In Episode 82 of The Holistic Nutritionists Podcast, Natalie Douglas and Kate Callaghan discuss how PCOS is diagnosed, the PCOS symptoms and what PCOS causes are in females.

• Update on Kate’s Breast Cancer journey
• Defining PCOS (it may not be what you think)
• Getting a correct diagnosis
• Different types of PCOS and why it matters
• Health consequences of sweeping it under the carpet
• To keto or not to keto
• Dietary principles for treating PCOS
• Is it forever?
• The most effective supplement interventions 

Intro 0:00
Hello and welcome to The Holistic Nutritionists Podcast, with your hosts Natalie K. Douglas, Thyroid Healer, and Kate Callaghan, The Holistic Nutritionist. Nat and Kate are degree-qualified dietitians and nutritionists, certified fitness instructors, speakers, and authors. If you love unfiltered banter, unedited bloopers, and authentic heart-sharing, then we are your ladies! Now it’s time to sit back, relax, and get ready for our latest tips on living your healthiest life possible.

Natalie K. Douglas 0:33
Hi, guys! Welcome back to the podcast. Kate, good morning.

Kate Callaghan 0:38
Good morning.

Natalie K. Douglas 0:45
Good morning, Mrs. Douglas. Do you remember doing that to teachers? Don’t you think that’s so funny that we did that, we sang people’s names.

Kate Callaghan
I think it’s nice. I’d like people to sing my name.

Natalie K. Douglas
Good. I’ll record a voice recording every morning and say good morning to you. It’s funny, my brother must get it actually because he’s a PE teacher. Although right now he’s in high school. You kind of stop it after like, three, don’t you? Nevermind, nevermind. That’s a long time ago since um, since school. I actually have my high school my 10-year high school reunion this year.

Kate Callaghan 1:22
Do you know how many like, three it’s away from my 20-year high school reunion.

Natalie K. Douglas 1:26
Did you go to your 10-year one? Did you have a 10-year high school reunion?

Kate Callaghan 1:31
I think we did but I don’t think I went. I think I went to the five-year one.

Natalie K. Douglas 1:34
Okay. Yeah, I don’t know how I feel about it, like part of me like I can’t wait to see everyone and catch up and see where everyone’s at. And then part of me, I hope it’s not just like a judgment fest, like, what’s happened to her. But I’m using it as a personal challenge actually, like, I’m gonna go with a positive attitude, I think. And I think what what makes me a little like, and this has been completely authentic and honest, is that when I was in high school, I was anorexic. So I was about 20 kilos, smaller than I am now.

Kate Callaghan
What?

Natalie K. Douglas
Yeah. And maybe 15 to 20 because I kind of fluctuated obviously at my worst, I was 20 kilos lighter. And so I look very different body-wise, and I’ve come to terms with it but, it is kind of it’s it’s not going to be something that’s unnoticed. And I’m just like, you know what, I’m going to use that as a practice in self-acceptance and being like, yep, you know what, there are going to be judgments, whether they’re good or bad, whatever that even means they will be there because it’s a significant change. And I’m okay with that. So that’s my practice of.

Kate Callaghan 2:56
But there are also might not be because there’ll be too focused on what everyone else is thinking about them.

Natalie K. Douglas 3:01
Probably too. Yes, I agree with that. I think there is a little bit of projection going on, which I’m also going to work on. But apart from that I’m actually like, because I I loved school like I really had a good time in primary school and high school. And I had a lot of friends from lots of different groups because I was just involved in a lot of different things. So I’m looking forward to seeing a lot of different people. So yeah, I think I’m just gonna enjoy myself.

Kate Callaghan 3:36
Do that, that’s important.

Natalie K. Douglas 3:38
And also I love like going out and being able to go and Boogie and we’re going to somewhere where we used to go like every Friday night when we were in high school and I’m like oh, flashbacks. I’m all about the dancing these days.

Kate Callaghan 3:53
I still love the disco.

Natalie K. Douglas 3:56
Oh gosh, oh but primary school disco’s was so challenging because the boy that I liked always used to dance with one of my friends and they’d once they dance to murder on the dance floor. On the stage, they get called up to the stage you know dancing to murder on the dance floor, holding hands, spinning each other, and my little heart was just breaking. I was like, I want to be murdered on the dance floor up there with you.

Kate Callaghan 4:21
Look, sorry that happen to you but you’re just giving me some inspiration for my zerofox Tuesday.

Natalie K. Douglas
Oh, there you go. You’re welcome. My pain is your game. It’s okay. I did get over it eventually. Anyway, any updates you would like to share with everyone because I’m sure everyone is also invested in your personal life at the moment to an extent but you shared.

Kate Callaghan
My boobs?

Natalie K. Douglas
You’re into into your boobs but you share what you’re comfortable with, with sharing.

Kate Callaghan 4:53
Um, okay, so at the moment, I mean, people would have seen it on my social media yesterday, if they did read it. So a plan of attack, surgically speaking is I’m going to be having a right mastectomy in a few weeks’ time. And they want to do what they call an exhilarate clearance, which means they’re going to take most of my lymph nodes. I am in conversations with my breast surgeon right now to not do that because your lymphatic system is super important, and while I can get new boobs made, if I want new boobs. You can’t put back your lymph nodes, essentially in the future, if you’re like, oh, now I want them back, sorry, too bad. And that can cause lymphedema issues, it can cause immune system issues. So there is this treatment called the surgical operation, exhilarated dissection. And my breast surgeon is one of the few people in New Zealand who is actually trained in it. So we are in conversations about that. It’s basically you inject to die, I think while you’re under so they can see what lymph nodes are affected by cancer and just remove those and leave the healthy ones. Yeah, so there’s surgery in a few weeks, and then I’ll have no boob. And I’ll get some chicken fillets.

Natalie K. Douglas
Well, you have one boob, right?

Kate Callaghan
Yeah, I have one boob. Yeah, I’ll have one chicken fillet. Aaron told me he made me a paper mache boob.

Natalie K. Douglas 6:33
I like it as you’re a forward thinker. I could play date out of it. Like the kids involved.

Kate Callaghan 6:40
Yeah. Because I remember making patch paper mache. I know what you’re talking about. And thank you for the very generous offer of a paper mache breast implant.

Natalie K. Douglas
What a legend.

Kate Callaghan
So, supportive. So, supportive.

Natalie K. Douglas 6:54
I think I need some husband like as it’s gonna paper mache a boob.

Kate Callaghan 6:56
Yeah, yeah.

Natalie K. Douglas 6:58
I don’t know how that would feel compared to a chicken fillet?

Kate Callaghan 7:01
I think a chicken fillet probably is gonna feel a little bit more realistic.

Natalie K. Douglas 7:07
Yeah but, paper mache might do it for you. Time will tell.

Kate Callaghan 7:15
So that’s the immediate plan. Everything else I have, you know, the doctors said what they want to do. And what I want to do might be slightly different. So we’re going to hopefully meet somewhere in the middle or slightly left of center. But I am researching, and researching, researching the actual scientific evidence and statistics. Not just documentaries, and which I mean the documentaries are amazing, and personal experiences are amazing but I need to combine that with what scientific evidence shows. I mean, it’s it’s kind of a big deal.

Natalie K. Douglas
Yes. Yes.

Kate Callaghan
It’s a big decision to make. I mean, before I had cancer, I always thought if I got cancer, I’d be straight off to Mexico and that’s that. Now I have cancer. It’s slightly more complicated.

Natalie K. Douglas 8:08
Yeah, you know, I guess it’s one of those things that you don’t really know how, like how you will react or what you’ll do until you’re actually in the situation. I think you’re taking a really good approach in terms of just weighing up all the pros and all the cons and making an informed decision in that way. And it’s a lot like you’re doing amazing to even muster up the emotional and brain energy to go through that process because that shit is hard to digest. But I guess you have a really good motivation too.

Kate Callaghan 8:49
Yeah, life.

Natalie K. Douglas 8:53
Yeah, yeah, just just that little little bit of a thing called living you know, nothing like that to to keep get a fire up your butt.

Kate Callaghan 9:00
Anyway, I guess the thing with chemo and everything is right now I don’t, I’m not sick. So, I don’t, I don’t feel sick at all. So if you’re going to say you’re now going to be sick. We’re gonna make you sick to get rid of this thing that actually isn’t causing you any problems at the moment is.

Natalie K. Douglas 9:19
Yes, well, keep us posted because I know that there’s many people that are very much invested in in you, and your journey, and your story, and we will absolutely do anything we can to support you including continuing to make jokes about paper mache boobs.

Kate Callaghan 9:37
Thanks. I’d started intermittent fasting.

Natalie K. Douglas 9:41
Yeah, you said that. How are you going?

Kate Callaghan 9:43
Hungry.

Natalie K. Douglas
Bored.

Kate Callaghan
Bored and hungry. Oh, not at the moment. I’m eating all the time during the day.

Natalie K. Douglas
Yeah.

Kate Callaghan
But overnight, long time to no food.

Natalie K. Douglas 10:01
Yeah, and you’re doing like 16 hours of fasting is that?

Kate Callaghan 10:04
Yeah, I’m working up to it.

Natalie K. Douglas
Yeah.

Kate Callaghan
It’s so weird to go from healing from hypothalamic amenorrhea and doing eat all the time, don’t fast, to essentially flipping it and going lower carb, higher fat, intermittent fasting. It’s, it’s bizarre to wrap my head around reversing everything that I’ve been doing for the past, what, seven years to heal my body. And now I have to heal my body in a completely opposite way.

Natalie K. Douglas 10:35
Yeah, it’s crazy, isn’t it?

Kate Callaghan
Yeah, just goes to show different strokes for different folks.

Natalie K. Douglas
Absolutely. Even at different stages of your life in the same person, I think that’s something to always remember is, what you do at one point may not always be appropriate for you over the long term. And that’s okay. And it doesn’t mean what you did at one point was wrong. It’s just that it’s not right for you anymore.

Kate Callaghan 11:01
Correct.

Natalie K. Douglas 11:03
Well, I think now would be a good time for us to start talking about our podcasting topic for today, which is PCOS. And we have actually talked about this previously, but I feel like it was quite a long time ago. And although some stuff may be repeated, I just feel like we’re better at podcasting these days. And I thought, it’s something that comes up a fair bit and is worth a revisit. And that’s why we chose PCOS. So, Kate, I know that you probably have a lot to say about this as to why because it is something that I feel like is over-diagnosed, and also is becoming more common, which sounds a bit contradictory. But that is what is happening I think. Where I thought we could start is just explaining what PCOS is for those who aren’t aware. Thoughts?

Kate Callaghan 12:04
Oh, you want me to talk?

Natalie K. Douglas 12:06
Yes, you can. Otherwise, I can.

Kate Callaghan 12:09
No, no, I could talk. So PCOS or some people call it Pcos. I don’t know why I don’t like Pcos.

Natalie K. Douglas
It sounds like a peacock.

Kate Callaghan
Yeah, it does. Yeah. Anyway, PCOS, it is polycystic ovarian syndrome. And the main part that I want everyone to think about and remember here is it’s a syndrome. So it’s a collection of symptoms. It’s not just one thing, and it’s often diagnosed by one thing, it can’t be diagnosed as one thing. So it’s a set of symptoms. Basically, it’s often diagnosed when women aren’t ovulating, or they’re not menstruating, or they have really irregular menstrual cycles, and therefore fertility issues. And the symptoms that you’re looking for obviously, menstrual irregularities or amenorrhea, elevated androgens, so high testosterone, then other things you might look for would be some hair loss, male pattern baldness, some acne, so around the jawline and on the back. And polycystic ovaries on in ultrasound would be the ones that I would look for. And for a lot of people, you might also see some insulin resistance in there.

Natalie K. Douglas 13:19
Yes. And I love that you pointed out that it’s a syndrome because the mistake that we see a lot is that as soon as someone has an ultrasound that has that looks Polycystic or has many cysts on it, the assumption is oh, I have a polycystic ovarian syndrome, which is incorrect, you need to have other things present. So, in terms of being diagnosed properly, ultrasound alone is not enough. It’s normal to have some cysts on your ovaries for example. I think it’s about six to 12 per ovary is normal. Does that sound roughly right?

Kate Callaghan
Yeah.

Natalie K. Douglas
I feel like that’s roughly right. For anyone wondering what are cysts doing on my lady garden pots, they are simply developing follicles and they should be one follicle. Gosh, what is going on this morning? My fancy microphone isn’t doing what it did for me last week. Anyway, there should be one dominant follicle. Oh, my gosh.

Kate Callaghan
Follicle. Follicle.

Natalie K. Douglas 14:31
Follicle. That is like that’s larger, which is indicative of you progressing to ovulation that month. If you don’t progress to ovulation, then that’s when there might be lots of under underdeveloped cysts, which is usually what they find on the ultrasound. So polycystic ovaries are only indicative of the fact that during the month of ultrasound that you got, you didn’t ovulate. And that’s it, it doesn’t tell you why it didn’t happen and it’s certainly isn’t enough to diagnose PCOS alone, because other conditions where we often see polycystic ovaries, like HA, or in like women on the pill, and honestly even in normal women every now and again, you might have one ultrasound that that month there were many cysts, but then the next month it’s absolutely fine. So according to the Androgen Excess Society, yes, that’s that’s actually a thing. Androgen Excess Society, anyway, to be diagnosed with PCOS you need to basically meet three criteria. So one is that you need to have irregular periods or no periods at all. Have high androgens on a blood test or the symptoms of high androgens, which is what Kate mentioned before. And three, other potential reasons for high androgens have been rolled out. And then you can have polycystic ovaries on the ultrasound, but you don’t necessarily have to. So in clinic or in practice, looking at blood tests, some quite defining findings would be low sex hormone-binding globulin or SHBG, high androgens, so free testosterone, DHEA, androstenedione, high LH is another one. Those would be some of them. And there are different types of PCOS. And this is where treatment changes a little bit based on the types and also where you still need to look because we always want to know what is causing you to have PCOS not just oh, here we found it that’s enough. No, we need to know why. So whenever it comes to a syndrome, we need to know what is driving it. So the most common one, which Kate, you touched on a little bit there, was insulin resistant PCOS. And I think this is a good one to explain because it is the most common one and then we’ll just briefly mention the others as well. So insulin and leptin basically regulate both blood sugar and appetite respectively. And they also help to regulate your sex hormones. When you’re insulin sensitive, which is what we want. After you eat food, after you eat food, insulin will rise and tell your cells to take up glucose and then it will fall and that’s normal. Now leptin is our satiety hormone and it actually communicates with our hypothalamus in our brain, and one of its jobs is to tell your pituitary to release FSH and LH. However, in insulin-resistant-driven PCOS you’re no longer sensitive to insulin and leptin so you’re resistant to them. So you might see these two hormones are high on your blood test. And insulin resistance can cause things like weight gain, which is why a lot of people with PCOS assume that this is why they can’t lose weight which can be true if your PCOS is an insulin-resistant kind. Insulin resistance also increases your risk for diabetes, heart disease, heavy periods, dementia as well. And it can be caused by too much sugar, being overweight, a high trans-fat diet, smoking, the pill, poor sleep, magnesium deficiency, and a few others. And the way that insulin resistance is actually causes PCOS is by impairing ovulation and instead of making estradiol which is our main natural estrogen that we make, your ovaries overproduced those androgens, and too much insulin will cause your maturity pituitary to make more LH which then further stimulate androgen production. And the other thing that happens is that too much insulin reduces sex hormone-binding globulin, which means you’ve got more of your testosterone free in your body rather than bound. So if you think of sex hormone-binding globulin as like a taxi that carries around your sex hormones, if there are not enough taxis, there’s going to be lots of free testosterone out on the streets, wreaking havoc, which is where we start to see some of those symptoms that Kate was mentioning in relation to hair loss, male pattern hair growth. And I think something to point out here is that when we say male pattern hair growth, we’re kind of talking about, you know, getting hair on your upper lip or on your nipples on your like a snail trail type situation. And it’s absolutely normal to have a few hairs on your upper lip that you pluck when you you know sitting at the lights because the light is really good.

Kate Callaghan 19:56
Have you ever been plucked an upper lip hair?

Natalie K. Douglas 20:00
Yes.

Kate Callaghan
So far out it hurts.

Natalie K. Douglas
It does but you know where I find the best place to do it? In the car when the, you stopped at some like at the lights or I hope this is not illegal. Can you pluck your upper lip hair? I totally do because the light just shines in the right place. And you’re like, damn lucky I caught this one because if someone was talking to me at an angle, this would definitely be shining. And I feel like that is normal to have, you know, a few here and there but it’s when it becomes quite noticeable. And you’re like, wow, every day I’m needing to pluck a new upper lip hair.

Kate Callaghan 20:36
I’ve got a mo.

Natalie K. Douglas 20:38
Yeah, I’ve got I’m competing in I’m like joining Movember with the men. That’s when you know, it’s time to check out your androgen levels. And then yeah, other other places where nails would have hair that females wouldn’t like nipples. And again, if you see one boob hair relaxed, it sucks, it’s okay it’s when you start seeing more that feel uncharacteristic. And that’s something to take into consideration.

Kate Callaghan 21:06
So I have to jump in there and there’s probably too much information but I do probably have a few. A few nipple hairs but I have never had PCOS.

Natalie K. Douglas 21:18
Yeah, I get a few every now and again just pluck them actually really love plucking baby hairs.

Kate Callaghan 21:23
Yeah, so do I, but I’d say I’d say I have more than just one or two.

Natalie K. Douglas
Yeah, I’m about.

Kate Callaghan
So if anyone looks down and go pretty exciting goes, I’ve got nipple hairs. Maybe I have PCOS, so as we said before it’s a syndrome, a collection of symptoms. Don’t just freak out by your nipple hairs.

Natalie K. Douglas 21:41
Yeah, no, no please.

Kate Callaghan 21:42
I just don’t give a fuck about people thinking what people think about my boobs anymore.

Natalie K. Douglas
No, me neither, I have.

Kate Callaghan
I had hairy nipples.

Natalie K. Douglas
Yeah.

Kate Callaghan
Sorry.

Natalie K. Douglas 21:51
I honestly reckon out of all the things that are fun to pluck baby hairs are the most satisfying. I also have this one hair it’s called forsey, which sounds a little bit inappropriate, but it’s not.

Kate Callaghan
What?

Natalie K. Douglas
It’s actually on my forehead, and it just grows. It’s just one though. And it grows like I’m a unicorn.

Kate Callaghan
Pretty cool.

Natalie K. Douglas
And I can’t. I never find it myself. But every now and again, I’ll be talking and Bowen will be like, forsey’s back right there. And I’ve had it ever since I was in high school because my friend Sam, who was one of my best friends in high school used to named him forsey and used to pluck him in class, when she could see him just like glistening in the light, sticking out like the unicorn of a woman I am and just bam. Just one same place. Actually, I don’t know if it’s `31`still there today.

Kate Callaghan 22:39
Embrace it. People say do you know you have a hair in the middle of your head? And you say yeah, I’m a fucking unicorn.

Natalie K. Douglas 22:49
Yeah, I do. Don’t touch it. Anyway, so totally normal to have a unicorn forehead hair, totally normal to have a few or a little bit more than a few nipple hairs. You know, if it’s in the absence of if you don’t have any of the other symptoms that we’re mentioning don’t worry about it. Enjoy plucking your baby hairs. Maybe don’t do that at the traffic lights. I’m not sure how distracting that would be for people around you and could be unsafe. But you know you do you. So in terms of treatment for insulin-resistant type PCOS, because I want to speak about this one a little bit more in-depth because it’s the most common, I would say my top treatments would be a low sugar diet. Intermittent fasting can work for some people, but don’t be attached to it completely because I don’t see it work for every single person. But definitely this is is a time where I would be strongly considering trying it at least, exercise absolutely, stress management, sleep, and then there are supplements which we’ll get into later. What are your thoughts, Kate, around using keto in this specific type of PCOS. A lot of people talk about, you’ve got PCOS you have to go low carb. And I agree that going low carb, lower carb for a period of time in this type of PCOS can work but I’d be interested to hear your thoughts on that and whether you think people need to go as far as going keto or if you yet what your thoughts are.

Kate Callaghan 24:26
I probably would agree with you and saying that lower carb is better. So keto is quite strict. I know it’s all the rage right now but if you’re thinking of true keto, it’s less than 30 grams of carbohydrates a day. So that’s pretty, pretty low, you get a few rice crackers in there which is a bit sad. And it really depends on the individual and what’s going on with your biochemistry if you’re really really insulin resistant. If you’ve got really high insulin levels, then yeah, I might say a short-term keto diet, I wouldn’t say you have to be keto for forever, it’s not something that you want to do forever, I don’t want to cycle in and out of it, and have a bit of a refeed with carbs every now and then to help your gut, to help your adrenals, to help your thyroid, to help everything in body really. It can be amazing but yeah, lower carb is probably a better option for most people. If you don’t have insulin resistance, then I would be more, well it’s still low carb, in comparison to mainstream but moderate in the whole alternative sphere.

Natalie K. Douglas 25:38
Yeah, yeah, I agree with that because I think too many times, people hear the word PCOS, and automatically fear eating anything that resembles a carb. And to be honest, most of the problem in relation to insulin resistance is more so in relation to research, more so to do with excess sugar intake than anything else. And I think that’s definitely a place to start. And that’s true across the board like we all should be eating minimum sugar, for health. And I think I agree with you, just get all the information first, find out if you actually have insulin resistance, and then start making steps towards a moderate amount of carbohydrates. I think we’re just drawn to things that are extreme because they’re sexier and then we can label ourselves and feel like we belong but I think there’s a lot that you can do just by cutting out sugar, eating more anti-inflammatory foods, all the stuff that we usually talk about. Now, the other thing I wanted to mention is that, as I’ve alluded to, they aren’t just there isn’t just one type of PCOS. And when we’re speaking about types, this is not official, like this is not official talk that in the medical, if you go to your doctor, and you’re like, which type of PCOS do I have? They will look at you like you also have a unicorn forehead hair.

Kate Callaghan
You know, the PCOS.

Natalie K. Douglas
Yeah, it’s more something that we speak about in this kind of space. And it’s it’s just a way of figuring out which is driving your PCOS. So other types would be inflammatory-driven PCOS, post-pill PCOS, other things driving it in terms of thyroid disease because it impairs ovulation or deficiencies in zinc, or iodine, vitamin D, selenium because your ovaries need those as well, or really poorly constructed vegetarian or vegan diet because of the deficiencies that can be created, particularly in zinc and magnesium. And I would also say that HA, Hypothalamic Amenorrhea is very commonly misdiagnosed as PCOS. Would you agree with that, Kate?

Kate Callaghan 28:08
100% I see it so often. It’s a bit of a disgrace, really, because of that, looking at the ovaries and just seeing polycystic ovaries, which are really common in hypothalamic amenorrhea because your body’s trying to push for that ovulation and it never quite eventuates. Yes, it’s misdiagnosed as PCOS and they don’t look at the blood markers.

Natalie K. Douglas 28:30
Yeah. And so looking at the blood markers, one example of what we might see that’s different is in PCOS, your androgens are elevated, in HA they’re often low. So that’s something to look out for. Would there be anything else that could be quite defining for people to look at Kate in that context of the blood test? HA versus PCOS, or would that be the main one you’re looking at?

Kate Callaghan 28:57
I’ll just put some roll slice in my mouth. Sorry.

Natalie K. Douglas 29:01
We know you’re gonna eat for eight hours straight so you can make up for the 16 hours of fasting. I like your approach girl, just you just do.

Kate Callaghan 29:11
So yes, absolutely, testosterone is going to be the key one. You can also look at LH and FSH. So LH will generally be elevated with PCOS. And you’re going to be looking at your estrogen as well estrogen’s typically really really low with hypothalamic amenorrhea. They would be the main ones.

Natalie K. Douglas 29:32
Yep. And none of these are that difficult to request from your doctor most of the time. I will say most of the time because I had a recent experience where I just I like to check in on my hormones every now and again. And I just went to the medical center doctor, and I was like, could you please test my sex hormones. He tested estrogen. It’s like hmm, I feel like last time I checked, there was more than just one.

Kate Callaghan
Yeah.

Natalie K. Douglas
Not sure. It could be wrong, I don’t want to disregard your many years of medical training in which maybe they weren’t but I just feel like maybe there are a few more sex hormones in my body anyway, that didn’t go so well.

Kate Callaghan 30:20
Oh, it sucked you don’t have estrogen.

Natalie K. Douglas 30:22
Yeah, it’s just not cool. Anyway, you can, you know, you can request it, you can also do it privately, but I would try at the doctor first. It’s not as difficult as like getting proper thyroid testing done, though, I feel like you may have to be more specific, and write down all of the sex hormones that you have, and then request it, or just go to someone who knows what they’re talking about, or get your practitioner. So for me as a practitioner, Kate, I’m sure you do the same as well. I will write a referral for my patient to take to the doctor, so they can hand it to them and know exactly what I’m asking to be tested. That still doesn’t guarantee that everything will be tested by any means.

Kate Callaghan
They really love when we do that.

Natalie K. Douglas
Yeah, I know. I try and justify it well, though, and I definitely try and use the dietician part at the bottom because they’re more medically minded. So they’re like, oh, she’s a dietitian. That’s if I put, you know, anything holistic on it, they’re like, oh naturopaths.

Kate Callaghan
Yeah, they don’t like me.

Natalie K. Douglas
No, they don’t understand.

Kate Callaghan
Even though I’m a dietitian, but I call myself a nutritionist.

Natalie K. Douglas 31:28
Yeah. So I try and try and like use the title, you just want to abuse it a little bit. That’s okay. I’m a unicorn after all. Okay, so what about health consequences of sweeping it under the carpet, because I’ve definitely had people say to me in the past, kinda like that, I don’t get a regular period, kinda like that it doesn’t come very often, it’s convenient, because I don’t really like having one. So for those people, which I don’t feel like there’s as many people listening to these podcasts that would have that thought, but if you are, no judgment because I was also there once. I would like to discuss what consequences there are of not really addressing it. And I would say one of the first ones that comes to mind for me is that regularly ovulating is a sign of health and it’s also the only way to produce progesterone. And progesterone has many amazing benefits in terms of making us feel calm, it thins the lining of your of your uterus, which can is helpful at the right time. And I also think that it makes us feel mentally well, having hormones that are balanced. And I also think that sweeping it under the carpet can have longer-term fertility implications infertility implications I should say. Kate, what else would you say is a bit of a long term health consequence of not addressing PCOS?

Kate Callaghan 33:11
Well, you kind of stole the big ones.

Natalie K. Douglas
I did, didn’t I? I was just gonna say one, and then.

Kate Callaghan
I’m just gonna jump in and steal the big ones.

Natalie K. Douglas 33:18
Now you go searching for all the little tiny ones that we haven’t thought about.

Kate Callaghan 33:23
So the other big one that I would think about is if you do have insulin resistant PCOS, then obviously, there’s the risk of diabetes and Alzheimer’s and heart disease and everything that goes along with insulin resistance and relatively high blood sugar levels in HbA1c. That would be the other big thing.

Natalie K. Douglas 33:44
Yeah. What are your thoughts on the conventional treatment for PCOS? What do you find most people are over? What else like I, a lot of people offered the pill.

Kate Callaghan 33:55
Oh, yeah. The pill and Metformin. We’ve spoken about what we think about that?

Natalie K. Douglas
Yes. Please refer back to.

Kate Callaghan
The pills are gonna be a band-aid. Metformin last resort. I would say, if you have the insulin-resistant PCOS.

Natalie K. Douglas
Yeah.

Kate Callaghan
No, I wouldn’t go at first line of action, pick, try to pick lifestyle and diet first. And then if you need to short term Metformin, taking all Metformin considerations into account. So supplementing with B12. Mindful that you might struggle with nausea but if you need to your short term if you can’t get your insulin resistance under control, then maybe it’d be something to lookout.

Natalie K. Douglas 34:37
Yeah, yep. And is it something that is PCOS something that is forever, or do you believe that it can be cured?

Kate Callaghan 34:46
Do you know I can probably get really slammed for this?

Natalie K. Douglas
Oh, do you want me to say it instead?

Kate Callaghan
No, no. No, I would say so maybe we could say remission, not cure.

Natalie K. Douglas
Yes, remission.

Kate Callaghan
Yes, it can be a remission. I need to stop eating this slice because I’m getting caught in my thyroid.

Natalie K. Douglas
It’s okay, Kate, we only have about 15 minutes left and you can eat all day.

Kate Callaghan
We got three minutes left.

Natalie K. Douglas 35:16
Okay, let’s keep going.

Kate Callaghan
Okay.

Natalie K. Douglas
Okay, cool. So all right. Last last question, what about supplements? Supplement intervention? So what would you say across the board for all the different types of PCOS would be appropriate?

Kate Callaghan 35:29
Broccoli sprout powder, because I love it. It’s so wonderful for estrogen metabolism. Myo inositol is really wonderful for polycystic ovarian syndrome, magnesium, zinc, your B vitamins, green tea, turmeric if you have any inflammatory PCOS going on. Anything that can is going to help with stress management. So looking at your calming essential oils, looking at ashwagandha, get healthy my big ones.

Natalie K. Douglas 35:59
Awesome. I agree. And I’d add alpha-lipoic acid, and vitamin D, and berberine, and cinnamon for anything that is insulin resistant driven. And I would add peony and licorice are really beautiful if its a pill-induced insulin resistance and inflammatory PCOS. You said turmeric, didn’t you? Yeah, you did.

Kate Callaghan
I did.

Natalie K. Douglas
And I would say add to that, NAC, acetylcysteine. And I also use Boswellia, or internally as well for inflammatory PCOS.

Kate Callaghan
The boswellia resin or essential oil?

Natalie K. Douglas
I use, well, I use the essential oil topically, I mean, like to apply to people and then defuse it and then I use the resin internally.

Kate Callaghan
Cool. Good one.

Natalie K. Douglas
And that’s that’s all and then all of the usual lifestyle stuff the sleep, stress management, exercise, etc. So hopefully that is helpful for everyone. Kate, we want to allow you to get back to eating your slice, but is there anything else that you wanted to add to this discussion?

Kate Callaghan 37:11
Just final point, if you are of the insulin-resistant variety, and you don’t want to go to low carb because you might have some stress in your life, then you’re trying to modulate that and not really wanting to bottom out your adrenal glands. Have your carbohydrates, but time them after a workout, preferably a resistance training workout when your cells are going to be most sensitive to taking that glucose up without the use of insulin.

Natalie K. Douglas 37:43
I love it. Good advice. I love carbs too. I really need to stop telling everyone that. Okay, cool. Well, oh, last thing reco’s, recommendation. I’ll go first and if you don’t have one, that’s okay. My recommendation for this week is go and see a pelvic floor physio and get a pelvic floor release because it’s amazing, and for anyone that suffers from period pain it actually really helped my period pain levels this month. So I have well, suspected endo and it did help with yeah my period pain because your pelvic floor absolutely play the role in in period pain to an extent so go and get a pelvic floor release.

Kate Callaghan 38:27
I like that.

Natalie K. Douglas 38:28
Yes. Any reco’s or would you like to skip this week’s?

Kate Callaghan 38:33
Mushrooms.

Natalie K. Douglas
Mushrooms. Good one.

Kate Callaghan
Medicinal kind. It’s not the magic kind. Although if you’re into that, go for it but yeah, I decided, as I’m saying off air, I just bought an immune-supportive blend of Reishi, my turkey, turkey tail. Lion’s Mane but mostly for what I’m going through at the moment Turkey tail and my turkey are what I’m loving or trying to love.

Natalie K. Douglas 0:00
Yes. Yes. Lots of research around those and I use actually use a fair bit of mushrooms for a lot of my autoimmune patients and I also use a lot of quadriceps for anyone who has a lot of stress or HPA axis / adrenal fatigue type presentation and I love them. And Lion’s Mane amazing for cognition, and memory, and concentrating. Great to spark your husband’s coffee with, just saying, just saying, hopefully, my husband’s not listening. Anyway, so we will wrap it up there. Kate, we love you.

Kate Callaghan
Thanks. Nat.

Natalie K. Douglas
And please keep us posted on all things breast journey.

Kate Callaghan
Boobs.

Natalie K. Douglas
Boob journey.

Kate Callaghan
Or boob.

Natalie K. Douglas
Boob. And we will we’ll have one less boob to pluck hairs from. Good or bad.

Kate Callaghan
Then my paper mache boob?

Natalie K. Douglas
Yeah, that’s right. Maybe, maybe we can make some sprouts on there. Broccoli sprouts on your paper mache boob.

Kate Callaghan
There we go. Now we’re talking. Now we’re talking. Yeah.

Natalie K. Douglas
All right. Well, we will see you all next week.

Outro 1:14
Thanks for tuning in to The Holistic Nutritionists Podcast. Remember, we love to make the show relevant to you. If you have any questions or topics you’d like us to discuss, just submit them to [email protected] and we’ll get them answered for you. Also, don’t forget to subscribe, rate, and review the podcast on iTunes and share it with your friend. And if you’re looking for more info about how we can accelerate your journey to your optimal health, you can find me, Nat, over at NatalieKDouglas.com, and Kate, at TheHolisticNutritionist.com. See you next time!