Everything You Ever Wanted to Know About PCOS Adrenal Health - PCOS Podcast

Everything You Ever Wanted to Know about PCOS Adrenal Health, Cortisol and PCOS, and the PCOS-adrenal connection. 

Mentioned in the episode:

NAC: https://s.thorne.com/NRI4c
Inositol: https://s.thorne.com/esr0F
Probiotic: https://s.thorne.com/RaN5D
Rhodiola: https://s.thorne.com/mVyrH
Theanine: https://s.thorne.com/ABrxm

In today's episode, I'll share not just my personal anecdotes but also dive into the signs, symptoms, and the nuanced process of diagnosing adrenal PCOS. We'll also unpack the role of stress hormones, the relevance of cortisol rhythm over mere blood tests, and discuss why adrenal health matters more than we might think, especially for those of us leading high-pressure lives.

Imagine being a high-flying professional or a dedicated athlete and discovering that your unwavering commitment to success could be silently contributing to hormone imbalances. It's a paradox I see often in my clients, and in this episode, we discuss why individuals with seemingly robust drive and stamina could be more prone to adrenal PCOS. We examine the telltale signs of adrenal imbalance, the surprising connection between past traumas and PCOS, and why even the strongest among us need to heed the call to manage stress.

In the closing chapter of our conversation, we embrace the delicate dance of fertility and menstrual health, confronting the irony that conception might just occur when we ease up on our strict health regimens. I'll also introduce you to my secret allies—rhodiola and ashwagandha—and share how these natural wonders can be instrumental in supporting adrenal function. By the end of this episode, you'll have a trove of lifestyle adjustments and holistic strategies to help you navigate your adrenal PCOS journey with grace and vitality.

Transcript

Speaker 1: 0:37

Welcome back to An Amber A Day, the Functional PCOS Podcast. I'm your host, amber Fisher. Today we are talking about the adrenals. I was posting a video the other day about the different root causes in PCOS and I have this quiz that people can take where they can find a percentage of different root causes they have. So are they 40% adrenal and 30% inflammation or whatever? And people love to take it and then they want to know well, I'm mostly adrenal, so where do I go from there? So I posted this video on Instagram referring them to the root cause quiz and I'm trying to put on my stories different podcasts that they can listen to, and I have a few about insulin resistance, I have a few about inflammation, but when I got to adrenals I was like where's my adrenal specific podcast? I could have sworn that at some point over the last five, six years that I've been doing this podcast, that I had done an adrenal-specific podcast, but apparently not. I have talked about the adrenals in different podcasts and I've talked about stress and things like that, but I don't ever think I've done all in one place. This is what we know about adrenals and this is what can help podcasts. So that's what we're doing today. I'm calling this everything you've ever wanted to know about adrenal PCOS, and that may be a really ambitious topic, but come along with me and find out. I'm really glad you're here. I don't know if I've said that already, but I am Thanks for being here. Before we get into today's topic, little updates on me. Currently I am procrastinating on cleaning my house. My in-laws get here tomorrow and there is a lot to do and instead of doing that, I decided let's talk about the adrenals. So here we are.

Speaker 1: 2:26

And also I made some Cheesecake Factory copycat bread. You know that bread that they have at the Cheesecake Factory, the brown bread. Oh my God, I dream about that bread. Especially whenever I'm cutting back on carbs for whatever reason. I literally will dream about this bread. I could live off bread and butter if it wasn't terrible for my hormones. I'd like oh man Anyway. So since it's a special occasion, I made a few loaves of this copycat and it is really really good. So if anybody wants that, be careful with it. It's addictive. But if you want the recipe, let me know. I found a really good one. And this interesting thing about this bread is that it looks like it's rye bread but it's actually not. There's cocoa powder in it to give it the color. Weird huh. Anyway, the more you know, so, honestly, that's really all that's up with me.

Speaker 1: 3:19

The other thing that's going on with me that I just thought about is audition week for the next round of salsa dance teams. So I am actively auditioning, trying to get on the sophomore team, which is the second level up. In fact, they asked if we wanted to, we could audition for whatever team. So I just said, I'm auditioning for varsity and sophomore because, reach for the stars. There's no way I'm getting on varsity. I'm not ready, but I'm manifesting it for later. One day you guys will come back and I will have a video for you of me dancing on the varsity dance team. Anyway, I'm trying to get on sophomore, so wish me luck. I will let you know next week if I ended up making it or not. Psych I actually recorded this podcast a while ago and the auditions happened weeks and weeks and weeks ago. And, yes, I did make the sophomore dance team.

Speaker 1: 4:13

So let's get into today's topic. We are talking about everything you ever wanted to know about adrenal PCOS and I have notes and I'm going to follow those notes and just be a good girl and not get off topic too much. So first thing you might be wondering is what are the adrenals? And if you're coming to an adrenal PCOS podcast, you likely already know what the adrenals are, but if not, here's what they are. So the adrenals are these little glands that sit on top of your kidneys and they produce various stress hormones, cortisol being the major one. They also are the site of creation of some androgens. So DHEA is an androgen and, if you remember back from what we've talked about before, androgens are male hormones, right. So in PCOS, we tend to talk about testosterone a lot, because most of us are dealing with high testosterone, but not always. Some of us are dealing with other androgens that are high, dhea being one.

Speaker 1: 5:14

So the adrenal glands are the site of creation for those hormones. They're also really key to our stress and energy balance. So if you've ever heard of something called adrenal fatigue, it's really a misnomer, because adrenal fatigue actually doesn't exist. But there comes a time, with certain types of adrenal dysfunction, where we might end up feeling super, super tired and drained all the time, and that's often described by people as something called adrenal fatigue. So, coming from the adrenals as well, it's an important place for reducing our stress hormones, but also helping us to have steady energy levels, which means that it's also connected to how well we sleep and all that kind of stuff. So it's an important area, and the little glands are so tiny it's amazing how much they can do. So that's what the adrenals are.

Speaker 1: 6:09

Now, why are we talking about adrenals and PCOS? Well, one of the root cause issues in PCOS is adrenal dysfunction, and there is a type of PCOS that tends to more heavily lean towards the adrenal type. What I've noticed over the years and I think I've noticed this with myself as well is that adrenal PCOS there is a specific subtype of person that tends to be an adrenal PCOS person. They almost look a certain way and have a certain personality. Even. It's interesting, but a lot of us will go through phases where we are also more adrenally focused or we have more adrenal issues. So, for example, with me, I started out my life as more of an inflammatory person, moving on to inflammatory and insulin and then culminating finally now that I am in my mid-30s and have gone through menopause and all of that. I had a hysterectomy, by the way, surgical menopause, in case you didn't know. So now that I'm through that phase, I am full on in mostly an adrenal PCOS situation, so I've experienced all the different types, which is so much fun, and now I bring my insights to you.

Speaker 1: 7:28

So adrenal PCOS, I think, is something that can affect us at different phases of our lives, but some people are more it's more their root cause than others. A lot of us the adrenal stuff develops over time due to different things that might happen or to long-term stresses on our bodies from the other root cause issues. But there are some people who dart out this way and there may be some different reasons for it. Of course, some of this, as with all things with PCOS, is unknown. So these are just a lot of this is opinion and mixed in with different research and facts that I've pulled and all that kind of stuff.

Speaker 1: 8:04

So if you want to know how like let's say, you have suspected before that you might be an adrenal PCOS person or you've heard the term before and were curious if it applied to you, how would you find that out, or how is that measured or diagnosed to you? How would you find that out or how is that measured or diagnosed? You're not going to go to a gynecologist or an endocrinologist and no one's ever going to tell you you're an inflammatory PCOS person or you're an adrenal PCOS person. That's not going to happen because they don't recognize these distinctions.

Speaker 1: 8:39

There are certain subtypes of PCOS, or they call them phenotypes, that are recognized in research, but they don't always 100% correlate with the functional nutrition kind of root cause PCOS issues. So there is a type of person with adrenal PCOS who tends to be on the more type A side, or oftentimes really thin women with PCOS, I think, lean this way as well, and they will help you figure it out by running a few different labs. So one of the things that they run frequently is something called DHEAS, and remember I said that DHEA is an androgen like testosterone. Well, dheas is the inflammatory form of DHEA. So when we have a lot of DHEA, oftentimes we will shunt that DHEA into DHEAS. And it might be useful for me to pause right here and mention that hormones occur in a breakdown process, so you don't just like from nowhere make your estrogen or make your testosterone or there's not like little testosterone factory or a little a little progesterone factory is. But I'm getting ahead of myself.

Speaker 1: 9:58

Hormones get complicated. Basically all of our hormones will start as cholesterol and then they kind of break down from there, and there are different pathways that they can break down as. So there's a pathway that they can break down and go into being progesterone. There's a pathway where they can go into being DHEA. There's a pathway where they can go into being testosterone and then from androgens, particularly from testosterone, we will then convert into estrogens. So estrogens are the end of the line for hormone processing, which is why, if our hormones are out of whack, we will often start seeing estrogen dominance type issues, because it's sort of the end of the line for hormones. And the adrenal hormones, dheas, are one of these pathways that cholesterol can take, and so they may measure something called DHEAS to find that out.

Speaker 1: 10:56

Another thing that they often will measure is cortisol, and the weakness with going into a doctor and having your cortisol run is that they typically will run a blood lab of cortisol, right, and it'll be based on whatever's happening at that exact moment. So, very similar to blood sugar, your cortisol levels will change throughout the day, and so, depending on the time of day that you have this run, even the day of the week, whatever your cortisol level may or may not look normal right. So one underpinning of a lot of us with PCOS is that we have high cortisol, we have imbalances with our cortisol and it can be really difficult to actually elucidate that from labs, because if we're just getting one marker we may not be able to actually see that that's happening. So those are two big ones that are bigly run. They also will run some labs like ACTH, which is adrenocorticotropic hormone.

Speaker 1: 11:56

I always have to read that one because it's so long. That's a hormone produced by the pituitary gland that stimulates the adrenal glands to produce cortisol. So sometimes if there's issues there, it can be an issue with cortisol production. Sometimes they'll measure your 17-hydroxyprogesterone because elevated levels of this can indicate adrenal hyperandrogenism or congenital adrenal hyperplasia, which is a genetic disorder that affects your adrenal gland function and your androgen production, and so that can be one sort of alternative pathway to PCOS because of those excess androgens. But they're not coming from excess testosterone through too much insulin. They're coming from an issue in the brain itself and its adrenal hormone production.

Speaker 1: 12:44

So what I'll tell you that I typically see as a nutrition professional is that people are coming in with DHEAS and maybe a singular marker for cortisol and not much else they might be coming in with progesterone too, but progesterone can be all over the place depending on which form is run and what time of the cycle is run and all that stuff. So usually what I'm seeing is that they're ruling out anything really major happening with the adrenals, like anything that they can address from a conventional medical side by looking at DHEAS and cortisol and kind of seeing where we're not there, along with the other PCOS labs. And so one thing that I like to do, if it's a possibility for people, especially if they really feel strongly that the adrenals are part of their picture, is to run a cortisol rhythm test, and this is a saliva test. That the cool thing is that because it's a saliva test, you can actually do it at home. They have home kits and I'll link to one that I like to use a lot.

Speaker 1: 13:51

But saliva, unlike for other forms of hormones I don't like saliva for a lot of different types of hormones, but for cortisol I like it because it can give you a better picture of what your cortisol levels look like throughout the day, because you fill these different tubes with your saliva throughout the day and it tells you how much cortisol is in your system. So typically cortisol is going to be higher in the morning, lower as the day goes on, and there's a rhythm to that. It's connected a lot to the cycles of sunlight and nighttime and all of that circadian rhythms, and in a healthy person it comes up and it going down in the evening is kind of part of the cascade of different signalers that signal to our bodies that it's time to go to sleep. So it helps us become sleepy. All that kind of stuff, and oftentimes this testing can show issues with adrenals that other forms of testing have not shown. So I wanted to mention that at the beginning, because if you feel like you're an adrenal PCOS person and a lot of this that we talk about today resonates with you, but yet you don't have a high DHEAS result or you don't have an abnormal cortisol result, that can be very discouraging.

Speaker 1: 15:01

But, as I've stated many other times before, when it comes to PCOS and hormone labs and things like that, they're not the end, all be all. A lot of people come in and they're like I don't have any issues with my testosterone, but I'm growing really thick hair all over my chin and my neck and there's what the test says. And then there's the lived experience of this person that's so androgenized, right. So it's like oh, there's the breakdown happening. It's likely with the way we're measuring things or with what we're measuring With the tools we have, we can clearly see that the person's dealing with some hyperandrogen issues, which is one reason why part of the criteria for PCOS diagnosis is signs of hyperandrogenism, and that doesn't necessarily mean that it has to be on a blood lab.

Speaker 1: 15:49

It can just be by physical appearance. So, anyway, that was a bit of a rabbit trail, but those are some labs, and if you have ever wondered if this is going on with you, I highly recommend a cortisol saliva rhythm. The one that I will link to also runs DHEAS, which is kind of nice to have too, and it'll give you details on what's going on, what your rhythm looks like, and the company even provides you some supplementation advice to help balance things out. There are also nutrition strategies and lifestyle strategies that are really important. Here, too. Supplements are not going to fix it, but they can be supportive on that journey. So it's nice to have something like that, and it explains things really well.

Speaker 1: 16:33

I don't know. I like it. I use it in my practice, actually, instead of doing my own thing. So let's move on. So let's talk about some symptoms that are associated with adrenal PCOS. I wrote some down because I want to make sure that I don't forget anything. But, like, officially, on paper, it's going to be the same stuff as the other, it's going to be the same PCOS symptoms, right? So those with adrenal PCOS can struggle with their weight, they can struggle with facial hair, they can struggle with irregular periods on cystic acne, all those kinds of things, right.

Speaker 1: 17:05

But what I've seen, that kind of distinguishes a client that I'm working with as an adrenal person versus an inflammation person or an insulin person, is number one. Everybody always has a little bit of all three. So that's first off, that those things are going on. But I've also noticed some stuff that tends to go along with this more adrenal expression. So I have seen a lot of athletes and type A personalities, and I think this comes from two places. Well, one place, the stress responses, right, but two different methods of this happening. So with athletes it's because, partially probably, personality.

Speaker 1: 17:45

A person who's going to stick with long-term athletics is a person with a lot of willpower, a person with a lot of determination, a person who has a tendency, a propensity, to push through pain, and it can be a good thing because it can lead to better performance and to accolades in that department. It can also be a really bad thing for the hormones. So I see a lot of athletes or ex-athletes like this and this is a very large percentage of my private practice. I end up seeing people who were college, high school or even pro professional athletes. I've seen professional cheerleaders, I've seen cross country runners, I've seen basketball players, I've seen thinking back on it. It is a lot of endurance type exercise activities. Oh, side note, I told you guys last week in the Exercise and PCOS podcast that I was trying to get this PCOS fitness influencer to come on and she agreed. So I will be having a podcast where we can pick her brain about this stuff soon.

Speaker 1: 18:45

But anyway, a lot of athletes and this is probably due to the fact that long-term pushing, pushing, pushing will lead not just to increased testosterone levels but also to increased cortisol levels and eventually maybe some kind of burnout happening there with the stress hormone responses. Lot of type A people and overdoers, and I think this comes from like chronic overproduction of stress hormones, overproduction of cortisol, adrenaline, just that kind of anxiety response, I guess, of life and people are more. People with type A personalities tend to be more anxiety driven and people with type B personalities tend to be more with the flow, sometimes more depression driven. It just depends. So it just happens to correlate that I tend to be more with the flow, sometimes more depression driven. It just depends, so it just happens to correlate that I tend to see a lot of these type A personality people who are dealing with adrenal, pcos stuff.

Speaker 1: 19:44

I also see a lot of people with stressful jobs and shift workers. So we're looking at a lot of nurses, teachers, people who are on their feet a lot or who have a lot of demands on their energy throughout the day. For example, a nurse or other healthcare professional doesn't get a lot of downtime and they may work unusual shifts. A teacher, same thing. They don't get a lot of time for themselves to just zone out, whereas somebody who works in an office and has a pretty non-forward facing job might have a few hours of the day that they can edge out or dissociate disconnect. A lot of times career paths like that. They have to be on most of the day. That's very draining for the adrenals. Have to be on most of the day. That's very draining for the adrenals.

Speaker 1: 20:35

And then I also see a lot of trauma survivors and there is a connection between PCOS and trauma, which I do believe I have a podcast on. But those of us with PCOS are often working with some extra trauma from childhood or what have you, and this leads to less resiliency around stress, and so those who have experienced things like that tend to struggle more with their stress responses and tend to have more anxiety and also tend to be more on edge. That feeling of being on edge is the feeling of a lot of these stress hormones being produced. I remember back in the day when my before I went through years of therapy, my stress responses were so on the edge of a. I always said it was like on a razor wire. It was like such a thin edge where any little thing could tip me into, like I could literally feel my cortisol burst in, and it was uncontrollable in a lot of ways. I couldn't do anything about it. I couldn't stop it from happening. It was just a physical reaction happening to anything that was potentially going to be a dangerous situation. I was primed to see a lot of things as dangerous, and so that often happens with people who are trauma survivors of different kinds, and that doesn't mean it needs to be capital T trauma where, like you know, you have PTSD from something really horrific happening or being a veteran or things like that, and that definitely can be part of the picture and often is a more severe expression.

Speaker 1: 22:05

But the influence of long term of lots of little lowercase t traumas can also have the effect of influencing your stress responses. So maybe not PTSD but CPTSD, right, complex post-traumatic distress disorder. I also see, like I mentioned before, a lot of women who have thin PCOS, and this is really thin. Pcos is a really controversial topic, right, because you can have adrenal PCOS and not be thin. You can have adrenal PCOS and still struggle with your weight. Cortisol can cause a lot of belly fat retention, and so that's definitely going on but naturally thin women who then have PCOS for whatever reason. I tend to see those two things connected with adrenal PCOS a lot. There's often some insulin resistance happening there too, because there is a type of person who can be insulin resistant and yet genetics are powerful. So, for whatever reason, their body doesn't prefer to store body fat even though they've got all that extra insulin, but nevertheless there's still some insulin resistance happening and oftentimes I will see that type of person being connected more to these adrenal PCOS responses.

Speaker 1: 23:19

So how do you know that you might have adrenal PCOS or that the adrenals may be a big root cause for you? Well, first of all, I would look at your responses, to stress a critical look, and you might need an objective outsider to tell you if this is you or not, especially if you are more type A or you are the personality type where, let's say, you're in a traditionally what would be considered a stressful job, like teaching or nursing or other kinds of healthcare work or there are various things, but let's say you're in what's considered traditionally a stressful or difficult job. You feel that it's not stressful or difficult for you, you handle it fine. But if this is where you might need an outsider because a lot of times people who work in those types of careers, they don't perceive it as stressful and yet they are stressed so if that's you, if you work in one of those fields, that may be something to look at there, because there is something where we can get addicted almost or used to, attenuated to the feeling of stress hormones and it can make us very. It can make us to where we don't notice we can actually get attenuated to the feeling of being stressed, which can make it to where feeling stressed and anxious is our normal. So when we are not stressed and anxious, we feel bored or we feel exhausted. So keep that in mind if you work any type of career like that and you'll know it if it's you.

Speaker 1: 24:55

But what I'm looking for when I'm looking at the adrenals playing a role is I'm looking at historical factors. So I'm taking a history to see if they've ever done some of the things we're going to talk about. Next of things I've seen with with adrenal PCOS people, but things like being an athlete growing up or working in a high stress career, et cetera. So I'm looking for those things because those can sometimes be the only clues if there's not other clues. I'm looking at the trauma history as well because again, that can be a clue even if there's not other clues. And I'm looking the absence of really severe issues with insulin or inflammation.

Speaker 1: 25:37

A lot of times the folks with adrenal PCOS who come in to see me, they have PCOS and they've got a lot of symptoms but they have normal digestion. They don't really deal with constipation or diarrhea and they their blood sugar seems like fine. They don't get hypoglycemic or weak and shaky between meals. Maybe they deal occasionally with a couple of these things, but it's not anything where I would be like oh yes, definitely You've got food sensitivities or you have food allergies or something's going on here with your inflammation levels. So it's very murky and they don't really fit really well in either category.

Speaker 1: 26:15

What I've seen historically with PCOS is that the insulin resistant PCOS person is pretty easy to identify. They're pretty obvious that they're insulin resistant because blood sugar issues are so physical. They have so many tells right Skin tags, akithosis, nigricans, like getting low blood sugar between meals and feeling really weak and shaky, needing to snack a lot. These things are really obvious and there tends to be a weight issue when insulin resistance is a big part of the picture as well, because it alters cravings and things like that. Inflammation is also often really easy to spot because these people often have autoimmune conditions surrounding them or maybe they have family histories of autoimmune conditions or they have really awful digestion or they know they have food sensitivities and food allergies. There's just a lot of immune stuff happening and so that makes it pretty obvious that that's where we need to start, whereas with adrenal PCOS it's like nothing is really screaming except the fact that this person seems like they are probably under a lot of stress. And bonus points if they're under a lot of stress but they don't realize they're under a lot of stress.

Speaker 1: 27:22

So the single most, I guess, important factor for me as a functional nutritionist, when I'm looking like where should I go, is this person adrenal or are they not adrenal? Nutritional nutritionist, when I'm looking like where should I go, is this person adrenal or are they not adrenal? Is how do they handle stress and how do they handle their life. And I mean life is hard right, and so these people tend to really impress you with their ability to handle it all and manage it all and oldest daughter syndrome, right, all that kind of stuff and shout out I'm the oldest daughter too. So I get it, but I'm actually more. I used to be. I think you would classify me as type A before. And then something happened to me over the last several years and now when I took a quiz the other day, I'm like am I type A or type B? Because that's me 10 years ago and I would have said I'm type A, but now I'm like I think I'm type B and according to this quiz I'm type B. So it doesn't make sense to me anymore, but it used to. Oftentimes that's a trauma response.

Speaker 1: 28:21

Anyway, guys, mercury is retrograde and whether you believe that or not, I can tell you that as a practitioner of online, of the online arts, it definitely is. Real Website was down this morning for no reason, literally no reason. I contacted the host he's Bluehost for hosting and they were like yeah, we don't know, probably your internet connection, and it was. It was my internet connection, just didn't want to load my website. But it was loading everywhere else on everybody else's internets and my internet was also loading other websites, just not my website. So that was fun. And the other thing that happens during Mercury retrograde is that I start to fall more into word salad, and that is definitely what's going on, even though I have great notes here, but anyway, I'm sorry, it's a little rambly today. What's going on, even though I have great notes here, but anyway, I'm sorry, it's a little rambly today.

Speaker 1: 29:13

So how do you know your adrenal PCOS? Well, how do you handle stress? Are you totally overwhelmed by your life? And or are you so on top of your life that everything is in its place, and how are your PCOS symptoms and do you struggle with inflammation or insulin resistance type stuff or not? And I will caution you to say that it's much more rare to be an adrenal only or an adrenal prominent person, especially pre-menopause. So as we age we tend to get into more adrenal stuff because the exhaustion of life tends to catch up with us, but in your younger years it's a lot more rare to be an adrenal first person. I think being an adrenal first person is more attractive type for PCOS because it has less to do with your diet than the other ones, I think, and so people can wrap their head around the solutions for it a little bit easier, or it just seems a little bit more, I don't know To me.

Speaker 1: 30:21

I get the sense that people find the adrenal PCOS to be a little bit more glamorous than insulin. Right, but the reality is that the other two root causes do play a big role in your adrenal health, and so if you've got a lot going on with insulin and inflammation, you should really probably start there, work on those things first, because those things will probably help your adrenals, and then if you've got a lot of adrenal stuff after that point, then you can move on and work on some of this stuff. But work on those things first would be my advice, and then, if you don't have a lot going on with those other things, then this is where I would start. Have a lot going on with those other things, then this is where I would start, and oftentimes what I've noticed is that the people who need to work on the adrenals the most are the least attracted to working on the adrenals. So if meditating or doing activities that are stress reduction activities fills you with dread, or you're like, oh my God, or you roll your eyes at her, you're just like no, I cannot, I can't sit still, I can't calm my mind, I can't that. Or you roll your eyes at her, you're just like, no, I cannot, I can't sit still, I can't calm my mind, I can't that.

Speaker 1: 31:23

Abe, you may be an adrenal person, because it's oftentimes the things that we don't want to do the most that are the things that we actually need to do. Same thing goes for like inflammation and adrenals. I find that my inflammation people are the ones who least want to do a gluten dairy-free trial. My adrenal people ask them to remove any food and they're like sure, I'll take out eggs, dairy gluten, I'll make a meal plan for myself. You don't even have to do it, I'll eat this many calories and this many grams of protein. Adrenal people will do that all day, right, but they won't sit down for 20 minutes and do a guided meditation the inflammation. People will do lots of guided meditations and they really will struggle with removing certain foods. I don't know, it's just human nature or something. I'm not sure what's going on there, but there's definitely something to it.

Speaker 1: 32:12

So how do you know you have adrenal PCOS?

Speaker 1: 32:16

Well, do you have high DHEAS? Do you know you have cortisol issues? Some signs of cortisol issues would be issues with sleep dysregulation. So if you get a second wind at night and you get really like you're sleepy at like 11 pm, but then at 10 or 11, you're like bing, I'm awake and you can't fall back asleep, so you struggle with sleep. Or if you get a really bad energy dip in the middle of the day and it's not connected to what you're eating which is key, it's not connected to what you're eating then those are often signs of cortisol issues, which can be earlier stages of adrenal stuff. So that's how you know and I recognize it's kind of hard to know, right, it's more murky than other things. And if that's very you know and I recognize it's kind of hard to know, right, it's more murky than other things. And if that's very frustrating for you, you may be an adrenal PCOS person, because murkiness and non-black and whiteness is often really frustrating for my adrenal PCOS people. They want answers and they're willing to work hard for solutions and the fact that there are no specific set in stone solutions for the adrenals is really tough for them, and rightfully so. It makes total sense that it's tough but anyway.

Speaker 1: 33:30

So oftentimes people are curious where this might come from, because it's so different from insulin and inflammation. Insulin is kind of obvious the impact of our environment and the way that you're fed, growing up and all of that, and paired with your genetics, I can see how it can get worse with age Inflammation. Same thing Say, you're born with a dairy intolerance and you continue. This is speaking from experience. You continue. You're a millennial and so you're raised having to drink a carton of milk every day at lunch and that screws up your gut. Those things are a little bit more obvious how they might impact your natural genetic predispositions. But adrenals are a little different, a little interesting right? And besides the impact of trauma, obviously, which is one we've talked about before, what are some other ones? So there's something called impact on fetal programming and this is something about when you are in the womb, so you're in your mother's room.

Speaker 1: 34:25

There's some evidence that fetal exposure to cortisol they call this programming can affect the development of various organ systems, including the ovaries. High levels of cortisol during critical periods of fetal development may disrupt normal ovarian development and hormone regulation, potentially contributing to features of PCOS. Another thing is with cortisol in particular. It's a steroid hormone, so it's produced in response to stress. Prenatal exposure to excess cortisol can disrupt the balance of other hormones, including androgens and insulin, which are known to play a role in the pathophysiology of PCOS. So the cortisol, potentially raising the androgens signaling the PCOS cascade, start in the womb.

Speaker 1: 35:09

Elevated cortisol levels during fetal development may contribute to insulin resistance in the offspring. Insulin resistance is a common feature of PCOS and is associated with abnormal glucose metabolism and hyperinsulinemia, which can further exacerbate the hormone imbalance characteristics of the syndrome and then inflammatory responses. So cortisol has anti-inflammatory properties and that is true, people always think it's super inflammatory, but it actually can be very anti-inflammatory when in the right amounts. But prolonged exposure to high levels of cortisol can lead to chronic low-grade inflammation. Inflammation is believed to be involved in the development of PCOS and its associated symptoms, including insulin resistance and ovarian dysfunction. So you can see how the other two root causes are playing a role even in the womb, right, but they're triggered by the start of that cortisol and I wouldn't be surprised if a lot of women with PCOS, even when adrenals are not their main issue, are dealing with some influence of this from the womb.

Speaker 1: 36:07

It brings me back to thinking about genetics and how we know that trauma responses can get passed down through different generations, right? So we're working with a really unhealed world right now. I think my generation and the generations around my age, gen X and below have and shout out to some of you, baby boomers are working on this too. I don't want to leave you out, but a lot of Gen X and particularly millennials, gen Z et cetera, are really working hard and trying to stop the cycle of these sort of traumas and things, to stop passing down this stuff, these ill-adjusted ways of having relationships with others, but a lot of us are working with parents, grandparents and other relatives who aren't working on that at all or don't know to care, and so if your mom was really stressed out during pregnancy because she was dealing with some mama responses that she didn't even know, right, there are many reasons why a mother could be exposed to a lot of cortisol, could have a lot of cortisol during pregnancy. But you can see how these things are. It's murky, right, and it could be part of the picture. So I just thought that was interesting. I thought I'd share that, because we don't often talk about the influence of the womb on PCOS, but it definitely is there and it'll be interesting to see more research on that, because that's still a developing thing. There's not a lot of research on that, but interesting.

Speaker 1: 37:36

So another question I get a lot about the adrenals is how does adrenal PCOS affect fertility and menstrual cycles? So I've seen that my clients with adrenal PCOS tend to, especially around the time when they're trying to get pregnant. They tend to struggle a lot with getting pregnant, even though they're doing everything right. So this is when I see people who are managing for inflammation, they're managing for insulin resistance, they're eating a perfect diet, they're taking their OPKs and they're doing all the stuff and they're having a lot of times. These people have regular cycles and do ovulate, but sometimes not. But you're doing all the right stuff. They're very good clients. Adrenal PCOS people if you would come work with me one-on-one, you're welcome to. They're very good clients, know PCOS people if you would come work with me one-on-one, you're welcome to. They're very good clients. They always do what you ask them to do. They're the type of people who are like give me a plan, I'll follow it.

Speaker 1: 38:26

A lot of times and unfortunately with the adrenals that sometimes following a big plan like that and having all these things that you have to take care of and all these little it's such little surges of cortisol throughout the day Waking up at 5 am to take your temperature is a little stress on your body that negatively impacts fertility. So I find that oftentimes these are my clients who they work really hard and it's not until they give up on all the tracking and all the working hard and start eating a little bit more carbs and things like that that they actually get pregnant accidentally. It's one of life's cruel jokes. So where I think we can account for this or measure for this or find a happy medium where you don't have to be throwing the towel completely, is that you can add in specific stress-reducing modalities to help with fertility, and this can go for also regularity with ovulation and regularity with menstrual cycles and reduction of PCOS symptoms too. So it's not just if you're trying to get pregnant. Working on fertility helps everything.

Speaker 1: 39:26

So where I've had a lot of success with this as a practitioner is having people incorporate acupuncture or some other sort of stress-reducing healing modality. So I've even seen people who do really well with Reiki. There were some cool studies that came out about Reiki recently. Lots of benefits from that, even though they don't know why, which we could get into at another time. But acupuncture, reiki, even whatever is interesting to you chakra healing, lymphatic massage there's all these different modalities. But the thing they have in common is they're relaxing and they give you, like you know, an hour where you just have to be still and let yourself be pampered a little bit, and that's good for your hormones. It really is. And also that's not to discount those modalities or other things to them. I'm a believer.

Speaker 1: 40:15

Anyway, it's mercury retrograde. So if I say anything out of turn and it sounds bad. I promise I don't mean it bad. I just things come out wrong during this time. It's not the best time, probably, to be recording a podcast. All right, I don't have a ton of time left on the timer here, so let's get into what we can do for adrenal PCOS. There are specific lifestyle and supplementation things that I like to use in practice that work really really well for managing adrenal PCOS.

Speaker 1: 40:42

So the first thing avoid fasting. If you think even slightly that you might be an adrenal person, don't play with fasting, just don't do it. It's just not going to be helpful. When we don't eat, if we experience stress during that time, our bodies will spike our blood sugar anyway Because, remember, we store sugar in our muscles and our liver. So if you are prone to little, you have a stressful job, or you're prone to little spikes of stress because you have anxiety or whatever, they're going to get triggered whether you eat or not. So it's much better to eat and give your body a little bit of that calming influence of starches can be very calming. Give your body protein, that can be very calming. Your stress responses are going to respond a lot better to that than skipping meals, especially breakfast.

Speaker 1: 41:28

Please don't skip breakfast and please don't drink caffeine on an empty stomach. That is so, so bad for your adrenals. If you're going to have caffeine, especially if it's going to be coffee or something like that please make sure that you have it with a meal. It's just not good for your blood sugar and it's not good for your stress hormones. Same thing goes for matcha is a little different. Like you're making a full on latte and there's like milk involved and you know that could be an okay breakfast. You put collagen in it and all that. But if it's just black coffee, please don't do that. Don't do that bullet coffee either. Regular and consistent meal timings this kind of goes along with it. But there is something about eating on time that is very calming for the body.

Speaker 1: 42:14

The body likes to know what to expect and that stability. It's almost like if you think about a child and how children. They like to push up against their boundaries, right, but they like to have the boundary too. They like the stability of the cocooning of like this is right, this is wrong. This is yes, this is no. Let me play around with pushing those boundaries. I like the boundary, I like having boundaries right. The body's the same way when it comes to food. Don't leave me hanging. When are we eating? Again? You know what I mean. The body gets stressed out when it's like I don't know where my next meal is coming from or when it's coming, because if you have a very sensitive constitution, you could interpret that as starvation or famine, and a lot of people think that those with PCOS are working with some real ancient genes that go back to lots of different famines and that it might be some sort of response to that. So don't freak your body out by not ever letting it know when it's getting a meal.

Speaker 1: 43:15

Try to have regular, consistent meal times within an hour every day. I usually, with my adrenal people, like to do three meals, two snacks or at least one snack, but we're working with breakfast, lunch, dinner and then maybe an afternoon snack and, yeah, that seems to work really really well and that's almost more important than what you eat is that you are eating. If that makes sense. Now, if you've got a lot going on with your blood sugar and stuff like that, then there may be some modifications that need to happen, because you might find that that doesn't work really well for you. You start gaining weight or things like that. But if you're an adrenal person, it will work. If you work out, eat a meal after, and it doesn't need to be a big meal, but eat something with protein at least preferably protein and a little bit of starch after a workout. If it's just like lifting weights at the gym for 45 minutes or the elliptical or something, just a protein shake will suffice. If you do something like you know I dance, or I was talking to a client today who plays tennis If you do something more intense like that, then a little mini meal is probably better. That's going to help bring your cortisol levels down. So that's really key.

Speaker 1: 44:25

If you get stressed out, you feel that ping of stress. Right when you feel that anxiety or that little feeling in your body of your stress hormones rising, do some exercise. Doesn't need to be anything crazy. Go walk around the block, do some jumping jacks, do some pushups in place anything you can do to get your heart rate up and then let it calm down. That will help your stress responses come down quicker. It'll also burn up some of the sugar that you're automatically going to release in response.

Speaker 1: 44:54

Remember that our body releases sugars when it gets stressed because it's to give you energy to flee, and a lot of times what we do is we just sort of internalize it and we just sit there still. But it's very similar to when you're going to give a speech or something like that. You just want to pace. Well, your body when it gets stressed, it wants to pace, it wants to jump, it wants to move, it wants to use that energy and it'll help your stress hormones come back down faster if you indulge that. So even something they taught us in my master's program was to shake. Animals will shake after they're like you'll see an antelope and he's like coming from a line, and then, once he's safe, he just like shakes and then he's back to normal and you're like what that's? That? Shaking calms the nervous system, so it can be very effective for cortisol.

Speaker 1: 45:43

Make sure you balance your blood sugar. I won't go into a lot of depth on that, because I talk about that all the time. Listen to any of my podcasts that even remotely concern insulin to find out how to balance your blood sugar. But blood sugar also helps prevent so many spikes, right, and that's going to help as well. And then make sure you're also looking more deeply at the base of the pyramid. Remember the priority pyramid I talked about a couple of weeks ago.

Speaker 1: 46:08

Make sure you're addressing for the. Remember that the adrenals are in the middle and so often there's deeper stuff going on with the gut or the immune system and even the cellular health, so nutrient deficiencies and things like that. So make sure you double check there with your diet and pay attention to your gut health and all of those things. Because if those things are not balanced already, you may be to the point where you already have them balanced and whatever, and that's fine, work on your adrenals. But if those aren't balanced, you really need to work more on that stuff, because working on the adrenals is not going to be as effective. For those things it will help, but it's more effective to do it the other way around, if that makes sense. Those things, those are the major things that I would have you do from a lifestyle perspective.

Speaker 1: 47:08

The other things that I would suggest doing, if it's in your budget, is incorporating at least one other alternative healing modality. That's very relaxing. So this could be anything from so. Lately I've been going to a sauna studio which is not budget friendly. I'm probably going to have to cancel it soon, but, oh my God, it's so, so nice. I get my detoxification out of the way. So it serves a purpose, because I know you want it to serve a purpose, but it's also just so relaxing, because it's like 45 minutes to yourself in a warm room.

Speaker 1: 47:39

Even better, though, if you can do something where it's another person kind of showing you love and care and attention, because there's something about that exchange that's really healing. So Reiki acupuncture is the one that actually has scientific evidence behind it, a lot of scientific evidence behind it, but I think you get a similar effect from a lot of these different things. So if you're trying to get pregnant, acupuncture, don't just acupuncture, do it. But if you can go, do something like that once a week and that is going to help you so, so much, and I know it doesn't seem like it will, but it absolutely will. The other thing is, if possible, daily meditation is really going to help reprime those stress responses. I know that seems so overwhelming when you have adrenal issues, because it's kind of scary to have to sit still with your thoughts and all that.

Speaker 1: 48:30

So one of the things that I typically recommend are these guided meditations for PCOS. It's not me, I didn't make it, although in one of my courses there is a guided meditation for PCOS in my functional PCOS course. But this is another mind-body practitioner who specifically has made all these really nice guided meditation series for PCOS. They're a little pricey I want to say 60 bucks or something but they're worth it because they're really involved. There's a lot of stuff and they're very specific for PCOS, so I will link to some of those because I really like those and I used those while I was going through IVF, the cycle that worked. Now I'm not superstitious and I'm not saying that that's why I got pregnant, but I do think it helped me a lot because it helped me visualize myself as pregnant and that's really key. The brain is really powerful. So something like that every day. It doesn't have to be a PCOS guided meditation, but if you struggle a lot with meditation in general, a guided meditation is going to be very helpful because it's going to tell you what to think about rather than you having to just sit there and try to clear your mind. I'll link as well to some books that I really like on this topic that can help you figure out what to do here. Maybe I will do another podcast specifically on line body techniques that are helpful. Let me know if you want to see that.

Speaker 1: 49:50

The last things I want to talk about are supplements, and really I have some go-tos. I don't think that we always need supplements all the time, but I do think supplements can be really supportive of the adrenals in particular. If we're doing all the other things, then adding supplements can really really take us to the next level. So magnesium, magnesium glycinate this is a muscle relaxant, helpful for mineral repletion. Ultheanine is my favorite for calming us down if you get anxious, and also before bed. I think it's really nice. I'm going to link to all of these.

Speaker 1: 50:28

By the way, rhodiola is an herb that is great for balancing adrenal responses. I often use it in the favor of energizing, so if you struggle with low energy at different times of the day, I like rhodiola a lot. It can be very helpful. And then ashwagandha is one that I use a lot for calming of the nervous system. So if you do have a lot of high cortisol issues, I like ashwagandha a lot and I found this to be really effective with adrenal PCOS. So I'll link to some of my favorites. I also have a blend of some stuff that I use a lot called cortisol calm, but anyway, we can go into more in depth on any of this stuff. If you guys didn't get all your questions answered, so let me know. But that's all I have for you today on the adrenals. I hope it helps and or at least I hope it kind of gives you some new information to think about on your own journey. So thanks for being here today and I'll see you next week. Bye.