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I am thrilled to welcome Carissa back from maternity leave! After spending precious time with her beautiful baby girl, Poppy, Carissa is returning to practice and will be available for online consultations on Thursdays. In addition, she will be the primary practitioner handling email consults, making it easier than ever to get expert naturopathic support from the comfort of your home.

Get to Know Carissa

What’s your favourite thing about being a naturopath?

My favourite thing about being a naturopath is based on one of the naturopathic principles “the healing power of nature.” It truly amazes me just how interconnected we are with the planet; how herbs and nutrients can support the body in restoring balance. It’s really rewarding working with nature to guide my clients toward better health with the tools we can find in our backyard!

What’s your latest obsession?

Right now, my latest obsession is kids’ nutrition, especially since my little girl has just started solids. I couldn’t resist diving deep into it! I’m loving the book Boob to Food—it’s been a great resource for creating healthy, nutritious meals for my bub (and hub). I find myself reading it weekly and picking up new tips every time.

Current herb obsession and why?

If I had to choose a favorite herb, it would definitely be the beautiful dandelion! It’s such a versatile plant—supporting everything from digestion to detoxification. Plus, it makes such a delicious tea. It’s hands down one of the herbs I use most in my formulas, and I’m always amazed by its benefits.

Favourite meal?

My favourite meal would be grilled salmon with sautéed greens (especially broccolini, kale and Brussels sprouts) with roasted pumpkin or sweet potato—yum! I could eat this every day.

Favourite conditions to work with?

Some of my favourite conditions to work with are skin issues like eczema, psoriasis, and dermatitis. I can really relate to these conditions, as I was that typical eczema kid growing up—constantly battling flare-ups due to a poor diet. It wasn’t until I discovered naturopathy that I started to find real relief, and now I’m passionate about helping others do the same.

What is something that you’ve learnt about pregnancy and motherhood since becoming a Mum?

Wow, where do I start? Since becoming a mum, what I’ve learned more than anything is just how incredibly adaptable the female body is, especially during pregnancy and motherhood. Our hormonal system is so complex, and it’s fascinating how it shifts and changes to support us through every stage—from conception to birth and beyond! What strikes me the most is the way our bodies respond to the demands of motherhood, from breastfeeding to the emotional rollercoaster we experience, and how everything is interconnected. As a naturopath, I’m in awe of how our bodies are designed to nurture and care for our little ones while keeping us balanced, even through all the changes we go through.

Carissa has a special interest in working with children’s health, pregnancy, and all aspects of skin health. Whether you’re looking for support with your little one’s health, navigating pregnancy and postpartum wellness, or addressing skin concerns naturally, Carissa brings her expertise and compassionate approach to every consult. Of course, as a fully trained naturopath, she is well-equipped to work with a wide range of health conditions, offering tailored, holistic solutions to support your well-being.

One unique aspect of working with Carissa is the incorporation of iridology into her consultations. Iridology is the study of the iris (the colored part of the eye) as a reflection of overall health and genetic predispositions. By analyzing patterns, colors, and markings in the iris, Carissa can gain valuable insights into your constitution, organ function, and potential areas of imbalance. For online consults, we make this process simple: before your appointment, we will send you instructions on how to take a clear photo of your iris and email it to Carissa. This allows her to integrate this valuable tool into your consultation, providing a deeper level of understanding and personalized recommendations.

Carissa also utilizes drop dose herbal prescribing, a method that involves using highly concentrated herbal extracts in small doses to create profound therapeutic effects. This gentle yet powerful approach allows for precise, individualized treatment, making it particularly effective for sensitive individuals, children, and those with complex health conditions.

Carissa is excited to reconnect with both new and existing clients and support you on your health journey. Whether through a video consult or an email consultation, she is here to help you feel your best with evidence-based naturopathic care.

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Endometriosis is a multifaceted gynaecological condition that affects many people with uteruses from as early as the first menstrual cycle, and possibly well into menopause. It is believed to be associated with a complex interplay of genetic, hormonal, and immune system factors that drive inflammation. A lesser known player that influences endometriosis is our microbes, in particular the bugs of our vaginal and digestive microbiome.

The vaginal microbiome is a complex ecosystem of bacteria, fungi, and other microorganisms that plays a crucial role in maintaining the health and function of the female reproductive system. In recent years, there has been growing evidence to suggest that changes in the microbiome of the vaginal and peritoneal fluid (the fluid which are reproductive organs exist within) may be associated with endometriosis.

Typically people without endometriosis are not shown to have many microbes within the peritoneal fluid, whereas those with endometriosis have been found to have dysbiosis of this area.

Photo by Alexander Krivitskiy on Unsplash

The vaginal microbiome can be imbalanced at many stages of life, however a long term imbalance such as in chronic candida can contribute towards inflammation and perpetual irritation of the nerves, aggravating the pain associated with endometriosis.

Dysbiosis within the digestive system can also aggravate endometriosis due to the increased production of lipo-polysaccharides (LPS) from dysbiotic bacteria, which contributes towards growth of endometrial lesions, increased inflammation and pain. Our gut bacteria play a large role in the balance of our immune system, and imbalances within our gut bacteria can disrupt this, worsening the inflammation of endometriosis which is driven by altered immune function.

If only correcting our microbiome was the sole answer, but it is part of the jigsaw puzzle.

You may be interested in these articles:

Endometriosis – Natural Management Options

Updates on Endometriosis

Thrush

10 Ways to Ease Period Pain

Endometriosis – an overview

The complexity of endometriosis makes it an overwhelming condition to tackle by yourself. Please don’t hesitate to get in touch if you would like to work together to improve this condition.

The post Endometriosis and the Microbiome appeared first on Alison Mitchell Naturopath.

Guts and Girl Bits Episode #50

As we reach the end of Endometriosis Awareness Month I wanted to release a little recording I made a while ago for women’s health week, in which I spoke about Endometriosis.

Endometriosis is a condition that can significantly affect a woman’s quality of life, however, there is a lack of awareness and understanding of this condition.

It is estimated that 1 in 7-10 women may have this condition, however it can take many years to receive a diagnosis. In this video discuss some considerations of addressing this condition with naturopathic medicine, addressing the root causes of immune imbalance.

Watch the Video:

Listen to the audio:

Subscribe and listen to the other podcasts here:

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Related posts:

Endometriosis

10 Ways to reduce period pain

Updates on Endometriosis

Heavy periods

Choosing the right products for that time of the month

Thrush

Transcript

0:08
Hi, everyone, you’re listening to Guts and Girl Bits. I’m Alison Mitchell, a practicing naturopath and I hope to share with you all sorts of information about women’s health and digestive health to educate and empower you to make informed choices about your own health. Please remember that all information is general and does not replace consulting with a healthcare practitioner.

0:31
It’s the end of March and March is Endometriosis Awareness Month. So I wanted to share a little video that I recorded a couple of years ago for Women’s Health Week as my latest podcast because in that video, I share all sorts of information about endometriosis, and about how to get to some of the underlying drivers that causes it. So I hope that that’s helpful for you. There has been more research coming out since then, as well. But most of the new stuff that I shared in that one is still relevant. So if you want to hear more information, then please subscribe to me on @gutsandgirlbits. And stay tuned as well for all my e courses that are coming out all about how to understand yourself by understanding your cycles and understanding your hormonal balance in more depth, which you can find over at my teachable account, which is gutsandgirlbits.teachable.com

1:30
Hey, everyone, I want to talk about endometriosis today. This is the last day of Women’s Health Week. So I wanted to finish it off by talking about a condition that I really love treating and that’s that’s endometriosis. So if anyone doesn’t know what endometriosis is, basically, it’s a painful condition that affects women. And it affects almost one in seven women approximately. And it can cause quite a lot of issues. So what’s what seems to be happening is that we women get these endometrial cysts, also known as endometriomas, or chocolate cysts, which are basically the content of the lining of the uterus being where it shouldn’t be. So when we normally have our period, what should be happening is that the lining should just you know, break down and dissolve and come out as normal menstrual blood. But sometimes what’s happening is that this isn’t staying in the uterus. This is actually forming little adhesions or cysts elsewhere in the body, such as around the lining around the outside of the uterus or in the fallopian tubes or stuck to the ovaries. And it can also happen in their peritoneal cavity where it’s actually attaching to the intestines, the bowel, bladder and those sorts of things.

2:55
So back up back when I was a student naturopath, we were taught that endometriosis is a condition caused by a hormonal imbalance. But with recent research, what we’ve come to understand is that endometriosis is actually an immune condition or an inflammatory condition. So it does have a hormonal component. There is certainly a hormonal driver behind endometriosis. And that is estrogen, but the immune system is actually the biggest player when it comes to endometriosis. And so there are a lot of different factors that actually feed into why the immune system is disrupted in the first place. But what we what we’re finding is that inflammation, in particular, coming from histamine imbalance, and coming from genetic imbalances and gut health is some of the biggest issues that seem to be driving our immune immune dysfunction. So there’s currently not really a great testing option available for endometriosis. It’s unfortunately something that can only be definitively diagnosed with a laparoscopy, which is a type of keyhole surgery where there will be some small incisions made in the abdomen, abdomen, and then they go in with a little camera. And so if they can see the presence of these chocolate cysts, then that’s confirmative of endometriosis. But the laparoscopy at the same time can be used as a treatment. But that’s not that’s not always the best option for every woman. Because for some women who are particularly inflamed or have a strong immune activation, then the actual incision or the actual surgery itself can actually worsen endometriosis. There, they will find that they might actually get some further adhesions developing where those original cysts were removed. There seems to be more of an issue when the laparoscopy is performed with the laser where it’s actually burnt off rather than incised. And that’s that’s something that again, has only really been discovered recently, but it seems to be

5:00
You know, while it’s a good thing for some women, but not for every woman, and again, it goes to show that endometriosis is a really, really complex condition. And so because of that complexity, everyone needs to be treated a little bit differently. And we need to try and figure out the cause of what’s going on for those women. So there’s a few, you know, possible causes as to why women can have that particular immune imbalance. And one of those things is a gut imbalance, so and or an infection. So if you’ve got an infection, then your immune system is going to be disrupted. And then if you’ve got that genetic tendency for endometriosis to go wrong, then that’s where it’s going to go out of whack for you. There’s some some naturopaths in the field at the moment that are doing research in this and they’re finding that there’s actually a whole different microbiome, which is your bacteria balance within the peritoneal cavity, which is basically the fluid that our organs swim in, and also within the vagina itself within our reproductive organs. And so if they are out of balance, if that microbiome in that area is out of balance, and our immune system is going to be unhappy, and correcting that can be helpful. Dealing with infections can also be really helpful to under to address that underlying imbalance. Now, the other thing that can sometimes happen is because what we know that it’s an inflammatory condition, and there’s an immune imbalance going on, but there’s certain genetics that are involved in that issue. And I find that the mthfr gene, which is a pretty common gene to have, and it doesn’t having the gene doesn’t always mean that there’s an issue, but it’s if that gene is not acting properly, then it affects the enzyme that deals with a lot of different processes in the body. But in regards to endometriosis, in particular, it affects our our main antioxidant recycler, glue to fire recycling of glue to fire. And now, if we don’t have enough antioxidants in endometriosis, then we can’t really mop up all that immune damage that’s going on. So it makes the inflammation worse. And so then, as a result, that makes pain worse. And that can also, you know, make all those other sorts of reactions worse as well.

7:17
One of the things that we also find going on is that mthfr gene affects the detoxification of certain hormones throughout the liver. And if we’re not detoxifying our hormones effectively, then we get that recycling and that uptake of those hormones through through the system, and so then we lead to having too much of certain hormones where they shouldn’t be.

7:41
In the case of endometriosis, what we used to think, as I said before was that it was a excess of oestrogen. But in this case, it seems to be that it’s a displacement of estrogen. So there’s too much estrogen being activated in the area of the endometrial tissue lining going on. And that’s causing a reaction with some of our other immune chemicals. So one of these immune chemicals is histamine. So histamine, can you probably know about histamine as an allergic sort of issue like, you know, hay fever and sneezes and rashes, and, and all of those. Well, when are mast cells, the immune cell that causes the histamine to be in excess is actually in reaction to the estrogen. And that causes more of that inflammatory reaction. And so then, you know, you get the pain and the redness and, and those painful reactions, that’s so common with endometriosis. And as a result of the inflammation that takes place, then when there is that, I mean, immune activation in that area, that’s why we’re more you’re more likely to actually get adhesions forming. And so this can be a really big problem for women with endometriosis is that the adhesions can cause a lot of damage, they can stick for free, you can stick your organs together, you can get the uterus can be stuck to the bow or bits of the bow can be stuck together. It can, you can have the bladder being involved as well. And all of that can cause quite a lot of pain. And it can also affect fertility quite significantly as well.

9:14
Now, and adhesions do seem to have a bit of a problem and that they can only really be resolved with surgery. So as we were talking about before that surgery isn’t certainly a good option for some women, but it’s not not the first line option for every woman. It’s actually better if you can try and get on top of endometriosis in the early days. But the thing with endometriosis is that it’s actually a condition that a lot of people are getting dismissed and missed about, if that makes sense. What I mean is that women are going to and young girls are going to their doctors and they’re complaining of pelvic pain, period pain, and they’re basically getting dismissed and it seems to be about 70% of young women with endometriosis are getting dismissed and that’s a huge number 70% so if we can get on top of this condition in the early days before adhesions formed and things are going to actually work out a lot better for these women what we need to do is we need to have the funding into a better research system but we also need to have more awareness and women need to be more empowered and educated so that they can make make these make these choices make ask the right questions so i think the fact that the main testing method is a form of surgery is probably pretty off putting but we can do a lot in terms of natural treatment and dietary techniques to actually take this under control one of the things we need to do is to get our gut flora and underbalanced under control and we also need to look at reducing our inflammation levels throughout diet for a lot of women with endometriosis one of the main inflammatory things that’s going on is that they intolerant to certain foods and the key food that i find a lot of women are reacting to is is actually dairy or cow’s protein in particular and this can be you know pretty hard to give up for a lot of women but getting that out of the system can make a big big difference now we also need to look at supporting that mthfr gene which is the one that i was talking about before so the mthfr gene basically it works on a particular enzyme which is can never remember the name of it and let me find it – methylenetetrahydrofolate reductase – and basically that works on the conversion of our fault for late into its activated form in the body now it’s more than just taking folic acid in fact if you’ve got issues with this gene you probably shouldn’t be taking folic acid you should be taking different b vitamins or activated b vitamins and so this is where it gets pretty complicated because depending on what you’ve got going on with this whole methylation pathway taking methylated b vitamin can actually make you feel a lot worse because you can be methylating too fast or too slowly and so if you’re methylating too slowly and you take methyls then that’s going to make you feel like help so we don’t want to do that so that’s where you know seeing a practitioner can come in really handy but if you can get your methylation under control that does a few things it brings histamine into balance it improves your detoxification of your hormones through the liver and it can dampen that immune dysregulation and therefore inflamed inflammation that’s going on so those are some really key things that’s going on and one of the other things is that it really really really helps with your glue to fire and recycling which is what you need to mop up all that damage that’s taking place now there are a lot of other things that we want to work on with endometriosis and as we’ve said a few times get that inflammation level under control so one of my favorite things to do is Turmeric. now turmeric does have a little bit of a blood thinning properties so depending on what your your bleeding is like if you tend to be quite heavy bleeder it might not necessarily be the thing there’s something called VAGF which is basically your some women have a higher level of capillary growth to these endometrial lining and certainly doesn’t happen with everyone but actually getting improved mop up of that area can be quite helpful with certain again immune herbes and things like that as well we also want to again work on those antioxidant levels so working on methylation is helpful but herbs and nutrients that will actually help with your antioxidant levels can be helpful to one of those is n acetylcysteine or you potentially taking gluta thione itself but n-acetylcysteine is a lot cheaper and also it can be converted into the body in the body to glorify and so that’s something that can be quite helpful for people as i was talking about before in terms of diet you want to reduce the foods in your diet that you might potentially be intolerant to that could potentially cause some inflammatory reaction for you so those are some things that you want to do and you also want to work on while it’s not hormone only cause to condition it is hormonally affected so if we can work on getting estrogen detoxification under control then that’s going to help with the estrogen displacement that’s going on some people might know that sort of concept as estrogen dominance what’s really happening though is that there’s too much estrogen in the wrong place not that there’s necessarily a lot of estrogen everywhere going on because for women with with this sort of condition they might actually experience some symptoms of estrogen deficiency like you know brain fog or hair loss and skin dryness and thinning and that sort of thing but then in other instances they’re going to be experiencing symptoms of estrogen excess such as their their period abnormalities and or pms symptoms and those sorts of things so again it comes down to the individual so that’s where you know seeing a practitioner can actually be really helpful to get that under control

15:35
so i think i’ve kind of rambled a little bit there that seems to happen when there’s topics that i’m quite passionate about i guess one of the take home points that i really want to say with endometriosis is that we know a lot more about it now we know more about the immune involvement about the inflammatory involvement and so because of that we can actually do so much more for it we can actually get really better treatment happening and so if you know if you if you were seeing a naturopath for endometriosis five or 10 years ago you’d get completely different treatment most of the time now so i would say you know if you want to get some treatment ask your naturopath what they think is the main cause of it what they would do to treat it and if they’re talking about some of these new research that’s going on then give it another try because i have a lot of patients with endometriosis nowadays that i get real good success with and we follow these these routes of look at the infections that might be driving immune imbalance and support methylation support the detoxification of the estrogen but as less of a priority you got to get all those other factors under control get that inflammation down once that see improves things start to get better for them much quicker than it used to back when i first started trading where it would take you know a good half a year’s 12 months maybe to get things much better under control whereas now it’s it’s you know half a year mostly it does always depend on the person always depends on the severity of the condition as well you know for some women their endometriosis is so severe that you know surgery is what is really really required and sometimes even going on something taking something like the marina or getting the marina in is important because that actually helps to improve local progesterone in the uterus and so that can help to improve that imbalance and so if you’ve got less of that estrogen activity taking place then you get to have less of that histamine reaction most of that immune reaction going on so you know one of the first things i would say is get your gut the gut microbiome in the gut and also in the vagina under control is blackmores women’s bio balanced is a product that i do recommend as a retail option there’s also practitioner ones that i use Femex have you know a really fresh diet full of antioxidant rich foods lots and lots of veggies eat your rainbow every day those things are really really important and you also really want to get your stress under control because i mean as you know stress has a big role and a lot of different things so we’ve got this thing called the the hpa axis hpo axis hpt axis where all of our hormones are talking to each other all of the time and if there’s some other things going out of balance for instance our hpa axis which is where our adrenal glands are out of balance that’s going to throw out our hbo axis which is where we’re talking to our reproductive hormones so we want these to be under control and calm so doing some mindfulness and some meditation taking stress herbes taking all your nutrients those are really important too in regards to nutrients i mentioned in acetylcysteine i think that can be really helpful but i also do think that you need to get your core reproductive nutrients under control so that’s firstly get using copper ratio right because excess copper can affect your estrogen levels i also think that you need to get adequate magnesium for your stress levels also to reduce into smooth tissue cramping and calcium is important too you need to have that right ratio going on and i and is is really important so you don’t want to have too much iron because iron in excess can cause oxidative stress which can be inflammatory but if you’re into if you’ve got insufficient levels of iron then you’re going to be more likely to bleed more and that’s going to be a big factor for a lot of women a lot of women with endometriosis have really really heavy blades so we don’t want that that with iron that’s one of the things that i always recommend getting iron levels tested before starting supplementation and get the dose, right? I think vitamin D is important vitamin D is really important for your immune health. And I recommend getting your vitamin D levels over, over 80. You don’t want it to be higher than 150 or so.

20:19
And you also need to be considering things that are going to help to bring down your inflammation levels. As far as Herbs and so I’ve said, I’ve said tumeric, I do love tumeric. But again, you just got to be a little bit careful with it, depending on the periods. And I also think that good quality, facials can be helpful, but the same same sort of thing. Although they do they, we’ve always had this bit of a concern with fish oils is that you know, they can cause they can cause a blood thinning activity, or they could cause excessive bleeding. But some studies that actually measured the amount of bleeding that you create with officials has shown that it doesn’t seem to actually cause that greater quantity. So it’s not like you know, you’re going to bleed out or you’re going to have like massive amounts of blood loss or anything like that. Anyway, so activated B vitamins and stay away from synthetic B vitamins, and try and also stay away from foods that are fortified with synthetic B vitamins too, because while not everyone has this mthfr gene, if that mthfr gene enzyme gets unhappy, regardless of the genes presence or not, then that’s going to cause issues with all of those other factors. So it’s going to cause issues with the histamine, the hormones, the antioxidants. So all of those things that we want to work with. Thank you all so much for listening. I hope that you’ve enjoyed today’s episode. Please join me over at the Guts and Girl bits Instagram page and share any other words of wisdom that you would like to contribute as well. TGuts and Girl Bits now has a collection of E courses that you can view online. The primary course available at the moment is natural menopause support, which provides a whole heap of information on supporting yourself through the major symptoms of metaphors and easing through this transitional life. You can find the collection of E courses at ghttp://gutsandgirlbits.teachable.com. And then you’ll also find a course of understanding underactive thyroid, and coming up soon will be a courses called The Cyclical Woman, Navigating the teenage years, children’s health, nourishing the mother, and more. If you’ve enjoyed today, please leave a review and share this episode to help spread the word. Thank you

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PCOS, also known as Polycystic Ovarian Syndrome is a complex condition that can significantly affect a woman’s quality of life. One of the biggest ways it does this is by impacting on a women’s ability to conceive and maintain a pregnancy, but it can also impact a woman’s self-esteem by making it difficult to lose weight, it causes acne and hair issues, such as too much hair where a woman doesn’t want it to be, and potentially thinning of scalp hair.

Of course, there is more to it than that, but those are the major things that women report as the issues they’re most upset by.

In this article and podcast I will discuss the lack of awareness and poor understanding surrounding PCOS, how it is often misunderstood and why its name has a role in this. I discuss the common, and not so common signs and symptoms of PCOS and talk about the driving factors that can cause PCOS to develop. I talk about how PCOS is often diagnosed and discuss some of the key ways PCOS can be addressed naturally.

You can listen to this article on the podcast links below, or in the embedded player.

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Understanding PCOS

Lack of awareness

Sadly, but not unexpectedly there is a lack of awareness and understanding of PCOS, with many people who have not been diagnosed not aware of the condition at all, but also women who have been diagnosed, and some health practitioners as well, not properly understanding the condition. A big part of this lack of awareness is the lack of research into the condition, but also I believe it is part of the bigger picture of gender bias in medicine, and many conditions that are specific to women do not have the attention they deserve, perhaps the exception being breast cancer. One of the other things that doesn’t help this lack of awareness and understanding is the name of the condition itself – polycystic ovarian syndrome.

The name makes a few false implications which cause overall confusion – so here are a few points I want you to know:

1. The condition doesn’t originate in ovaries and the condition is not all about ovaries either, after menopause, the condition can persist. It is more of a metabolic condition, with systemic high androgens and insulin resistance being the core drivers.
2. A PCOS ovary doesn’t actually have ‘cysts’, rather what you can see on ultrasound is immature follicles. Follicles are the little sacks that your oocyte, or eggs sit in waiting for the hormones from the brain to tell it to mature and then ovulate. The issue is these follicles in PCOS is they aren’t developing properly, so if we got them to develop fully these so-called cysts would be a baby (if met with a sperm).

A new name?

Many physicians and researchers have proposed a name change for PCOS, however, that was being proposed in 2013 and it’s 2020, so who knows when that will happen. I agree the condition does need a name change, as I feel PCOS is not a good representation. One of the names suggested which I like is ‘metabolic reproductive syndrome’, however other names suggested were Poly-follicular ovarian syndrome with metabolic dysfunction and/or hyperandrogenic manifestations (PFOS-MD and/or -HM).

The list of potential signs and symptoms is long for PCOS, which explains why there are so many women out there that don’t know why they have the symptoms they do.

PCOS Symptoms

Most common symptoms of PCOS include:

• Irregular periods or absent periods
• Acne
• Weight gain
• Excessive hair growth, also known as hirsutism. This can vary in locations and intensity and it will also be different dependant on your nationality.

Less well known, but still common symptoms:

• Anxiety and/or depression
• Fatigue
• Brain fog
• Skin tags
• dark patches on the skin
• low libido
• Sleep disturbances and snoring (Sleep apnoea can also be more common due to the higher level of androgens. Poor sleep can worsen PCOS by worsening insulin resistance.)

And more than that, there are other complications, especially regarding fertility and baby’s health. The higher levels of androgens can increase the risk of miscarriage and are also linked with some increased risk for baby such as higher birth weight. Women with PCOS also tend to have difficulty with breastfeeding and a higher risk of diabetes after birth.

Thankfully, many of these risks are modifiable by correcting the underlying causes of PCOS, which I will discuss later.

Causes of PCOS – How does the switch get turned on

There are different ways PCOS can express, and for these different subtypes, there are different causes.

The main cause is insulin resistance, which causes the male hormones androgens to become high. Insulin, when it is too high, can trigger more production of testosterone, but it can also lower the amount of SHBG (sex hormone-binding globulin) which means our bodies can’t bind up the excessive testosterone as well, and so more is circulating our body, causing the symptoms of PCOS such as acne and hair issues. Insulin excess also affects our FSH : LH ratio which is important for ovulation, and high testosterone stops our follicles from maturing completely, so this means woman’s ability to ovulate is affected, and if that is affected their chances of conceiving is reduced, and oestrogen and progesterone balance is also affected.

There are different types of androgens, such as testosterone, DHEA and androstenedione, and depending on which one is elevated we can get an idea of what is driving your PCOS. For instance, if DHEA is high, we know that stress is a big driver.

It is also possible to have PCOS without insulin resistance and this is typically due to inflammation. this is a much rarer subtype, but certainly something to consider.

Something else to consider is your gut health can play a role in both hormone balance and metabolism. Your gut bacteria are responsible for so many things in the body, and if you’ve listened to my previous podcasts or read some of my other blog posts you’ll know that your microbiome is of vital importance in improving health. How does it affect PCOS? Well, if your microbiome is out of balance it can affect your metabolism, which can worsen insulin resistance. And an out of balance microbiome can also cause hormone problems, by allowing more of your ‘bad’ hormone metabolites to cycle back through the body.

Why do you have a PCOS ‘switch’ in the first place?

We know there is a genetic component to it, and there is some possibility that your genetic likelihood can be influenced by exposure to endocrine-disrupting chemicals in past generations, substances that are passed through generations. So effectively, what chemicals and diet your Grandmother was exposed to will impact your risk for PCOS.

This transgenerational effect has been demonstrated in animal studies when mice were fed an obesogenic diet and were given substances that mimic a high androgen state to bring about a metabolic state of PCOS, and it was found that their subsequent generations also expressed this condition.

It was also found that women with PCOS had levels of chemicals in their system that were not in use anymore and was found to have been passed through in utero from their mothers and grandmothers.

These chemicals are increasing the activity of the androgens and also acting as obesogens, contributing to the weight gain and insulin resistance.

Diagnosis issues

So how common is PCOS? The prevalence is about 8-13%, effectively 1 in 10 women. But it is a condition that is it is both over-diagnosed in young girls, and under-diagnosed in older women.

One of the issues in getting diagnosed is that there isn’t one specific diagnostic criteria, so you can get mixed messages.

Three main diagnostic criteria exist- the National Institutes of Health, the Rotterdam criteria and the Androgen Excess Society criteria.

All of the criteria require all other possible endocrine disorders to be excluded.

My criteria of choice is the Rotterdam diagnostic criteria. It requires a female to have two of these three criteria:

1. Irregular periods
2. Clinical and/or biochemical hyperandrogenism
3. “Polycystic ovaries”

Many young girls are being prematurely diagnosed with PCOS. But it is normal for young girls to present with some symptoms of PCOS and this often resolves in a few years without intervention. It can take 3-6 years for a menstrual cycle to regulate itself, however if there is early intervention this can prolong this process, and it is thought that the most common recommendation given at this time – the oral contraceptive pill (OCP) can worsen insulin resistance, which perpetuates the condition.

What are the other causes that need to be excluded?

This could be conditions such as Cushing’s, Adrenal tumours or congenital adrenal hyperplasia. Screening would include blood tests for TSH, prolactin, FSH and anything else your practitioner feels warranted based on your signs and symptoms.

PCOS and Teens

Getting back to teenage girls and their periods, it’s not uncommon for girls to have irregular periods when they’re young, and this will usually regulate itself within 6 years. My personal preference in clinic is to not interfere with hormones in young girls but to allow their bodies to regulate themselves. If hormones are interfered with too early, then it will typically delay the regulation until later. This is relevant to not just herbs, but especially to things such as hormonal contraceptives.

A common understanding is that women with PCOS literally have cysts on their ovaries. But this isn’t the case, as the name implies. the polycystic ovarian appearance that some (but important to note, not all) women have on ultrasound is actually a higher count of immature eggs within their follicles. These eggs aren’t getting the signal from the brain to mature further, triggering ovulation and release.

If you can remember the diagnostic criteria, the presence of 2 of the 3 criteria is what it takes to get diagnosed, so if a woman has irregular periods and signs of high androgens, she can have PCOS without the presences of any ‘cysts’ on her ovaries at all.

A more positive perspective.

One of the perspectives I have heard before about PCOS which I love is that this is an evolutionary trait which in years gone by was protective. if you consider that being pregnant and giving birth was a life-threatening thing at worst, and a depleting event at best, it can make sense why a condition like PCOS which can reduce one’s fertility may be protective in tough times. Insulin resistance is beneficial in times of scarcity as it allows you to store more of the energy from foods, which in famine times if beneficial. In times of plenty such as now, this, unfortunately, works against us. In a time without contraception, women may have gone from one baby to the next without a break, which can be quite a high level of stress and depletion. So, for women with PCOS who have longer times between ovulation, and so fewer opportunities to conceive, this could be considered a positive thing. Nowadays this might not be much comfort especially if you’re wanting to conceive, but I believe anytime you can view your health from more a positive light it is beneficial, so ladies with PCOS you might like to shift your frame of thinking to more of an ‘I’m a survivor’ mindset.  

Other considerations for PCOS

Sleep

Sleep disturbances are reported to be twice as likely for women with PCOS. Studies show found that women with PCOS are more likely to report difficulty falling asleep, to have restless sleep occasionally and often feel severely tired. Sleep problems also occurred in women with PCOS who were in the normal weight range.

It’s still unclear how PCOS affects sleep but we know that the metabolic impacts of the condition play a big role. The hormones melatonin and cortisol are responsible for our sleep cycles to a large degree and these are strongly influenced by insulin resistance and elevated testosterone, as well as the stress placed on the body if obese.

Sleep apnoea is also often reported in women with PCOS, more often in those who are overweight. In those people who are considered to be ‘severely obese’, (BMI >40kg/m2) the prevalence of sleep apnoea in both men and women can be as high as 92%.

The mental health impacts of PCOS which is an increase of anxiety and depression have a bidirectional association with poor sleep quality and insomnia.

Weight loss and exercise is one of the best ways to improve sleep quality in women with PCOS, and if needed there are herbal medicines which can be of support.

Nutrients such as magnesium and calcium and the amino acid l-theanine can also be supportive to calm the nervous system and promote relaxation and sleep.

PCOS and Mental Health

Women with PCOS have higher rates of anxiety and depression. PCOS can be a very distressing condition for many women and this varies from person to person, with some of the highest reported contributors to the anxiety and depression is the impact to fertility, the impact on physical appearance and self-esteem such as weight issues, hirsutism and acne, and also the frustration about the lack of a clear cut solution, and a lack of awareness and understanding of the condition. There was a study that found that women with PCOS were physically active reported less depression and anxiety than those who were inactive. So, while I love to use herbal medicines to support mood and the nervous system, I do frequently recommend exercise to support mood in women with PCOS.

Potential pregnancy risks

There are a few things to consider when trying to conceive, as women with PCOS have an increased risk of some complications during pregnancy. The good news is that if PCOS has been treated, these risks return to almost the same levels as women who do not have PCOS. The risks include an increased likelihood of developing gestational diabetes, pregnancy-induced hypertension and preterm birth, and an increased risk of neonatal complications.

The increase in birth weight of babies born to women with PCOS also suggests an increased likelihood of c-section deliveries.

The treatment used in the study I mentioned before was anti-androgenic therapy, which means correcting hormonal balance before conceiving will improve pregnancy outcomes.

one small study looked at the incidence of gestational diabetes in women with PCOS and found the prevalence was 30.2%, and that these women had impaired blood sugar levels after having their babies. What we can take from this is that PCOS can have a long term impact on glucose metabolism, and again it highlights how important it is to try and take steps to improve your hormones and blood sugar level balance before conceiving.

I recommend that all couples do a preconception care program before conceiving, which at a minimum entails taking a high quality preconception care nutrient complex for 3-4 months before conceiving but if there are hormonal imbalances its important to work on this with a practitioner before trying to conceive.

Complications with breastfeeding

A lesser-known complication with PCOS is that it can cause some difficulties with breastfeeding and milk supply – however, this can also be supported by working on hormones before pregnancy, and with the support of a lactation consultant after birth. Thankfully not all women with PCOS experience difficulties breastfeeding and the information that says it is potentially problematic is only based on small studies. In the research that we do have available, the breastfeeding difficulties were only experienced in the first 3 months and seemed to regulate after that time.

Breastfeeding requires the hormones prolactin and oxytocin to work properly, but we also need adequate progesterone during pregnancy for the breast tissue to develop properly. Insulin resistance and high androgens can affect hormones in all these aspects.

How to manage PCOS

There are so many options for treating PCOS, and as it usually the case with naturopathic remedies, you get the best results when you are treated holistically. This means considering various things like what exactly is happening with your PCOS subtype.

The information I am giving you is a starting point to take to your practitioner to discuss whether it is right for you and to give you hope that there are so many possibilities to help.

while there have not been studies finding some remedies that tend to be universally helpful for most PCOS sub-types, and one of that does seem to be of great benefit is the amino acid Inositol. Taking 2g twice a day is my recommended dose for this.

Diet and lifestyle changes are great for treating insulin resistance, and while it’s tricky to find research specifically for this in PCOS we know it helps address the cause.

I recommend 150 minutes of exercise a week, which can be split into small blocks of exercise such as 30 minutes 5 times a week, or larger chunks such as 50 minutes three times a week. Eating a low GI/GL diet is also very important to address insulin resistance, and having a diet rich in antioxidants and low in inflammatory foods is also very helpful.

If you are overweight and have PCOS, then aiming to lose 5-10% of your body weight is a fantastic goal, and this amount seems to be the magic number that improves fertility rates and reduces risks for diabetes. Losing weight ideally would be done through a combination of diet and exercise.

Nutrients such as magnesium, b vitamins, particularly activated B vitamins, vitamin D and chromium can also be helpful.

Omega-3 fatty acids such as fish oil or algae oil can also help with some of the components of PCOS such as high cholesterol and inflammation.

Other herbs that I would consider is Berberine containing herbs such as Phelledendron which helps with improving insulin resistance and regulates blood lipid levels. There is also evidence showing that Black Cohosh can be helpful alongside other PCOS treatment.

The combination of Peony and Licorice has been looked at in Chinese medicine studies, and this is still a good inclusion in treatment, depending on the individual. Bulgarian Tribulus can also be helpful to regulate ovulation.

Spearmint can be helpful to reduce excessive androgens. I like this when used in a tea and is why I included it in one of my tea blends that supports skin health, to address this aspect.

Supporting gut health is also very important, as a poor microbiome can impair metabolism and worsen inflammation. So eating a diet rich in vegetables with lots of diversity is fantastic for improving the flora diversity in the gut, but it can also be helpful to take probiotics or prebiotics, so discuss this with your practitioner to make sure you’ve got the right type for you.

References

Bahri Khomami, M., Boyle, J. A., Tay, C. T., Vanky, E., Teede, H. J., Joham, A. E., & Moran, L. J. (2018). Polycystic ovary syndrome and adverse pregnancy outcomes: Current state of knowledge, challenges and potential implications for practice. Clinical Endocrinology, 88(6), 761-769. https://doi.org/10.1111/cen.13579

Bahri Khomami, M, Joham, AE, Boyle, JA, et al. Increased maternal pregnancy complications in polycystic ovary syndrome appear to be independent of obesity—A systematic review, meta‐analysis, and meta‐regression. Obesity Reviews. 2019; 20: 659– 674. https://doi.org/10.1111/obr.12829

Fernandez, R. C., Moore, V. M., Van Ryswyk, E. M., Varcoe, T. J., Rodgers, R. J., March, W. A., Moran, L. J., Avery, J. C., McEvoy, R. D., & Davies, M. J. (2018). Sleep disturbances in women with polycystic ovary syndrome: prevalence, pathophysiology, impact and management strategies. Nature and science of sleep, 10, 45–64. https://doi.org/10.2147/NSS.S127475

Guerrero-Bosagna C, Weeks S, Skinner MK (2014) Identification of Genomic Features in Environmentally Induced Epigenetic Transgenerational Inherited Sperm Epimutations. PLOS ONE 9(6): e100194. https://doi.org/10.1371/journal.pone.0100194

Guo Z, Qiu H, Wang L, et al. Association of serum organochlorine pesticides concentrations with reproductive hormone levels and polycystic ovary syndrome in a Chinese population. Chemosphere. 2017 Mar;171:595-600. DOI: 10.1016/j.chemosphere.2016.12.127.

Holton, S., Papanikolaou, V., Hammarberg, K., Rowe, H., Kirkman, M., Jordan, L., McNamee, K., Bayly, C., McBain, J., Sinnott, V., & Fisher, J. (2018). Fertility management experiences of women with polycystic ovary syndrome in Australia. European Journal of Contraception and Reproductive Health Care, 23(4), 282-287. https://doi.org/10.1080/13625187.2018.1483020

Mo L, Mansfield DR, Joham A, et al. Sleep disturbances in women with and without polycystic ovary syndrome in an Australian national cohort [published online December 26, 2018]. Clin Endocrinol (Oxf). doi:10.1111/cen.13922

Rosenwaks, Z. (2017). Polycystic ovary syndrome, an enigmatic syndrome begging for a name change. Fertility and Sterility, 108(5), 748–749. https://doi.org/10.1016/j.fertnstert.2017.09.030

The post A Holistic Guide to PCOS appeared first on Alison Mitchell Naturopath.

Guts and Girl Bits Podcast #42 with Renae Bartlett

If you’ve just had a baby, chances are you’re feeling tired and worn out. But what is that feeling is not just normal Mum fatigue, but instead a sign that something else is a bit out of balance.

The thyroid is a delicate, butterfly shaped gland that sits on your neck. It is responsible for your metabolism, and when it goes out of whack you can feel tired, cold, depressed and you can experience things like hair loss and dry skin. Sometimes the thyroid can become too overactive, which can make you feel irritable and cranky and cause unwanted weight loss.

During pregnancy and early motherhood your thyroid glands are sensitive to changes in your immune system and nutritional status, and so this is a time where your thyroid is susceptible to having issues.

In this episode I chat with nutritionist Renae Bartlett about her journey with postpartum thyroiditis, what women need to look out for, how to get screened if you suspect an issue, and we discuss some of the ways you can support your thyroid health as a new mother through your diet.

The Podcast

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Renae Bartlett is a Clinical Nutritionist who until 12 months ago, was based in Adelaide South Australia. She is currently residing in Canada for the next two years with her husband, one year old daughter and their dog Diego. Renae assists people by focussing heavily on the fundamental basics of using ‘food first’ for healing, health and wellbeing. Renae was diagnosed with Hashimoto’s in 2016 and Post-Partum Thyroiditis following the birth of their daughter in 2018. This has led Renae down a path focussed on helping women who may have been diagnosed with post-partum thyroiditis, or who are at risk of developing this condition.

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Podcast Transcript

Alison Mitchell 0:05
Hi everyone, you’re listening to Guts and Girl Bits. I’m Alison Mitchell a practicing Naturopath. I hope to share with you all sorts of information about women’s health and digestive health to educate and empower you to make informed choices about your own health. Please remember that only information is general and does not replace consulting with a practitioner.

You’re listening to Gut’s and Girl Bits. Today I’m joined with Renae Bartlett, who is a clinical nutritionist who until 12 months ago was based in Adelaide, South Australia. She’s currently residing in Canada for the next two years with her husband, one year old daughter and their dog Diego, and she assists people by focusing heavily on the fundamental basics of using food first for healing, health and well being. Renee was diagnosed with Hashimotos in 2016, and postpartum thyroiditis, following the birth of her Daughter in 2018. This has led Renae down a path focused on helping women who hope may have been diagnosed with postpartum thyroiditis, or who are at risk of developing this condition. So thank you so much for joining me today.

Renae Bartlett 1:14
Thanks, Alison. I’m really glad to be able to speak with you today and your podcast.

Alison Mitchell 1:19
Yay. So let’s start with some basics. So what’s the thyroid gland responsible for in the body.

Renae Bartlett 1:27
So it’s a very important organ that’s part of the body. So it’s part of the endocrine system and its role is centered around producing the hormones that control the metabolism of all of ourselves. So to put that in simple terms, so some of the body functions that it’s involved in is breathing, regulating our heart rate, regulating body weight and body temperature, menstrual cycles, brain function, mood, just to name a few Very, very important organ that’s part of our body.

Alison Mitchell 2:04
Yes, so important so much.

Renae Bartlett 2:06
Yes, a lot.

Alison Mitchell 2:09
All right, and then let’s talk about what is postpartum thyroiditis.

Renae Bartlett 2:15
So postpartum thyroiditis, if we look at the two terms separately, so thyroid-itis means inflammation of the thyroid and postpartum being post pregnancy. So essentially it is a inflammation of the thyroid as a result of having a baby and it causes both hyperthyroidism, so overactive and hypo thyroidism. So an underactive thyroid with hyperthyroid or even happening at first in that instance. So, the main the main difference between postpartum thyroiditis and say other inflammation conditions of the thyroid is that it’s that pregnancy that really triggers it.

Alison Mitchell 3:06
Okay. And how common is it?

Renae Bartlett 3:09
So it’s believed that it’s between five to 10% of all pregnant women will be diagnosed with this condition. But a point tonight is it’s often misdiagnosed. And the reason for this is the symptoms can be very similar to those that are women may experience just by virtue of having a baby. So, for example, you know, the the things such as being fatigued, losing hair, insomnia, weight fluctuations, can easily be attributed to just having a baby when in fact, it may actually be postpartum thyroiditis.

Alison Mitchell 3:49
Yeah. So many of those things people would just get dismissed about like it’s just because you’re a mom, or something along those lines, but it could be so much more.

Renae Bartlett 3:58
Absolutely. And postnatal depression is also something that can be closely linked to postpartum thyroiditis. So it may in fact be the thyroid that’s causing the depression state rather than depression as an as an isolated incident. So, even though it’s five to 10%, it may actually be be more than that.

Alison Mitchell 4:21
For sure, yeah. And how do you go about getting it tested.

Renae Bartlett 4:27
So it’s simply a blood test after having a baby. Important to note that symptoms generally won’t start until about six weeks after having a baby. So it’s probably important to speak to clinician about the independent factors that may require the blood test at certain times. But generally recommendation would be around about that. Two month period postpartum and then monitoring after that.

Alison Mitchell 4:57
So if say a woman has been feeling Okay for the early stages of the postpartum period, and then she starts to feel a bit more downhill is that way you’d be thinking maybe it’s the thyroid connection,

Renae Bartlett 5:09
it could very well way and it’s just simply a blood test that it there’s nothing terribly invasive about really saying whether someone may have a thyroid condition after having a baby. And it can simply confirm whether that is something that needs to be further looked at and treated, or it can, it can then be be lumped into another condition and go down that path. So I would certainly recommend for women who have had a baby to have their thyroid tested, regardless after they’ve had had their baby, but certainly those that are in the risk group of developing the condition.

Alison Mitchell 5:50
And does your thyroid function actually changed during pregnancy as well like is this process starting earlier than postpartum?

Renae Bartlett 5:59
So Things happen a lot with pregnancy and the thyroid, think of it like a stress test for your thyroid when you fall pregnant. And the reason for this is that the first trimester, the baby is 100% dependent on the woman’s thyroid. So if there’s already an underlying issue there or even a known issue of of thyroid dysfunction, the that can have have severe implications for the woman’s first trimester of pregnancy. And unfortunately, in some cases, this is where complications such as miscarriage can occur. Between because the thyroid and the body in general cannot sustain the mother let alone the baby as well. If the pregnancy does manage to continue, the baby will then start in that second trimester to use its own thyroid to function and then from about 18 to 20 weeks. The baby will then start producing time for thyroid hormones. So when you look at that, for for someone that may have dysfunction, you’ve got the first potentially 20 weeks where that that woman needs to produce enough thyroid hormones for herself and for her baby as well.

Alison Mitchell 7:19
Yeah, okay. So it’s under a lot more pressure during that period of time. Yeah. And I guess because you know, your thyroid is dependent on certain nutrients as well. So if there’s going to be a funneling of nutrients into the baby, then that’s going to be leaving the mother a bit more deficient, possibly. And then, like you said, there’s an immune involvement too. So I guess that would have an impact.

Renae Bartlett 7:47
Yeah, absolutely. So, an important thing to differentiate is the the immune system is suppressed during pregnancy to account for the fact that the body is essentially creating something that’s foreign. So some people may actually notice if they have a autoimmune condition that their symptoms tend to be a lot better when they’re pregnant in some cases, because that immune suppression, that rebound effect after pregnancy, typically from about the six weeks and certainly in postpartum thyroiditis is is what really drives this, this thyroid inflammation and it’s that rebound of the immune system kicking back in and then going into overdrive. So there really is that the two parts playing in developing this condition, certainly.

Alison Mitchell 8:39
For sure. Okay, so, we’ve talked about, you know, how some of the symptoms that are very similar to that postpartum period generally for women like insomnia and fatigue and possibly depression, are there any other symptoms that women should look out for that might suggest that they have a thyroid issue, possibly during and post pregnancy.

Renae Bartlett 9:02
Yes. So during can be incredibly difficult when you’re just looking at symptoms. And that is because the symptoms are very similar to those that you would experience as a result of being pregnant. So for example, there can be weight changes, typically, weight gain, there can be lack of sleep, there can be irritability, anxiety, there can be mood changes, there can be skin and nail changes. So dry skin, brittle nails, all of those are quite common symptoms in particularly hypothyroid saints, but also their common symptoms that you get when you’re pregnant. Right. So, diagnosing during pregnancy is most often by blood tests, but that usually is monitoring the thyroid to see how it is coping with pregnant. Certainly after pregnancy, if a woman is in that hyperthyroid state, she’s going to experience things like increased heart rate. That could be tremors, heart palpitations, overheating, heat intolerance, insomnia, irritability, anxiety. And then when the condition swings to hyperthyroid, if that does occur, then it goes the other way. So things like fatigue, hair loss, poor memory, constipation, cold intolerance and depression are some of the main things that you would say. Okay.

Alison Mitchell 10:43
So the blood test that we’d be looking at is that typically your TSH and if that’s out of balance, then your T3, T4 and your thyroid antibodies is fairly similar to your standard thorough tests.

Renae Bartlett 10:56
Yeah, that’s correct. Yeah. Okay.

Alison Mitchell 11:00
Are there any predisposing factors for developing past postpartum thyroiditis?

Renae Bartlett 11:05
Yeah, there is. So there’s certainly a strong link between having thyroid autoimmunity before pregnancy. So typically the the TPO antibodies. Also there’s a history of thyroid dysfunction previously, and that can even be transients or may not even be be permanent. If there’s been a family history of any thyroid disorders, or a previous history of postpartum thyroiditis in another pregnancy, and also other autoimmune disorders, particularly type one diabetes, they’re at high ris k of developing this condition.

Alison Mitchell 11:51
Okay. And so it is something that does tend to recur so like if you’ve had it one pregnancy, you’re likely to get it another time.

Renae Bartlett 12:00
Not necessarily at the moment, it’s estimated that about 20% of recurring. So that is some good news that it doesn’t mean that for every pregnancy a woman is necessarily going to continue to have postpartum thyroiditis. It may be one time timeline in which is good news as for that, that 20% it tends to be women that have very high anti thyroid antibodies, where their TSH levels are not in the normal range when they fell pregnant, so certainly about about five I believe or even above 10 and that that is the most likely risk factor for perhaps having it recur.

Alison Mitchell 12:51
Okay. Now, I know that you’ve had a bit of a journey yourself with this, is it something that you would be able to share Your journey with postpartum thyroiditis?

Renae Bartlett 13:02
Yes, certainly. So, I was aware that I had a pre existing thyroid condition before I fell pregnant. And I did have some some difficulties falling pregnant. And I do believe it was it was probably due to my thyroid condition. So once I was successful in falling pregnant, I made sure that I monitored my thyroid levels throughout pregnancy. And I wasn’t on any thyroid medication either. So it was more to just make sure that my body was handling it appropriately. Thankfully, it was everything went along really, really well. I had a really wonderful pregnancy, wonderful birth. And then after having my baby at about three months postpartum, I felt generally quite well but I thought I really need to go and just make sure that my thyroid is functioning as it should. And knowing that I had a previous history I thought that would be a good idea. As it turned out, I was very hypothyroid. Much to the surprise to myself and my, my doctor, because I wasn’t really presenting with very strong symptoms, which I came to find is relatively common. It’s more of a hypothyroid state. If it does swing to that word becomes quite known that there may be an issue. And so I monitored my bloods every four weeks, and I believe after about two months, I then transitioned into hypothyroid. And I did then certainly start to notice symptoms. For me, I had extreme fatigue. I would say quite Moody, you know, crying without really understanding what I was crying about. I can remember one day I was out walking my dog and it was a beautiful day and I started crying and I’m like, Why on earth? am I crying? This is not know. I don’t really understand what’s going on. So luckily for me, I knew that it wasn’t just as a result of having a baby and I knew that wasn’t me going crazy and thinking, you know what? What’s going on? I knew that it was my thyroid driving this and I think that really helped me in dealing with it appropriately and just letting my body try and regulate itself, rather than trying to figure out what was wrong with me, in an essence, so I thought, quite lucky that I managed to do that. And then I ended up deciding to take thyroxine because I felt as though I was lucky that my symptoms were okay but I didn’t know how bad I could get and given my history of having a thyroid condition, I thought it best to go that action. And my doctor said, You know what, let’s, let’s give it a go. And if it’s at a time we feel it appropriate, we can see if we can when you offer and take it off and see how your body handles. So I really liked that approach that, you know, we can just try and manage it how we can and then and then see how my body adapts to it at some point, so. So yeah, that’s kind of been my, my journey with it so far.

Alison Mitchell 16:30
Well, thank you for sharing that. Yeah. And I love how much you were trusting your own body to go through those processes as well.

Renae Bartlett 16:37
Yes, sometimes you’ve just got to take your hand off the wheel, I think and just let it do its thing.

Alison Mitchell 16:42
Yeah. So did you find that it affects breastfeeding?

Renae Bartlett 16:49
I was very fortunate that it didn’t affect my milk supply. I was able to breastfeed and I still am now. My baby will be one in two weeks. So thankfully, I am have been able to do that. But it certainly can affect milk production and is a common symptom in women that have thyroid issues. So it’s certainly can can impair that. Hmm,

Alison Mitchell 17:14
well, hooray for extended breastfeeding. I’m a big fan of that.

Renae Bartlett 17:17
Yeah. Yeah. I felt a sigh of relief when I knew that. That was something that I didn’t have to worry about. Yeah,

Alison Mitchell 17:25
yeah. But it’s so interesting, the way that it expresses differently and everyone and how this the different interplay. So it’s not just a straightforward thyroid effects product and no, it’s there’s other things involved.

Renae Bartlett 17:39
Yeah, yeah. Yeah. And you’re so right. And this is where really getting to know yourself, I could have easily spent my entire postpartum period, not even knowing that I had postpartum thyroiditis. Honestly, I really could have because you could have just easily put the things I experienced down to having a baby It’s just it just really presents so differently to any to everyone really? Yeah, symptoms really do vary.

Alison Mitchell 18:08
Yeah, and I do observe quite a lot of the time that it is uncommon to get this thorough testing done even as a general screening. And sometimes, you know, you can be having done it too early, or you might because the thyroid changes so much as well. Like sometimes you do need to repeat a TSH and go up and down and by itself, it’s not always that great an indicator, so you might need to get that complete picture of the testing with antibodies.

Renae Bartlett 18:37
Yeah, absolutely.

Alison Mitchell 18:40
Alright, so knowing what you know now, like say, theoretically if you were to have another bubby. would you do anything to look after your thyroid, preconception or during pregnancy to try and prevent this from happening or, or how would you advise other women to look after their thyroid to prevent it.

Renae Bartlett 19:01
Yeah, so that’s a really good question. Because I have looked back and gone ‘What What could I have done?’ I was really good at at having having a really great, very varied diet you know, a good amount of vegetables, fruits, quality protein fats, I started taking a really good quality prenatal vitamin, three months before pregnancy, fish oil, all of that. The one thing that I didn’t do that I would be really interested to see how that would go and that is taking a supplement of selenium. And the reason why I say Selenium is there has been some clinical studies done that shows some promise in that Selenium supplementation during pregnancy. Even with women that has positive antibodies does significantly reduce the risk of postpartum thyroiditis so I caution that we saying further studies need to be done and certainly it’s not the be all and end all that you know, you take Selenium and you’ll be fine but it is quite promising to show that that nutrient did show some improvements in a study that was done I believe in 2011 so that’s one thing that I didn’t do and I think that’s something that I would I would probably look at and I doing with my next pregnancy

Alison Mitchell 20:35
Yeah, it’s interesting and you know, there’s a lot of multivitamins out there that are pregnancy targeted that have virtually like, you know, very little Selenium in them. Yeah, taking a better quality multivitamin is advisable and or taking some additional selenium anymore. At the very least, I guess eating more Selenium rich foods. but that’s so hard to do, isn’t it? Because

Renae Bartlett 21:01
Yeah,

Alison Mitchell 21:03
A bit hit and miss in foods.

Renae Bartlett 21:05
It is and it varies so MUCH. And then of course, you know, you want to you don’t want to just be taking taking pills all the time, you know, and trying to remember to do that, especially if you’ve already got got children I’m a big advocate for trying to use food as much as you can rather than relying on supplements but with pregnancy there is that increased demand and you know, if it means that it could, could possibly help you after pregnancy then it’s it’s a it’s something worth looking at, if you if you can.

Alison Mitchell 21:42
For sure. And what sort of dosages he generally looking to work within the range of because I know that many people are a bit hesitant to do higher doses of selenium.

Renae Bartlett 21:55
Yeah, so, the study that I that I spoke about that showed some Promise the supplementation was at 200 micrograms a day. The upper limit for Selenium is often recommended for 150 micrograms per day. I feel quite comfortable that if someone wanted to try, try that under the useful direction of a qualified nutritionist or naturopath, that 200 micrograms would be suitable and ensuring that there isn’t Selenium coming from other sources that might push that too much further over the edge. I think I think that that is a safe, a safe way and actually shining in studies that it might be useful.

Alison Mitchell 22:43
Yeah. And you know, a nutritionist or a naturopath could guide you with that, I guess. Yeah, absolutely. even look at monitoring your levels through your Bloods and making sure that they’re not going in a pattern that’s a bit uncomfortable for you.

Renae Bartlett 22:57
Yeah, yeah, that’s right. Yeah. Cool.

Alison Mitchell 23:01
So are there some other areas that you often look at supporting women with postpartum thyroiditis?

Renae Bartlett 23:08
Yeah, look, stress is a huge, huge, huge factor. And I know that gets thrown around a lot. I know, you know, nearly every condition you can think of, you know, you get told look out for stress, but honestly, it is so big in driving this condition, it’s not funny and it can be so difficult. You’ve just had a baby, and then you’ve got someone telling you to Oh, you know, just don’t stress so much. And you know, look at that, yeah, that’s really great. But if there are things that you can try and do, whatever it is, whether it be five minutes of meditation just before you go to sleep, or maybe it might be just going out for a walk with your baby or maybe just catching up with some girlfriends, for coffee once a week, whatever it is, just try and do that. That whatever it is that kind of makes you feel that you can just let it out, you know, be writing things in a journal or exercising and he can, you know, all of these things really will play a part in, in trying to reduce that that cortisol and that stress that can really be making this condition a lot worse than what it should be.

Yeah, for sure.

Alison Mitchell 24:22
Yeah.

So stress is a really big one.

Renae Bartlett 24:25
Yeah, yeah. It’s huge. Yeah.

Alison Mitchell 24:30
Great. Are there any other areas that you often look at?

Renae Bartlett 24:34
So nutritionally, we’ve spoken about Selenium. There is also, I guess, when we look back at the pregnancy status is having sufficient iodine to support the thyroid function during pregnancy, and then continuing that for breastfeeding as well. That’s really important. And I think it’s often a nutrient that does get overlooked when you look at prenatal support. So that’s something that really is important. So iodine and selenium for that nutritional and then for postpartum when I look at nutrition, I like to try and simplify it and go you know you’re already trying to reduce your stress let’s not stress it out anymore by you know, throwing these hardcore diet things in there. Let’s make it really simple. You know, think of food first try and think of of getting things as fresh as possible. By you know, going and getting vegetables and fruit just starting with that getting some protein sources. Even if you need to buy frozen vegetables and and cook that up on a meal that’s perfectly fine. You know if that’s going to save you a trip to the supermarket, when you’ve got other things going on. Do that you know, if you need to keep eggs in the fridge so that you can just do some scrambled eggs for dinner. Do that, you know, try and simplify your nutritional routine. Don’t overthink it. Don’t. Don’t try to be this fantastic mom who can just do it all just simplify it, you know, as long as you’re able to eat well. With basics, you’ll be fine. You really will.

Alison Mitchell 26:27
Brilliant. Yeah, yeah. It’s so important for mothers to just eat.

Renae Bartlett 26:32
Yeah.

Alison Mitchell 26:33
Yeah. So easy to just like, you know, let that part of your life to stop because you know, you’re worried about the baby and of course, but you gotta eat.

Renae Bartlett 26:44
You do, you do have to eat and you know what, get when people come to visit you don’t get them to bring gifts of you know, more baby clothes and things like that. Tell them to bring food. Say: “Bring food! What I need, you know, that’s the best gift you can give a new Mama.” Yeah. Yeah, certainly in the month after Don’t forget, you know, they’re still trying to to raise a little human being there. So. Mm hmm. For sure.

Alison Mitchell 27:15
Yeah, for sure. And I always think about iron when it comes to thyroid health as well. Is that something that you look at?

Renae Bartlett 27:23
Yeah, absolutely. And particularly after giving birth, because women will often lose blood as a result of childbirth. So making sure that iron levels are adequate is is really important for that for the thyroid to function. Now, so yeah, that’s that is a very important nutrient. Absolutely. Yeah, for sure.

Alison Mitchell 27:46
Okay, and any, any other areas?

Renae Bartlett 27:50
So we, I guess we’ve touched a bit on nutritional and then the emotional or sorry, well, the lifestyle side of trying to reduce stress, but I think that emotional support is Well, because postpartum thyroiditis is really not known by many people, I think it’s really important to be open and honest with those in your family, your support networks, let them know that, you know, you don’t just have the baby blues that you you know, you are going through something and it can be transients at times between your symptoms, and to just get that added support. So that’s probably my my main take home is look at your emotional support. Lifestyle, you know, try and reduce your stress and nutritionally try and keep it simple by eating the best that you can when you can and don’t overcomplicate it. Yeah, for sure.

Alison Mitchell 28:44
Yeah. Okay. So, can you give some women that have having postpartum thyroiditis or worried about it, three actionable actionable steps that they can do?

Renae Bartlett 28:57
Yeah, so, I guess Further on to what I just I just mentioned then, first of all, figure out who your support network is. Talk to someone about your your condition and how you’re feeling and and really get them to help you in whatever that is for you. It may be getting someone to bring you food, it may be someone helping out with the baby might be someone to just catch up with the coffee, whatever that is. Number two, really try and figure out a way that you can reduce stress in your life. As much as that may be a difficult task for you, even if it’s just five minutes to try and have some time where you just sit there and and write in a journal, read a book, meditate, whatever it is go for a walk. It’s really important. And then third of all, really try and figure out with your nutrition, what you can do with minimal stress on yourself. So whether that Is meal planning so planning out your meals for the week and doing one shop if that works for you brilliant do it if that’s going to enable you to eat the best way you can then do it. If it’s cooking a lot of food and freezing it do that. If it’s having frozen vegetables, boiled eggs, nuts in the fridge, things that you are ready to go because maybe you’re not someone that doesn’t batch cook you’re not someone that doesn’t meal plan you just ate as you go has those things ready there for you. So try to simplify it but stick to foods that are going to give you the most nutrient dense so you know any of you vegetables, fruit quality protein sources, so eggs, meat, tofu. Lovely whole grains think of quinoa, think of making some lovely muffins with spelt, buckwheat, all of those kind of things are really going to be helpful for you. In that postpartum phase, make sure you’re ea ting.

Brilliant. All right and last question for you. What is your favorite food for thyroid health?

Okay, so this is difficult because there’s so many great ones but I’m going to have to go with the very simple egg. The reason being is it’s full of so many wonderful nutrients that are going to support your thyroid so it does have iodine, it has a lovely amount have a really lovely fats which is going to do wonders for your your skin, can do wonders for your hair, protein as well that’s going to support your immune system. And it’s such a versatile food, boil it up, have it as a snack. scramble it have it for breakfast, mixing something vegetables, all that kind of thing. So I think I’m going to go with the humble egg.

Alison Mitchell 32:04
I think that’s a great answer. Great. So thank you so much Now Renae, do you have any offerings on at the moment?

Renae Bartlett 32:14
So at the moment, I’m currently working on a couple of things within my business. So at the moment, I’m looking at putting together a series of helpful, simplified food tips. So that’ll be a compilation of videos, how to shop guides, how to cook guides, but simply for your family. I’m hoping to have that finalized within the next six to 12 months. And also some ebooks on how to look after your thyroid after having a baby.

Alison Mitchell 32:50
Beautiful. Yeah. Oh, well, that’d be so good. Yeah. Okay. Thank you. And if people want to know more, how can they get in touch with you?

Renae Bartlett 32:59
So They can get in touch with me My business is Reborn Health. So the most effective way is just send me a message on facebook Rerbon Health Nutrition. And I’m also on Instagram as well, which is also Reborn Health and Nutrition.

Alison Mitchell 33:15
Great. And I’ll put the links for those in the show notes as well.

Renae Bartlett 33:18
Great.

Alison Mitchell 33:19
So thank you so much for sharing all this wonderful information today. It’s been an absolute pleasure talking with you.

Renae Bartlett 33:26
It’s been great, thanks so much for having me.

Alison Mitchell 33:29
Yay. So thanks, everyone for listening. Please hop on and leave us a five star review. And if you have anything you want to learn about in the future, don’t hesitate to ask. So thank you, everyone.

Renae Bartlett 33:42
Bye bye.

Transcribed by https://otter.ai

The post Thyroid Problems After Having a Baby appeared first on Alison Mitchell Naturopath.

Health & Wellbeing Podcast #33

This episode I’m joined again with the lovely Brooke Hile – women’s health physiotherapist. She joined us previously to talk about hypertonicity of the pelvic floor muscles (aka when the muscles in your vagina are too tight) and is back to talk about our lady bits again, but this time it’s the boobs. We are chatting about mastitis, and how physiotherapy can be helpful to reduce the occurence of it and how it can help with treatment. We also talk about how to prevent it with proper feeding techniques, probiotics for mastitis, herbs for mastitis, and what to eat to prevent mastitis.

Have a listen at Soundcloud here on on the embedded player below, then check out the pretty diagrams showing how you can do some self drainage at the bottom of this post.

Podcast Breakdown

0:00 Intro

1:50 What is mastitis?

2:25 Why you should learn about mastitis whether you plan to breastfeed or not

3:08 What are the symptoms of mastitis?

4:08 Abscess in mastitis

5:00 Benefits of breastfeeding

6:00 Conventional and common treatments for mastitis, and the wrong way to massage your breast if you have mastitis

9:37 When should antibiotics be considered for mastitis?

10:17 Antibiotic resistance

11:32 The golden key with mastitis: drain the breast. Some tips on how to feed on the affected side with mastitis

13:12 Ultrasound treatment of mastitis

14:26 Reasons why women can get mastitis

16:00 Breastfeeding isn’t easy

18:45 the natural treatment for mastitis including diet and herbal medicine

19:48 Echinacea, Calendula and lymphatic herbs for mastitis

21:45 How stress affects the milk ejection reflex, and how herbs can help this

23:50 Probiotics for prevention

24:25 Prevention tips

24:45 Posture when feeding

26:50 More on probiotics

27:50 Gut health and biofilms

28:30 Looking after your immune system with nutrition, dealing with stress and the importance of a village

30:50 How recurrent mastatitis is associated with some common vitamin and mineral deficiencies

32:00 How an incorrect latch and tongue tie may affect drainage

Self-Drainage for Mastitis

These exercises can be practised daily to encourage good lymphatic drainage and help prevent mastitis, but they can also be done to help with a current infection.

Thanks to Brooke for the guidance with these exercises. Drawings are by Caitlin Duckett.

Effleurage Encouraging the flow from the breast to the lymph system for clearance, gently sweep under the breast up towards the armpit

“The Pec Wobble” Pull the pec muscle off the chest wall and give it a wobble, this is as aggressive as you will get – not it is not the breast tissue you are moving but the muscle.

“The Lift and Twist” Gently cup the breast and lift it upwards, maintain the lift and gently rotate the breast back and forth.

“The Lift and Bob” Gently cup the breast and lift upwards, maintain the lift and bob up towards the collar bone and underarm

Get in Contact with Brooke:

Instagram @thingsdownthere
Brooke’s booking page: https://auappts.gensolve.com/p360/clinician/details/brooke_hile

Want to subscribe to get podcasts automatically? You can do that here:

iPhone   Stitcher   Youtube   Soundcloud

Related

Caring for Mama Podcast

Self Care for New Mothers

The amazing benefits of breastfeeding

Why You Should Choose Chemical-Free Products For You & Your Baby

Filling Your Own Cup First

Naturopathic support in pregnancy

How to manage reflux in babies

Why Gut Health is Critical to Your Wellbeing

The post Mastitis – How Naturopathy and Physiotherapy can help with Prevention and Treatment appeared first on Alison Mitchell Naturopath.

Health & Wellbeing Podcast #29

Pelvic floor tightness, pelvic floor dysfunction, or hypertonicity of the vagina is when the muscles of the pelvic floor are too tight. This can cause pelvic pain for women that just doesn’t seem to make sense. They might experience pain during intercourse (dyspareunia or vaginismus), pain in relation to going to the toilet (1s and 2s), IBS and period pain that doesn’t get better with other treatment. These issues can be due to a tightness in one of the muscles of the pelvic floor, something which a women’s physiotherapist is able to help with.

Most women are well aware that the muscles of the pelvic floor can get weak, but tightness of these muscles is something that hardly anyone knows is even an issue. I didn’t appreciate how much this can be a problem until I attended the Endometriosis symposium and learnt about the connection between tight pelvic floor muscles and chronic inflammatory conditions of the pelvis. Since then I have been in awe about how much this issue can affect women, but moreso how little awareness of this is out there. Learning about this issue was a light-bulb moment for me and I hope that this podcast can be as eye opening for you.

In this episode I chat with women’s physio Brooke Hile about all things related to pelvic hypertonicity.

Listen on the Soundcloud website here or in the embedded player below.

Want to subscribe to get podcasts automatically? You can do that here:

iPhone   Stitcher   Youtube   Soundcloud

Get in Contact with Brooke:

Instagram @thingsdownthere
https://www.herhealthphysiotherapy.com.au

The post Pelvic Floor Tightness/Hypertonicity – Podcast #29 appeared first on Alison Mitchell Naturopath.

Polycystic ovarian syndrome is a condition that is affecting more and more women and girls – it affects 1 in 7 women worldwide making it one of the most common endocrine disorders to affect women of reproductive age.

This is one of the most common conditions that I see in our clinic, as women are usually frustrated by the lack of conventional treatment options available to them.  Unfortunately, this condition is often incorrectly diagnosed and misunderstood in a lot of women. It is also being increasingly diagnosed in young girls – often unnecessarily

It really seems that PCOS is becoming an epidemic, and information about this condition is greatly lacking!  PCOS is a 20th century condition, along with the increase of heart disease, diabetes and obesity.  And the reason they are all increasing together is because they are all being (mostly) caused by the same things.  We’ll get into what that is later, but first we should cover what PCOS actually is.

The name poly-cystic ovarian syndrome implies that the main feature of the condition is the presence of small cysts on the ovaries, however with current diagnostic criteria this is actually not required for a diagnosed, and not all women with PCOS have cysts on their ovaries.  This is just one of the possible symptoms that makes up this condition.

In this article I wrote for Western Sydney Mum’s Hub I discuss what PCOS actually is, as well as outline the symptoms of PCOS and debunk some myths. I also talk about the causes of PCOS, and my key natural treatments.

PCOS SYMPTOMS

Symptoms may include:

·       Irregular or absent periods

·       Insulin resistance (high insulin levels picked up in a blood test)

·       High testosterone (androgen) levels in a blood test

·       Hirsutism (Excess hair growth, usually in areas such as the lip, arms, lower back)

·       Acne

·       Sugar cravings

·       Blood sugar fluctuations (e.g. feeling irritable or dizzy if you skip a meal)

·       Weight gain or difficulty losing weight, especially from around the middle

·       Ovarian cysts (picked up by ultrasound)

·       Thinning head hair

·       Painful periods or pain on ovulation

·       Fertility problems including difficulty conceiving and increased miscarriage rates

·       Skin tags

·       High cholesterol levels

Diagnosis

The condition is diagnosed differently according to different criteria, however most commonly it is by the presence of 2 of the following 3 factors:

·      Irregular or absent ovulation/periods

·      High androgen levels (the male hormone) found in blood tests

·      Symptoms of high androgen levels such as hirsutism and acne.

·      Other conditions which cause these symptoms must be ruled out.

LET’S CLEAR UP SOME PCOS MYTHS

1. 1. Having cysts on the ovaries is not the main way of diagnosing PCOS. Not all women with PCOS have cysts, and as a stand-alone symptom having cysts on the ovaries isn’t enough to diagnose PCOS.
   2. It’s normal for cysts to grow on the ovaries – these are actually your ovarian follicles (or eggs) growing and releasing, however in PCOS these do not grow properly and this is what can result in the typical appearance of a PCOS ovary.
   3. PCOS doesn’t always affect your fertility negatively. This understanding is mostly based on people with severe cases of PCOS and so the understanding of to what degree it affects the fertility of those with milder forms of PCOS is lacking.
   4. You aren’t always stuck with PCOS for life. Many young girls who are diagnosed with PCOS can grow out of this condition by the 30s.
   5. The oral contraceptive pill is not the best way to treat PCOS. Yes it can bring on a regular, predictable bleed, but remember that this is not a true period, and the pill can make the condition worse after stopping.
   6. If you get period pain it is not due to PCOS – there is likely something else going on that is contributing to the period pain such as endometriosis or primary dysmenorrhea (the fancy term for period pain not attributed to an obvious cause). It is possible to have both endometriosis and PCOS.
   7. Thin women and girls can have PCOS too, and can still have insulin resistance.

Top causes of PCOS

Insulin Resistance

Nearly all cases of PCOS have insulin resistance.  Insulin resistance is when the cells have difficulty taking up glucose from the bloodstream, often resulting in an increased secretion of insulin, which worsens the symptoms of PCOS.

Even if your blood sugar levels are normal, you can still have insulin resistance. It is vital that insulin levels are tested too, but they aren’t always automatically done, so you may need to ask.

As I was mentioning earlier, I believe that insulin resistance is the link between these 20^th century conditions.   Insulin resistance can be a genetic problem, but the food choices that we make play the biggest role in the development of this condition.  Highly processed foods, refined carbohydrates and excess sugar are the evil culprits that lead to the development of insulin resistance by causing our blood sugar levels to be elevated over a long period of time.  Insulin is a hormone that is secreted by the pancreas in response to high blood sugar levels.  Its job is to put the sugar into the cells.  When the levels of sugar in our blood are high for an extended period of time, insulin is produced more and more, and our cells begin to ignore it (like in The Boy Who Cried Wolf).  This leads to high circulating insulin, and this is where the problem comes from.

Insulin is known for its ability to lower blood sugar levels.  The way that insulin does this is by storing the sugar in the form of glycogen – but the body can only store so much of this, and when it’s full the sugar gets stored as fat (most commonly in the abdomen, causing the typical apple body shape).

High androgen levels

Androgen are a group of hormones that includes testosterone. They may be called ‘male hormones’ but both men and women produce androgens, just in different amounts and with different actions.

There are a few different types of androgen markers that are tested in blood tests, including total testosterone, SHBG, androstenedione and DHEA.

For most women with PCOS the insulin resistance is usually the biggest issue which causes high androgen levels. However, for some (approximately 20%), high androgen levels may be present unrelated to insulin resistance, and this is most often due to stress.

Other causes

Sometimes there can be some less common causes of PCOS. This can include nutritional deficiencies (such as iodine or zinc), inflammation and thyroid disorders. For some women they may have developed PCOS because of taking the oral-contraceptive pill. Often this will resolve within about a year (herbal medicine can reduce this time frame to 3-4 months).

Key Natural Treatments for PCOS

What treatment is used for PCOS depends on the underlying cause and a practitioner can guide you further on this. These are some of my favourite treatment tools:

1. Test for and treat insulin resistance, typically with an exercise regime and a low-GI diet (you can read some tips for a Low GI, Nutrient Dense Diet here).
2. Cut out/down sugar in the diet.
3. Cut out/down dairy.
4. If androgen levels are high without insulin resistance, herbs and nutrients that can reduce the excess of this hormone include Saw Palmetto, Peony and Licorice, and the mineral Zinc.
5. If DHEA is high or there is a lot of stress around the time of puberty or currently, herbal medicine to support the nervous system such as nervine and adaptogen herbs, the mineral magnesium and B vitamins can be helpful.
6. The amino acid myo-inositol is helpful for supporting blood sugar levels and reducing anxiety and can be a great tool in the kit to treat PCOS.

If you or your daughter has been diagnosed with PCOS or you suspect that this may be an issue for you, seek advice from a naturopath experienced in this area as there is much that can be done to help.

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