Reversing PCOS with Dr. Fiona McCulloch: Rational Wellness Podcast 065

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Dr. Fiona McCulloch tells how to reverse Polycystic Ovary Syndrome with diet and lifestyle changes with Dr. Ben Weitz.

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Podcast Highlights

4:04  Polycystic ovary syndrome has been around for a long time, since these symptoms were mentioned in ancient medical texts, but it is on the rise today for several reasons. One is because of all the endocrine disrupting chemicals in our environment, such as Bisphenol A found in plastic bottles, canned food, and shiny cash register receipts, which if a woman who is pregnant gets exposed to, then their offspring might get PCOS.  These endocrine disrupting chemicals commonly found in our environment, like plastics and pesticides, disrupt the way the ovary develops, and the ovary doesn’t go through its usual development. The follicles around the eggs have an abnormal structure and they produce too much testosterone, which inhibits them from getting ovulated on time and they accumulate in the ovary, which is what is seen on ultrasound as cysts.  Also, women with PCOS have insulin resistance, which is one of the underlying causes, and our modern diet with all the high glycemic carbohydrates encourages insulin resistance and diabetes.

7:32  Inflammation is the main underlying factor in PCOS, as it is in many chronic diseases.  Inflammation in PCOS is primarily metabolic inflammation, so reducing insulin resistance with diet is the most important thing you can do.  Following an anti-inflammatory diet, exercising, and taking high EPA fish oils and antioxidants like grapeseed extract and resveratrol can be helpful.

9:15  Dr. McCulloch prefers that her clients with PCOS eat a lower carb breakfast and only include a carb like berries with some protein, a lot of non-starchy vegetables that add a lot of fiber, and some healthy fats, like avocado or nuts or seeds. The starchy carbs she recommends are sweet potatoes, squash, root vegetables and quinoa. She recommends a little with lunch and bit more with dinner. She recommends that women stop eating three hours before bed and not to snack between meals.  She also likes resistant starch with dinner that comes from cooking and cooling potato and then eating it.  Dr. McCulloch feels that eating every 2-3 hours to maintain a more constant blood sugar doesn’t tend to work as well with women with PCOS. 

13:49  While the glycemic index is often recommended as a guide for which carbohydrate foods to eat, Fiona prefers to use the food insulin demand, aka, the insulin index. 

16:35  High androgen levels are a common factor in PCOS and balancing your insulin levels will reduce that and you can also take spearmint as a tea and you should put 3 spearmint tea bags in one cup of tea. Saw palmetto lowers DHT which is a strong androgen that causes hair loss in women.  Also N-Acetylcysteine, which is an antioxidant, it lowers testosterone in women, but not in men.

18:55  Anti-Müllerian hormone is a hormone that’s secreted by the ovary that is primarily used as a marker of how many eggs a woman has left in her ovaries, but in PCOS the ovary secretes more of this hormone than is related to the number of eggs. So, it’s a functional marker that she likes to follow to chart a patient’s progress. As a woman’s PCOS gets better, this level actually lowers and becomes more normal. Serum testosterone levels may look normal, even if the woman has PCOS. 

20:56  Since testosterone levels are difficult to measure in serum and serum test results often are normal, Dr. McCulloch prefers to look at urinary testosterone metabolites, and she likes to use the dried urine DUTCH test. However, she may test androstendione, DHEA, and DHT in serum.  She will often run a cycle day two or three FSH and LH, with the FSH typically being higher than the LH in PCOS but the opposite if there is no PCOS.  She will also run a two hour glucose insulin challenge, which is similar to the glucose tolerance test but we check insulin at every marker. So, the person has 75 grams of glucose and then we check them fasting at their insulin and glucose. Then we check them every half hour and we see how high did their insulin go?  She also often tests HsCRP to look at inflammation.

24:05  To deal with the infertility associated with PCOS, Dr. McCulloch often recommends a myo-inositol and D-chiro-inositol supplement and they should be in a ratio of 40:1 to be effective.

 

                              

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Dr. Fiona McCulloch is a Naturopathic Doctor and founder of White Lotus Integrative Medicine in Toronto, Canada, serving thousands of women with hormonal conditions. Dr. Fiona’s book, 8 Steps To Reverse Your PCOS, offers her well-researched methods for the natural treatment of Polycystic Ovary Syndrome (PCOS). Dr. McCulloch is available to see patients and can be contacted through her website   https://drfionand.com/ where she has a quiz you can take to find out what your unique PCOS type is.

Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.

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Podcast Transcripts

Dr. Weitz:                            This is Dr. Ben Weitz with the Rational Wellness Podcast. Bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness Podcast on iTunes and YouTube and sign up for my free ebook on my website by going to drweitz.com. Let’s get started on your road to better health.

Hello Rational Wellness podcasters. Thank you so much for joining me again today. For those of you who enjoy the Rational Wellness podcast, please go to iTunes and leave us a ratings and review and subscribe to our YouTube channel which is Rational Wellness or Weitz Chiro. Our topic for today is polycystic ovarian syndrome. PCOS. This is actually the most common hormonal disorder among women between the ages of 19 and 44, affecting up to 20% of women in this age group depending upon how it is defined. It’s also one of the leading causes of infertility. According to the Rotterdam Consensus, PCOS is present if two out of the following three criteria are present. Number one is delayed ovulation or menstrual cycles known as anovulation. Basically if your cycle lasts 35 days or longer, that qualifies for this.  Number two is high levels of androgenic hormones like testosterone and DHEA. Three polycystic ovaries seen on ultrasound. Besides irregular periods are often associated with PCOS. Weight gain and difficulty losing weight, fatigue, facial hair and male pattern baldness in women, acne, infertility, mood swings, pelvic pain, headaches, and sleep problems.

Here to help sort things out for us with PCOS is Dr. Fiona McCulloch. She’s a naturopathic doctor and the founder of White Lotus Integrative Medicine in Toronto, Canada, serving thousands of women with hormonal conditions. Dr. Fiona wrote a book, 8 Steps To Reverse Your PCOS, which offers well researched methods to the natural treatment of polycystic ovarian syndrome.  Fiona also developed a nutritional methodology for the open source health PCOS project which analyzes molecular, genetic, metabolic, and hormonal markers in women with PCOS. Thank you for joining me, Dr. Fiona McCulloch. Would you rather me call you Dr. Fiona or Dr. McCullough?

Dr. McCulloch:                   Oh you can just call me Fiona. It’s great to be here on the show.

Dr. Weitz:                            Excellent. So, how did you come to be so interested in polycystic ovarian syndrome?

Dr. McCulloch:                   Well, I do actually have this condition myself. So, because of that, I went through many many years of not being diagnosed with this and not knowing what was wrong. So, as I went into practice, I became more and more interested in different kinds of hormonal issues. I just always found hormones really fascinating and so obviously having these issues myself, I became more and more interested. It’s such a misunderstood condition, so I love unraveling different mysteries and help solving problems. So, I guess it just was really really fascinating to me.

Dr. Weitz:                            Yeah. That’s great. That’s one of the things that attracts me to functional medicine as well is solving the mystery of the person and peeling back the layers of the onion until you can help them achieve better health. Why is PCOS seemingly such an epidemic today?

Dr. McCulloch:                   That’s actually quite an interesting question. So, we know that it’s been around for a long time because even in ancient medical textbooks, there were these symptoms of PCOS that were mentioned but it does seem to be on the rise. What we know now is that it’s a combination of genetic predisposition along with something from the environment that turns it on. So, for example we know that certain endocrine disrupting chemicals can cause PCOS if a woman is exposed to those while she’s pregnant can cause PCOS in the offspring. So, we know that’s definitely a big part of things. The other interesting components are that most women with PCOS have insulin resistance which means higher level of insulin and it’s much easier to gain weight.  Our food these days is actually often quite aggravating to that. With insulin resistance, the more insulin resistant you get, the worse PCOS gets. So, it also makes the condition itself worse. So, we see more of it in medical practice because of that.

Dr. Weitz:                            Interesting. You mentioned the endocrine disrupting substances. In your book, you talk about the connection with BPA as being directly correlated with PCOS and one thing I find really interesting is these endocrine disrupting substances like plastics and BPA and there’s a whole bunch of other pesticides we often think of as estrogenic. I just think it’s so interesting that in men, these substances often reduce testosterone levels, whereas in women, they’re increasing testosterone levels.

Dr. McCulloch:                   Yeah. It’s actually very interesting. So, what actually happens with these is not so much that they act directly like an estrogen, although they do have estrogenic properties but it’s when a baby is developing and the ovaries are developing, when you expose the ovaries to something unusual from the environment, it just disrupts the way the ovary actually develops. What we know in PCOS is that the ovary doesn’t go through it’s full and normal development at puberty. It kind of gets stuck in a state where too many androgens are produced because this is actually a normal state temporarily but in PCOS, it’s like it gets stuck and we think that the endocrine disrupters actually cause the blockage, but really the development of the ovary amongst other things.

Dr. Weitz:                            Interesting. Is that correlated with the development of the cysts?

Dr. McCulloch:                   Yeah. So it’s quite interesting because although it’s called polycystic ovary syndrome, the cysts aren’t actually real ovarian cysts. They’re just eggs that haven’t fully gone through the development process so they kind of get stuck. So, the follicles around the eggs, they have abnormal structure and they make too much testosterone. Because of that, it inhibits them from getting ovulated on time and they just sort of accumulate. So, it makes the look cystic but they’re actually just a whole bunch of eggs that haven’t ovulated.

Dr. Weitz:                            Oh. Interesting. You write that inflammation is the main underlying factor in PCOS. Of course we’ve been learning that inflammation is one of the main factors in so many different chronic diseases, heart disease, etc. etc. What are some of the best ways to reduce inflammation?

Dr. McCulloch:                   That’s a great question. So, inflammation and PCOS is very much typically metabolic inflammation. So, we’re looking at the inflammation that comes really from fat cells. Especially abdominal fat. So, the type of fat that’s around our liver. So, obviously the best way to deal with that is to reduce insulin resistance because that is what causes us to gain weight around the abdomen and so diet is definitely the most important thing that you can do for this specific kind of inflammation. There are also many other things that you can do which include for example exercise is anti-inflammatory. Hot and cold therapies can be anti-inflammatory and there’s many different supplements that are anti-inflammatory. So, high EPA fish oils or antioxidants like grapeseed extract or Resveratrol.  So, there’s all of those elements too. So, of course no supplement is really going to make up for a poor diet, so it’s always those cornerstones first and then the supplements can definitely help as well.

Dr. Weitz:                            So, when it comes to insulin resistance, what type of diet do you think is optimal? Today, there’s a big emphasis on low carb diets and we have ketogenic diet being utilized more. What is your take on diets for insulin resistance?

Dr. McCulloch:                   So, yeah. I feel that women who have PCOS are a little bit different in that they often have other hormonal imbalances. So, they often have thyroid conditions or problems with their adrenals. So, the types of diets that tend to work well for them are not often the typical diets that might work well for other people, but if we think about what insulin resistance is, it’s that we’re secreting too much insulin at all the wrong times. So, normally we’re supposed to make insulin when we eat and it’s supposed to go down in between the meals. So, what I really like to focus on is creating meals that really balance the blood sugar. So, starting off with a protein. A source of protein and then a lot of non-starchy vegetables to add fiber and then a source of healthy fat. So, something like avocado or nuts or seeds.

Then the carbohydrates I typically recommend would be in the morning a lower carb breakfast. So, something like berries along with those other components of the meal. A little bit more at lunch and more of the carbs with the dinner. I often recommend not to snack in between the meals. The reason that we have the lower carb breakfast is not to spike the insulin first thing in the morning.  But having those solid meals keeps the blood sugar stable, so there’s no tendency to eat or snack or feel that you have to raise your blood sugar by having carbs. It just breaks the pattern and allows the blood sugar to be very stable and then the insulin to come down in between the meals.  Then I always recommend women stop eating three hours before bedtime or even earlier if possible and leave that nice long window without eating overnight, so that the insulin can come down. That’s usually a 12 hour window is really helpful to do that.

Dr. Weitz:                          Now some people recommend shorter spans like snacks in between so that you have something to keep your blood sugar stable every two or three hours during the day.

Dr. McCulloch:                   So, yeah. That is one of the methods that works for some people, but most women with PCOS it does not work very well for them because what happens is every time they eat in between the meals, they actually raise their insulin again. We’re trying to train the cells to be more sensitive to insulin. So, when we just create those really solid meals with quality food, really stabilizing impacts on blood sugar, there’s no real need to eat in between. So, we often see a lot of women, they just stop having to snack and their insulin levels just become more normal.

Dr. Weitz:                          So, what kinds of carbs do you recommend for lunch and dinner?

Dr. McCulloch:                   So typically I like to recommend root vegetables. They’re great. They’re very nutritious. So, sweet potatoes or squash are fantastic. Quinoa is also a really good carb. It has many different vitamins and minerals in it. So, these would be my general top choices I think.

Dr. Weitz:                          What about legumes?

Dr. McCulloch:                   Oh sorry. I like to recommend usually resistant starch with dinner because it really stabilizes the blood sugar. So, you can get that by cooking and cooling potato and then eating it. This actually causes all the starch to crystallize and it keeps the blood sugar very stable.

Dr. Weitz:                          Interesting. What about legumes?

Dr. McCulloch:                   Legumes. So, I think legumes are actually quite nutritious. They have a lot of beneficial nutrients in them. They have a lot of very beneficial starch and carbs. A lot of times people think of them as a protein, but they’re actually a combined carb and protein. Some people don’t tolerate legumes very well and they might have issues with their microbiome if that’s the case, they might have to be a little more careful with them or take an enzyme to make sure that they’re actually digesting them properly. And then I usually recommend that people don’t eat them with every single meal, because they can contain components that can bind up different minerals and vitamins.

Dr. Weitz:                          The dreaded lectins?

Dr. McCulloch:                   The lectins. Yeah. But I do think that we see in all of our population studies that eating them is associated with very good health benefits. So, I think if they’re incorporated for the right person here and there, I think they’re actually quite helpful.

Dr. Weitz:                          Good. So, it’s common for practitioners to recommend the glycemic index for helping to balance blood sugar, but I understand you’re using a different strategy. Can you tell us what that strategy is?

Dr. McCulloch:                   Yeah. Absolutely. So, I guess the most important thing is the structuring of the meals, but then I use something called the food insulin demand.  This is a metric that was actually developed by the same researchers that developed the glycemic index at the University of Sydney.  What they found was that as they were testing type one diabetics who actually have to inject insulin after every meal because they don’t make any, they were finding that looking at the glycemic index wasn’t really predicting how much insulin they needed to inject. They were like, “Well, what’s going on with that?” So, the glycemic index only includes carbs. So, that’s a limitation of that. What we know now is there are other components to what we eat that affect our insulin other than carbs.

So, the proteins but especially the type of amino acids that’s in a protein that we’re eating. For example, dairy proteins is extremely stimulating to insulin which is why a lot of people who are weight training they use whey protein in proximity to the workout because it raises insulin which drives those amino acids into their muscles. Now, if you’re waking up for breakfast and you’re not weight training, you’re not a body builder and you’re drinking a big whey protein shake or a big yogurt, you’re going to drive your insulin up. So, that’s the metric I tend to use.  We know the food insulin demand of many different foods now and even combinations of foods. So, I usually recommend a certain food insulin demand of protein, healthy fats, non-starchy veggies and carbs for each meal.

Dr. Weitz:                          If whey protein stimulates insulin so much, what’s a better source of protein for those who want to use a protein powder supplement?

Dr. McCulloch:                   Yeah. So I mean I think whey protein is totally fine if the person is not sensitive to it and if they’re working out and actually going to have that into their muscles.

Dr. Weitz:                          Well, let’s say this is somebody with insulin sensitivity, blood sugar problems.

Dr. McCulloch:                   So, I would usually recommend the vegan types of protein that are out there. They do have different kinds of amino acids so they’re actually not as stimulating to insulin. So, there’s a lot of really good ones. Just check the label and the amount of sugar is low, the grams of sugar because a lot of them do hide sugar in these shakes.

Dr. Weitz:                          Okay. So, let’s see. High androgen levels are a major factor in PCOS and they tend to result in facial hair and acne, male pattern baldness, infertility. What are some of the most effective natural herbs and supplements to lower androgenic hormones in women?

Dr. McCulloch:                   Yeah. There are actually quite a few that we know of. I guess the first and most important thing to consider is that insulin causes women to make the testosterone. So, any way that you can work on that first you’re going to get way more benefits from what you’re doing.

Dr. Weitz:                          Always start with diet first. Absolutely.

Dr. McCulloch:                   Exactly. Then looking at some of the supplements that you can take or herbs, so one of the ones that we have a good amount of research on is actually spearmint. So, spearmint actually has been found to reduce the hair growth that a lot of women that PCOS have on their chin or their face. It has a lot of antioxidants but it’s also an anti-androgen in women. So, this is actually something that’s really easy to incorporate as a tea. Most of the studies are in three cups a day. I usually suggest that you just put all three tea bags in to one big cup and drink it all at once just to make it easy. So, that’s one option. There are some other herbs that are anti-androgenic. There is for example, saw palmetto which is often something that we see used for prostate conditions, but it does have the effect of lowering DHT which is a very strong androgen that tends to cause hair loss amongst other unpleasant types of issues.  Then some of the other supplements that lower testosterone work a little bit indirectly but for example, N-Acetylcysteine which is an antioxidant, there’s quite a bit of research only in women with PCOS however showing it lowers testosterone. It wouldn’t do that in men.

Dr. Weitz:                          Is there anything that NAC can’t help with? This is one of the most amazing supplements ever. Every topic I research NAC seems to have benefits for.

Dr. McCulloch:                   It’s so true. It’s one of my favorite supplements just because it works so well for so much. Glutathione is such an important antioxidant for our cells in general.

Dr. Weitz:                          Cool. I’m sorry to cut you off there.

Dr. McCulloch:                   Yeah. No.

Dr. Weitz:                          You mention in your book anti-Müllerian hormone. I think for sure most patients and quite a number of practitioners are probably not aware of what this is. Could you talk about it for a minute and what role it plays in PCOS?

Dr. McCulloch:                   Sure. So anti-Müllerian hormone, it’s a hormone that’s secreted by the ovary and it’s not something we’ve been able to test until maybe the past decade or so. It’s primarily been used to test a woman’s ovarian reserve. So, just as a marker of how many eggs she has left in her ovary. What they noticed was that women with PCOS tend to have very high levels of this hormone. This is always related to age. So, there are different ages for different ranges, but in PCOS, what they found is that the ovary secretes more of this hormone than is related to the number of eggs. So, it’s a functional marker. As a woman’s PCOS gets better, this level actually lowers and becomes more normal.  A study was recently released showing that even in utero, women with PCOS secrete high levels of AMH and that this may also be one of the endocrine disruptors that’s involved in the development of the condition because it can affect the brain.

Dr. Weitz:                          Do you monitor that hormone as a marker for how they’re progressing in managing their PCOS?

Dr. McCulloch:                   Yes I do. Absolutely. It’s also another marker. Sometimes it can be hard to see PCOS in lab tests because it changes at different times in the life span and the serum testing for testosterone, it’s not very accurate in women. So, a lot of women, their testosterone looks normal, but yet it’s actually high. They have a lot of the symptoms. It’s just that the marker itself isn’t very sensitive. So AMH is another marker that is quite sensitive. So, we do consistently see that it’s higher in women with this condition so it’s great for diagnostics if I’m unsure.

Dr. Weitz:                          So, what is the best way to measure testosterone levels in women?

Dr. McCulloch:                   So, I prefer generally to look at other androgens unless the PCOS is very severe. Because most of the time, the serum levels do look normal. There are urinary metabolites which do tend to be a little bit more sensitive. So, I’ll run some of those urinary hormone metabolite tests. Another marker-

Dr. Weitz:                          Do you do a 24 hour urine or do you do the dried urine?

Dr. McCulloch:                   Yeah. I usually do the dried urine, the DUTCH test. So, that’s definitely one of the more common tests that we do. The great thing with that is it picks out a lot of different testosterone metabolites. Different types of androgens from either the adrenal or the ovary. A lot of research shows that a lot of these hormones actually that are androgenic come out of the adrenal glands. So, that test gives us a little bit more information. Androstenedione is one in the blood that I do a lot because it does tend to be a little bit more of a sensitive test. Some women also have high DHEA levels, but not all. So, it depends. There are certain women with PCOS that that will come up as an issue as well.

Dr. Weitz:                          So, if you were to just name maybe the top five lab markers that you like to use for PCOS, what would those be?

Dr. McCulloch:                   So, I would definitely often do a cycle day two or three FSH and LH. So, follicle stimulating hormone and luteinizing hormone. We would tend to see that the luteinizing hormone is higher. Without PCOS it would be the opposite. Typically the FSH is higher than the LH so that’s one I do quite a lot. I always test for insulin resistance. So, I tend to do a two hour glucose insulin challenge which is similar to the glucose tolerance test but we check insulin at every marker. So, the person has 75 grams of glucose and then we check them fasting at their insulin and glucose. Then we check them every half hour and we see how high did their insulin go? You can really see huge differences with that.

Anti-Müllerian hormone is definitely one that I test quite frequently. I often test CRP so high sensitivity CRP to look for inflammation. So, that’s definitely one. Then I’ll try to look for androgens as well. So, either Androstenedione or looking at DHEA-S, so I’ll choose some different androgens depending on the presentation. Sometimes if it’s hair, I’ll test DHT. So, if a woman is losing a lot of hair, I’ll go right for that because that’s definitely one of the ones that has the biggest effect on hair lost.

Dr. Weitz:                          Okay cool. You test that with serum or with urine?

Dr. McCulloch:                   Yep. Serum usually. You can see that in urine as well though.

Dr. Weitz:                          Okay. We respect to PCOS and infertility, I know this is a huge topic and we could probably talk about it for a while, but can you talk a little bit about it? When I was looking at your book, I notice that one of the supplements you mentioned was this myo-inositol and D-chiro-inositol supplement. So, can you talk about infertility a little bit?

Dr. McCulloch:                   Sure. So, PCOS is the number one cause of ovulatory infertility which is definitely a huge cause of infertility, but regardless of that, I don’t like to think of it as an infertility type of condition. Because usually women are just less fertile because they’re not ovulating at the right time. They have too much inflammation that can affect egg quality and implantation, but it’s really something that’s quite treatable. So, the vast majority of women with PCOS will get pregnant. It just takes a little bit longer and they have to work on it. One of those ways to work on it is absolutely with inositol which is probably the most researched supplement toward PCOS in general.

So, when we’re looking at the ovary and a good quality eggs, they have a lot of myo-inositol inside of them. Myo-inositol works as a messenger for insulin. So, when insulin attaches to the cells receptor, inositol is the one that takes the message inside the cell. The inositols are really involved in so many different processes, but we’ve seen in studies over and over again that using inositol can improve egg quality, it can improve ovulation rates, it can improve insulin sensitivity. So, even for women not trying to conceive who have PCOS, inositol is still helpful. But especially if they’re trying to conceive it has that added benefit for egg quality too.

Dr. Weitz:                          Cool. I know we have used a project that contains both of those. Myo-inositol and d-chiro-inositol. I actually just checked the label and they didn’t say exactly what the ratio was, but I guess the ratio is really important. Isn’t that right?

Dr. McCulloch:                   Yeah. It seems that the physiologic ratio of 40 to 1 is the best with respect to looking at seeing the most impacts for both egg quality and insulin sensitivity. We do know that if a woman takes a high amount of d-chiro-inositol that it seems to actually have a negative effect on embryo quality. So, we know that this 40 to 1 ratio is very good for both fertility and also for insulin sensitivity. Myo-inositol alone is also okay but that combo seems to be particularly powerful. It’s actually the same ratio that’s in our bloodstream.

Dr. Weitz:                          Cool. Is the Designs For Health product, are you familiar with that one? Does that have that ratio?

Dr. McCulloch:                   I am not sure because it’s proprietary so I don’t know what the ratio is in there actually.

Dr. Weitz:                          Yeah they didn’t say but I looked at their technical literature and they do talk about the fact that the d-chiro shouldn’t be too high.

Dr. McCulloch:                   Yeah. So, it may be okay. The one I tend to use a lot is Ovasitol by Theralogix. So, yeah they have the 40 to 1 and then they have individual pouches which are really convenient. So, a lot of patients just pop those into their bag and bring them with them. It’s a really good product, but I love Designs For Health and I use a lot of their products as well.

Dr. Weitz:                          Great. So, I think that’s all the questions that I had prepared today. Are there any other things you’d like to tell our listeners about PCOS?

Dr. McCulloch:                   Well, yeah. It does affect 1 in 10 to 15 women. There’s about 50% of women going around with this that don’t know that they have it. They’re suffering. I remember in my case I went I had cystic acne which was super severe and all kinds of issues. Nobody really ever looked into that for me. So, if you have any of those symptoms, go ask for a workup. Definitely educate yourself because a lot of the times, many doctors don’t really understand that PCOS is a very big spectrum of different issues. So, if you feel something is up with your hormones, try to seek out a functional medicine practitioner who can really get a good look at and get some of these tests done for you so that you can really understand if that’s what’s going on.

Dr. Weitz:                          I think it’s really important. You pointed out some of the subtleties of the lab markers because I’ve seen other patients who went to see typical practitioner, a conventional doctor and they ran certain testosterone and maybe hemoglobin A1C and they said everything is fine. So, I guess it’s really important to be a little more detailed in looking at some of these markers more carefully.

Dr. McCulloch:                   Oh totally. Yeah. I get lots of women coming in and saying, “Oh, my A1C and my fasting glucose are normal so I’m not insulin resistant. Meanwhile they’re carrying all their weight around their stomach, they’re not able to lose weight no matter what they do. So, it’s just the wrong tests are being done a lot. So, I think make sure and educate yourself and find someone who does functional medicine because they’re going to be able to help you with these things.

Dr. Weitz:                          That’s great. Getting the right testing done is so important. How can viewers and listeners get a hold of you and contact you? I understand you have some programs out there that are available?

Dr. McCulloch:                   Yeah absolutely. So, my website is drfionamd.com. I have a PCOS quiz there, a lab test guide so feel free to hop over and grab those. I have an online nutrition program called Eating for PCOS which if you head to that website you’ll be able to find me there. Then I have a clinic in Toronto. Which the website for that is whitelotusclinic.ca.

Dr. Weitz:                          That’s great. Thank you Fiona. You in a very short amount of time shared a lot of really good, interesting, clinically useful information.

Dr. McCulloch:                   Thank you so much for having me on your show, Dr. Weitz. It’s been great.

Dr. Weitz:                          Sounds good.