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[2:12] Hillary shares her acceptance into the Women’s Functional and Integrative Training Program, offered by Dr. Aviva Romm. This is a huge honor, and Dr. Romm has been one of Hillary’s trusted teachers and an inspiration for shaking things up in the medical world and applying wisdom and evidence-based medicine.
[2:42] Just because something has been traditionally used, doesn’t mean it’s a good idea for us. Hillary gives examples of pharmaceutical debacles from the 1950s up until recently.
[6:52] Hillary recounts her experience with Accutane and the severe side effects.
[8:28] It’s important to know what you are taking, the potential side effects, and whether it is traditional or alternative treatment.
[10:46] How we take care of our bodies in the 12 months prior to falling pregnant has a huge impact on the next two generations. For the first time ever in the United States, children are being born with a lower life expectancy than their parents. And if we are sending down copies two generations at a time of our genes and we’re not teaching people how to ensure that these genes don’t trigger or mutate into various health issues, then we’re not actually practicing preventative medicine.
[12:11] In the U.S., one in 10 American women will have a diagnosis of PCOS at some point in their life, which is the equivalent of five million women. There are about 10 different types that can present and are not what a majority of healthcare physicians think of as PCOS. Usually, they consider it to be someone that’s overweight, with high testosterone, and a 2:1 LH: FSH ratio, and having cysts show on an ultrasound around the ovaries. But in reality, there are so many different presentations that it’s more like a spectrum with women being affected to different degrees causing different symptoms and severities.
[13:43] Although 85% of women affected with PCOS can reverse it naturally, a lot of physicians don’t look at it like it’s reversible.
[16:44] Polycystic Ovarian Syndrome was previously considered a gynecological problem, diagnosed on the presence of polycystic ovarian cysts by ultrasound. Now, it’s actually recognized as a complex endocrine disorder with multiple possible causes and clinical manifestations. Only one of those actually yields polycystic ovaries on an ultrasound.
[18:23] When women begin to understand that it was likely a predisposition was from their mother in utero, based on changes in the food supply, they can have a little more grace and compassion with themselves as well as motivation to try and stop it for the next generation.
[19:23] How is it diagnosed and what are the symptoms? PCOS is a clinical diagnosis and it is primarily diagnosed based on having some or all of the classic symptoms and having other medical conditions being ruled out. While testing the blood on day three, looking at the ratio between LH and FSH, estrogen and testosterone, can certainly be one of the ways that we diagnose PCOS.
[20:31] Traditionally, PCOS was thought to cause weight gain and abnormal hair growth from the excess testosterone, which does happen in one phenotype, but not all.
[21:30] Symptoms of Polycystic Ovarian Syndrome can include any of the following: infertility, irregular periods, lapses between periods for months at a time without being pregnant or breastfeeding, acne, weight gain, unwanted facial hair, hair thinning or hair loss, which oftentimes looks like male pattern baldness in PCOS, and then less commonly, you can have darkening of the skin in the armpits, the back of the neck or the groin. The other aspect to consider is that women with PCOS are also more likely to suffer from depression and anxiety, or they have eating disorders, particularly binge eating.
[23:31] You are 20 to 40% more likely to experience a miscarriage due to the insulin resistance and the hormonal problems that it creates. Oftentimes, there is estrogen dominance and there’s not enough progesterone to actually hold a healthy pregnancy. I do see a lot of chemical pregnancies or early stage miscarriages in women that maybe didn't even know that they had PCOS. But then after we do a little bit of deeper digging we find that they have these symptoms, and then it’s really important to control for blood sugar dysregulation as well as the hormones when they’d go to get pregnant again. Diet becomes super important in those women.
[28:00] You have to understand, the key is getting your blood sugar under control first, and the insulin resistance under control, before you start experimenting with the fasting. In terms of the science behind the diet, low inflammatory, low glycemic Mediterranean diet or a modified ancestral diet, meaning Paleo with lots of vegetables in it, not just all meat, has been the one that has been shown in the evidence to have the most dramatic effect on PCOS. And the bottom line is that most patients with PCOS will respond to a diet that is no more than 80 grams of carbohydrates a day and has about 60 to 90 grams of protein, and the rest being good fat.
[29:59] Vitamin D has been associated with insulin resistance in low amounts. Having your vitamin D tested to see where you’re at is super easy and then supplementing depending on how low you are, with 2,000 to 5,000 units a day, and then re-testing again in 30 to 60 days to see if it’s making a difference on the levels themselves can be really helpful. One of the supplements that Hillary uses when encountering a woman with diagnosed or suspected PCOS is inositol. Inositol comes in a couple of different forms and a lot of the studies that have been done actually show that it’s advantageous to have a combination of Myo-inositol with D-chiro-inositol, at a ratio of 40:1 of Myo-inositol to D-chiro-inositol. The reason for that is, it’s naturally occurring in the body in that ratio. With the Myo-inositol you want to take up to 4 grams a day and the D-chiro you can go up to 1,200 milligrams a day.
[33:19] Another herb or supplement that is used in blood sugar regulation is cinnamon and we use this all the time in Chinese medicine. In fact, the main formula by which most others are based on for treating PCOS is derived from is Gui Zhi Fu Ling Wan.