[SPEAKER_00]: Hello and welcome to the Aquaman podcast.
[SPEAKER_00]: This is an exploration of woman kind.
[SPEAKER_00]: Here we discuss what it is to be a woman in the modern world while utilizing ancient and modern modalities in tandem to create a bounty of health for the body, mind and spirit.
[SPEAKER_00]: Hello ladies and welcome back to the Aquaman podcast.
[SPEAKER_00]: Before we get started, let's pay our respects to the oldest past, present and emerging in the lands of La Troia de Tasmania where I'm recording this podcast today.
[SPEAKER_00]: Always has, always will be baby.
[SPEAKER_00]: I forgot to do my acknowledgement of country last week.
[SPEAKER_00]: Sorry about that.
[SPEAKER_00]: I won't let that happen again.
[SPEAKER_00]: I thought I would delve into PMOS previously PCOS today because I think it's really important to just give you a bit of foundational knowledge on PMOS.
[SPEAKER_00]: I listened to my previous podcast on that and went woof.
[SPEAKER_00]: I don't like this.
[SPEAKER_00]: I don't like the audio quality.
[SPEAKER_00]: I don't like the information.
[SPEAKER_00]: It's all a little bit outdated, which is great.
[SPEAKER_00]: Because the research is emerging so quickly because finally we're funding research in PMOS.
[SPEAKER_00]: PMOS is not a condition where you can just be told to lose weight and given the pill and bobs your ankle, you're done.
[SPEAKER_00]: No.
[SPEAKER_00]: It's not that simple.
[SPEAKER_00]: It is a life long condition that needs quality care throughout the lifespan to make sure that we're taking care of women because they're worth looking after fancy that and this is really great as well because it accommodates my resources that are now emerging.
[SPEAKER_00]: So my PMOS Masterclass my PMOS ebook and now the ebook has been turned into a paperback that will be available for more of my physical learning girlies myself included.
[SPEAKER_00]: I love getting a pen and a highlighter and
[SPEAKER_00]: just delving into a book and kind of destroying it.
[SPEAKER_00]: So that's going to be available soon as well.
[SPEAKER_00]: So I just thought, let's just talk about PMOS for about an hour and a half to hours.
[SPEAKER_00]: Let's see how long I can last.
[SPEAKER_00]: And I have my master class here, but I'm going to be using as my notes for this podcast.
[SPEAKER_00]: So let's get into it.
[SPEAKER_00]: Let's touch on prevalence.
[SPEAKER_00]: So one in eight women worldwide have PMOS, but over 70% of those women are undiagnosed, which is really serious.
[SPEAKER_00]: The diagnostic delay is around two years, so that's when you first start to show symptoms of PMOS, and when you finally get a diagnosis of it, and 33% to 80% of women with PMOS struggle with weight, which is really the most
[SPEAKER_00]: current thing that we see throughout P-MOS is struggles with cardiovascular health and wait because the underlying condition of P-MOS, we 95% get a time, is insulin resistance, 3 to 8 times more likely to develop mood disorders and 70 to 80% of women with P-MOS struggle within fatigue.
[SPEAKER_00]: is actually the leading cause of invitility worldwide.
[SPEAKER_00]: So that's just to start out not looking good.
[SPEAKER_00]: So how do we diagnose?
[SPEAKER_00]: What is the criteria that we use for PMOS?
[SPEAKER_00]: So it used to be the Rotterdam criteria and it still is a really good criteria for the diagnosis of PMOS but now we use the 2023 evidence-based guideline which was made by Helen Atide and Michael Costello.
[SPEAKER_00]: They were the leading people on it and that's coming out of Monash University and they are working on
[SPEAKER_00]: but the Rotterdam criteria.
[SPEAKER_00]: So first is polycystic ovaries.
[SPEAKER_00]: So how many cysts do you have in the ovaries?
[SPEAKER_00]: Do you have about 12 in one ovary?
[SPEAKER_00]: Okay, great.
[SPEAKER_00]: So that's one of the diagnostic criteria.
[SPEAKER_00]: Apple androgenism.
[SPEAKER_00]: So that could be in a lab test.
[SPEAKER_00]: Maybe you have low sex hormone binding globular and you have high testosterone or you can have the symptoms.
[SPEAKER_00]: of hyper-antrogenism.
[SPEAKER_00]: Are you losing hair in the middle of your head?
[SPEAKER_00]: A.K.A.
[SPEAKER_00]: might male-button boldness.
[SPEAKER_00]: Do you have hair growing on your chin?
[SPEAKER_00]: Do you have acne?
[SPEAKER_00]: Those are all signs of hyper-antrogenism and an ovulation.
[SPEAKER_00]: So, have you been tracking your cycle?
[SPEAKER_00]: And there's really high LH all the time, but you never really any progesterone.
[SPEAKER_00]: You don't really see a change in your B.D.T.
[SPEAKER_00]: When we track your cycles or even when we look with an ultrasound,
[SPEAKER_00]: we're not seeing that any of those follicles erupturing the staying as AKA sits, but they're not really sister unruptured follicles.
[SPEAKER_00]: You're not ovulating, okay.
[SPEAKER_00]: So that is one of the diagnostic criteria.
[SPEAKER_00]: So you need two of the three underneath the Rotterdam criteria to be diagnosed with p-mas.
[SPEAKER_00]: So you can turn up to the doctor and not have
[SPEAKER_00]: all the cystic ovaries, which is why the name has been changed because I think a lot of people were going to the doctor and saying, I have all the symptoms of P-MOS in accordance with the 2023 International Base Guideline because I read it because I'm super smart and doctors are saying, well, no, because you're not overweight and you don't have cysts therefore you can't have P-MOS wrong.
[SPEAKER_00]: wrong, wrong, that's not true.
[SPEAKER_00]: You can turn up to the doctors office and you can have acne, you can have high AMH, which is also kind of showing an associated with an ovulation and a regular cycles, which goes under an ovulation as well.
[SPEAKER_00]: So if your cycles are 45 days and then 33 days and then 23 and then 90 or you just had a long time getting your period after going off the pill or when you were in your puberty.
[SPEAKER_00]: So it took you a really long time to start cycling regularly
[SPEAKER_00]: But if you have some of those symptoms that aren't necessarily a part of the polycystic morphology, you can still be diagnosed with P-MOS, so that's why the name change has been so, so important.
[SPEAKER_00]: And so you're probably thinking, alright, there's a lot of variation in P-MOS.
[SPEAKER_00]: Are there some subtypes?
[SPEAKER_00]: And yes, there are.
[SPEAKER_00]: Depending on what criteria you're using, I'm basing off of the 2023 evidence-based guidelines and a little bit of the Rotterdam criteria.
[SPEAKER_00]: usually say.
[SPEAKER_00]: So absent or very irregular periods, jaw and chin acne often really cystic and painful and quite debilitating, I would say, as well as someone who used to have cystic acne, wolf, girl, I feel you, herticism, so face neck and abdomen, that's hair growth.
[SPEAKER_00]: crown hair thinning.
[SPEAKER_00]: So again, that male pattern baldness that I spoke about previously, central weight gain and fatigue.
[SPEAKER_00]: So that's weight gain around your waist.
[SPEAKER_00]: So that means your hip to waist ratio isn't looking so great.
[SPEAKER_00]: So we have a lot of adipossi being stored in your stomach area, low mood and poor sleep.
[SPEAKER_00]: So that's your type.
[SPEAKER_00]: In Type A as well, when we look underneath an ultrasound, we have polycystic morphology, irregular cycles, and we also have hyper-androgenism that can turn up in a lab test as well.
[SPEAKER_00]: Type B, so that's irregular cycles, hyper-androgenism, and no polycystic morphology.
[SPEAKER_00]: So this might be the one that is still quite serious, but gets missed because you don't have PCO, polycystic ovaries.
[SPEAKER_00]: Type B shares the same hormonal roots as Type A, so those elevated
[SPEAKER_00]: but the ovaries appear normal in scans and the AMH is within range.
[SPEAKER_00]: Generally with Type A, your AMH is really, really, really high.
[SPEAKER_00]: And with Type B, your AMH can be more, but you still have all of the same symptoms as someone with Type A, but you just don't have polycystic ovary morphology, which can be really tricky.
[SPEAKER_00]: With Taipei, you have the highest metabolic risk.
[SPEAKER_00]: Taipei goes down to just high.
[SPEAKER_00]: And with Taipei goes down again.
[SPEAKER_00]: So we have moderate metabolic risk.
[SPEAKER_00]: And with this, it's regular cycles.
[SPEAKER_00]: Hyper-androgenism.
[SPEAKER_00]: So you have regular cycles.
[SPEAKER_00]: It comes every 28 to 32 days, right?
[SPEAKER_00]: But you have hyper-androgenism.
[SPEAKER_00]: So you might be having some hertusesism and also some acne showing up as well.
[SPEAKER_00]: But you also have polycystic morphology.
[SPEAKER_00]: And I think this is really tricky for a lot of people to understand because I think a lot of women think well,
[SPEAKER_00]: No, no, no, no, no, no, no.
[SPEAKER_00]: Type C, we see very often, women have regular cycles.
[SPEAKER_00]: So they're on the clock.
[SPEAKER_00]: Every 28 days, every 32 days, every 45 days, they're regular.
[SPEAKER_00]: Okay, the cycle is always the same length, but they're not ovulating, right?
[SPEAKER_00]: And we also see polycystic morphology, which is associated with an ovulation, right?
[SPEAKER_00]: Because those follicles are not rupturing, turning into the corpusllidium, yadiyada yada yada.
[SPEAKER_00]: So it's regular or near regular periods, very confusing, hormonal acne along the jaw and chin, third two systems, so that male pattern growth of hair, Lydia phase mood changes, so we see a lot of PMS and PMDD, and also ADHD in that type C group I would say as well.
[SPEAKER_00]: Elevated AMH upon testing, again, boosts we have PCO, and skin managed cosmetically for years.
[SPEAKER_00]: So these women fall under the radar.
[SPEAKER_00]: Type C and Type D, they fall under the radar all of the time, and it's really really sad, because even though the metabolic risk is lower in comparison to Type A and Type B, it's still higher than a normal cohort of women who don't have PMOS, so very, very serious still.
[SPEAKER_00]: Let's talk about Type D.
[SPEAKER_00]: So irregular cycles, you have no hyper-androgenism so your skin is clear and you don't have male, pattern, boldness or hair growth and you have polycystic morphology.
[SPEAKER_00]: So you might have irregular, we were in frequent periods, no visible acne or hertusism, fatigue and low mood, fertility challenges, because you might not be ovulating frequently.
[SPEAKER_00]: Ludial phase anxiety or disruption and weight changes and very often,
[SPEAKER_00]: And this is the group of women also that we see highly associated with a high ACE study score.
[SPEAKER_00]: So the ACE study score is basically a childhood adversity scores.
[SPEAKER_00]: You can do this online.
[SPEAKER_00]: I'm speaking about it a few times on this podcast.
[SPEAKER_00]: I run my clients through it every now and then when I think about it.
[SPEAKER_00]: Maybe there's a bit of a cortisol dysregulation thing happening here, epigenetically from early childhood experiences and very often women do come back with really high ACE and really high cortisol and other stress hormones as well.
[SPEAKER_00]: So that's your four types, type A, B, C and D, right?
[SPEAKER_00]: And so let's talk about what the diagnostic journey might be.
[SPEAKER_00]: So not only figuring out if you do have P-MOS, but what?
[SPEAKER_00]: kind of type you fit into and no one's going to fit 100% in each of these.
[SPEAKER_00]: I think they're just nice guideposts for people to understand where they stand and what they need to focus on, whether it's cardiometabolic, whether it's insulin resistance, hot tip, it's insulin resistance, it affects everyone like 95% of women with p-mas, whether it's cortisol disruption, whether it's
[SPEAKER_00]: So presenting symptoms.
[SPEAKER_00]: So you go to the doctor and you present with symptoms, right?
[SPEAKER_00]: Do you have a regular cycle?
[SPEAKER_00]: Do you have acne?
[SPEAKER_00]: Do you have her autism?
[SPEAKER_00]: Do you have weight gain if infertility in some near depression and anxiety?
[SPEAKER_00]: These things really matter.
[SPEAKER_00]: I think going to your doctor's office prepared and saying, I have a acne for six months.
[SPEAKER_00]: And this is how it is changed in severity.
[SPEAKER_00]: have had her autism for this long, and this is how it's changed in severity.
[SPEAKER_00]: I think going in very prepared and not being vague makes it easier for your health care provider to do that job and it also makes you very hard to dismiss.
[SPEAKER_00]: Excluding other causes is really important with Pima's because it can have some presentation differences or similarities, I should say, with hyper-thyroidism and hypotherodism, cushions, puberty, pregnancy, NCA-h.
[SPEAKER_00]: and hyperprolactomania.
[SPEAKER_00]: So these are all things that we need to rule out before we rule in Pemos.
[SPEAKER_00]: So they should be doing tests on all of those things to rule those out, or rule them in, alongside doing tests on your Pemos.
[SPEAKER_00]: So what that might look like is a lab test for your AMH, a lab test for fast and glucose and fasting insulin, maybe IGF1, if you have a history of looking at your insulin resistance, maybe looking at your
[SPEAKER_00]: It might also be looking at a translational ultrasound or just a normal ultrasound to see what your polycystic morphology looks like if there is any polycystic morphology.
[SPEAKER_00]: It also is looking at the clinical symptoms that you're presenting with.
[SPEAKER_00]: Do you have acne?
[SPEAKER_00]: Do you have hair loss or hair growth?
[SPEAKER_00]: do you have photos of those things that are kind of recently or tell the story, right?
[SPEAKER_00]: And even if you don't get lab testing in that moment, if you're showing them your app and you're like, look, on my app here, it's really a regular and they're like dope.
[SPEAKER_00]: Okay, I see that.
[SPEAKER_00]: Thanks for being that in.
[SPEAKER_00]: Also, I have all of these photos of Racistic Acne.
[SPEAKER_00]: Okay, no, no, no, no, no, no, no, no, no.
[SPEAKER_00]: Also, he's this previous lab showing really high insulin, which indicates insulin resistance.
[SPEAKER_00]: That health care provider in that moment should go, right?
[SPEAKER_00]: Okay, cool.
[SPEAKER_00]: So it's looking like
[SPEAKER_00]: So you get those back, right, and so the first criteria is irregular cycles, right?
[SPEAKER_00]: So do have irregular cycles, yes or no.
[SPEAKER_00]: Either way, we're looking at hyper-androgenism.
[SPEAKER_00]: So do we have irregular cycles and hyper-androgenism?
[SPEAKER_00]: If the answer is yes, P mosses confirmed.
[SPEAKER_00]: not ultrasound is needed and you're most likely going to be type A or type B.
[SPEAKER_00]: If you have a regular cycles and you don't have hyper-adjudinism, it might not be P-mas.
[SPEAKER_00]: Okay, and I think a lot of women want to have P-mas because they want to know what's going on in their body.
[SPEAKER_00]: Right?
[SPEAKER_00]: It's not like you actually want to have this disorder.
[SPEAKER_00]: You just want an answer.
[SPEAKER_00]: And I think that's really great.
[SPEAKER_00]: Just look at that information as neutralize you can and go, okay, it's not that, but these are still clues and the puzzle piece of my body and I'm going to understand it.
[SPEAKER_00]: let's rule out cushions, hypothyroidism, hyperthyroidism, et cetera, et cetera.
[SPEAKER_00]: If you have a regular cycles and hyper-androgenism or you don't have hyper-androgenism, what about your PCO morphology?
[SPEAKER_00]: Do you have PCO morphology?
[SPEAKER_00]: Yes, okay, cool.
[SPEAKER_00]: So you're most likely going to be Type-C or Type-D and if you don't, you don't meet the criteria, okay?
[SPEAKER_00]: And so that's looking at the criteria through the Rotterdam criteria, we're missing a lot of things here as well.
[SPEAKER_00]: We're looking at AMH, we're looking at cortisol, we're also looking at things like family history as well because we know that there is a genetic component two P-Most.
[SPEAKER_00]: So there's some things that you need to take into account and consider when you're looking at going down the diagnostic journey to look at P-Most.
[SPEAKER_00]: All right, so we've ruled in P-Most.
[SPEAKER_00]: You've gotten that diagnosis back and now you're at a point where you want to understand what's going on.
[SPEAKER_00]: Everyone talks about P-MOS and insulin resistance because in 95% of the cases with P-MOS, it is an underlying cause.
[SPEAKER_00]: Everything you present with, pathophysiology and with your symptoms comes back to insulin resistance and in 5% of the cases it's not.
[SPEAKER_00]: So 95% of women with P-MOS controlling for weight, so even if you're at weight or underweight.
[SPEAKER_00]: You can have P-MOS that is insulin resistance lead.
[SPEAKER_00]: Okay, we need to let go of this belief that only bigger women have P-MOS Because that's not true.
[SPEAKER_00]: I see women in my clinic all the time that present with P-MOS and have diagnosed P-MOS Who are at weight or underweight or struggle to keep weight on could you believe that?
[SPEAKER_00]: It's hard to believe, but it is the truth, right?
[SPEAKER_00]: So insulin resistance is the underlying cause in 95% of the cases of P-MOS.
[SPEAKER_00]: So what is insulin resistance?
[SPEAKER_00]: I think everyone throws it around online and non-really truly understands what insulin resistance is.
[SPEAKER_00]: So let's get into it today.
[SPEAKER_00]: So first we need to understand blood sugar regulation.
[SPEAKER_00]: So when you eat a banana, banana goes into stomach.
[SPEAKER_00]: Stomach receptors go, well,
[SPEAKER_00]: This has got carbohydrates.
[SPEAKER_00]: Great.
[SPEAKER_00]: We're going to put that into the blood system.
[SPEAKER_00]: And then your stomach receptors send messages to your pancreas and the pancreas goes dope.
[SPEAKER_00]: There's about this much carbohydrates when you need to release about this much insulin because insulin is going to go into the blood system and it's going to buddy up with its friend glucose in the blood system.
[SPEAKER_00]: Go hi hi hi.
[SPEAKER_00]: I'm going to help you out.
[SPEAKER_00]: I'm going to attach your receptor site on the cell membrane.
[SPEAKER_00]: And then that's going to tell the cell membrane, hey, okay, there's glucose around because insulin's telling us glucose is here.
[SPEAKER_00]: We need to go and get our transporter protein, glut4.
[SPEAKER_00]: All right, and she's going to bubble up to the surface of the membrane.
[SPEAKER_00]: She's going to grab that glucose, bring it in, and take it to the mitochondria so she can do our job as the powerhouse of the cell.
[SPEAKER_00]: Okay, that's how you usually use of his work.
[SPEAKER_00]: But with insulin resistance,
[SPEAKER_00]: you eat a banana banana goes into the stomach and your body goes great there's insulin here there's a heaps of glucose here but the cell is like I'm sure if I want glucose today we've got enough glycogen stored in the cell which is the stored version of glucose and I think we need it
[SPEAKER_00]: I don't think we need it, so I'm not going to listen to you.
[SPEAKER_00]: So it's going to take away the insulin receptors, the receptors where am I going to park my booty?
[SPEAKER_00]: Has no way to park?
[SPEAKER_00]: Or the cell does the listen to and receive the insulin, but it goes, it's just not going to tell platform.
[SPEAKER_00]: What happens is the pancreas goes.
[SPEAKER_00]: The glucose from the banana is still here, but the insulin is the same, and this is all the same amount of glucose around, which means that insulin isn't working.
[SPEAKER_00]: So I'm going to release more insulin.
[SPEAKER_00]: Maybe that's the problem.
[SPEAKER_00]: Maybe that just isn't enough insulin, and it's just not doing its job.
[SPEAKER_00]: and it just gets worse and worse and worse.
[SPEAKER_00]: And more insulin tends to create other problems in the body.
[SPEAKER_00]: It is the root behind high androgynous.
[SPEAKER_00]: It is the root behind high cortisol.
[SPEAKER_00]: It is the root behind all of your symptoms.
[SPEAKER_00]: You're a regular cycle, all of that.
[SPEAKER_00]: It is insulin resistance.
[SPEAKER_00]: So what are the causes of insulin resistance?
[SPEAKER_00]: Because I just said the rear is a genetic predisposition to P-MOS and most of that genetic predisposition with P-MOS and women is a genetic predisposition to insulin resistance.
[SPEAKER_00]: So if you have family members who have had P-MOS or who have had type 2 diabetes, you have a greater risk of developing insulin resistance than their 4P-MOS.
[SPEAKER_00]: a hyper-androgenism.
[SPEAKER_00]: If you have high levels of male hormones like testosterone, which is common in females, that can directly disrupt how cells respond to insulin, so we can have the cell receptor there, but we might not want to listen to insulin and actually get that club thought to bubble up to the surface and intake that glucose inflammation.
[SPEAKER_00]: So if you have wide spread inflammation,
[SPEAKER_00]: that changes how insulin receptors respond to that glucose and insulin.
[SPEAKER_00]: So when I talk about inflammation, I think that's quite an a furious thing to say at the moment because it's so misunderstood and often mistaken with oxidative stress, which they're not the same.
[SPEAKER_00]: Information is basically your white blood cells doing their job.
[SPEAKER_00]: They release inflammatory cytokines and other compounds like histamine into look and six, into look and eight into look and 18.
[SPEAKER_00]: And they do their job inherently, they're doing the right thing, but if we have too much,
[SPEAKER_00]: it can negatively impact the balance of the body and how sensitive we are to insulin.
[SPEAKER_00]: Another one is obesity and body fat.
[SPEAKER_00]: I think a lot of people think of body fat as this inert tissue in the body, but it's really not.
[SPEAKER_00]: It's metabolically and hormonally active.
[SPEAKER_00]: What we know is that that fat tissue actually is quite overactive with its use of something called a rematase which can turn testosterone into estrogen.
[SPEAKER_00]: which then encourages more fat gain in the area.
[SPEAKER_00]: And then if we have more estrogen and our ovaries are overexpressing, aromatase, that can turn back into testosterone.
[SPEAKER_00]: It sounds chaotic and it is.
[SPEAKER_00]: And it can also negatively impact our hunger and satiety hormones.
[SPEAKER_00]: So we feel hungryer than we actually should be, because we have all of this stored energy as fat in our post tissue.
[SPEAKER_00]: So it impacts our metabolic health and our hormonal health.
[SPEAKER_00]: and also elevated cortisol.
[SPEAKER_00]: So long lasting physical mental and internal stresses can cause their adrenal glands to release cortisol in elevated amounts, and in a dysregulated way.
[SPEAKER_00]: And that is also one of the reasons why we're seeing women with p-mas in that type C type D tend to have really high cortisol, and that might not be from anything else happening in their body.
[SPEAKER_00]: It might be from their early childhood experiences and having a higher incidence in the exposure to child
[SPEAKER_00]: So that's how all of these things can predispose women with P-MOS to insulin resistance.
[SPEAKER_00]: And then that kind of creates this cascade of events, which is almost self-sustaining and makes the problem worse and worse and worse.
[SPEAKER_00]: And so this creates this like hyper-insulinemia cascade.
[SPEAKER_00]: So let's look at your diet quality.
[SPEAKER_00]: So maybe the diet quality isn't that great.
[SPEAKER_00]: It's really high and refined carbohydrates.
[SPEAKER_00]: Maybe we had early childhood trauma that has dysregulated our cortisol and our HPA access.
[SPEAKER_00]: Maybe we have chronic stress.
[SPEAKER_00]: Maybe our childhood was fine, but we have a really stressful job.
[SPEAKER_00]: Maybe we have genetic factors.
[SPEAKER_00]: Maybe our mom and dad both had type 2 diabetes, right?
[SPEAKER_00]: So look at that.
[SPEAKER_00]: That's going to go into insulin resistance and poor insulin signaling, whether the receptor site is not there, whether it's not actually doing its introsolial and messaging to look at how we can get glut4 to do its job.
[SPEAKER_00]: It could be either.
[SPEAKER_00]: It could be both.
[SPEAKER_00]: Then the hyper-insulinemia is going to cause the pancreas to overcompense.
[SPEAKER_00]: Now the pancreas is going, well, this insulin is not working, so I have to work really, really, really hard.
[SPEAKER_00]: I'm going to pump out as much insulin as I bloody can.
[SPEAKER_00]: Right, and that's also going to increase something called IGF1, which is also associated with our acne.
[SPEAKER_00]: I digress high insulin equals high ovarian androgens because the insulin goes over to our thicker cells.
[SPEAKER_00]: So when we look at our follicle, so our follicle is that amazing cellular structure that holds the over which is only one cell, the bigger cell, our water that we can see with the naked eye, the only cell we can see with the naked eye, I digress.
[SPEAKER_00]: We have the thicker cells on the outside and we also have the granulose cells on the inside.
[SPEAKER_00]: And what can happen is when insulin is around, it can attach to the thicker cells and goes, hey, become really thick and proliferate beyond your means, beyond what's normal.
[SPEAKER_00]: And so we start to have this really thick thick layer, whereas I think it would be like double the size of what we usually see in a woman who doesn't have p-mas.
[SPEAKER_00]: And what that does, that thicker cell is also going to increase the production of antigen's like testosterone.
[SPEAKER_00]: So that leads into hyper-angrogenism.
[SPEAKER_00]: So insulin connects to hyper-angrogenism.
[SPEAKER_00]: We also see, when the pancreas is working really hard and releasing too much insulin, that causes the liver which produces something called sex hormone binding globulin.
[SPEAKER_00]: Remember, whenever you hear globulin, we're hearing jail, jail for hormones, sex hormone binding jail.
[SPEAKER_00]: So that's going to mean that if sex hormone binding and globulin goes down, it means all of that extra hydrogen in the workmaking has no secondary modulator.
[SPEAKER_00]: So it's just going about the body doing its hyper-anrogeninism thing.
[SPEAKER_00]: It isn't being controlled in a secondary way by the liver, by a way of sex hormone binding globulum.
[SPEAKER_00]: And that means we have way more testosterone, and we have way more active hydrogens, okay?
[SPEAKER_00]: Acne, hair loss, and hair growth.
[SPEAKER_00]: Okay, then we also have follicular arrest because that thick layer is so thick and it's hard for that to ovulate and the body goes, oh God, we have not ovulated yet.
[SPEAKER_00]: I don't I don't sense or see any progesterone around.
[SPEAKER_00]: Do you the hyperthalamus goes, let's just release Morgan out of trooper and releasing hormone against and that's going to release more lootinizing hormone and more lootinizing hormone does what thickens the thicker layer even more right so we start to see these really quite intense positive feedback loops that have no end to them.
[SPEAKER_00]: And then we start to see an ovulation.
[SPEAKER_00]: So no egg is being released.
[SPEAKER_00]: So we have no progesterone.
[SPEAKER_00]: So we're in this chronically elevated state of estrogen and testosterone.
[SPEAKER_00]: And we have low progesterone.
[SPEAKER_00]: And when we have low progesterone, we have low aloe progenolone, which is what it metabolizes out in the brain, which is calming and upregulates something called GABA that keeps you calm.
[SPEAKER_00]: So we get anxious.
[SPEAKER_00]: And then we start to feel very, very depressed as well.
[SPEAKER_00]: No progesterone means mood disorders, and we have like a neurosteroid effect that is impacting the brain negatively, that I spoke about before, and we also have unopposed estrogen.
[SPEAKER_00]: Not really talks about the unopposed estrogen impact of P-MOS, but the unopposed estrogen impact is what increases the risk of women with P-MOS for the development of endometriol and vary in cancer.
[SPEAKER_00]: Ovarian cancer, that might be partially disputed, it's only increased by what, thanks one point for
[SPEAKER_00]: for one increased odds, whereas endometrior cancer is about two to three times increased risk.
[SPEAKER_00]: So that's why.
[SPEAKER_00]: A lot of people talk about the uniposed estrogen bit and how in longevity we see really negative outcomes for that.
[SPEAKER_00]: There is no progesterine around in an annual vialotory body and progesterone is a really, really, really important hormone for a lot of different reasons.
[SPEAKER_00]: So that's kind of the cascade of events that has happening inside of a woman with p-moss, sounds super fun, sounds so fun.
[SPEAKER_00]: Okay, so what are the long term risks?
[SPEAKER_00]: The long term risks of untreated p-moss are the same risks that we see with type 2 diabetes because insulin resistance is 3 diabetes.
[SPEAKER_00]: Yes.
[SPEAKER_00]: So neurological, cerebral vascular disease, stroke, neuropathy, intercranial hemorrhage, epilepsy, we can see periodontal disease in the oral cavity, hypertension coronary heart disease, peripheral vascular disease, heart failure, arthritis growth.
[SPEAKER_00]: As we see chronic and acute kidney failure, renal implants,
[SPEAKER_00]: We also start to see foot ulcers.
[SPEAKER_00]: Yes, join issues.
[SPEAKER_00]: We start to see arthritis, hepatic cirrhosis in your liver.
[SPEAKER_00]: We can start to see blindness and lack of vision, depression, dementia, increased risk as well.
[SPEAKER_00]: This is really serious.
[SPEAKER_00]: I think when people hear these things, they go, hang on us again, no one told me this.
[SPEAKER_00]: So hang on, hang on, hang on, hang on.
[SPEAKER_00]: I just got diagnosed with P-MOS, and I was given a combined oral contraceptive pill and told to lose ways like like I haven't been trying to lose weight my entire life.
[SPEAKER_00]: Yeah, it's so serious and then we consider that 70% of women with Pemos are not diagnosed.
[SPEAKER_00]: That means these groups of women who are not being treated, not being diagnosed sufficiently, are at a higher risk of these very serious health outcomes later in life because it was not detected.
[SPEAKER_00]: Okay, so that's why I do the work I'm doing.
[SPEAKER_00]: It's so you know and you're equipped and you can go in and say, no, no, no, no, no.
[SPEAKER_00]: I want you to test my AMH.
[SPEAKER_00]: I want you to look at this.
[SPEAKER_00]: I want you to look at that.
[SPEAKER_00]: I want you to spend the time and sit down with me and talk to me about how I can modify my risk factors and lifestyle factors to decrease the risk of development of cardiovascular disease because that is a very real thing that we see with Pima.
[SPEAKER_00]: So right off the bat, if you do have Pima, these are the labs I want you to get.
[SPEAKER_00]: Okay, pen and paper, pen and paper, go and get it, go and get it.
[SPEAKER_00]: So, fasting blood glucose always with fasting insulin.
[SPEAKER_00]: It's just this week, a few of my clients have went to go and get the fasting glucose and fasting insulin to do with their doctor, just to keep an eye on it.
[SPEAKER_00]: And their doctors are like, I don't want to do your fasting insulin.
[SPEAKER_00]: So, whenever you ask for it, please, I don't know why doctors tend to go in trends with not wanting to do certain labs.
[SPEAKER_00]: Last year it was be 12 now, it's insulin this year.
[SPEAKER_00]: So, we always want to do fasting blood glucose and fasting insulin together.
[SPEAKER_00]: Why fasting?
[SPEAKER_00]: So, we want to look at what your baseline glucose and insulin is.
[SPEAKER_00]: independent of food intake.
[SPEAKER_00]: So we want to see how it's responding to that.
[SPEAKER_00]: You don't need to do a glucose monitor unless you're pre-diabetic, but I think it's really good.
[SPEAKER_00]: Other than that, we can also do Homer IR, and that's calculated from fast and glucose and fasting insulin.
[SPEAKER_00]: It quantifies insulin resistance as a single number, a score above two indicates insulin resistance in most clinical frameworks, which is why we need both.
[SPEAKER_00]: We need both of those to calculate Homer IR.
[SPEAKER_00]: Okay, really important.
[SPEAKER_00]: You can also look at HBA1's C and that reflects the average blood glucose of a 90 days by measuring glycated hemoglobin over a period of time and also IGF1.
[SPEAKER_00]: So that's the one that your pancreas starts to release to really desperately try and get glucose in the blood system down and into the cells because insulin is not working.
[SPEAKER_00]: So those are ones that I think
[SPEAKER_00]: every single woman with p-mas should get and these are also really great to diagnose p-mas as well.
[SPEAKER_00]: Specifically, fasting blood glucose, fasting insulin, and homo IR and even HB A1C is really great too.
[SPEAKER_00]: And if you have skin problems, IGF1 can be really great to look at as well.
[SPEAKER_00]: Another thing that we really need to take into account with p-mas is inflammation and oxidative stress.
[SPEAKER_00]: let's talk about these two things.
[SPEAKER_00]: Because I think they're complicated a lot.
[SPEAKER_00]: I did give you the rundown on what inflammation is before, so that's your immune system's natural way of protecting you from injury infection, harmful things, there's two types, acute and chronic and very often with women with p-moss they have really, really, really, really, really chronic inflammation.
[SPEAKER_00]: Okay, that's slow, long-lasting response that can go on for months to
[SPEAKER_00]: And so that could be via white blood cell counted could also be most likely your white blood cells being a little bit overactive and producing and releasing too many of the compounds that have an inflammatory impact on the body, which is a pretty no bueno that can impact a lot of different things in the body.
[SPEAKER_00]: So that can block thyroid hormone conversion, that can trigger Hashimoto's thyroiditis, that can disrupt fat processing, and that can also lead to non-alcoholic fatty liver disease.
[SPEAKER_00]: It can lead to inflammatory substances damaging insulin producing cells and block receptors, which leads to type 2 diabetes.
[SPEAKER_00]: Inflammation and hormonal imbalances can also cause the uterine lining to overgrow and disrupt implantation, raising the long-term risk of endometrial cancer, scary.
[SPEAKER_00]: That scary, you should be scared by that your doctor should also be very, very confronted and worried and on top of that for you as well.
[SPEAKER_00]: Inflammation disrupts key brain chemicals, so that can increase the incidence of anxiety and depression, a chronic inflammation damages your vest blood vessel linings and the impact of how effective your heart works, inflammation weakens the gut lining, and that can also increase intestinal hyper permeability, aka leaky gut, and inflammation prevents follicles from maturing and it drives excess testosterone.
[SPEAKER_00]: So super important that we're looking at how we can eat an anti-inflammatory diet and modify some lifestyle factors that we'll be talking about later in this podcast so you can decrease inflammation.
[SPEAKER_00]: And then we have oxidative stress.
[SPEAKER_00]: Let's talk about inflammation impact on the gut because when we talk about inflammation, we're talking about white blood cells and when we're talking about white blood cells, we're talking about the good.
[SPEAKER_00]: And when I'm talking about the gut, I'm talking about your large intestine, okay?
[SPEAKER_00]: Your large intestine is where about 80% depends on what study you're looking at.
[SPEAKER_00]: Sometimes it's 60, sometimes it's 90%.
[SPEAKER_00]: Some are in between there.
[SPEAKER_00]: Of your white blood cells, they live there.
[SPEAKER_00]: The difference between us and the microbial world of trillions of microbes that live inside of our gut is one cell thick.
[SPEAKER_00]: I just want us to quickly look at a one's little piece of hair.
[SPEAKER_00]: I mean, it's going to differentiate on thickness depending on everyone.
[SPEAKER_00]: I don't have the thickest of hair.
[SPEAKER_00]: I just have a lot of it.
[SPEAKER_00]: And when you really look at your hair, really look at it.
[SPEAKER_00]: And then lengthwise, why is if you can't imagine this, I want you to split it 12 ways, right?
[SPEAKER_00]: That's how thin the cell lining is between you and your gut.
[SPEAKER_00]: So no shit.
[SPEAKER_00]: That's why all of your white blood cells live there.
[SPEAKER_00]: It's because if something gets in, they need to be on top of it, okay?
[SPEAKER_00]: they're really there to be almost the guardians between us and these trillions of microbes that are beneficial opportunistic and sometimes harmful.
[SPEAKER_00]: And so generally our gut is in a state of symbiosis.
[SPEAKER_00]: We have a lot of lack of bacillus, we have a lot of faith of bacteria and saccharomyces, we have some opportunistic bacteria and yeast like Candida that can live there and they're all friends.
[SPEAKER_00]: Okay, it's a socialist environment.
[SPEAKER_00]: Okay, it's New York.
[SPEAKER_00]: Okay, it's New York and your white blood cells that they're all Mamdoni that's what symbiosis looks like in your gut But what happens is well your blood glucose goes high and your insulin is high and Candida starts to grow this is perfect
[SPEAKER_00]: I'm going to start eating all of this glucose, and I'm going to opportunistically spread.
[SPEAKER_00]: And we can also start to see that whenever we see high insulin and high glucose, white blood cells, Mumdani starts to get a bit stressed out, okay, and he starts to release a lot of cytokines, like into looking six, into looking eight, into looking 18, okay?
[SPEAKER_00]: These are inflammatory compounds.
[SPEAKER_00]: And that can start to break apart the colonocytes.
[SPEAKER_00]: and what really holds them together are tight junctions.
[SPEAKER_00]: And when they start to split apart, we can get into the gut.
[SPEAKER_00]: So blood particles and things like that can get into the gut.
[SPEAKER_00]: And gram, negative, and microbes can get into us.
[SPEAKER_00]: And sometimes that's a serious no-bwinner.
[SPEAKER_00]: Also, food particles can start getting into us as well.
[SPEAKER_00]: That's why food and sensitivities are associated with intestinal hyper permeability.
[SPEAKER_00]: So this
[SPEAKER_00]: intestine is now hyper permeable where it's not usually supposed to be permeable.
[SPEAKER_00]: To go from the gut and be absorbed into the blood system, you have to get through the colonocide, the colonocide has to let you through, okay?
[SPEAKER_00]: They are almost the people taking your visa at the booth when you're traveling internationally, okay?
[SPEAKER_00]: You're a food particle, you're a bug or something, and you're lining up.
[SPEAKER_00]: And the colonocide goes pretty much says yes or no.
[SPEAKER_00]: And if you get through, you go through basically.
[SPEAKER_00]: And then Mumdani's on the other side, he's like, welcome.
[SPEAKER_00]: Welcome to New York.
[SPEAKER_00]: So then you're in.
[SPEAKER_00]: But if the colonel site says no, then you stay in the gut.
[SPEAKER_00]: But what happens if those visa marshals governing entry are not there?
[SPEAKER_00]: There's just simply not there.
[SPEAKER_00]: I'm no better than anyone else.
[SPEAKER_00]: Okay, I would be looking left.
[SPEAKER_00]: I'd be looking right.
[SPEAKER_00]: And I'd be like, oh, this, I'm in, you know.
[SPEAKER_00]: So that's what's happening, right?
[SPEAKER_00]: We can start to see LPS, which is like a gram-negative bacteria, which is a bit nasty, starting to get in.
[SPEAKER_00]: We start to see opportunistic overgrowth.
[SPEAKER_00]: We start to see lactobacillus-bifidobacterium and saccharomyces, though don't have the food they need, nor the environment that they like to start producing short-chain fatty acids like buterate, which feed the colonocytes and keep those tight junctions together, which worsens the leaky gut.
[SPEAKER_00]: Okay?
[SPEAKER_00]: Again, it's this positive feedback loop, which gets worse and worse and worse.
[SPEAKER_00]: So if we have
[SPEAKER_00]: and we have high compounds like into looking six, into looking eight, into looking at 18 from white blood cells, and our white blood cells are overactive when we have an inflammatory system.
[SPEAKER_00]: It can lead to intestinal hyper permeability, and that can make the problem worse as well.
[SPEAKER_00]: So that's why we often see intestinal hyper permeability, and we see other symptoms associated with food sensitivities and digestive symptoms are highly associated with females.
[SPEAKER_00]: And the other thing associated with that is that most of our neurotransmitters made in the gut.
[SPEAKER_00]: serotonin is made in the gut.
[SPEAKER_00]: It's made in the gut and then it's taken to the brain and it's used there.
[SPEAKER_00]: And then serotonin is made into melatonin.
[SPEAKER_00]: Okay, so if we're not producing serotonin, we don't feel happy and driven and energetic in the day and then we can't fall asleep at night.
[SPEAKER_00]: Sound like you?
[SPEAKER_00]: Yeah, no shit.
[SPEAKER_00]: Your gut has a lot to do with it.
[SPEAKER_00]: It's also with dopamine as made as well.
[SPEAKER_00]: So we have to remember serotonin and dopamine.
[SPEAKER_00]: They are made out of constituents of
[SPEAKER_00]: So if you are digesting those food parts and the enzymes in your gut that make the precursors to those neurotransmitters aren't around and they're not working properly because it's such a topsy-turvy, dispyotic environment, then yeah, of course you're going to feel like crap from a mental health perspective because your gut's out because of drum roll, insulin resistance.
[SPEAKER_00]: It's always insulin resistance or it might be called as all as well.
[SPEAKER_00]: What about oxidative stress?
[SPEAKER_00]: So oxidation is a natural chemical process that occurs when molecules in your body lose electrons.
[SPEAKER_00]: When triggered by exposure to oxygen, toxins, environmental stresses, or when you produce energy, you're mitochondria that take energy like glucose and turn it into ATP.
[SPEAKER_00]: That will create reactive oxygen species.
[SPEAKER_00]: And that's why eating a diet high in antioxidants is really great because they basically clean them up.
[SPEAKER_00]: We also produce our own antioxidants.
[SPEAKER_00]: as well in our body to take care of this problem.
[SPEAKER_00]: Oxidative stress is when there is an imbalance between free radicals and the body's antioxidant defenses.
[SPEAKER_00]: So this is when we maybe are not eating properly, right?
[SPEAKER_00]: So we're not eating a lot of antioxidants.
[SPEAKER_00]: That can increase oxidative stress because our body doesn't have what it needs to clean up these free radicals from basically ripping apart in the body and trying to find electrons and strip them off of cell membranes and out of DNA to balance itself.
[SPEAKER_00]: whereas we have antioxidants that do that.
[SPEAKER_00]: That's why eating an antioxidant rich diet is always really important for P-MOS.
[SPEAKER_00]: I think we're so sick of hearing it, but I think when you actually understand, this is a physiological process that is happening, uh, trillions, uh, if not, what's bigger than a trillions?
[SPEAKER_00]: It's happening all the time in your body.
[SPEAKER_00]: It's really, really important to understand oxidative stress.
[SPEAKER_00]: It's not the same as inflammation, but it is really important because it's associated with cell damage and it's also associated with the worsening
[SPEAKER_00]: of Pima symptoms.
[SPEAKER_00]: And the reason why oxidative stress really tends to worsen Pima's a few different reasons, but one of them is its impacts on the liver.
[SPEAKER_00]: Again, oxidative stress can negatively impact the liver's ability to make sex hormone binding globulin, which can worsen testosterone.
[SPEAKER_00]: So that's always something that I focus on, say if someone's labs came back and they instantly resistance is fine, their glucose is fine, but they have all of these symptoms of p-mas.
[SPEAKER_00]: I know that they have a lot of oxidative stress, and that could be from actually feeling stress and having a stress of life, but it also could be from a low antioxidant diet.
[SPEAKER_00]: So really important to eat a lot of antioxidants.
[SPEAKER_00]: I'm going to read a few out here, so this synthetic, so the nanowandyoxidants, and we also have the phenolidic antioxidants, and that's like the HAB-HT,
[SPEAKER_00]: I would say, if we can go for your more natural antioxidants, they're going to be easier and cheaper, right?
[SPEAKER_00]: So you're probably more likely to be familiar with your exogenous antioxidants.
[SPEAKER_00]: So they are vitamins, trace minerals, caratenoids, and polyphenols.
[SPEAKER_00]: We've heard about all of those before, right?
[SPEAKER_00]: Escopic acid, aka vitamin C. We can also look at selenium zinc.
[SPEAKER_00]: iron, paratine, lycopene, flavoids, phenolic acid, these are things that we find in fresh fruits and vegetables are various different colors, right?
[SPEAKER_00]: And also things like iron, I think a lot of people are really surprised that iron can be a part of our antioxidant capacity.
[SPEAKER_00]: We could also look at enzymatic ones as well that we produce in the body as well, like glutathione, you can supplement with ubiquinol, they're really, really great and that's why they work so well for women with
[SPEAKER_00]: So whenever you get your labs back and it shows low sex hormone binding globulin, you know internally now.
[SPEAKER_00]: Okay, my liver must be experiencing quite a significant amount of stress from oxidation.
[SPEAKER_00]: So maybe I'm going to increase my antioxidant.
[SPEAKER_00]: Maybe you'll take a supplement or maybe I'll just improve my diet a little bit to include more antioxidant rich foods.
[SPEAKER_00]: Another part that I wanted to talk about is PMOS and the thyroid, because not a lot of people talk about this.
[SPEAKER_00]: I have a whole episode on the thyroid, but I thought it's well worth talking about this because no one really talks about it online.
[SPEAKER_00]: It's not really even in the 2023 evidence-based guideline.
[SPEAKER_00]: There is a part of it.
[SPEAKER_00]: I will say we'll give them credit for including a little bit on that, but I would like to see a lot more.
[SPEAKER_00]: But I would say there is that much research on the connection between these two things, but the research that we do have is significant and does show really interesting correlations perhaps between hypothyroidism and Hashimoto's and PMOS.
[SPEAKER_00]: So let's start with hypothyroidism.
[SPEAKER_00]: That's low functioning thyroid.
[SPEAKER_00]: That occurs when your thyroid produces insufficient T3 and T4.
[SPEAKER_00]: in Pemos, it's not really ever a simple iodine deficiency, wouldn't that be fun?
[SPEAKER_00]: If it was just an iodine deficiency, it's very rarely that.
[SPEAKER_00]: Very often it is subclinical hypothyroidism from high amounts of insulin, high amounts of cortisol, and high amounts of oxidative stress that negatively impact the thyroid's ability to produce T3 and T4.
[SPEAKER_00]: It might also be deficiencies in things like selenium zinc,
[SPEAKER_00]: iron, magnesium, these are things that we need to make T3 and T4.
[SPEAKER_00]: We also need iodine, which I think a lot of women probably could eat a little bit more iodine, things like seafood.
[SPEAKER_00]: T3 has three molecules of iodine and T4 has four, right?
[SPEAKER_00]: So we need iodine to make these hormones.
[SPEAKER_00]: And we also need other nutrients in order to make those hormones.
[SPEAKER_00]: So it could be that, but it also is a higher increase risk of something called Hashimoto's thyroid artist.
[SPEAKER_00]: Hashimoto's thyroiditis is an autoimmune destruction of thyroid tissue by antibodies against TPO and thyroid globulin.
[SPEAKER_00]: This is the most common cause of hypothyroidism in P-MOS, and the connection is bi-directional.
[SPEAKER_00]: Insulin resistance and hyper-antrogenatisms, so high-antrogen's high-insulin, they amplify autoimmune activation and intestinal hyperperpermeability, your white blood cells, going absolutely psycho, being a little bit overactive, starting to recognize self, auto,
[SPEAKER_00]: as problem immunity, right?
[SPEAKER_00]: So we're becoming immune against self.
[SPEAKER_00]: This triggers thyroid antibody production simultaneously, thyroid autoimmunity worsens in sealant resistance.
[SPEAKER_00]: And so this is what I see a lot of the time.
[SPEAKER_00]: If you have P-MOS, so you have all the symptoms of P-MOS that we spoke about before.
[SPEAKER_00]: But you're also noticing that you have cold hands and cold feet.
[SPEAKER_00]: You can't wake up in the morning.
[SPEAKER_00]: You fall asleep really, really easily.
[SPEAKER_00]: You can sleep for like 12, 13 hours and you still be tired when you wake up.
[SPEAKER_00]: You have intense brain fog during the day.
[SPEAKER_00]: You're starting to notice just generalized hair thinning, not just in the middle of your head.
[SPEAKER_00]: You're noticing that your skin is really dry and flaky.
[SPEAKER_00]: These are all signs that your thyroid is under functioning.
[SPEAKER_00]: And that needs to be investigated because we know that there is a high incidence.
[SPEAKER_00]: and co-occurrence of Hashimoto's Thyroiditis, which is basically your immune system is destroying your thyroid, and we don't regrow Thyroid tissue as far as I know.
[SPEAKER_00]: So it's really important to get on top of that.
[SPEAKER_00]: And if it is just a simple iodine deficiency, you can do an iodine loading test.
[SPEAKER_00]: You can also supplement in iodine or eat foods high in iodine.
[SPEAKER_00]: and see what that does as well.
[SPEAKER_00]: Of course, always with the practitioner.
[SPEAKER_00]: But I think that's just really important to touch on because not a lot of people talk about that.
[SPEAKER_00]: Next let's talk about some hair and skin.
[SPEAKER_00]: I think when we have to look at the pathophysiology and the seriousness of pain mask, actually skin and hair might not be the most important thing to touch on, but skin and hair, too women, I think is really important for our mental health and sense of well-being for that reason I'm touching on it.
[SPEAKER_00]: I kind of imagine what it would feel like to have acne all over my face that is painful and debilitating like I kind of imagine really smiling, eating, breathing, sleeping, always in pain because your sister's acne is so painful.
[SPEAKER_00]: That sucks.
[SPEAKER_00]: That's going to negatively impact your self-worth and also your confidence and your mental health because you probably won't want to go out and also you're here falling out as well.
[SPEAKER_00]: I think that's really distressing when I went through my health things earlier this year.
[SPEAKER_00]: when I started to see a little bit of hair loss because I had really a lot of iron, which was really surprising to me.
[SPEAKER_00]: I freaked out.
[SPEAKER_00]: I think a lot of women really freak out when they start to see these things cropping up especially your hair.
[SPEAKER_00]: I think when your hair is falling out that's like well okay, that is a canary unicorn man.
[SPEAKER_00]: I'm gonna pay attention to that.
[SPEAKER_00]: So let's touch on Fowl, Insulin and Androgens impact your skin and your hair.
[SPEAKER_00]: So as I said before, remember how I said, all of the genetic or maybe non-genetic predispositions lead to higher insulin, insulin leads to your thickest self-stickening and therefore we have more androgens.
[SPEAKER_00]: Yes.
[SPEAKER_00]: So whether you're male or female, we are still going to have androgens receptor cells, I should say.
[SPEAKER_00]: around the derma of where your skin is.
[SPEAKER_00]: So in each pore, you have a little hair growing out of it basically.
[SPEAKER_00]: And we have lots of little receptors there that are hormone sensitive.
[SPEAKER_00]: If you have more
[SPEAKER_00]: they're going to attach to those receptors.
[SPEAKER_00]: And what tends to happen is because we have part of our DNA coming from our father, we have these antigens here that are sensitive to it.
[SPEAKER_00]: And what we notice is the cavity that holds the sebum, which is the oil, tends to become larger and really overactive.
[SPEAKER_00]: So we're pumping out lots and lots and lots of sebum all the time onto the skin.
[SPEAKER_00]: And that can negatively impact the skin surface and that can feed some of those nasty bacteria and microbiomes and your skin that can be associated with acne.
[SPEAKER_00]: And that can also clog your pore and it can lead to infections.
[SPEAKER_00]: So we start to see cystic deep acne with women with pemas very generally.
[SPEAKER_00]: You can pop as much benzach on there as possible as you want, but at the end of the day, it's a hormonal problem.
[SPEAKER_00]: And what we also see is that it tends to thicken the hair and with the thickening of the hair that can create more infection sites as well in that area and we can start to see in that area where genetically men are more sensitive to those high endrogens that grobeids we start to see that growth of that hair and it's also in the same area where we see that acne so the jaw and the chin around the mouth kind of in this band from the ear.
[SPEAKER_00]: between the nose and the mouth and across to the other one.
[SPEAKER_00]: In this band, we generally see more hair growth and more sebum production that can lead to acne because genetically men have more hydrogen receptors there.
[SPEAKER_00]: That's an offshoot that we have as well.
[SPEAKER_00]: And that's why it tends to impact the skin and the hair growth here.
[SPEAKER_00]: But acne and hair growth here, and also losing a bit of hair on the top of your head is also because Androgen and receptors are more frequent in the middle of the head here because men start to lose hair there, especially when they start doing a hormone replacement therapy, like taking lots of testosterone.
[SPEAKER_00]: They start to lose hair here, right?
[SPEAKER_00]: And they start to grow more hair on their face.
[SPEAKER_00]: It's the same thing, but we have more naturally occurring testosterone, because the thicker cells are releasing more and more and more Androgens.
[SPEAKER_00]: That isn't the only skin impacts we see.
[SPEAKER_00]: Because of oxidative stress, high insulin, and high glucose, we also start to see generally information on the skin.
[SPEAKER_00]: And women with pemas have a high incidence of developing a suboric dermatitis.
[SPEAKER_00]: I also used have dermatitis, so I know how annoying it can be, which is really quite a drying of the skin.
[SPEAKER_00]: Really irritated your skin barrier is just very, very, very sensitive.
[SPEAKER_00]: So that's something that we can see women with pemas as well.
[SPEAKER_00]: We can also start to see dark patches, so insulin stimulates fibroblast proliferation via IGF-1 receptors, and that can produce dark velvety thickening and pigmentation in depth mirrors the insulin resistance severity.
[SPEAKER_00]: So that could be acne scars and it could also be where we see friction.
[SPEAKER_00]: So under the arms on the neck where your uniform or your clothes might rub on your neck, if you start to see dark velvety patches here, that is also because of high insulin high IGF1.
[SPEAKER_00]: Also skin tags.
[SPEAKER_00]: If you've noticed a few skin tags, this is a funny one that I think is now hitting online a lot of people are becoming more aware of it, but skin tags are a really great clinical indication of insulin resistance.
[SPEAKER_00]: And also going back to Suboreg Dermatitis before I close up on skin and hair.
[SPEAKER_00]: High in sealant and IGF1 also tends to decrease serimide production in the skin, so if you're a woman with P-MOS and you do have Suboreg Dermatitis, putting on some serimides can be so great for dermatitis.
[SPEAKER_00]: Of course, talk to your dermatologist about that.
[SPEAKER_00]: And a few labs for skin and hair might be free testosterone IGF1, fasting in sealant and fasting glucose.
[SPEAKER_00]: That would be really, really great.
[SPEAKER_00]: and see what is impacting your skin negatively.
[SPEAKER_00]: So there's a few things that I just want to touch on.
[SPEAKER_00]: I think I've touched on out of relation because the thicker cell is so thick and it could touch on everything but everything is in my masterclass and my e-book.
[SPEAKER_00]: I also touch on pregnancy, postpartum and menopause and it's impacts on PMOS in my e-book as well.
[SPEAKER_00]: So heal PMOS the infradient way.
[SPEAKER_00]: It's only available in ebook.
[SPEAKER_00]: It will be available paperback very very soon or you can look on the masterclass.
[SPEAKER_00]: The only difference between the masterclass and the ebook is that the masterclass doesn't go into pregnancy, postpartum and menopause because I wanted to keep it affordable around the same price market as all of my other masterclasses, but it's two and a half hours long.
[SPEAKER_00]: And I thought if I included these two things, it would be four and a half hours long.
[SPEAKER_00]: I would have to increase the price.
[SPEAKER_00]: It wouldn't be available to all a lot of women.
[SPEAKER_00]: So to ameliorate that problem, I am going to be having people on in the future.
[SPEAKER_00]: So I'm going to be having experts on to talk about P-MOS and postpartum, P-MOS and pregnancy and postpartum, and also P-MOS and menopause as well.
[SPEAKER_00]: Because I think those are important things to take into account through the lifespan.
[SPEAKER_00]: And I know that a lot of listeners here are from a lot of different age groups and are in a lot of different journeys with their body, whether they want kids, whether they don't, whether they are pregnant, whether they're on their TTC.
[SPEAKER_00]: whether they're postpartum and I think if you have PMOS, it also adds another layer there.
[SPEAKER_00]: So if you were interested in that, that's coming and if you wanted to learn about it right now, the ebook is there for you.
[SPEAKER_00]: Before we close up, let's talk about diet.
[SPEAKER_00]: So I think there's a lot of misinformation online about how you should just be eating, look, have a hydrate diet, and I'm guilty, lock me up, I used to promote that because that was the diet that was popularized by the data that we have.
[SPEAKER_00]: But now we have better data.
[SPEAKER_00]: and it suggests that it's not so much the carbohydrates and cutting out carbohydrates is the type of carbohydrates.
[SPEAKER_00]: So I'm a big proponent of focusing on your glycemic index.
[SPEAKER_00]: So glycemic index is basically some foods have a high insulin impact.
[SPEAKER_00]: So say you ate 20 grams of a banana because of the amount of fiber and the type of sugar that's in it whether it's fructose or glucose, it will have a certain impact on insulin.
[SPEAKER_00]: So a banana, for example, a ripe banana, a very ripe banana when it's, you know,
[SPEAKER_00]: Are we freezing this and making it with smoothies or are we making banana bread?
[SPEAKER_00]: I'm not eating this as is.
[SPEAKER_00]: It's kind of gross.
[SPEAKER_00]: Really, really ripe banana.
[SPEAKER_00]: Really, really, low and fiber and really high and sugar.
[SPEAKER_00]: That same banana when it was almost raw and green is going to have a different impact on your insulin.
[SPEAKER_00]: So that green banana has a low to moderate GI, but that very ripe banana will have a very high GI impact.
[SPEAKER_00]: And so for women within ceiling resistance, we're very, very sensitive to insulin, we're very, very sensitive to carbohydrate.
[SPEAKER_00]: So what I'd proposition to women when they look at the diet is looking at carbohydrates and what type of carbohydrates we're eating and when.
[SPEAKER_00]: Because early in the day, it makes sense.
[SPEAKER_00]: You've been sleeping glucose is our preferred fuel source.
[SPEAKER_00]: sorry to all of the paleo fanatics and everyone out there who thinks insulin just helps you gain weight that's not true at all insulin puts glucose into the cell so we can use it as energy and glucose is the preferred fuel source.
[SPEAKER_00]: No, I will not be taking any comments.
[SPEAKER_00]: We're not taking any questions.
[SPEAKER_00]: Go read through PubMed, okay?
[SPEAKER_00]: I've done a degree in nutrition, okay?
[SPEAKER_00]: That's what it is.
[SPEAKER_00]: Glucose is our preferred fuel source.
[SPEAKER_00]: Fight me on it.
[SPEAKER_00]: Anyway, if we've been asleep, say we went to sleep at 10 o'clock, but our last meal was at 7.
[SPEAKER_00]: we have an eaten like 10 to 13 hours.
[SPEAKER_00]: Our body wants glucose.
[SPEAKER_00]: So what does it do?
[SPEAKER_00]: It automatically increases insulin to the highest and it will go in the morning, which is why it's kind of okay to eat higher carbohydrate in the morning because your body is ready to hand of that because as all of the insulin around,
[SPEAKER_00]: to put it into the cell.
[SPEAKER_00]: Of course, that's difference with p-mas.
[SPEAKER_00]: You're not going to be eating really high glycemic index foods.
[SPEAKER_00]: What you are going to be eating though is moderate to look.
[SPEAKER_00]: And you can also time cover hydrate intake as well.
[SPEAKER_00]: So maybe you could have a high GI cover hydrate just before you go for a run because your body is going to use that energy in order to do work.
[SPEAKER_00]: Right.
[SPEAKER_00]: Another thing that we can take into account is making sure we're eating and then walking.
[SPEAKER_00]: And so that's activating something called a MPK.
[SPEAKER_00]: This is pretty amazing.
[SPEAKER_00]: So we think that insulin is the only way to get glucose into the cell, and thus lower blood glucose, right?
[SPEAKER_00]: Not true.
[SPEAKER_00]: We also have a MPK, and that's almost the back door to the party in a way.
[SPEAKER_00]: So what that does is basically, we eat a banana.
[SPEAKER_00]: Our insulin goes high our blood glucose goes high, which is a problem if we have p-moss, right?
[SPEAKER_00]: Because we're going to gain that as fat because it's just going to stay in the blood system and then we feel fatigued
[SPEAKER_00]: Right?
[SPEAKER_00]: It's pretty no bueno, we don't want that.
[SPEAKER_00]: So what happens with AMPK?
[SPEAKER_00]: I eat that same banana, but I go for a 10-minute walk.
[SPEAKER_00]: What that does, that muscle constriction and that action, actually tells our body, oh, okay, insulin is not working.
[SPEAKER_00]: We can't depend on insulin, but we can use AMPK.
[SPEAKER_00]: And this is a different cell signaler that tells glut4, that same transport of protein for glucose, to go and grab as much glucose as it can and bring it into the muscle cell so we can use it.
[SPEAKER_00]: Your muscle is a mob.
[SPEAKER_00]: I don't think a lot of people think that your muscle is metabolically active, but simply because it uptakes glucose.
[SPEAKER_00]: Simply because it is responsive to hormones in the body, and it produces hormones as well.
[SPEAKER_00]: It is metabolically and endocrine active.
[SPEAKER_00]: Okay, your muscle is a tool.
[SPEAKER_00]: And if you have p-masters well, you should be working out.
[SPEAKER_00]: You should be going to the gym.
[SPEAKER_00]: You have more androgyns, okay?
[SPEAKER_00]: You can gain more muscle.
[SPEAKER_00]: very, very, very, very, very quickly.
[SPEAKER_00]: So you should be working out and gaining more muscle.
[SPEAKER_00]: And then when you eat high carbohydrate foods or carbohydrate rich foods, then you're able to metabolically handle that because you have that muscle tissue to basically collect all of it and put it into the muscle tissue and store it as glycogen and then you can access energy more frequently when you move, right?
[SPEAKER_00]: So that's a few things you want to keep in mind with carbohydrates.
[SPEAKER_00]: It doesn't need to just be low carbohydrates.
[SPEAKER_00]: It's being mindful around what carbohydrates you're eating when in the day.
[SPEAKER_00]: at what type of carbohydrates you're eating before you work out to fuel yourself through those workouts as well.
[SPEAKER_00]: And it's also how you eat those carbohydrates in relation to other foods.
[SPEAKER_00]: So there's heaps of studies that look at, okay, you have a plate of food.
[SPEAKER_00]: So you have one quarter of it is a high glycemic food boiled potato.
[SPEAKER_00]: So mashed potato, you have some salmon, and you have some beans.
[SPEAKER_00]: What they found with people who ate the potato, and then they ate the vegetable, and then they ate the salmon.
[SPEAKER_00]: They had a really high insulin response.
[SPEAKER_00]: In comparison to the people that had the exact same meal, but they sat down and they had the salmon, and then they had their green beans, and then they had the potato.
[SPEAKER_00]: They had a statistically significantly less insulin response with the same meal.
[SPEAKER_00]: So there's a few just tips and tricks, right?
[SPEAKER_00]: Another one you can add on is vinegar.
[SPEAKER_00]: I think a lot of people, I talk about histamines a lot on my channel, so I think people go, well, I can't even think of it because it's high in histamines.
[SPEAKER_00]: Not all vinegar is high in histamines, okay?
[SPEAKER_00]: Just you're playing white vinegar, that's not high in histamines.
[SPEAKER_00]: Apple cider vinegar, yes, is high in histamines, but if you're not worried about histamines,
[SPEAKER_00]: and you don't have itching and you don't have headaches on migraines or any of the flu symptoms just for your period that you don't really need to worry about it.
[SPEAKER_00]: Apple cider vinegar in your water.
[SPEAKER_00]: If you just have it in your water throughout the day or you just focus on having that about 15 minutes before you eat, that lowers your insulin response significantly as well by about 15 percent.
[SPEAKER_00]: So that's really really great and that has other health impacts as well down the line on your gut.
[SPEAKER_00]: Another one you can keep in mind as well is Burberine, so Burberine is really really great for lowering the insulin response, so about 500 milligrams before each meal.
[SPEAKER_00]: Of course, you need to work up and tie, trade up very, very slowly with Pima's, but I think that's really really great as well.
[SPEAKER_00]: Burberine's also wonderful for Candida, which I think is a huge problem for Pima's too.
[SPEAKER_00]: it breaks down the bio films and it can be really really great for it at the treatment and prevention and the slowing down of the progression of Candida if you do have Candida and used overgrowth in the body.
[SPEAKER_00]: So Burbury does both of those things.
[SPEAKER_00]: It does a lot of different things.
[SPEAKER_00]: I have a whole podcast on Burbury.
[SPEAKER_00]: So those are a few things you want to focus on.
[SPEAKER_00]: Protein, I think this is another one that everyone really is up and arms about.
[SPEAKER_00]: So protein, you want to be making sure you're eating enough.
[SPEAKER_00]: If you can aim for like what?
[SPEAKER_00]: 1.61.8 grams per kilogram that's going to be different for everyone and you can be going higher, maybe going for two grams per kilogram per day, if you're exercising, right, to make sure you're giving your muscle what they need to repair and produce more muscle tissue so you can mop up more of that glucose.
[SPEAKER_00]: Protein sources, though, it's not just plant-based, it's not just animal-based, because animal-based protein is really, really, really bio-available, and it also has lots of minerals and vitamins in it as well.
[SPEAKER_00]: But your plant-based protein, tofu, and itamame, for example, they're not so bio-available, but they're really rich in antioxidants.
[SPEAKER_00]: Okay, so eat 50, 50.
[SPEAKER_00]: I think have the best of both worlds for dinner if you could have Ed and Marme or some tofu but for lunch you're having salmon and in the morning you're having some full-cream milk right with heaps and heaps of calcium.
[SPEAKER_00]: Going on from that as well, another thing that I need to talk about with diet in relation to P.M.
[SPEAKER_00]: There are some pretty big people online who are dietitians who are talking about how you shouldn't eat dairy and gluten if you have P.M. And I have a huge problem with this.
[SPEAKER_00]: because women with females have a higher risk of the development of eating disorders.
[SPEAKER_00]: I'm sorry.
[SPEAKER_00]: Let's just hold up.
[SPEAKER_00]: Where in your dietetics training did they tell you that convincing women to eat a lower diversity diet that's actually harder for them to commit to is actually going to be good for the prevention of eating disorders?
[SPEAKER_00]: I don't think they're said that too.
[SPEAKER_00]: Also, gluten.
[SPEAKER_00]: can be a whole grain that can increase the production of breederate, which feeds the colonocytes and it can improve constipation and dairy is really rich in both fat, calcium, vitamin D. It's a really reasonable carbohydrate source as well.
[SPEAKER_00]: Cottage she's just having a moment at the moment for a good reason, okay?
[SPEAKER_00]: Full good reason.
[SPEAKER_00]: I don't think it's a good idea at all to tell this group of women to not eat dairy and gluten.
[SPEAKER_00]: If you think that you might have Hashimoto's thyroiditis, yes, okay, maybe consider giving up gluten because of molecular mimicry and that can negatively impact the progression of Hashimoto's thyroiditis.
[SPEAKER_00]: Yes, but if you don't have any reaction to gluten, continue eating gluten.
[SPEAKER_00]: The type of gluten matters.
[SPEAKER_00]: Make sure it's organic.
[SPEAKER_00]: If you're going to spend the money on something organic, please make sure your grains and legumes as someone who did broader cropping in her farming era.
[SPEAKER_00]: I will tell you, they are spraying so much glyphosate on your food and that can negatively impact your gut microbiome.
[SPEAKER_00]: We don't want that.
[SPEAKER_00]: So organic gluten only, organic legumes only, but you don't need to cut it out.
[SPEAKER_00]: Yeah, cut it out if you're sensitive to it.
[SPEAKER_00]: If you're lactose intolerant, yeah, don't eat dairy.
[SPEAKER_00]: But I think there's a lot of women who go and have that diagnosis of peemars, and they go, okay, cool.
[SPEAKER_00]: No alcohol, no coffee, no gluten, no dairy, and then they end up with bulimia, or they end up with eating disorders, because they can't eat anything, and they're so hungry all the time, and they get these binge eating disorders, and they get anorexial or thoraxia.
[SPEAKER_00]: It's just, that's not appropriate.
[SPEAKER_00]: It is so inappropriate.
[SPEAKER_00]: So here's my message to you if you're listening to this and you have peemars.
[SPEAKER_00]: You don't need to give up gluten and dairy.
[SPEAKER_00]: Okay.
[SPEAKER_00]: If you love those foods and you're not reacting to them different at all, maybe just invest in maybe more expensive grains and gluten based foods.
[SPEAKER_00]: You don't have to give them up.
[SPEAKER_00]: If you like having your shortcake in the afternoon as like a little treat and you like having white flower every now and then, by all means go or by all means have it.
[SPEAKER_00]: While we're on things that we don't want to eat also, we don't need a worry about anti-nutrients and you don't really need to worry about soy and you don't really need to worry about seed oils, okay?
[SPEAKER_00]: Don't worry about these things either.
[SPEAKER_00]: I will talk about those individually at a later date.
[SPEAKER_00]: I'm not going to get into it here.
[SPEAKER_00]: I don't have hours and it will take hours for us to get through those things.
[SPEAKER_00]: Okay, finally, let's look at some supplements.
[SPEAKER_00]: Let's look at insulin resistance first.
[SPEAKER_00]: So, myocytol.
[SPEAKER_00]: So we want to be looking at myocytol in a 40-to-one ratio.
[SPEAKER_00]: So, with D-chiroinocytol, that's the most evident supported natural insulin sensitizer.
[SPEAKER_00]: So, hyper-insulinemia affects 95% of women with p-mass,
[SPEAKER_00]: and my own oscillator is really great for that.
[SPEAKER_00]: I know so many women who started taking my own oscillator and their cycles were regular, pretty much immediately, like within a month.
[SPEAKER_00]: So that's the one that you should definitely go and get.
[SPEAKER_00]: Another one is NAC, because NAC is really, really great at decreasing oxidative stress.
[SPEAKER_00]: It's also really important for improving insulin sensitivity via glutathione replenishment, and it's also demonstrated comparable outcomes to metformin, for ovulation induction and in an ovulatory PMOS.
[SPEAKER_00]: So if you're an ovulatory, an AC.
[SPEAKER_00]: Burberry and I spoke about Burberry in just before for a few different reasons.
[SPEAKER_00]: I think it's really great.
[SPEAKER_00]: Apple side of India I spoke about that as well.
[SPEAKER_00]: So, if you've just gotten the diagnosis for PIMOS and you don't know where to start, the three supplements I would start with is my own oscillator, NAC and Burberry, and maybe get some apple cider vinegar.
[SPEAKER_00]: If you're worried about histimines, work in some acidic acid from white vinegar, that's low, if not, you know, it doesn't have any histimines at all.
[SPEAKER_00]: Access androgens, this is the other one.
[SPEAKER_00]: So if you have acne and if you have hair, growth and hell of, that's male pattern or androgens like, sore palmetors really, really great.
[SPEAKER_00]: that blocks the hydrogen receptor binding at the follicle and sebaceous gland level.
[SPEAKER_00]: So we see a decrease in DHHT as well, which is kind of a naughty testosterone, which is associated with more hair growth and also more acne.
[SPEAKER_00]: You can also do spamming T. So spamming T has been really effective at two cups a day and it tastes delicious with a little bit of honey or a little bit of maple syrup.
[SPEAKER_00]: So that's really great because it produces significant reductions in
[SPEAKER_00]: Also, zinc inhibits five alpha reductase directly reducing the conversion of testosterone to the more potent DHT at the follicle, okay?
[SPEAKER_00]: So it's not only testosterone at the follicle, but it turns into DHT and DHT tends to be a little bit more potent.
[SPEAKER_00]: So saw palmito, spmitty, and zinc all tend to do this, and then green tea.
[SPEAKER_00]: If you can just switch out for a green tea or marcher in the morning because it's really rich in a compound called EGCG.
[SPEAKER_00]: And this inhibits alpha-5 reductase, it reduces DHT conversion and it's anti-inflammatory and it's anti-oxidated stress because it's so rich in polyphenols.
[SPEAKER_00]: Huge win for green tea.
[SPEAKER_00]: I think green tea and marcher is probably the best thing that you can do.
[SPEAKER_00]: Okay, what about if I have that intersection of hypotheraidism and I also have some p-mas.
[SPEAKER_00]: So vitamin D, if you can aim for 5,000 I use a vitamin D, you're going to see such a huge improvement in lots of different constellations of your symptoms, specifically on your thyroid.
[SPEAKER_00]: So your energy production is going to be improved.
[SPEAKER_00]: It's also going to improve your skin barrier and just your skin overall.
[SPEAKER_00]: Selenium, two Brazil nuts a day.
[SPEAKER_00]: We need Selenium to make T3 and T4 iodine is also really great.
[SPEAKER_00]: So at eat more sea weed foods, if you can, sea kelp is really great.
[SPEAKER_00]: Everyone's obsessed with sea moss.
[SPEAKER_00]: That's pretty rich in iodine.
[SPEAKER_00]: If you can work that into smoothies, you can't really taste it.
[SPEAKER_00]: You can always do thyroid drops as well, but I
[SPEAKER_00]: Kind of I'm careful around the recommendation of iodine supplementation until you've done an iodine loading test.
[SPEAKER_00]: I'm going to add magnesium actually to those five that I recommend at the very start.
[SPEAKER_00]: Magnesium, we need magnesium at the cell membrane to be sensitive to insulin and a lot of women are low in magnesium.
[SPEAKER_00]: And don't even get me started on the magnesium test.
[SPEAKER_00]: It doesn't matter unless you do an intracellular and magnesium has a really low risk, right?
[SPEAKER_00]: And most often people are low in it.
[SPEAKER_00]: So magnesium classinate.
[SPEAKER_00]: If you could go for like 300 to 400 milligrams a day, you're gonna see such huge improvement in your energy and weight loss because all of a sudden, insulin's working at their cell receptor site.
[SPEAKER_00]: We can use that energy sort of surrounding this fat and we don't feel so fatigued all the time.
[SPEAKER_00]: It's gonna improve sleep on sets.
[SPEAKER_00]: Really gonna be great for insulin.
[SPEAKER_00]: it's going to be really great for anxiety and depression if that's what you're dealing with and insomnia which can be really hard for women as well.
[SPEAKER_00]: And finally, let's talk about some lifestyle factors I touched on them before.
[SPEAKER_00]: After your meals, at least two meals a day, please go for a little walk.
[SPEAKER_00]: Please go for a little walk.
[SPEAKER_00]: Please just do it.
[SPEAKER_00]: I had someone comment on one of my posts the other day saying that she lost 15 kilos just with that one change in about six months Okay, so don't underestimate after meal walk doesn't have to be every single meal if you can just go it's really hard for me to do that with breakfast But I can commit for lunch and dinner.
[SPEAKER_00]: Okay, then do that.
[SPEAKER_00]: Okay, and we are going to be weightlifting.
[SPEAKER_00]: We are going to be weightlifting at least two to three times a week
[SPEAKER_00]: and that is progressive overload as well.
[SPEAKER_00]: I have an amazing podcast with the doctor Alyssa Olnick who has her PhD in sports physiology.
[SPEAKER_00]: If you have no fucking idea, where to start, her resources are really great and that podcast is really great to start with as well.
[SPEAKER_00]: Okay, that's everything.
[SPEAKER_00]: If you wanted to learn more, again, head over to my website arquement.com.au to find those PMOS resources.
[SPEAKER_00]: You can look for the ebook, heel PMOS, the infrarity, and way, and my heel PMOS masterclass.
[SPEAKER_00]: And you can watch the first 10
[SPEAKER_00]: 10 minutes online for free.
[SPEAKER_00]: You can get a bit of a feel for what I teach, how I teach is about two and a half hours long.
[SPEAKER_00]: So it's really evidence-based, yet all of the information you need and it's really great.
[SPEAKER_00]: To fork, a really good understanding about P.M.S.
[SPEAKER_00]: and how you can live with this condition for your life.
[SPEAKER_00]: Remember that P.M.S.
[SPEAKER_00]: can never be reversed or cured, but it can be put into remission.
[SPEAKER_00]: You can do that with lifestyle intervention, which is what we're all about here.
[SPEAKER_00]: Thank you so much for taking the time out of your busy day to listen to this episode.
[SPEAKER_00]: If you loved it, please remember to like, subscribe, and send to a loved one.
[SPEAKER_00]: If you want to learn more from our quaman, please check out the website at arquaman.com.au where you can find a pothora of offerings like charts, masterclasses, courses, and organic clothing.
[SPEAKER_00]: You can also head over to patreon.com slash arquaman.
[SPEAKER_00]: or sub-stack.com slash our comment to join the community.
[SPEAKER_00]: I hope you have a really beautiful morning, afternoon or evening wherever you are in the world, and I will see you on the next episode.