Trying to get information about your hormones through lab testing can be quite difficult and it’s definitely a place where garbage in, garbage out applies. So many times when we’re looking at what tests to order and when to order them and when to have them done during our cycle, it’s often overlooked how important the timing of these tests really is. In today’s episode, we are going to take a deep dive into functional lab testing with special guest Rachel Hoeppner. Rachel is a holistic nutritionalist, integrative nutrition health coach, and women’s health hormone and fertility specialist. She became passionate about and dedicated herself to holistic health as a result of her own journey to heal chronic hormone, gut, and thyroid dysfunction naturally. Her mission is to help women heal their hormones so they can achieve their health goals to look and feel their absolute best. She specializes in addressing stubborn weight loss, chronic fatigue, hormone imbalances, including symptoms related to periods, PMS, PCOS, and endometriosis. Thyroid dysfunction and autoimmune symptoms, fertility, pregnancy, postpartum care, food sensitivities, and digestive issues. She decided to dedicate her practice to the specialty of women’s health hormones and fertility after she realized that women are underserved, written off, and not listened to more often than men in our current healthcare system. Through one on one group coaching, functional lab testing, master classes, and free challenges, Rach is able to further her mission of educating women on the science of how their bodies work, how to easily and effectively care for the specific needs women have, and how to cultivate lifelong, sustainable wellness. Without further ado, let’s dive in and welcome Rachel.

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 I am so excited to be talking to our guest, Rachel Hoeppner, today, all about functional labs and hormone testing, because those are some favorite topics of ours. Welcome, Rachel. I’m so glad to have you here.

Thank you so much. I am so excited to be here. And yeah, we’re talking about one of my favorite topics, so I can’t wait to get into it.

Awesome. So what got you into this topic? What made you so excited to learn more about and spend so much time learning about and working with hormones and labs?

Yeah. So, Hi everyone, I am Rach. I run Real Health with Rach, and I’m a holistic nutritionist, I specialize in women’s health, hormones, and fertility and my health journey started when I was 15 years old and like many teenage girls, I was having symptoms of hormonal imbalance. I was having irregular periods, acne, mood swings when I would have a period, they were heavy and painful and my mom did what I would assume many moms of teenage daughters do and took me to the gynecologist to figure out what was going on and after a very uncomfortable pelvic exam, I left with a prescription for hormonal birth control. No real information or education on what it was or what it was going to do to my body, but I just wanted a solution and I wasn’t sexually active at the time, but I said, Okay, well, this also seems like a two for one because when I start having sex, I’ll be able to avoid pregnancy. I started taking it without really questioning what it was or even asking, Well, why am I having these symptoms? I didn’t know what to ask, I don’t think my mom really knew what to ask and I then went on to spend the next 10 years of my life getting more and more sick. so it seemed like every year that I was on the birth control, my symptoms got worse. I went from having mild acne to very severe cystic acne that covered 60 % of my face, I gained 50 pounds over the course of four years, and I ended up on antidepressants for panic attacks, anxiety, depression, I then ended up on sleeping medication because then I couldn’t sleep when I was taking the antidepressants, I ended up on migraine medication, I ended up on Sildenolactone to try to help with the acne. I was then diagnosed with hypothyroidism and put on levothyroxine for thyroid support and I woke up maybe five or six years after, and I was on six medications. I hated the way I looked, I felt like crap all the time and so I started dieting because I was so afraid of the weight that I could not seem to get rid of and chronic dieting and restriction led to me developing a binge eating disorder. So now here I am in college, I’m on six medications, I hate the way I look, I hate the way I feel, and now I have a.

Because our listeners can’t see you. But today you are gorgeous, has amazing skin and I know we’re getting to the fast forward part, but I just want our listeners to know what I’m seeing. Radiant skin and go ahead with your story. But I had to just interject, acnees all cleared, beautiful all around.

You are so sweet. Thank you. Yes, I promise you this story has a happy ending, this was over a decade ago for me, and I was very overweight. I’m only 5’3. So for me to gain 50 pounds in a short amount of time and basically go from 110, 120 pounds up to 150, 160 pounds was very scary for me and so I fell into dieting, I think, as most young women do, out of fear of weight gain and desire to be thin because then equals happiness, success, love, whatever, we’re putting a label on it and so I developed a very dysfunctional relationship with food and severe under eating and over exercise led to my hair starting to fall out. I wasn’t having a period at all because on hormonal birth control, you don’t have a period but my hormones continued to become more and more dysregulated and I remember going into a doctor’s office and saying, Could my birth control be one of the problems here? and it was never the problem, it was no, no, no. We just need to switch you to a different one, maybe you don’t respond well to this one and so I tried every different form of the hormonal birth control pill on the market and unlike some women that have immediate side effects of like, Oh, my God. I start taking this and I feel crazy, mine was a slow degradation of my health and so I didn’t attribute it to my birth control for a very long time. But I had this realization that these medications are not healing me. My symptoms are not going away, I’m not getting better and then it’s like a game of whack a bull. I’m ending up with side effects from medication A, so I’m put on medication B to treat the side effects from medication A and I was just in a really tough place physically, mentally, emotionally and I said, There’s got to be something else, there’s got to be a better way, there has to be something that people are not telling me that my doctors either don’t know or don’t want me to know and I need to figure it out for myself because nobody is going to advocate for me. And so I actually went to school originally for business, I graduated with an undergraduate degree in business because I didn’t know what I wanted to do. I don’t think many 18 year olds know what they want to do. But I started getting into health purely to heal my own body. That was my only goal 10 years ago, was starting to put little puzzle pieces together of my journey and my story of, okay, what are some ways that I can heal acne? Oh, I’m learning about acne and now I’m learning about gut health and oh, now I’m realizing these medications I’m on are destroying my gut and, Oh, foods can be inflammatory like what foods should I be eating? What’s going to nourish my body the most? and it was a slow process, it was many, many years of me doing trial and error and just turning over one rock here and one rock there and reading books and podcasts and it wasn’t until a few years later that I actually decided to go back to school to become a nutritionist. Again, purely to heal my own body, I was like, There’s got to be more here I need to dive in let’s figure out what’s going on in my body and so it was actually not until 2017 that I finally got diagnosed with PCOS and I was put on hormonal birth control in 2007. So it took me over a decade to get a diagnosis and I think that’s very common, women are typically undiagnosed or misdiagnosed or in my case, nobody bothered to look. My hormones were never tested, I was never given an intake or questioned of, well why is this happening? when is it better and when is it worse? And I feel like once I got that diagnosis, I was like, Okay, this is it. Now I know what to do and I asked the doctor myself at the time, I said, Okay, so what do we do about it? and they were like, Well, there’s no cure, I recommend you just stay on your hormonal birth control and then if you decide you want to get pregnant later in your life, we’ll just figure it out when you get there, and I was like, I don’t buy that, I don’t buy that I am just doomed to have this diagnosis and not see my health improve. And my health had started getting better and so it was after this point that I said, Okay, let’s get rid of the birth control, let’s see what happens. I’m married and I don’t want children. My doctor is like, I don’t know, I don’t think that’s a good idea, you could get pregnant, all this stuff. I said, I just want… If it’s a terrible idea, if I feel worse, if I get worse, we’ll come back, we’ll circle back to this topic but I said there’s no harm in me trying because I’ve tried everything else. Most women was like, F this birth control, I threw it in the garbage one day at the time, I did not have the wherewithal to know that you should not stop birth control cold turkey. Everybody listening, if you are like me, if you’re like, F this birth control, let’s get rid of it. Please, regardless of whether you work with a practitioner or work with me or do it on your own, please do not stop birth control cold turkey without having a plan in place. It talks from the synthetic hormones. So it was a rough year. That first year off birth control, my acne got way worse, I gained 30 pounds in six weeks, my body was like, WTF, what are you doing to us? Because I’ve been on it for 12 years at this point.

When you say that you gained 30 pounds in six weeks, people think that’s an exaggeration. It’s not. Same thing happened to me when I had my when I had we were ready to have kids. It was like 40 pounds in two weeks.

Yeah, it’s a primitive, visceral survival response from your body and I was like, Oh my… Literally, within a month, my clothes weren’t fitting and I was like, Holy crap, what is going on? So it was a year of me figuring out and really getting into it and that’s when I decided to specialize in hormones, again, selfishly, just to heal my own body and figure out what the heck was going on and so by 2019, my health was in an entirely different place. I was all of a sudden in a place where I was having a regular period despite having PCOS, they were light, they were easy, they were pain free. They surprised me when they happened. I was ovulating regularly. My acne had cleared up on its own with zero medication. I no longer take any prescription medications, including for hypothyroidism and that’s when people started asking me, Well, what are you doing? I’m having that problem. Can you help me? And so I started Real Health with Rach in 2019 as an answer to other women who were having the same issues that I was. Because my journey was not miraculous I’m not one in a million, I’m not some miracle case that is impossible for others. I realized that it is possible to heal our hormones, to put PCOS into remission, to get off medications that are not serving us, and to really live in harmony with our bodies instead of trying to work against our biology. Our cycle, our hormones are such a gift and I think society has told us that they’re a burden and then we have symptoms that just validate that story that they are a burden and women don’t get the cure that they so desperately need to really understand how their body works, what’s going on, where are the problems and the roadblocks and then once you know what they are, what do you actually do about it? And so I’ve been running my business now for four years, and I feel so grateful to have a practice that gives women the care that I wish I would have received because I know if I would have had help, it wouldn’t have taken me 10 years to get where I am now. I know how much easier and faster it can be when somebody just gives you a roadmap and says, Here’s where you are and here’s where you want to go and here’s what you need to do to get there. I feel so lucky to have the health that I do now. But I remind everybody that I am not one in a million. What I achieved is absolutely possible for everyone, especially women with conditions like endo, PCOS, hypothyroidism, Hashimotos. I see a lot of those conditions where women are written off by doctors and said, Okay, well, here’s your prescription, have a nice day. And they’re not really given tools for deep, long lasting healing.

Well, in the place where you are different from other women and one of the places that both you and I were fortunate is that we were able to take the time to get educated in health care and nutrition and all of those things because that’s not something that everybody has years and years to spend going through those training. Unfortunately, like you said, medicine doesn’t have a lot to offer on a lifestyle basis. The types of conditions that are so in need of lifestyle care just get thrown to the side and I think one of the reasons why, and see if you agree with this, one of the reasons why sometimes it takes so long to even get the diagnosis is that it’s not really of interest if the doctor is not going to have something to do about it. It’s like, does it really even need to be… We need to go down that rabbit hole. There’s not much we can do about it anyway.

Right, I agree. I think that there are some things that seem very straightforward in conventional medicine. Like if I broke my leg, I would want to be able to go to the emergency room and have somebody fix it. Thank God for modern medicine when it comes to acute care and surgery, like I don’t know how to fix a broken leg, I would not know how to perform surgery on myself, so thank God that exists. That is acute care where our… I don’t even like calling it a health care system because it’s a sick care system.

It is. Once you’re broken, once things have gotten over that hump of you don’t need medical care.

Yeah, exactly that. We treat symptoms, we don’t treat root causes, and we don’t do a good job of treating chronic illness. Chronic illness, you may think of it as, Oh, somebody that has type 1 diabetes as a chronic illness. But chronic illness can be everything from metabolic dysfunction, hormone imbalance, stress, anxiety, those lifestyle factors that we don’t really give… We don’t even enable doctors to care for those types of patients accurately. Most of my doctor’s visits, I’m in and out, they’re given 5, 10, maybe 15 minutes with me, and they have to crank out a high volume of patients. They’re not set up for success.

How the system is set up and so we don’t have that preventative health is lacking in the healthcare system.

Right. Yeah. Versus when I see my clients, I spend 90 minutes in my first session with them and then 60 minutes every session thereafter for six months because it takes time and that’s what our system does not allow doctors to be able to do and I think that it’s complementary, like we should view health as more of a holistic field of, hey, you’ve got the emergency room for this type of care. You’ve got a gynecologist for your pelvic exam. You’ve got your pediatrician for your kid, somebody that specializes in that. And there needs to be more of a focus and understanding on practitioners for nutrition and wellness and lifestyle because that’s a part of the puzzle, too. But I don’t write prescriptions, so there’s no money to be made in me telling people lifestyle changes or nutrition changes to me.

I think that a lot of this starts with understanding, on our own sense, understanding a little bit more about how our bodies work. In the sense of hormones, I think that for women, that comes down to how their cycle works. Maybe a good place to start too, as we get into some more about functional lab testing and really understanding your body is just getting down to the basics of how does our cycle work and what hormones are in play. You talked a little bit in your journey about how you went from very difficult periods to really easy periods. What would be normal? Sometimes the modern medicine world leads women thinking that it’s normal to have a heavy and hard period. So can you tell us a little bit about how that cycle should be working?

Yeah. So if you don’t know this yet, I promise you, you are not alone. I went many, many years in my life not even understanding how my own cycle worked because we don’t get the sex ed that we actually need as young girls. We’re basically told, here’s what a pad and tampon is and don’t have sex, and if you have sex, you’re going to get pregnant or get an STD. The sex ed at my school was terrible. So just know this is not your fault. What you need to know about your cycle is that it is our fifth vital sign as women. It is so fundamental to our health that it is now referred to as the fifth vital sign, like your blood pressure, your heart rate, your temperature, those types of things. That is how critically important it is.

Even during the time don’t recognize that now. So that’s exciting. Right.

Yes, exactly. There’s a reason why if you go into the gynecologist, they say, what was the date of your last period? Now, we’ll get into birth control here in a second and why that’s not actually a period but your cycle starts, day one of your cycle is the first day of your bleed, the first day of your period. Your period is the first phase of your cycle known as your menstrual phase, where you are shedding your uterine lining because you did not become pregnant in the cycle previously. From day one until for most women, days anywhere from four to seven is their menstrual phase. The broader first part of your cycle, moving into the second phase is what we call the follicular phase. So your follicular phase technically starts on day one as well, along with your menstrual phase, and it runs all the way through ovulation and what’s happening in your body is hormones are building, your hormones are building up in your bloodstream, your ovaries are sending signals to your brain and to your adrenals to create estrogen and testosterone. Lutenizing hormone gets made later, but our follicle stimulating hormone gets made earlier in our cycle to tell your ovaries, Okay, a new cycle has begun, we are going to release mature eggs here in a couple of weeks with the hopes of becoming pregnant. The middle of your cycle is marked by ovulation. Now, a lot of women with PCOS don’t ovulate. We can get into that if you want to. There’s a lot of anovulation in the PCOS community, which is why fertility is a challenge. But let’s say everything goes according to plan. Your body has a surge of hormones 24 to 48 hours before you ovulate that actually releases the egg. The egg starts floating down the fallopian tube, waiting to be fertilized by a sperm. This is typically for a woman with a healthy cycle where you would have your high sex drive. You have a biological incentive to procreate during this time and if you become pregnant, you go on path A. If you do not become pregnant, you go on path B. So let’s go with path B. You did not become pregnant during this cycle. Your egg is only viable for 24 hours. So as soon as ovulation is over, that egg’s got 24 hours to make it or break it and if it does not get fertilized, it dissolves. You then enter your luteal phase, which is the second half of your cycle from ovulation until your next bleed and during this phase, your hormones are winding down. Your body says, Okay, we didn’t get pregnant, try again next time, let’s start reducing hormones, which tells your body, Okay, it can shed that layer of uterine lining. We’re going to start the whole process all over again and there’s a very important hormone that gets made during the luteal phase called progesterone. Women with PCOS, commonly struggle with progesterone deficiency, I have struggled with it myself and progesterone is your feel good hormone, it’s the hormone you became pregnant would keep sky rocketing through the roof and your body starts to make more of it during your luteal phase in case you become pregnant it’s a pre and straight and you should feel relaxed and you should calm and you should sleep better, and so when you’re struggling with progesterone deficiency, you may feel more anxious. You may feel more on edge, you may not be getting good sleep and if we talk about like androgen dominance and estrogen dominance, where your hormones should be declining during luteal phase. If you have too many and your stay elevated, this is where PMS comes in. There is a discrepancy between where your hormones should be and where they are and your body is like, I’m going to send you some warnings. I’m going to send you some warning lights here on your dashboard. Cramps, mood, bloating, insomnia, you’re irritable, you’re cranky, you’ve got cravings for sugar or carbohydrates and this is when we’re like, Oh, shit. I know my period is coming because my life sucks right now and then when your period actually happens, that’s when it can be really heavy, that’s when it can be really painful. I mean, I see clients that have normalized being in bed the first day of their period because they’re so fatigued and their cramps are so painful and I’ve had the painful cramps. I’ve had the sweat, period poops, all kinds of bad symptoms when my hormones were out of whack and then it usually gets a little better and a little easier as the days of your periods go on and the cycle repeats. So you have four phases of your cycle menstrual phase when you’re bleeding follicular phase from day one of your cycle until ovulation, which for most women is between days 14 and 16. Ovulation, which is a 24 hours window, it’s the shortest phase when your egg gets released if you’re ovulating and then your final phase is your luteal phase, which is the longest phase. It’s typically going to be 14 days for most women, unless you’re very maybe one or two days. It’s the most consistent. It takes a certain number of days for your hormones to wind down and the cycle repeats. So a normal total window is somewhere between 25 and 35 days. So if your cycle is less than 25 days, it tells you something’s going on. If your cycle is more than 35 days, it tells us that something is going on. That 10 day window is about average for most women. You may fluctuate a little bit, you might have one cycle that’s 27, another that’s 29. But if you’re consistently having irregularities in your period, it’s telling us that something is going on under the surface is keeping things from working as intended.

Which leads right into how people like to put a bandaid on that and mask that something’s not going quite right and prescribe birth control. How does birth control then affect that cycle so that people understand, our listeners understand what’s going on when we add birth control to that mix of how a cycle should be working?

Yeah, absolutely. So if you are using hormonal birth control, either in the form of an IUD, a ring, or a pill, you do not have a cycle. It is a lie if anybody has told you that you have a cycle or a period while using hormonal birth control because you do not. Let’s just make sure we’re all on the same page. It is not a period, it is not a cycle. Because you are getting a dose of synthetic hormones that turn off ovulation and in order for you to have a period, ovulation needs to have occurred. So if ovulation didn’t occur, you don’t have a period. You are getting synthetic estrogen and some contain synthetic progesterone in the form of progestion that are overriding signals from your ovaries to your brain. They are stronger than your natural signals. So your ovaries get suppressed in their natural hormone production, which is why your symptoms may appear to go away because we’ve just turned off your cycle. Now, in the 1960s, when Hormonal Birth Control first came out, there was no, quote unquote, period. And women in the clinical trials gave feedback that it scared them because we associate no period with being pregnant so they scientifically engineered a withdrawal bleed to give you the semblance of a period to put your mind at ease. It is not a real period. It is a withdrawal from the synthetic hormones while you’re taking the sugar pills, which means you don’t have to take the sugar pills. It’s basically just there to make you feel better that you’ve had some bleeding, but it is not a real period because you’re not growing and shedding your uterine lining as your body intended and for a long time, it was touted that hormonal birth control did not affect your fertility. It was basically putting a pin in your fertility so that if you’re 15, like I was, my mom was like, Well, what if she wants to get pregnant? There’s nothing for her to worry about. She can stop taking this when she’s ready to become pregnant, and everything’s going to be great. And we now know that is not true. There was a study done that looked at the ovary size of women that did not use hormonal birth control compared to the ovary size of women that did and hormonal birth control can shrink ovary size by up to 50 %. And we know that your ovary size can be a direct indicator of your fertility. So the larger your ovaries, typically the more follicles you have, the more engaged those follicles are, the better chance you have of ovulating consistency and at a high quality and the smaller your ovaries, the less engagement, the fewer follicles. You might have more cycles where you don’t actually ovulate and so this is where a lot of women come to see me is they were on birth control. They’re like, All right, I’m 30, I’m 32, I’m ready to start my family. Here we go. They take their birth control, throw it in the garbage, they don’t detox from it, they start having unprotected sex with their partner, and they’re not getting pregnant. And they’re like, What the heck? I was told this is what was supposed to happen but their body went into a type of hibernation. It’s like if I parked your car in a garage and I didn’t start it for 10 years, do you think it would turn on if I put the key in the ignition? Chances are it wouldn’t. The battery is dead, the oil has gone bad, there’s no gas in the tank anymore, but we expect our bodies to start up right away after they’ve been dormant for a very long time and then this is what happens is, and not to go on a fertility and infertility tangent, but this is where women then go into their gynecologist and they say, Well, here’s a fertility specialist and then what do we do? We start pumping women full of more synthetic hormones to take the place of our naturally occurring hormones that aren’t working anymore and so I have a lot of women that come to me either because they don’t want to do fertility treatment, they can’t afford to do fertility treatment, or they want to explore natural alternatives first and they find that when we get their body working as intended, again, fertility is easy. Pregnancy comes easy to them, even with endo, even with PCOS, even with autoimmune, because we need to love on our bodies and care for her like we would care for a garden, care for our pets and that’s not what we’re taught. So if you’re using hormonal birth control, know that you don’t have a cycle. Know that those synthetic hormones are suppressing your naturally occurring hormones and those synthetic hormones are building up in your bloodstream and in your adipose tissue over time. Your body is storing them to hold on to them for later, and that’s why it’s really important that we detox from them and that we teach your body how to have a period again, how to have a cycle, and how to ovulate again, whether you have family planning goals or not, I don’t want children, I don’t use hormonal birth control anymore, but I know exactly when I’m ovulating. I know exactly when to either have protected sex or not have sex with my husband to ensure that I don’t get pregnant and that’s where a lot of women are scared is they’re like, Well, if I come off this, I’m going to get pregnant. Because they don’t actually know when they’re fertile and when they’re not fertile and so if you are cycling as intended, you can only get pregnant for a maximum of six days per month per cycle. Sperm can live for up to five days and your egg is good for one day. So in total, there may be six days maximum where you could become pregnant and I woke up and had the realization that that six day window was not worth me feeling like crap the other days of the month, the year, the rest of my life.

100 % agree with that. So whether someone has been on hormonal birth control or is still on hormonal birth control. There are definitely reasons for some people to want to continue it. We’re going through the broad picture here. But you talked about not wanting to feel like crap. That leads us to what symptoms is our body giving us that something’s not working correctly? I know I talk about that a lot, but as we get into functional lab testing, I think it’s really important to review. Our body gives us the window into what it’s needing, and that’s through symptoms. So let’s talk about a little bit about the symptoms that are going to give us that window into where our body is struggling and needing a little extra TLC.

Yeah, definitely. I’ll share this with all of you, I put together a Hormonal Imbalance checklist because there are so many symptoms and I want you to be able to identify where they’re coming from for you. But I’ll go through the top ones I see in my practice. So most common is our weight. Women come to me and they say, I either can’t lose weight no matter what I do, or I’m gaining weight and it’s really scaring me, weight retention happens as a biological defense mechanism and for women, it’s primarily focused around our midsection, where our reproductive organs are. So if you’re having issues with your belly, your hips, your thigh, your booty, your legs, your stomach, your body is creating a protective barrier because it thinks something is wrong or that your reproduction may be in danger. Remember, our body’s prime directive is survival and reproduction, and that is what it is protecting. I didn’t understand this for a very long time, and that’s why I fell into the trap of dieting, I didn’t realize it was hormonal, and so I just started eating less and I tell people, I remind them all the time, there is no amount of dieting or calorie restriction that fixes hormonal imbalance. Zero. You could eat 500 calories a day and you could continue to not lose weight or actually probably gain more because then your body thinks that you might be starving and that’s why dieting does not work when women are struggling with hormonal imbalance. Number two, chronic fatigue. So you have these cute little things called your adrenal glands. They sit on top of your kidneys. They look like little top hats and they are so incredibly important for women’s health that it cannot be not be overstated. So where men make about 90 % of all of their hormones from their testicles. They rely a lot less on their adrenals than we do. About 60% of all of our hormones are made by our adrenals. So think about that difference. Men rely on your adrenals, maybe 10% of the time, we rely on our adrenals 60% of the time and when they’re being overworked by stress, underlying hormonal dysfunction, inflammation, all of those things, they stop working as effectively, which means they cannot make enough energy. So that’s when I see women that are like, It doesn’t matter how much I sleep, I’m exhausted. I can’t make it through the day without multiple cups of coffee, I’ve got cravings for caffeine, sugar, carbohydrates, three o’clock rolls around and I feel like I need a nap, I can’t get through the day. That’s your body saying, Please slow down. We need to rest. Something is wrong, but we don’t live in a world that allows us to slow down and rest, especially if you work or you’re a parent or you’re going to school or maybe you’re doing all three of those things at the same time. One of the ways our body tries to detoxify is through our skin. So you can detoxify through your pee, poop, and perspiration. So if you’re experiencing anything related to your skin like acne, eczema, dry skin, flaky skin, itchy skin, random rashes that are appearing, your body is trying desperately to get things out that may be making you sick and I didn’t realize that. I didn’t realize that my acne was my body trying to get my attention that things were wrong. Women with PCOS can experience hair loss on their head. So I was losing a lot of my hair, my hair was really thin, really brittle. You could be having hair grow in places you don’t want, like your chin, your neck, your chest, your nipples, your stomach, and maybe growing places where you would see it on men, and it shouldn’t be on women’s bodies and then you can have symptoms related to your period. So it could be the heavy, painful, very long, very short, they could be missing altogether. I went six months without a period when I was 15 years old, and that’s when my mom was like, Okay, something’s going on because you should be having one. Birth control gives you the semblance of having a period. But all it does is cover it up. We just like, laid a laity tart over a hole in the ground and we’re like, Okay, the hole is not there. Don’t worry about it anymore. But I promise you, you could still very much step in that hole and that’s where symptoms usually come to rear their ugly head when you finally stop using your birth control is we never fixed the problem. We just covered it up, but it was still there all along or maybe it got worse over time because hormonal imbalances tend to get worse and not better if we don’t intervene, which is why symptoms can seem like they snowball.

Well I think you’ll get into this when we talk about the labs. But one of the big reasons to remember here is with our periods, we’re talking top of pyramid hormones and a lot of the things that are broken are a lot deeper down into our metabolic and endocrine health, and so we’re hiding deep root problems by just covering up that top of the pyramid of our period not working quite right and I know we’ll talk about that when we get into the functional labs, but I think sometimes it can be confusing as well. Why is it such a bandaid just quick cover up? And I think it’s that we forget these hormones, although these are the ones that are causing annoyance, they’re being thrown out of balance by a much deeper problem.

Yeah. I remind people that your symptom is the last thing to happen in a disease cycle. The symptom happens last. The problem starts, it wors, worsens, worsens, and then you have a symptom. So by the time you’re experiencing a symptom, you’ve had an underlying imbalance somewhere that’s been going on for a little while. It could be a month or six months or a year or in my case, multiple years. And that’s where we have to start looking. It’s like, Okay, your symptom is getting our attention. Awesome. You come to me and you tell me the what. I’m having chronic fatigue, digestive issues, I’m gaining weight, my hair is falling out, I don’t want to have sex with my husband, I feel like I’m set off at a moment’s notice, I have no patience for my kids or my job. I’m like, Okay, that’s the what? Your body, your labs are going to tell us the why. Why is that happening? Then we say, Okay, so here’s why it’s happening. Now, here’s what we’re going to do about it.

So that would be then, what labs do you typically like to focus on? Because I know a lot of people are going to have questions. A lot of the women I work with, they come to me and they’re saying, Hey, look, my doctor didn’t really think anything was that impressive in my labs. There may have been one or two things off, and then we get that just I guess you must have PCOS because nothing else is wrong with you guys. What labs are you looking at? Then also while you’re going through that to help people understand, when we talk about functional labs versus the traditional lab panels, why are we talking about that a little bit differently?

Yeah, it’s such a great question. It’s really important for me that you are empowered and knowledgeable and have agency over your body and your lab work. You can test… We’ll start with hormones. You can test your hormones through one of three ways. One is with blood, another is with saliva, and the last one is with urine. Most doctors are testing with blood, it is the easiest to do, and it’s what they are classically trained on in medical school. Your hormones are least sensitive in your blood because of all of the other things that are in your blood when we look at it. For women, your hormones are changing throughout the day and throughout the course of your cycle. So if you go in and you tell your doctor, Hey, I think something’s going on with your hormones, and they order a blood drop for you, and you get your blood drawn at 9 AM on the first day of your period, your hormones are going to look very different than they may look at 3 PM in your luteal phase. So context matters when it comes to when your hormones are tested. Because if you get them tested on day one of the month and your doctor reviews the results with you, I bet $100 that they’re like, Oh, your hormones are low because your hormones are at their lowest point when you’re on your period. So that’s looking at blood. We can also look at saliva and we look at urine, and so when I do hormone testing, I use urine because urine does a few incredible things for us. Not only can we see volume of hormones in your urine, we can see how you metabolize them, which is really, really important. I use PCOS as an example because two women could have identical levels of testosterone and woman A could metabolize it through the EDoC pathway, which is our preference as women and woman B could metabolize it through the and aldosterone pathway, which is the non preferential, that’s the androgen dominant pathway and so just looking at your level of testosterone in your blood does not tell us how you metabolize it. It can be a perfectly healthy level of testosterone for you, or it could be a detrimental level if you are metabolizing it through a pathway that causes androgen dominant symptoms. In addition, when we look at hormones with your urine, the test that I use, which is the Dutch test, it is a dried urine for comprehensive hormones test. You pee on strips of paper multiple times over the course of 24 hours on a specific day of your cycle after you’ve ovulated. So we can say, okay, here’s where your hormones should be based on that specific day. And then we can see how your hormones trend over 24 hours. So if I test your hormones with a blood draw at nine AM and your cortisol looks fine, but your worst fatigue is happening at three o’clock in the afternoon, and I never tested your hormones at three o’clock in the afternoon, I can’t see what’s happening there and so this test looks at all of your sex hormones as well as your adrenal hormones to get a full picture of what’s going on. It also looks at what we call organic acids, which are measures of inflammation and metabolized vitamins we can see in your urine. So how does your gut look? How does your liver look? How are your adrenals looking? Are you making enough neurotransmitters? Are you making melatonin? We can look at B vitamins and Glutothiol. We can see all of these other different measures from one urine sample. I think a lot of people don’t know their options when it comes to lab testing. I asked a doctor for many years to test my hormones and was like, You’re young, everything’s fine don’t worry about it. Wouldn’t even order the test for me. I want people to know you have agency. In the US, you can order your own labs. You do not need to go through a doctor or even a practitioner to order your own lab work, but you may not know how to rate it and that’s I think where context really matters. If you’ve ever seen a Dutch test or you go to Google and you look up an example of a Dutch test, it’s a pretty complex test if you’ve never seen it and don’t understand how to interpret it and so that’s where I think a lot of the expertise comes in when you work with a practitioner is saying, Okay, here’s what this means. I want you to understand how to read your own test, but here’s what we do with the information. Because if I just say, Okay, well, yeah. So let’s say that you have androgen dominance. And I’m like, Okay, congratulations, you have androgen dominance, I send you on your way. You’re like, Okay, well, that’s great. But what do I do about it? Versus saying, Okay, you have androgen dominance, here are the strategies that we’re going to use to help change the way that you metabolize testosterone. QAMaybe your progesterone is also deficient. Maybe you have estrogen dominance at the same time. There are a lot of facets, I think of a mobile hanging over a baby’s crib that if one piece is missing or one piece is too heavy, it throws the entire mobile out of balance. That’s how your hormones work, we want things to be in harmony with each other and there are certain things that we can’t see in the level of detail that we want if we just test your hormones with a blood draw.

I think you were mentioning how sometimes you couldn’t even get your doctor to order a lab test. Back when I was trying to learn more about my PCOS years and years ago now, I went to a naturopathic physician because I had figured I’d gotten pretty much everything that I needed from my medical doctor. I have a medical degree, so I knew what they were. I understood the medical model and I knew that, that’s the extent of what they can do. I wanted help with the lifestyle part of it. I had gone to a naturopathic physician and even then, I wasn’t having regular periods. One of the reasons why she was wanting to do a Dutch test was because she wanted to see what was going on with my periods and there was this… And she brought it up and I knew it too. Okay, so how do we know what data test? That comes into play and so she hesitated and I said, Well, is there a test that… Because this was back before I knew anything about all of this. And I said, Is there a test that I can just take every single day to see what’s going on during the month? And she’s like, Well, yeah, there is, but it’s really expensive and I’m like well, I would rather just do the right test than take another stab in the dark and hope we get something that’s helpful. I think that ties in to what you’re saying about we need to, as women know what’s out there and then we can make our own choice of, Is this a rabbit hole that I’m wanting to explore right now? It was. I wanted to figure out where I was in my cycle, what was going on with it, and I wanted a hormone test because I’d already had plenty of the blood work ones that didn’t really show anything relevant. I wanted one that was going to actually tell me something. Otherwise, I didn’t want to waste my time and money.

Yeah, absolutely. I think in my experience, people, they want to feel better. They want to be healthy. I think especially women, we want to look good, we want to feel good and so a lot of people that come to me, they’ve done diet, they’ve done exercise, maybe they’ve done some elimination of toxins or ultra processed food, some nutritional things and they’re like, okay, maybe they see the dial move a little bit. But they’re like, I feel like there’s something I’m doing everything right and things still aren’t adding up the way that they should. Especially when we go on social media and it looks like everybody’s perfect and everybody’s got it all together and everybody looks flawless and that just creates this terrible comparisonitis, and it makes us feel like we’re the problem. If I was just stricter with my diet, if I just worked out more, if I just didn’t crave the sugar or carbs or whatever it is, if I could just stop scrolling my phone or watching Netflix for hours and hours on end, then I would blank, fill whatever that is, weigh what I want, look a certain way, have a relationship, be happy, fill in the blank with whatever that is for you and it makes us feel like we’re the problem. There’s something wrong with us, and it’s so important for me to make sure that women know that your hormones are in the driver’s seat of your entire life and your entire body. You are in the passenger seat, essentially.

It’s true.

And if your hormones are not happy, you’re not happy and so diet and light, I specialize in nutrition. I love nutrition. Food is medicine. Yes, we can do so much there. But if we’re fighting an uphill battle because of PCOS, endometriosis, thyroid dysfunction, other hormonal imbalance, autoimmune, hormonal birth control, medications you might be taking, there’s roadblocks in our way. We’re not going to have a straight line on the map. We’re going to have to zig andzag and go around things and lab testing can help us to identify where are the roadblocks and how can we get them out of the way so that your path to your destination is a straighter, easier line and so a lot of women that come to me, they’re like, Okay, I’ve done X, Y, Z. I still feel this way. Things are still not working. Now I’m ready to take off the lid of my hormones and see what’s inside the jar.

So where should someone get started in lab testing? I think that’s something where, as we discussed, practitioners are not always super helpful in helping us get the labs that we need. How would someone go about deciding where to get their labs done, how to order them, which ones to order? How to navigate that? Because I think when I worked with patients in a clinical setting, one of the things that really stood out to me was how, if you don’t understand health care or how the body works even, you don’t know where to start and sometimes you don’t even know what questions to ask.

When it comes to hormones, if you’re currently using hormonal birth control, hormone testing is not going to be very accurate for you. I don’t recommend it because you’re spending money on something that is not going to give you the best insights. It’s like if the windshield on your car was ice over, it’s really hard to see the road and that’s what Hormonal Birth Control does to our view and to to your hormones. So if not coming off of your hormonal birth control, if you’re like, Hey, I want to stay on this. This is the decision I’ve made for X, Y, Z reasons, then you’re probably going to be looking elsewhere. Okay, what’s going on with your glycemic control? Let’s take a look at your metabolism, let’s take a look at your lipids, let’s take a look at your inflammation, your inflammatory markers. I do food sensitivity testing on all of my clients because food can be medicine, but food can also be poison if it is something that doesn’t agree with you. So maybe you want to start with food and find the foods that your body loves the most and doesn’t like and work on healing your gut. If getting off your birth control isn’t a top priority, if you’re already off hormonal birth control or you’ve never taken it and you’re like, damn, I’m really excited about hormones. That’s a place that you can very easily start if you’re excited about it. But it can be hard to navigate on your own and I’ve had people come to me that have ordered 10 different tests. They’ve just gone on Google and they’re like, I want an HTML and I want a bio and I want a Dodge and I want to do this and I want to do that and then they’re super overwhelmed because they don’t know how to read them or interpret them or put them into action and then it feels like a waste of money if you’re not actually using it. So that’s where I think working with a holistic practitioner, somebody that gets to know you, understands, Hey, where are you right now? Where do you want to be? And then can help to make some recommendations of, Let’s do this test and then see how you feel. Maybe the person’s worst issues are GI related and it’s like, Okay, starting with the GI map is going to give us X, Y, Z inputs this is where I think we need the most healing. Okay, let’s do that first. Maybe it is hormones. Maybe it is food sensitivity testing, maybe it is looking at a vitamin and mineral analysis. But having someone that can help take some of the guesswork off of your plate is immeasurably valuable because I just did it all by myself and it took me a very long time and painful trial and error and probably wasted thousands of dollars on things that didn’t actually work that I could have just skipped if somebody said, Yeah, don’t bother with that. It’s not worth it and that could be everything from prescriptions to at least for acne topicals and treatments and all kinds of other things or workout plans or meal plans. But having somebody that can get to know you and then help to make informed recommendations, I can just take the overwhelm out of it because like you said earlier, not everybody goes to school for this and it’s okay if you’re not an expert because we don’t expect you to be. But don’t put the burden on yourself to feel like, if I don’t do it myself, then it doesn’t mean… It means that I wasn’t successful in it.

You had mentioned you have a guide that goes through a checklist on hormone imbalance. Is that a good place to start to learning it, watch labs, to dive into?

I think it’s a great place to start using terminology that resonates with your experience. So if you go through and you check nine out of the 10 symptoms under androgen dominance, we could assume that there may be a pretty good chance that you have androgen dominance. If you tell me you’ve got cystic acne, hair is growing where you don’t want it, you’re losing hair on your head, maybe you notice your breasts are shrinking, your stomach is growing, you’re having irregular or missing periods, I’m like, Okay, there might be something there that we want to investigate further. Maybe your top issues are with your adrenals. You’re having some cortisol dysfunction, you’re having chronic fatigue, you’re hungry an hour after you eat, you’re craving sugar, you can’t make it through the day without caffeine. I’m like, Okay, maybe we focus in on your adrenals first, and you can start using terminology that resonates with your experience. I think I have androgen dominance, or I think I have estrogen dominance, or I think I might be progesterone deficient, and you can start using those terms to feel more informed and empowered when you speak to a practitioner. If you just go in and you say like, Hey, my periods are regular and I’ve got acne, they might not immediately draw the connection without you using terminology that resonates. That’s what I want is I want you to be informed and empowered. I think it’s a really good place to start to just figure out what’s going on with my hormones and where is it coming from?

Well, I will put that link in the show notes below. Then where is a good place on social media for people to follow you and learn more?

Yeah, you can find me on all social media @realhealthwithrach. My website is realhealthwithrage.com. If you connect with me on Instagram and you have questions, just send me a DM and tell me that you found me through the podcast. I would love to talk with you and just provide any insight and answer any questions that I can. If you can’t tell, I love talking about this stuff and we could do an eight-hour podcast and I wouldn’t run out of things to talk about. My goal on Instagram is to be a source of information and education. I’m a huge foodie, so sharing recipes that are hormone healing and supportive. You can just scroll through my feed and find some inspiration or education on things that are relevant to you. I believe when this podcast will be coming out, I’ll be gearing up for my next free five day Happy Hormones challenge. So if you’re really excited and you want to dive in right away with some training more on functional medicine, understanding your hormones, quick action that you can take to help with your healing journey, I’d love to have you be a part of that as well.

I will drop the links for your Instagram and website in the show notes as well so people can find those and is there anything else that you want to leave us with about functional lab work before we wrap up for today?

I think what I would leave you with is, regardless of where you are right now in your health, if things suck right now, because I’ve been there, I have had the days where it just felt like it was never going to get any better. My skin is never going to be clear, I was never going to lose the weight, I was never going to feel the way I wanted to. It seemed like it was so far away. I promise you the healing is possible. It 100% is for every single one of us. And if lab testing is one of the tools that helps you to get there faster, then I think the juice is absolutely worth the squeeze. Because if I would have had answers 3, 5, 10 years sooner, I think about how it could have changed the trajectory of my life and I want you to be informed and empowered and excited about getting answers. I’m a huge data driven person. I’m a big science person. I love data, I love insights and if you could just see on a piece of paper, you’re not crazy. There are the things going on in your body that are standing in your way and keeping you from feeling your best. I think it allows us to breathe a side of relief because we’re not the problem.

I couldn’t agree more. Thank you so much for joining us today, Rachel. It was a pleasure to have you here and have a conversation on a topic that we both find so important and fascinating.

Thank you so much. It was great to be here and I can’t wait to connect with you guys over on Instagram.

All right, everyone. Bye for now.

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