Episode #99: Ask Ashlene Anything

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Ask Ashlene Anything

What you’ll learn in this episode

In today’s episode of the PCOS Repair Podcast, I’m answering listeners, just like you, questions about managing PCOS, from supplements to improving symptoms like how to lower high testosterone levels. Thank you to everyone who has answered your questions— your curiosity and engagement truly shape our discussions here. Let’s get started and tackle some of the most pressing queries from our community.

PCOS Q&A

I appreciate the courage to reach out with personal health questions. In this, I’m answering a selection of those queries, providing detailed insights into managing PCOS with a blend of medical knowledge and personal and 100’s of client experiences.

Questions Asked and Answered

  1. Optimal Dosing for Inositol:

You will learn the recommended ratio and dosages for Inositol, how it benefits PCOS symptoms, and the best times and ways to take this supplement.

  1. Managing High Testosterone in the Absence of Insulin Resistance

Exploring how high testosterone can manifest without apparent insulin resistance or elevated LH levels, and what alternative pathways might contribute to this condition.

  1. Hair Loss Solutions

Tips on combating hair loss associated with PCOS, including effective supplements and lifestyle changes that can help improve hair health.

  1. Alternatives to Progestin for PMS and Mood

 Evaluating non-hormonal options for managing PMS and mood fluctuations often exacerbated by PCOS.

  1. Can PCOS Be Cured?

 Addressing whether PCOS can ever “go away” and strategies to manage symptoms effectively throughout various life stages.

  1. Does Thin PCOS Have the Same Root Causes as Classic PCOS?

Clarifying misconceptions around ‘thin PCOS’ and discussing how it compares to more recognized forms of the syndrome.

 

Your questions help make the podcast more informative and relatable. Continue to participate by asking your questions in my DMs on Instagram @NourishedtoHealthy. And be sure to follow me and stay tuned as I address these topics and more.

Let’s Continue The Conversation

Do you have questions about this episode or other questions about PCOS? I would love to connect and chat on a more personal level over on Instagram. My DMs are my favorite place to chat more.

 

So go visit me on IG @nourishedtohealthy.com

 

Let’s Continue The Conversation

Do you have questions about this episode or other questions about PCOS? I would love to connect and chat on a more personal level over on Instagram. My DMs are my favorite place to chat more.

 

So go visit me on IG @nourishedtohealthy.com

 

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Read The Full Episode Transcript Here

Welcome back to the PCOS Repair podcast, where today I want to start by saying thank you for everyone that has written in questions and DMed me questions on Instagram for today’s episode. Some of these are the exact questions that I got. Some of them are a combination of similar questions on the same topic. It’s really helpful for me to know what specific questions are coming up for you. I know it can take a little bit of bravery to step out and ask a question, so I appreciate everyone that has done so. With that, let’s dive in.

You’re listening to the PCOS Repair Podcast, where we explore the ins and outs of PCOS and how to repair the imbalances in your hormones naturally with a little medical help sprinkled in. Hi, I’m Ashlene Korcek, and with many years of medical and personal experience with polycystic ovarian syndrome, it is my joy to watch women reverse their PCOS as they learn to nourish their body in a whole new way. With the power of our beliefs, our mindset, and our environment, and the understanding of our genetics, we can heal at the root cause.

All right, so welcome to today’s episode of Ask Me Anything PCOS-Related Questions. Our first question today is, what is the correct dose for Inositol? There isn’t an exact dose. Of course, you want to make sure that whatever you’re taking is approved by your healthcare provider, but also is approved by your body. Sometimes certain doses work better with us. The research shows that typically somewhere in the 4 grams is a really good upper limit, so anywhere between 1 and 4 grams daily. Now, typically this is best absorbed if we take it into two different doses throughout the day. One of my favorite brands for Inositol is Ovasitol, and I will link that in the show notes. Not an affiliate link so that you know what I’m talking about. What I like about this one is that it’s a combination of myoinositol and decryoinositol. These two together have slightly different purposes. They both have slightly different superpowers in the body. Ideally, the research shows that we want these to be in a ratio of 40 to 1. This is the only supplement that I see that routinely done. There are maybe a few newer supplement brands that have that, but basically, we’re looking for a combination of both mio and decryo-inositol, and in a ratio of 40 to 1, so 40 mio, 1 decryo.

Then we’re looking for somewhere in that 1 to 4 grams. If you take ovasitol, they have it, essentially each dose is 2g, they have it in milligrams. It says 2,000, but it’s in milligrams versus grams. Then what happens is that take that morning, ideally a night. Now, the cool thing about this particular supplement is you can dissolve it in any fluid, and it really does dissolve well. It’s not gritty, you don’t know it’s there, so you can throw it in your coffee, you can throw it in water, you can throw it in a smoothie. The heat doesn’t denature it or make it less potent, and so that’s a really nice thing with this particular supplement. Side note, with this supplement, not quite in the question that was asked here, but it’s very helpful to take this with folate. The two work nicely together, so taking somewhere in the 200-400 micrograms of folate a day would be a great addition along with your inositol powder or supplement.

Then what are the benefits? I just want to touch on these real quick because for those of you who don’t know what inositol is, it’s sometimes thought of a B vitamin, but it’s more than a B-vitamin. It actually is involved in the glycogen synthesis and storage. It helps your metabolism and it helps to also take care of the lipids. So your LDLs, your HDLs, and your triglycerides are also going to be improved through this. Basically, it’s really working in your metabolic health, which is a huge part of our root cause PCOS hormones. Now, and I do want to also note that as with every supplement, supplements with PCOS are not a magic bullet. There is not a supplement out there that I talk about on this podcast or that you will read about elsewhere that will take care of your PCOS. There’s ones like Inositol that can help you when you’re doing the lifestyle changes but by itself, Inositol is definitely not powerful enough to overcome what we’re eating if we’re not moving, if we’re not managing our stress, and if we’re not creating lifestyle habits that support our PCOS health needs. That’s a really important first step and some people find that it’s really helpful to get a supplement first, some people find that it’s really helpful to add a supplement to boost what they’re already doing. I think this comes down to more of a psychological endeavor.

Sometimes by In the act of purchasing a supplement, it’s like I’m almost committing in my mind to over the next several days, weeks, months, because if I buy a 90-day supply, three months, I’m going to put the effort into taking the supplement and eating and moving throughout the day that’s going to enhance the supplement’s benefits. That is where these supplements really shine. Taken without doing the lifestyle, I don’t know that you would really notice a big difference. I mean, Ovasitol or Inositol. It’s Ovasitol is a brand of supplement, but Inositol is the actual substance. This is not as powerful as metformin. It’s not the same as metformin. It’s used for similar purposes as metformin. That’s where, again, you’re going to want to talk to your health care professional. It may not be wise to be on both of these. Some people are able to be on both of these, but that’s a question you would want to ask your healthcare provider. Now, this is not as strong as that, and metformin itself is not strong enough to overcome lifestyle. There’s nothing out there that lets us just live however we want and have the health that we want. We have to do the lifestyle and learn what the root causes are and learn what our body is needing and provide that for our body but this can give us a little extra boost, and that is always welcome.

Moving on to our next question. Someone was wanting to know about high testosterone. What are some alternate pathways that may produce excess androgens that aren’t high LH or insulin resistance? The way I’m reading into this question is that they have high testosterone, but they don’t have high LH or high insulin resistance. What other pathways could be leading to this high testosterone? Let’s continue the pathway here, and then we’ll talk about the labs of LH and insulin resistance. In PCOS, the genetics tend to have excess androgens. Our body already tends to produce excess androgens through the and also there’s other things that will convert. So estradiol and testosterone can convert back and forth based on levels and so there’s a disconnect in our body’s ability to balance some of those at baseline, especially given other outside forces from those pathways acting upon them. It’s a little complicated to discuss verbally. It’s very complicated to discuss verbally.

It’s even very complicated to draw it all out but essentially, there are many little small pathways that all come together, and they can all shut off or turn on based on what is going on at any given time but the simplifying version is that in PCOS, ovaries will produce more androgens. Those androgens are typically going to be converted towards testosterone, which is why we tend to see high testosterone in women with PCOS. Now, that is not always the case. You may have PCOS and not have elevated testosterone. Again, we have to remember that what is normal is a fairly large range for how tiny of a change creates symptom changes. What I mean by this is that a really small deviation in your testosterone levels, so just a small bump up or a small bump down, can have a huge difference in your experience of symptoms. Now, in labs, that small bump up or small bump down may be completely insignificant, and they may both be within the range of normal. What does that mean? It means that when we take laboratory values, the testosterone or any hormone, it could be gestrone, estradiol, these hormones, small changes make a big difference in how we feel.

We have to go off of symptoms even more than lab values. A high testosterone is a high testosterone. High lab values are high lab values. Low lab values are low lab values. However, a normal lab value with symptoms is still significant to the person that’s having the symptoms and can still mean that those hormones are not optimal for that person. I just want to make that caveat because a lot of times we get our labs done and we’re like, I have high testosterone, my LH is normal, and I don’t have insulin resistance. If we’re only relying on the labs, we’re not looking at all the information. We have to focus primarily on symptoms when it comes to PCOS. This is true even if your labs were drawn at an optimal time, which is depending on which hormones you are evaluating, maybe in the middle of your luteal phase or it may be in the first three days of your new cycle. Women with PCOS often don’t have a regular cycle, and so oftentimes these lab values are drawn at random, and that makes the lab values even less accurate. When someone tells me they have a certain lab value, these are all things that I want you to be considering when you look at your lab values.

This doesn’t make them unhelpful. It just is important to look at what are they or are they not showing? In other words, what conclusions can we draw from these labs and what do they help us know? If we have a random lab drawn because we don’t know when our period was because our periods are irregular, we don’t know where we’re at in our cycle. This is where, side note, a Dutch test can be very helpful because you can do a full cycle mapping but beyond doing something like that, you can use this information as baseline random, meaning you have a pretty good idea of where it is and you can always backtrack it. If you got your labs done and then say you started your period three weeks later and you had a period 60 days before. So yes, it’s a big window of when you’d had your period but typically when your period starts, unless it’s a breakthrough bleed, you would backtrack two weeks to when you probably ovulated or had a pseudo ovulation, potentially. Again, we are aware, because we don’t have a regular period, that these labs are a guideline, not as strong of evidence for our hormones as if we knew exactly where we were in our period but say six months from now, we’re having more symptoms or less symptoms, we could get those labs done again and see what the trends are showing us between test one and test two, and there is helpful information in that but we don’t want to get too excited about when our lab values are showing more or less significant than our symptoms are for a specific hormone. If we are seeing a ton of facial hair, but our testosterone doesn’t seem that impressively elevated, I’m still going to treat that person as if they have elevated testosterone for them, and we’re still going to do the things that are going to help lower that testosterone.

Back to our question, what are alternate pathways for the ovaries to be producing excess androgens? The two big ones are going to be insulin. I know you’re like, I don’t have insulin resistance. The two ways that we elevate insulin are through cortisol. If we raise our cortisol through stress, it will raise our insulin. The reason is that when we are in a stressful state, our body wants to be able to respond. It knows we are going to need blood sugar available to us. It also will elevate our insulin. Those pathways are very closely linked. Having excess cortisol leads to having excess insulin production in the body. The other one is what we eat. When we eat, blood sugar moves into our bloodstream from the foods that we ate as it’s broken down and digested. That blood sugar signals our body to release insulin in the amount that’s needed to absorb that blood sugar. Think of it like a spill. If you spilled your coffee and it was just a couple of drips on your desk and you just needed a quick little napkin to wipe it up, that would be one thing. If you spilled your entire venti latte as soon as you got to work, that’s going to require a lot of paper towels or a big cloth or something because you spilled a whole venti cup of coffee as compared to just maybe it dripped a little bit and you have a little ring on your desk. That’s how insulin works. It is going to be released in the magnitude of which it needs to mop up or let that sugar into the body’s cells. That insulin circulating your system affects your ovaries, completely independent of whether or not you have reached insulin resistance status. I think that’s the part that everybody is confused about when it comes to, Oh, but my doctor says I don’t have insulin resistance.

Insulin resistance is a state of health deterioration that we reach prior to reaching a further deterioration of type 2 diabetes. What happens is that when we are young, our body compensates. Our labs are not going to show insulin resistance. What medical professionals were taught is that you are considered insulin resistant once your labs reach a certain mark. The problem is that in young people, we haven’t usually reached that mark yet. Now, if we have been overweight since we were children, if we have really eaten poorly and really not exercised, we may reach insulin resistance in our late 20s, which is still really young, but mid-30s for sure is possible but the problem is, what we’re dealing with PCOS is from teens to about 40 is usually the window where women are diagnosed. Now, we still deal with it beyond 40 but the problem is that doctors are telling women “but you’re not insulin resistant”. Well, that’s correct. You haven’t reached that level of health deterioration yet. That doesn’t mean that every time you eat, you aren’t spiking your insulin.

When we eat, the blood sugar constantly spiking and requiring that insulin to mop it up. When we do that over and over and over in large magnitudes, it’s normal to have a breakfast that gives it a little spike, a lunch that gives it a little spike, a dinner that gives it a little spike, maybe a snack or two in there that gives it a small spike but when we are shooting it up with high sugared coffees or drinks in the morning with large amounts of processed, carbohydrate-rich foods, we’re spiking it way higher than it needs to. We’re spilling that venti latte and needing a huge insulin cleanup. When we do that over and over and over and over, we’re wearing out our system. Over time, decades of time, we will eventually reach insulin resistance but before we reach that, every time that we require that amount of cleanup from our insulin to come in because we spiked our blood sugar, we are essentially telling our ovaries to produce more insulin androgens. In PCOS, we have a tendency to already produce more androgens through our ovaries. When we have that extra insulin present, we are amplifying that tendency to produce more androgens.

When we reduce the amount of insulin that our body is coming into contact with on a daily basis, we reduce the androgen effect of our PCOS. It’s really linked to our food. It has very little to do with insulin resistance. It’s more of a marker of how far we’ve gone. It’s not a marker of it doesn’t start happening until we are insulin resistant. I think that’s one of the biggest misconceptions that women have about PCOS and the foods that they’re eating. Hopefully, that clears up that question.

High LH, testosterone drives LH. If we are high T but not a high LH, that’s just because our testosterone isn’t elevated enough or hasn’t been elevated enough or that particular lab draw wasn’t showing an elevated LH, it could be what time of month the LH was drawn or whether or not it was a random LH. With LH values, this is such a cyclical hormone, testosterone is going to be a little more stable. Testosterone is a lot easier to test. Lh is going to rise and fall throughout your cycle. It’s going to be at a certain level and then bump up. So wherever you are finding it. Again, there’s a range there of what would be considered normal because if you have LH at a decreased level, but you still get a really good surge, when one can still ovulate with that. The LH level, what we really want to see is, do you get a good surge of LH at ovulation? Otherwise, ovulation isn’t going to occur. If you already are starting at a high level ovulation, it’s a lot harder for your body to pump out enough extra to give that difference because it’s that difference that tells your body, All right, go ahead and ovulate. Lh is a higher level hormone to this question. It’s not the cause of testosterone being high. Testosterone being high can lead to high LH.

All right, so our next question was about hair loss. PCOS and hair loss typically is because of the excess androgens. This in itself is a sign and symptom and would be on the signs and symptoms list of diagnosing someone with PCOS if they have a hair loss or if they have excess hair on the body. When it comes to hair loss, stress is a big one for hair loss. PCOS and high testosterone are a big one for hair loss. However, just hormone imbalance in itself can be difficult for hair loss. One of my favorite supplements for hair loss is omega-3s. I like Nordic Naturals, and they have a pill or they have an oil. The oil is a little like… It’s probably a better form. It’s probably going to be better absorbed. I don’t tend to be as willing to gulp down a teaspoon of oil, whereas I’m really willing to take the large omega-3 pill, but I find that my hair is much more glossy and thick and grows better. I have to go get my roots touched off a lot more often when I’m taking my omega-3s. So I really encourage that one but at the base of improving your hair loss, it’s always going to come down to root cause, lifestyle measures to improve your hormone balance because anything else you do is still fighting that hormone imbalance and so the first step is always discover your root cause, adjust your lifestyle appropriately, to care for your body and its unique needs, and then a great supplement for hair loss would be omega-3s. Keep in mind, when it comes to hair loss, this is not something that you’re going to see quickly.

So you’re going to want to look at your other symptoms. Maybe it’s your cycle, maybe it’s your energy throughout the day, maybe it’s your cravings, your weight. It’s something that’s going to be a little easier to measure on the short term because if you’re noticing that your hair is falling out and that’s your biggest concern, that one’s going to be a lot harder to adjust your lifestyle off of and what I mean by that is that if you are irregular in your cycle, over the course of about 28 to 30 days, you’re going to see, is this improving things for me? Whereas for hair, we don’t expect it to really be much better. Maybe we’ll start to see some improvement at about three months. That’s a very long time to try something and not change it in hopes that we’ve got it right. Now, when you know how to look for your root cause and you know how to care for those root causes, you’re going to be 80% on target with what your body needs but there’s going to be little tweaks. It’s very difficult to tweak your lifestyle to fit you and your body’s needs when you’re looking at something that takes three months to adjust.

It’s easier when you’re looking at something that like bloating, that’s something we do on a 24-hour basis. When we notice that we’re less bloated, we feel more energized, that’s something that we can track a lot earlier. Look at those other symptoms to track whether or not you’re improving your hormone balance. Then once your hormone balance has improved, we would expect our hair to also improve over a longer time frame of 3-6 months. I hope that answers that question.

Okay, alternatives to progestin birth control to help with PMS and mood. This is a question really coming down to birth control and birth control helping with symptoms. There’s nothing wrong with taking birth control. The problem is we do have to know what birth control is doing.birth control is not a natural synthetic hormone that works with our hormones to boost our hormone production or to act in adjacent to our hormone production. Hormone replacement therapy with bioidentical hormones isn’t perfect, but for women who have tried everything else and who are entering perimenopause, it is a beneficial way to augment what the body is doing but when it comes to birth control, the synthetic hormones in birth control are actually taking over.

It’s not dosed to… I’m sorry, I’m starting to enter perimenopause, so I’m starting to take some HRT. It’s a whole different topic but the way that I’m taking them is to look at my lab values and be like, Okay, I’m a little low here, and I’m slowly adjusting based off of symptoms and where I’m not already showing being too high on my labs to adjust for symptoms, but I’m adding to my own natural hormones. Whereas in birth control, these are not dosed for the individual. These are a flat-out dose that comes into play with a override mentality. The birth control is going to take over your hormone production, and your hormones are supposed to go on the back burner, your own body hormones. You’re supposed to just sit on the back burner and wait until you’re no longer in birth control and then magically kick back in. The birth control is creating a negative feedback loop. It’s shutting down your own production so that you’re not having excess. The problem with why you’re probably having mood swings and PMS is because your progesterone is low. You’re finding that adding in stem synthetic progestin is helping your symptoms.

Now, the hard part here is in a bubble, the way that we would want to handle this is to remove the birth control, to probably do that after a month or two or three of really improving our natural lifestyle to support a healthy progesterone level, but also to help regulate all of the hormones so things are in balance because progesterone and estrogen need to be in balance to each other, you can be estrogen dominant just by having too low of progesterone, or you can have normal level progesterone, but be estrogen dominant because you have too high of estrogen. We want these to be relatively in balance with each other. Of course, they’re going to fluctuate a little bit throughout the month. The first half of the month is where we want estrogen to shine, the second half of the month is when we want progesterone to shine, and oftentimes it does not. This is where a lot of times women with PCOS struggle with fertility and all sorts of the second half of the cycle tends to be sluggish. When we look at trying to improve this off of birth control, my recommendations would be to look at your root cause, to really focus on that second half of your cycle.

It oftentimes comes into play with stress management because stress is one of the biggest killers of progesterone. That’s something to look at there. Then ultimately, though, we’re trying to get our hormones nicely balanced through root cause lifestyle adjustments. If needed in the short term, there are bioidentical progesterones that you could take the second half of your cycle. So you can essentially… This does not work, this is not birth control. Just be sure to be aware of that, but if you go to a… Usually, this is going to be something done by either a functional medicine doctor or a naturopathic physician. Basically, you would take progesterone the second half of your cycle. You can do a progesterone cream or a pill. These are often found through compounding pharmacies. They may or may not be covered by insurance, but you take the pill the second half of your cycle at night, and it can elevate your progesterone levels. Now, some doctors will do these as well. Some doctors are just not as familiar with them, and that’s why doctors who have extra training in functional medicine or who have an interest in it and who have learned more, they are able to prescribe these, but they may or may not be comfortable depending on their interest in this particular area of medicine.

Okay. Does PCOS ever or go away? No, it does not. It is part of our genetics. However, when we learn to work with our genetics, we can basically turn down the volume on these genes that make us more prone to PCOS. Just like we were talking about with the excess androgen production with the ovaries, if we eat in a way that we’re not stimulating the insulin to tell our ovaries to make more androgens, then we didn’t make more androgens and we’re able to mute that PCOS gene or significantly turn it down to where we don’t feel like it’s there. Is this something that is harder to do than someone who doesn’t have PCOS, so eating healthy, exercising? Yes, we will work a little bit harder for our gains. However, everyone works hard for their gains. Health doesn’t come easy to anyone after a certain age, especially. I think where PCOS in some ways is the meanest is in our teens and early 20s. Then lifestyle starts to catch up with all of us. I think that is where we definitely deserve our little self-pity party early on, and then also when it comes to fertility, PCOS can really mess with our fertility, whereas other women who are moderate lead to low-level health can still get pregnant if they don’t have PCOS. Whereas women with PCOS really have to make their health a focus if they want to conceive naturally. It can be really frustrating because when we’re ready to start a family, we don’t want to spend two or three years getting our health back to where we want it to be. We want this to happen over a couple of months. That’s where I think PCOS can be really devastating. However, it doesn’t go away, but we really can significantly dampen the effect of it and to really quiet those genetics. I hope that answers the question.

This is often confused if you can’t cure it, but you can heal it. People use these different words. The bottom line is that you can’t get rid of your genes. Your genes are your genes, so you can’t cure it per se. However, you can live in a way where you would feel like you don’t have it anymore but if you ever went back to eating fast food every day and not exercising and not caring for your health, which I wouldn’t recommend even if you didn’t have PCOS, because then everybody’s body will suffer under those circumstances, PCOS or not, then you would notice your PCOS symptoms creeping back in.

Okay, so someone is asking, Our next question is, they don’t have any cysts on their ovaries, but their hormones indicate that they have PCOS. What do they do? Cysts are really just a symptom like hair loss, facial hair, irregular periods, we don’t all have all the symptoms. This is what makes us unique, makes our specific situation unique, our specific lifestyle, our genetic makeup. There is not one PCOS gene. There are many genes that we see being slightly different in women that have PCOS, but there’s a whole slew of them. All of these different genes tend to be found in either our inflammatory pathways, our metabolic pathways, and they affect the production or the lack of production in our hormones but there is not one gene when it comes to this, and so everyone’s going to show up a little bit different. Plus, everyone’s been exposed to different things since the moment they were conceived to the moment when they’re trying to figure out what’s going on in their health and what’s going on in their environment will even change over the course of their lifetime. As our hormones naturally start to decline towards our 40s and into our 50s, and so there’s lots of different changes for women throughout their lifetime with PCOS.

Cysts are just a symptom. Cyst will come and go. You actually may have cysts. There’s been times where my ultrasound shows zero cysts. There’s been times where I have an ultrasound for a different reason and they see cysts. So cysts come and go. It really has to do with whether or not you’re ovulating. If you’ve had a lot of anovulatory cycles, just some people have them, some people don’t. So nothing to get too worked up about. If your hormone levels and your symptoms indicate PCOS, then the diagnosis would be PCOS, and you’ve had other things rolled out. That’s an important piece of that. Your irregular periods and other symptoms aren’t due to something else. Is it okay to supplement with Inositol and NAC over the long term? Yes, it is. It’s something that you should talk to your health care provider about, and different health care providers will have different opinions based on during a pregnancy. Both NAC and an Inositol are considered safe during pregnancy, but any time you’ve been taking supplements that were considered safe over the long run and then become pregnant, it’s always really important to make sure that your doctor also knows that you are taking those supplements because anything else they give you may interact or they may have a reason why they would not want you to be taking those. Just because you were good before and they are considered safe, still, we want to have that conversation with your doctor. But yes, they are considered safe for the long run.

Then last question for today’s episode, How does thin PCOS happen? Is it exactly the same as classic PCOS? All right, another great question. I do have a full episode that talks a little bit more about thin type PCOS that I will link to in the show notes. However, it is technically similar. The same genetics are affected. The difference is, and This is my own personal bend. You have to remember, there’s not a lot of research on PCOS, period, compared to other things and because we’re looking at so much in the terms of lifestyle now, when it comes to PCOS, a lot of those things are very difficult to study because you’re asking people to adhere to a certain lifestyle, and so they can’t be done over very long periods of time. Otherwise, the adherence rate and the fall-off rate of the research participant is going to make the study very difficult to have any conclusions. The logistics of studying some of this can be problematic. We don’t have really studies that discuss and differentiate between thin versus non-thin types or classic type PCOS.

My gut feeling on these from my own personal research in just working with many different types of women are that this has to do with a high metabolism, possibly a higher than average thyroid. Maybe not a pathologically high thyroid, meaning your thyroid levels may be still within normal limits, but instead of being on the sluggishly low side, they may be on the sluggishly high side, or that you may have a really, really, really great way of, to this point, being able to maintain your weight. When I work with women who have, quotes, thin type PCOS, they tend to fall in the categories of I think they have probably some degree of a elevated metabolism, possibly secondary to high thyroid levels or they are, just like how there’s naturally thin people, families that are really just naturally thin people can still get PCOS, and they’re going to have less of a weight problem than other people. Just like in the rest of humanity, outside from women that have PCOS, there is a huge variance in body types, there is in PCOS as well.

When you ask, Is it different? No, it’s not different. The hormone aggravation is still the same. What’s going to tell our testosterone to be elevated? The metabolic, the inflammatory systems, the insulin root causes, the cortisol root causes, all of these are still going to be at play. They’re still going to work through the ovaries to increase the androgens to cause problem. The biggest difference, though, is that insulin is somehow not causing the same weight gain. This may be due to calorie restriction, or it may be due to the fact that this particular individual burns calories at a higher rate. They have a higher BMR. Then this can be due to something like just a higher base metabolism that runs in their family, this can be due to lifestyle. That’s another thing that we oftentimes don’t look at. Someone who has always had a very, very, very active lifestyle, some people just have the heebie-jeebies. Some people are able to just sit. Some people, that’s me, I can just sit still. My mom can’t. She just can’t. She can’t stay seated. She sits in wiggles in her seat. She just can’t. She doesn’t have ADHD. It’s not that hyperactivity, It’s just she has a motor inside of her that doesn’t shut off, and she burns more calories throughout the day. So she can eat a lot more and not gain weight.

Now, that’s the same thing for people. When you look at the thin, it’s really more as an absence of a symptom but a lot of women with thin type PCOS that I’m working with are actually keeping their calories ridiculously low, and they’re staying thin through their own control. That can actually be why they’re having such problems with their PCOS as well. There is not a one-size-fits-all in thin-type PCOS. We really have to almost dig into its own particular root cause of, is the lack of excess weight, you don’t have that symptom of PCOS, or is it that you are overcompensating? Some of your other symptoms from PCOS are stemming from the fact that you’re keeping your calories so low in order to maintain a healthy weight. The other aspect that I find a lot for women with thin type PCOS is because the ones that are naturally thin, they can get away with eating things that are aggravating their PCOS.

Again, it’s a complex picture. Technically, the answer to this question is they are the same. Just like we would dive into any type of PCOS, we would look at the root causes, we would look at the symptoms, we would look at what’s causing those symptoms, we would look at the domino effect of what symptoms are playing off of which other symptoms because some hormones play off of weight. Weight is a big middle-of-ground symptom. We have our root causes, then we have that mid-layer where that mid-layer is still going to affect that pyramid tip top of our hormones such as testosterone, progesterone, estrogen, LH, FSH, and so forth.

There you have it. There is a lot of really great questions and conversation starters here in this episode. I want to, again, thank you all for writing your questions. As this episode airs, I know there’s going to be a lot more questions. The best place to come and ask those is going to be over on Instagram. You can find me @Nourishedtohealthy, and I will do my best as this episode comes out to answer those questions in the stories on my Instagram page. Be sure to follow me over there because there will be people that are asking questions, and then you can see the answers to questions that you may not even thought of asking. Until next time, please head over to Instagram, ask any of your PCOS-related questions. Thanks for listening and until next time. Bye for now.

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About Show

Welcome to The PCOS Repair Podcast!

I’m Ashlene Korcek, and each week I’ll be sharing the latest findings on PCOS and how to make practical health changes to your lifestyle to repair your PCOS at the root cause.

If you’re struggling with PCOS, know that you’re not alone. In fact, it’s estimated that one in ten women have PCOS. But the good news is that there is a lot we can do to manage our symptoms and live healthy, happy lives.

So whether you’re looking for tips on nutrition, exercise, supplements, or mental health, you’ll find it all here on The PCOS Repair Podcast. Ready to get started? Hit subscribe now