Episode #56: PCOS Ask Me Anything Volume 2

One of my favorite things about having this podcast and working with Women with PCOS is getting your questions. Today in this Ask Me Anything episode, we are going to go through a lot of the questions that I have gotten over the last few weeks and because I know if one woman has them, chances are there is another woman out there that also has these questions. I think they’re really important ones to bring up here on the podcast. So as I go through these today, if you have any other questions or a question that is a spin-off from one of these questions, please, one of the best places to reach me is over on Instagram @Nourishedtohealthy. I love to hear from you all in my DMs, so feel free to ask your questions there. I will either respond to you in messenger or also here on the podcast and make sure that the content that we are talking about is relevant in what you want to be learning about. 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.

Welcome back to the PCOS Repair podcast, where today I am answering a bunch of the questions here on the podcast that I have been getting in my DMs and in my email over the last few weeks because I know if one person had these questions, chances are you might too. Let’s go over some of the questions that I have been getting. One woman asked about thyroid disease and PCOS. She said that she has been told she has thyroid disease. That’s something she has known for a couple of years but now she’s also starting to deal with symptoms of PCOS. Are they related to the thyroid or could she be having something else like PCOS going on? Her doctor is currently testing her for PCOS and she’s confused as if do these go hand in hand? Are they linked or are they two completely separate things and what can she do about it? Okay, so first of all, PCOS is a fussy, funny little disorder. It’s really not a very well-defined disorder, and that’s why we call it a syndrome. So a syndrome is less to do with an exact reason why you have it and more to do with a collection of findings, basically, things that we’re going to see on labs, these things that we would see if we did a physical exam on you. Things like you might have a dark, hairy upper lip, that would be a finding, or things that you would tell us in a patient history. Things like my periods aren’t regular. We don’t really test that in the clinic. We don’t really test that in labs per se, although we test hormone levels. But that’s something that a patient would tell us. They would say, Look, I had periods all over the place where I’m not having a period. So listening to the history, doing a physical exam, and then running some tests. When certain things are showing up, we’re like, Well, it’s painting a picture that’s very similar to PCOS. This is why doctors will oftentimes say things like, You have PCOS, you have a mild version of PCOS, you may have PCOS, but it’s not really worth testing because your symptoms are probably related to, and then fill in the blank, things like thyroid. The question here is thyroid and PCOS related, and do we address them together? Do we address them separately? What do we do when we have multiple things going on? So for this particular person asking the question, they’ve had thyroid issues for a while, they’re probably on thyroid medications, you would continue all of that.

You would need to run repeated labs on your thyroid to make sure that your thyroid is responding appropriately. You would want to adjust your medications to where it’s not only happy when you run lab values, but also your symptoms are in a good place. You’re not starting to have symptoms of too many side effects from your medications, but you’re also alleviating the symptoms that would go along with the thyroid disorder. Step one is to individually get each disorder under control. Now, some things like thyroid, some people can manage their thyroid without medications. Most people are going to need medications. Depending on what type of thyroid disease you have, chances are that there’s definitely getting medications involved. However, what medications, the dosing of those medications, all of those need to be uniquely formulated for the person for their symptoms and how they’re responding to the medications to the best of our abilities as humans. Okay, so then is PCOS related to thyroid disease? So a lot of the PCOS symptoms can be mimicked by having a disorder like thyroid disease. Now, if your thyroid disease is completely controlled, your labs are good, your symptoms have been controlled, and now you’re dealing with some issues of PCOS or maybe you had issues with PCOS all along, but they weren’t distinguished as a separate thing because there was this underlying other problem that took over the spotlight. So all the things that we would do from a health style standpoint or from a lifestyle standpoint to create better health for our PCOS are going to support a healthy thyroid. So that’s the good news, right? There’s not going to be things where if we need to eat really healthy foods for our PCOS that’s going to be bad for our thyroid. If we are trying to optimize our exercise, that’s not going to be bad for our thyroid. If we’re trying to reduce our stress and manage our stress and get enough sleep, that’s also going to benefit our thyroid. However, just fixing our thyroid or just fixing our PCOS is not going to fix the other one and so they are two separate entities in that standpoint. PCOS is something that true PCOS, because thyroid can mimic period problems and hair problems. You can lose hair on your head with thyroid, it can mimic all sorts of weird fatigue issues and things like that that we would also see with PCOS.

So if the thyroid again is controlled and we’re looking at PCOS separately, they can have some similar surface symptoms but if we back up into those symptoms and we look at the root cause of your PCOS symptoms, they are going to be from things like systemic chronic inflammation in your body, which can be due to a lot of different reasons, it could be due to another disorder such as psoriasis or autoimmune disorder, you could have a insulin effect where your body is just more sensitive to carbohydrates, or your body is creeping along that spectrum towards insulin resistance and type 2 diabetes, and you’re starting to really see the impact of that in how your body is behaving and the symptoms that it’s producing, your body could be having some hormone imbalances or nutritional deficiencies due to diet or being on things like birth control that can deplete our nutrition as well as throw our hormones out of balance, you may also be responding poorly to the stress in your life and even if you feel like you have it all together, your body is feeling stressed and scared and creating hormone responses to that that are ultimately leading to and worsening your PCOS symptoms, so those are all very different than thyroid. However, thyroid can definitely worsen PCOS, Hashimoto’s is an autoimmune disorder and so that can create more inflammation and all of that. So although they are two separate things, they will be addressed in two separate ways. They do have crossover, they do have mimicking symptoms, and so it can feel like a really tangled mess from a personal standpoint of which one is which and the main thing is you’re going to really focus on getting your thyroid taken care of with your doctor. There’s definitely good nutrition and things like that that are also going to help. General health principles are still going to apply but then when it comes to our PCOS, because it’s rooted in metabolic health, PCOS is going to be a lot more responsive to lifestyle adjustments, and those lifestyle adjustments are not necessarily geared towards healthy thyroid. There may be some crossover there, but you’re going to gear those toward where your PCOS root cause is pointing. So hopefully that makes sense and if there’s any follow-up questions, find me over on Instagram.

The next question I got after a recent episode where we were talking about what is standing in our way of creating the habits that we feel would be helpful for our PCOS. Okay, so we can learn things where we’re like, okay, I have this problem, this is what I need to do about it and then we paused and we’re like, I don’t want to do that, here we have this conundrum, we have this problem, we’re given a solution. I don’t know if you ever did this as a kid, but my kids do this all the time. My mom calls it the yes bug game, like you’re like, I’m hungry. You’re like, Well, do you want me to make you a sandwich? No, I’m not hungry for them and we do that when it comes to our health, we are like, Well, I have this problem and then someone gives us a solution, and we’re like, uhm hmm.. and then we sit there and now we almost feel worse about ourselves because we know what we’re supposed to do about it but we don’t want to do it, we just sit there and don’t make any progress. The example that they asked about was, what about caffeine? Do I need to cut out caffeine? Well, here’s the thing. This is actually a perfect example because I don’t think you need to cut out caffeine for PCOS. I think there are some situations where reducing your caffeine intake is probably important but for the average female that has PCOS, caffeine in reasonable amounts is perfectly fine. So how do we go about addressing all the different issues here? First of all, we need to make sure that the information that we received about what we need to remove is credible. We need to make sure that solution is a reasonable, legit, actual factual based on reasonable information solution. In this case, it’s actually not. That would be step one. Most people do just fine with caffeine if they have PCOS. Now, there are some considerations, and depending on the individual, we go over a great deal of when and where, and how much and things like that that you may want to consider as far as caffeine consumption goes but for the point of this question, for the most part, caffeine is fine. Then we need to deal with what is going on that I now have a solution. Now, for the purpose of this example, say the solution was a valid solution. Now we have to think about to, you have a valid solution, why don’t I want to do it?

Because now we’re sitting in this icky limbo of I have this thing, I have this should hanging over me, but I don’t want to do it. So a lot of times it comes down to what we have to give up, exercise. If I’m going to exercise, I have to give up time. I have to somehow squeeze this into my day and it’s like this gift that keeps on giving because then I have to take a shower. I can’t just roll out of bed and go to work. I have to get up, shower, redo my hair, all these things. Whatever the things are for you, all of a sudden there is this time commitment, I have to set my alarm earlier, it starts to encroach on what I’m doing the night before because I’m getting up earlier. It’s annoying. I don’t want to do that. So when we’re starting something new, I think that it can feel very overwhelming, it can feel like I have to do all of this and it’s taking away from what we used to find enjoyable, like sleeping in until six. Well, now I have to get up at five because if I’m going to get my exercise in, I have to get up at five. As we look at that solution from a standpoint of your lifestyle, do you have to get up at five? What about the evening? Would the evening be better? What about your lunch break? Would that be better? These are the things that we can slowly start to look at or we can also look at, was our problem something that mattered to us enough that this solution is actually less annoying than our problem is? When we start to look at things and not be feeling quite so like, hold that we have to do something, it can really help us to find our own way of taking that advice of that solution. When it comes to PCOS health, the solutions offered by me in my programs or by other experts aren’t meant to be a one size fits all. If someone means it to be a one size fits all, I would definitely question that solution because when it comes to an individual, there is rarely a one size fits all. When you’re looking at, what do I have to give up? We need to look at to what degree would I need to give it up? What are some alternatives? What could I do instead? How could I fit this into what I want to do? When you think about caffeine, if you’re wanting to reduce caffeine, if you’re having some issues with fatigue, I have had times in my life, I have three children, I have a very busy life like everyone else does. We all have tons of things going on in our lives at all the times and then all of a sudden we think we’re almost going to have it under control and lo and behold, a whole bunch of new stuff hits our calendar. So we all have to juggle that. There’s been times in my life where I have let my caffeine consumption get out of control, where I’m drinking it too late in the day, and then I’m creating a negative cycle of it’s making me so I don’t sleep as well at night, or it’s keeping me up too late, and I have to dial it back. And yes, there’s going to be a couple of afternoons where I feel sluggish, but that didn’t mean I had to cut out my caffeine. I had to be more careful about when I consumed it, how much I consumed it.

But I think there’s a lot of people that say you shouldn’t just have caffeine for breakfast. I agree with that. However, I start my day with a coffee. I need to do an Instagram on this because I do a lot of really good things in my coffee that includes collagen and is not just empty caffeine and empty calories. It’s a combination of things that make it taste really yummy. But at the same time are actually some supplements and health things that I’m getting in my day and I’m getting them early in my day and it really makes a huge difference in my appetite and my cravings all because of my morning coffee. So to say that coffee and caffeine are all bad wouldn’t necessarily be true for all women with PCOS. The other thing is if you really want to dial back on your caffeine but you love coffee, if you’re willing to invest in some really nice coffees, good, well-roasted organic coffee, there are some really good brands. There’s one on the Oregon Coast in this small coastal town of Cannon Beach called Sleepy Monk. I love Sleepy Monk and they have incredible coffee and their decaf coffee is actually just as good as their regular coffee, which is a rare thing and so a lot of times I’ll make my coffee half-caf where I mix decaf and caff and caffeinated, or I just do full decaf because I don’t need as much caffeine, but I can still have the enjoyment of a morning cup of coffee. I can still add all the things that I like to add to my coffee to get my collagen and everything else and so these are things where we can think outside of the box of realizing I have this problem and I’ve been given this solution and I don’t like the solution. We may need to step back from the solution, let it sink in a little bit, see what we want to do with it, and then revisit it and let it become our solution that works with our lifestyle, that works with our health, that fits our needs. I hope that helps answer the question. There’s a lot of layers to that question, but gives you a little bit of that insight into we don’t have to take this solution that is distasteful to us and adopt it in this forever life sentence way. PCOS can make us feel like that. I know we talked a lot about that in the last episode, but such an important topic. I want to bring that up again.

The last question that we had that I wanted to go over, and I touched a little bit on this in last week’s podcast episode, but someone DM’ed me and asked me that they have been doing everything right for three months and they’re still not happy with the progress that they’ve made. First of all, congratulations on making it three months. Making any habit change, small, medium, or large, and keeping it up for three months is just so commendable. We have to celebrate that. We have to pause and be like, Wow, kept it up for three months. However, if you’re not happy with the progress you’ve made, it’s time to look at what we need to do differently. So sometimes I think that we talked about last week, there’s different phases of our PCOS health journey. There’s the healing phase, the maintenance phase, and sometimes it’s difficult to be as diligent as we need to be in the healing phase for long enough to really see results or to really get that strict even at all. I know I’ve been working with some private clients that have been told by various people that they need to cut out all dairy, all glue, and they’re like, Well, I just don’t have the bandwidth to even figure out what to eat. I help them figure out recipes and things like that and work with that but I don’t necessarily think that we have to be that strict for three months. However, I think that I have a lot of women run through the PCOS detox. What the PCOS detox is a mini program that I have. If you want the link to it, feel free to DM me, I’ll get that for you. But it’s a mini program that you can walk yourself through a week of eating and then a few weeks of follow-up where you remove everything for a week, you really kickstart your hormone rebalancing, you really kickstart getting over the cravings, getting really back in control of what you’re eating, having examples and meal plans, recipes to help you figure out what it really looks like to eat to nourish as compared to eat to be less unhealthy, which is oftentimes what we end up doing instead of really packing in the nourishment and that it can actually taste good and not be too difficult at the same time. So you do that for a week and then we slowly reintroduce some of the foods in a healthier way than maybe they were before to see, do we really have a problem with them? and where is that sweet spot to where we start to not make as much momentum in our symptoms? and so when we are saying, okay, I did everything right for three months and I’m not getting the results I want, that’s all the information I have from this question. So that could mean that we need to give it a little bit more time or it could also mean that we may need to step up our game a little bit, maybe we’re being a little bit too much in maintenance mode and we need to be a little bit stricter, maybe we’re a little bit off on what our root cause is or what our root cause is needing. It’s very easy to be really good at parts of healthy living and we really dive into those and we think we’re all in, but we’re ignoring the ones we don’t like as well and so making sure that our healthy habits are well rounded, well rounded with our mindset, well rounded with our fitness and our exercise, well rounded with our nutrition, well rounded with our stress reduction, stress management, coping mechanisms, getting enough sleep. If all of those are mostly in balance, we’re going to see a lot more progress than if one of them is just all imperfect, but we’re forgetting some of the other ones.

So from the little bit of information I have on that question, I hope that sheds some light on when you’re not seeing something working, the steps that you’re going to want to take is dive into that root cause. If you need to get support, get help, that’s when I come in. If you need my help or support, feel free to DM me. We can talk about which place in working with me would be a good place to start. Then you’re going to look at the degree of addressing those root causes that you’re doing. Do we need to do more? Do we need to just look at balancing each of the pillars of our PCOS health, like stress management, exercise, mindset, nutrition? Do we need to balance those a little bit better? Because maybe we’re focusing too much on one. Ultimately then, what is it working? That’s a constant try something, evaluate it. Is it working for you in your lifestyle? Is it working for your body, for your health? Adjust as needed, this is very fluid, we have to get really comfortable with listening to our body, responding to our body, listening some more, see if we got it right. It’s not a cookie-cutter exact science because each body is so different, each environment is so different, and what our body needs are different. All of these things, they require us to get really good at listening, interpreting, and providing the care that our body needs.

With that, my friend, if you have further questions about PCOS, you know where to find me. I want to hear from you over on Instagram @Nourishedtohealthy. Send me a DM, comment below this post, and I cannot wait to connect with you over there and answer some of your questions. And until next time, bye for now.

Did you know that studies of PCOS epigenetics have shown that our environment can either worsen or completely reverse our PCOS symptoms? I believe that although PCOS makes us sensitive to our environment, it also makes us powerful. When we learn what our body needs and commit to providing those needs, not only do we gain back our health, but we grow in power just by showing up for ourselves. This is why I’ve created a guide for you to get started. My PCOS fertility meal guide can be found in the show notes below. I want to show you how to create an environment that promotes healing while still being able to live a life that you enjoy. This guide is completely free, so go get your copy now so that you can step into the vision that you have for your life and for your health.