the gastric health membership is designed for that because I, I’ve kept it at a price point that can be affordable for most people, but yet give you that time and space to shift your lifestyle and to shift your choices and to shift your mindset to get you in a place that you get these things down and you quit, get you quit running towards those diet culture mindset traps and looking for that next solution. You just need some good foundations and you need to do ’em daily. And that’s what the gastric health membership does.

Insulin-sensitizing medication

(42:41):

It helps you do them daily so that you get that as a routine and a behavior. So the next one is insulin sensitizing medications. This is metformin and there are as many great studies about metformin as there are not great. So to me, I’m neutral on metformin. I see nothing wrong with it if you have no genetics behind it, that could set you up for problems in the future. So one thing that I don’t love about Metformin is there is a connection with Parkinson’s and Alzheimer’s. So if you have family members with Parkinson’s, Alzheimer’s or a history of some type of cognitive decline. I would probably not want you to stay on metformin long term, but I would not be opposed to you doing it short term. I don’t think there’s anything wrong with that because it can really help improve your insulin function. Regulate your blood sugar, reduce the androgen produ production, and just really kind of get your hormones back in check.

Family genes

(44:02):

But if you had that heritability, your family genes are there. Then metformin may not be the best long-term solution for you because of that risk. You can also do some supplements like berberine, anatol. Those are also great ways to support with supplements I would typically use when it comes to insulin. I would use my acetol and that can help really improve. I’m actually using that myself. I’m using a myo acetol for my insulin, and I went from 11 to 4.9 in, oh gosh, I think eight, 12 weeks. I can’t remember how many weeks it was. But I also, at the same time, I’m not going to give it all the my acid all the credit because. I would say I don’t do it. I’m not consistent at doing it every day, but I do it, I would say a good three to four times a week.

Nutritional Support: 

Several (45:11):

But I also added in around the same time I added in my strength training. Which also helps support and improve insulin sensitivity. So I think combining the two really helped get me across the line and. Get me back in that two to five reference range, just barely. But I got there and it worked. So again, I think it’s now it’s just kind of continuing to watch my trends to see how much I really need. So when I run out of this nasal, so this one container is all I’ve I will have done once I run out of that, then I will stop it. But continue my strength training and see what happens to see if I can continue to need this supplement to help manage my insulin. Some additional studies have found there are benefits with omega-3 fatty acids and vitamin D supplementation for PCOS management. So those are great things to add as well. There’s also some evidence with aloe vera, Vitex, Camile have all been shown to be supportive and improve, give you some improvement with PCOS symptoms, also weight management. And to me, this is of course, if you have PCOS and you are struggling with your weight, this is something you already know. So again, working with someone that can help pull all of these things together is great.

Weight Management: 

(46:56):

Also, managing your gut. So if you have gut dysbiosis, getting that back in balance is a great way to help. Support a healthy hormone balance and really getting everything working correctly. Your blood sugar insulin really does matter when it comes to gut health. So let’s kind of wrap this up. PCOS is complex and does require some diet and lifestyle approaches. And although there are

Conclusion

(47:28):

Several factors that contribute to PCOS development, including insulin resistance, genetics, obesity, and your gut microbiome. There are solutions that you can apply by adding supplements like my acetol or berberine. And modifying your diet or finding that sweet spot with your carbohydrate intake, adding strength training. And of course if you have more of the adrenal, you would want to really work on your stress management. Which I really didn’t cover too much, but stress management really can help improve that. And then also sleeping well, those will all help do the full circle for a female with PCOS and. Collaborating with your healthcare practitioners and. Your team is a great way to get all angles of this complex disease back in remission. So hopefully you guys have enjoyed this PCOS topic. This again, like I said earlier, this was something I’ve been wanting to cover because. It is so prominent in the bariatric community that I want you to see there are solutions and. I want you to see that it’s important to understand maybe your genetics that are driving some of this. But I also want you to realize there are solutions. Not that you can be a size two from it. But that you can have health and you can get your health back in line. That you can feel fabulous and really be in a great place with your health numbers. And actually making your doctor proud and yourself proud. You can have all of that even if you have PCOS. So I hope you guys have a great week and we will see you next time. Bye-bye.

Listen, Learn, Enjoy…

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3. Chudzicka-Strugała, I., Gołębiewska, I., Banaszewska, B., Brudecki, G., & Zwoździak, B. (2022). The Role of Individually Selected Diets in Obese Women with PCOS—A Review. Nutrients, 14(21), 4555.

4. Cowan, S., Lim, S., Alycia, C., Pirotta, S., Thomson, R., Gibson-Helm, M., … & Moran, L. (2023). Lifestyle management in polycystic ovary syndrome–beyond diet and physical activity. BMC Endocrine Disorders, 23(1), 14.

5. Yang, M., Bai, W., Jiang, B., Wang, Z., Wang, X., Sun, Y., … & Wu, F. (2022). Effects of a ketogenic diet in women with PCOS with different uric acid concentrations: a prospective cohort study. Reproductive BioMedicine Online, 45(2), 391-400.

6. Yang, M., Bai, W., Jiang, B., Wang, Z., Wang, X., Sun, Y., … & Wu, F. (2022). Effects of a ketogenic diet in women with PCOS with different uric acid concentrations: a prospective cohort study. Reproductive BioMedicine Online, 45(2), 391-400.

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