How To Navigate PCOS Naturally

PCOS (polycysitc ovarian syndrome) is a fairly common health issue that affects women during childbearing years. Caused by an imbalance of reproductive hormones, the symptoms vary from mild inconveniences, to irregular periods, and even infertility. There isn't any known cure and conventional treatments usually revolve around hormone therapy or invasive procedures, we're thankful to partner with a doctor that has a more natural approach to healing.

 

Meet Dr. Patricia McLelland:

Patricia McLelland, M.D., FACOG is a board-certified OB/GYN with over twenty years of experience in her specialization. She's a graduate of Vanderbilt and decided to spend her residency at Emory. She wants to partner with women as they experience new health challenges and continue to find unique opportunities to improve their health through each stage of life. In recent years, she's focused her learning on functional medicine and taking classes through IFM (Institute for Functional Medicine) to improve her ability to address health issues through lifestyle changes instead of immediately going to conventional prescription medications.

Some Points We Discuss:

  • 1:11 - Some background on Dr. McLelland.
  • 3:56 - How Dr. McLelland saw the limitations of conventional medicine.
  • 7:38 - What is PCOS?
  • 9:55 - The power of balanced blood sugar.
  • 12:40 - What's an ideal insulin level?
  • 13:41 - How to change your diet for optimal health.
  • 21:13 - Supplements to help with PCOS.
  • 24:21 - How PCOS is diagnosed.
  • 25:55 - Dr. McLelland's natural guide to PCOS.
  • 32:11 - How to lose weight and keep it off.
  • 36:00 - The connection of stress and PCOS?
  • 41:15 - How to get better sleep.

Cady Kuhlman 0:01
And you've touched on something that's huge for me, if females come in and are saying they're a little bit more anxious or depressed, and you could speak to this, I don't think that's the cause always of the anxiety or depression. But it could be a trigger, if they're going to just ride that blood sugar wave all day. So when I've been able to fix blood sugar for clients, it's like they feel like a new person.

Dr. Patricia McLelland 0:21
You're exactly right. They don't realize the the level of how they how bad they feel, sometimes until you've normalized that, and almost every hormonal issue that I helped manage, there is definitely an insulin resistant component to that, again, sometimes it's not obvious in the lab work. But as soon as you make these same adjustments, will feel so much better.

Brian Strickland 0:48
You're listening to the nutrition world podcast, a show about navigating the intricacies of holistic wellness. We're a natural health food store located in Chattanooga, Tennessee, and we believe that optimal health and peak performance should be accessible to everyone.

Cady Kuhlman 1:11
So I am honored to be here with you today. Dr. Patricia McClellan is on our podcast. And you know, I have a long relationship with Dr. McClellan. It's from a place of partnering in a clinical setting. And I would call it a friendship setting as well. And we're very united on our belief system and getting a client to their goal. And so I think that it's a beautiful, beautiful place when we can when we can bring together what they call Western medicine or the conventional approach and pair that with supplementation and herbs and lifestyle changes. And the end result we're both just wanting, you know, the betterment of our clients and our patients. And so, we are here today together to chat on the subject of PCOS. But before we do that, I want to introduce Dr. Patricia McClellan. And just speak a little bit about her credentials and her her background. So she's a OB GYN board certified, went to Vanderbilt University and then moved on from there to do a residency at Emory. And after Emory moved on into, you know, her line of work and I think you had said before, to me, you kind of saw everything at Emory during your residency. So you were handed a very, a big plate of okay, here's kind of everything that could possibly happen now, you know, come up with an approach and move through that and help those patients and so I know you do a lot for our town you do a lot for Galen medical of which are the director of the women's

Dr. Patricia McLelland 2:45
Well, I'm part of Galen medical, but I've was medical director of women's services at Erlanger east for awhile,

Cady Kuhlman 2:53
okay. Okay. And then I know you do a lot with pregnancy and postpartum and, and, you know, aging female hormone. So as they're getting into post and Peri and menopause age. So really, to me, she's one of Chattanooga as most experienced and just most comprehensive OBGYN that we have in our town. And what really drew us together I think, was the functional medicine approach through the IFM Institute. So the in the Institute for Functional Medicine that she went back into and learned and got certified through because you saw a lot of patients coming to you wanting to look for those root causes those deeper answers of why did this dysfunction happened? Why are my hormones changing? And what's going on with the symptoms that I'm seeing? Can we dig a little bit deeper. And so I think that really opened my eyes to this potentially huge partnership and ability to to help our patients and our clients. So thank you for being here today.

Dr. Patricia McLelland 3:56
Yeah, I've been practicing now for about 24 years, and probably over over time, I've seen the limitation of a conventional approach to a lot of the things that I helped manage, and in medical school said, Tell somebody to eat healthy, well eat healthy, but what does that really mean? And what that meant 25 years ago, is different than it is today. And that's what really led me on the journey of looking for a more functional approach. And I started with IFM. But I just completed a real deep dive integrative approach for women's health with a doctor in New York named Dr. Aviva ROM. And that's been such an amazing approach because it really digs even deeper into women's health, which has been wonderful. So now I feel like I can not only tell somebody to be healthier, but to really help engage what that means for that. Individual, wonderful. One of the things you and I had talked about is our real goal is to help women engage into a healthier lifestyle and how they first step into that is going to vary for everyone based on values based on what issues they're dealing with. And so the more options we have to really help that woman step into that is means we're meeting more women's needs. Exactly,

Cady Kuhlman 5:29
exactly. I totally feel that and we had discussed before, if, if we set up this plan of make these 10 changes, take these eight pills three times a day, and they're not willing or capable, or their stress levels are too high to manage that many changes, that we're not really serving anyone. So the point is, is we have to tailor these plans for, you know, the, the person at where they're at. And I love to see in our practice, and our store, nutrition world and my health coaching role. I love to just make small tweaks that almost sometimes a client will leave, and I'll think, Oh, that was such a tiny tweak. But it felt like it was all that they can handle, maybe for this one week. And then the next week, I'll reassess and add something small on. And sometimes those tiny steps just start that snowball effect. And then we look back and we're like, oh, okay, over those three months, that actually was a big change. And those are so rewarding to see

Dr. Patricia McLelland 6:24
it is rewarding. It's very rewarding. And it's very empowering, because, first of all, the woman feels heard. And the value of being heard is one of the most empowering things and hearing well enough to say, Here are the options, what do you think you will be able to do at this point, also give empowers them and freeze them in order to take those steps. And if you can help them figure out what is the most effective, then they're also going to see benefit. And if you see benefit, then you are more likely to continue on that path.

Cady Kuhlman 7:05
Totally, totally. So I know today's topic, I kind of wanted to surround it around the topic of PCOS. And so I can't even tell you how many times have a female or even maybe sometimes the husband of the female is coming in saying my wife's complaining of the symptoms, or the female herself is walking in saying I'm having these symptoms, I'm unsure of what to do with them. So let's kind of move into what polycystic ovarian syndrome is, and how prevalent and kind of some symptoms that a female may see if they are experiencing this.

Dr. Patricia McLelland 7:38
So with PCOS, the rate of PCOS is increasing. But about 10% of women have it in the United States. The basic definition is irregular periods or no periods, and that's related to either ovulating every now and again or not ovulating. And the other main symptom is evidence of too much testosterone. So either a woman has elevated testosterone levels and on her lab work, or she has acne, facial hair, or male pattern hair loss. So where there's loss more in the temple region, a lot of these women will also have weight gain. But I think it's important to remember a lot of women there are a percentage of women with PCOS that do not have weight gain their normal weight, and oftentimes they're diagnosed later. Because weight gain is such an A typical component of that Gotcha. Other associated issues that women can have would be issues with getting pregnant. Issues seeing an increase miscarriage during pregnancy, women will oftentimes have a higher rate of diabetes, high blood pressure, those would increase the risk of C section. Other issues would be uterine cancer or uterine pre cancer because too much estrogen over long periods of time increase that risk. A lot of women will have insulin resistance or diabetes, so pre diabetes or diabetes. I would say most women when I diagnose them with PCOS, they're in the pre diabetes range, okay. And almost all of them all the women with PCOS will have some element of insulin resistance. And even if their lab work looks fairly normal addressing diet, thinking through insulin resistance is the most effective.

Cady Kuhlman 9:50
Explain a little bit of insulin resistance for our viewers, if you don't mind or what that will apply to. Yeah,

Dr. Patricia McLelland 9:55
so diabetes is when your blood sugar levels are too high. Your insulin maintain is, is the hormone that your body makes to maintain a normal blood sugar. Initially, your blood sugars can still be normal. But the insulin level, the insulin isn't working very well. So your body has to make more insulin to keep the same blood sugar. Insulin resistance is associated with pretty much everything that we just discussed. The one thing that we didn't discuss, which also is a huge component of this is heart disease, it's a higher risk for heart disease. This can also be associated with difficulties losing weight, or maintaining weight. And all of these women also see a higher rate of anxiety, depression, mood changes related to this as well.

Cady Kuhlman 10:59
Yeah, that was a great description, I think for, you know, my health coaching and role that I have in our weight loss clinic at our at our store, one of our biggest goals, or the biggest goal is to work on insulin levels. And so oftentimes, if you send a client into us, or we a client walks in just you know, off the off the streets or heard about us, if they've said they've had a long period of not being able to lose weight successfully, or they have weight around the abdominal region that's kind of, you know, just placed right here, maybe with some skinnier legs and whatnot. And we start asking and diving into how much sugar how many carbs are they eating? Oftentimes, people don't know that, because they're not even aware, as much of what is a carb? What is sugar, how much should I eat. But my main role in weight loss, and with this insulin issue is to balance out the blood sugar so that regularly, they're not skipping meals, they're not eating too much in one meal, tanking in between that eating a big meal again, and riding that roller coaster of blood sugar, and you touched on something that's huge for me, if females come in and are saying they're a little bit more anxious or depressed. And you could speak to this, I don't think that's the cause always of the anxiety or depression. But it could be a trigger, if they're going to just ride that blood sugar wave all day. So when I've been able to fix blood sugar for clients, it's like they feel like a new person.

Dr. Patricia McLelland 12:24
You're exactly right. They don't realize the the level of how they how bad they feel, sometimes until you've normalized that exactly in almost every hormonal issue that I helped manage, there is definitely an insulin resistant component to that, again, sometimes it's not obvious in the lab work. But as soon as you make these same adjustments, women will feel so much better.

Cady Kuhlman 12:50
Yeah, totally. So tell me for those that are listening. And I don't know if it can be this simple for you, is there an insulin level that you like to see their insulin under? If they do get that blood test?

Dr. Patricia McLelland 13:00
Well, I look at several different things. Because there's really no one test, that's perfect. I do look at the A one C the benefit of the hemoglobin a one C is you don't have to be fasting. And that means you can draw at any time. I do look like to look at the fasting insulin level prefer for that to be below 10. But if you look at normal ranges, the normal range is higher. Kind of the gold standard is a two hour diabetes screen. But most women would prefer not to do that. So I started off with a one C and fasting insulin. Okay,

Cady Kuhlman 13:41
that's super helpful. So tell me in terms of a diet change what you would kind of set out for a client that was looking to lower their insulin help with their insulin resistance, what would be one little tweak or a couple of tweaks that you would give a client

Dr. Patricia McLelland 13:57
your you alluded to several of them, one of them is protein. Most women do not get enough protein. And I will periodically do what I call a spot check on a food diary. And even with everything I knew, I thought I was probably getting about 8090 grams of protein a day. And it was 50.

Cady Kuhlman 14:21
Yep. I had the same exact issue. That was two weeks ago. Yeah.

Dr. Patricia McLelland 14:25
And so I made some tweaks, but I feel like if I have a hard time with that and other women who have a lot of knowledge, then most of us need to relook at our protein intake. So looking at protein intake is an important part. And then the other is is trying, you know, in the process of reducing carbs. Another way to look at it is well how can I help you increase increase vegetables and nonprofit assessed foods. It's been more popular these days to do intermittent fasting. And sometimes that helps women with issues like this, but not consistently, and definitely not for the majority.

Cady Kuhlman 15:17
I agree, I don't put a lot of my clients on the intermittent fasting if they're dealing with insulin issues, I think a lot of times if a female's having a little thyroid dysfunction, or a little bit of higher stress levels, cortisol and things, I don't see the intermittent fasting being the the fix for them. You know,

Dr. Patricia McLelland 15:34
because they, you know, the insulin, you see a bump in the insulin, that's going to actually bump the cortisol, then that will bump cravings, so then you'll have more cravings, you'll initially feel better, but you've bumped up your insulin again, which triggers the cortisol. So it's kind of a vicious cycle. And one of the most important things for women with hormonal issues is to make sure they eat a healthy breakfast. And the problem is, is that's probably for a lot of people, the hardest meal to have healthy because all the ready stuff ready made stuff. It's all carbs, all of it, processed or carbs. Yep,

Cady Kuhlman 16:20
yep, totally. And so for me, just as an example of a breakfast that has been quick and easy and healthy in my life with two little kids and getting everybody ready and going in the mornings and all that, you know, you don't have the time to say cook from scratch, always. But you need something with enough protein, something not processed. So what I do is I'll do a plant based protein drink or a whey based protein drink, but then I add avocado, I add some spinach, I add some goji berries, some flax seeds, and I just blend it up in my NutriBullet. So I'm getting the healthy fats, I'm getting some of the greens, some spinach, I'm getting the protein. And that all takes maybe about three to four minutes for me. And there's my whole breakfast that's actually very balanced. And so that sets that tone for the day. That's kind of what I like to say, I think if we start off that day, on that blood sugar roller coaster we spoke about, we're just going to continue that throughout the day. So one small tweak could be Let's just analyze the breakfast and maybe make that the first lifestyle change. And really make it easy. Make it easy. Yeah, yeah, we're also busy and, you know, stress levels and burdened with not burdened, I guess that's a negative way of looking at it. But we all hold a lot on our plates. And so the mental load, we've got a lesson out a little bit and make it a little bit more streamlined. So the

Dr. Patricia McLelland 17:40
other nice thing about that, too, is when you have issues with insulin resistance, and you are eating more carbs, it does impact your thought processing, it creates more brain fog affects that processing. So a lot of women will see that when they make these changes. Wow, I can think a little bit more clearly, that's huge. And if you are able to tie those two. And for myself, I can tie those two together I can do with if there's like if I eat a lot of sugar, which doesn't happen very often. But that definitely can affect create anxiety. Definitely thought processing. And I don't want to I don't ever want to feel that way.

Cady Kuhlman 18:29
No, I don't either. No, I totally agree. I think if people knew how good they could feel, by making certain tweaks, there would be that, that movement and that energy towards wanting to do that. But until they can connect with oh, I can feel better, I can feel more vital, I can have more energy, it's hard to want to make a tweak. But when you see that, then it's a little bit more self serving to kind of keep moving through those tweaks. So you know, I you know,

Dr. Patricia McLelland 18:53
that's where coaching really helps to, because you might come up with one breakfast option. But that's not sustainable. Because you really need a variety. And I need, what can I eat on the day that I have to rush out? What do I eat when everybody's home? And I'm cooking breakfast? And then what can I eat? Oh, where you know, we're going to be on vacation next week. What can I eat? And so that's one of the great things about having a health coach is partially the accountability, but also helping come up with easy solutions.

Cady Kuhlman 19:28
I agree totally. And a prime example I had a client the other day, who was after about three or four weeks of meeting with me admitted that she's obsessed with coke and she drinks it all day long. But she didn't say that the first three weeks that she met with me, even though that's one of the questions on my questionnaire. I don't know if she felt like I was going to judge that or she thought you know, I won't speak to that right now. Well, after the fourth week of meeting she said I drink probably about 64 ounces of Coke a day. So I don't exactly know how much sugar that is but that's in the hundreds probably like it's that's a lot a lot of sugar. While I was thankful that she admitted that to me, because that's a huge, that's the number one thing I would need to change in her diet. But I also realized that you can't just pull something away and not have another answer or a solution for her. So I actually love a line called Zevia, which is a stevia sweetened coke replacement. And so without the colors and without the added ingredients, but also without the high fructose corn syrup, or the aspartame or the sucralose, whatever it may be, in generally, a real coke could be the high fructose corn syrup, which is not good for insulin and liver function and any of that. So I pulled her and got the Z via drink for her, we changed one other little thing where at night, instead of going for that she went for a hot cup of tea because it was satiating and calming. And so we chose one that she liked. So looking at that, that's two small tweaks, but that lowered about 120 130 grams of sugar in that day, you know, so exactly what we're talking about. So let's hit a little bit on. Let's hit a little bit more on, you know, supplementation. And what that looks like with PCOS for you is there is there some go to supplements and some with really backed research that you pull from when someone's Yes.

Dr. Patricia McLelland 21:13
What's interesting is when you do the full assessment, and you're looking at the, you know, the diagnosis of PCOS, insulin resistance, heart disease, cholesterol. One thing we didn't mention earlier, I don't think I mentioned earlier, but women who have PCOS also have a much higher rate of fatty liver, so their livers affected. So there are several supplements that I do recommend standard. But it does vary a little bit based on what their health issues are, as well. So typically, I'm going to recommend a general multivitamin, recommend vitamin D, because vitamin D is a cofactor. In so many of these processes, and up to 85% of women in the United States are vitamin D deficient vitamin B 12. And typically, I'm going to recommend that in a B complex, because the vitamin B's have such a huge part of these processes as well. One of the root causes for PCOS is inflammation. And when you see higher triglyceride levels, then I will oftentimes recommend fish oil. There are other things that I can recommend that also have anti inflammatory components, but fish oil is one of the most common. So pretty much I'm going to recommend some variation of that to all women with PCOS. Really also, with the emphasis of trying to get as many of those nutrients in their diet, the goal would be five to 10 servings of veggies daily. And I would say on average, and this has been shown in in studies as well is the average really is more 123. I believe that. So the ones that are doing really well or maybe four to six. But true five to 10 a day is not is not typical.

Cady Kuhlman 23:24
Yeah.

Dr. Patricia McLelland 23:27
So then when I think about other supplements, there's great data on Myo inositol, helping with insulin resistance, and actually has been shown to be just as effective as Metformin, which is the first go to for insulin resistance when you're looking at medications, and so just as effective, with fewer side effects. In my experience, it works as well, but it does seem to take a little bit longer. And so I do have to remind somebody, yes, this will take longer. And if you know that from the get go then then you're okay with that. Berberine is also beneficial. But I'm usually going to start off with my inositol because at least in when you're looking at at PC, insulin resistance with PCOS, that's where the good studies have been.

Cady Kuhlman 24:21
I agree. I definitely agree to that. I don't want to backtrack, but this is coming into my mind. Could someone have a diagnosis through an ultrasound where they would see you know, the cyst on the ovaries? Is that another way or no? I'm

Dr. Patricia McLelland 24:35
glad you brought that up because small type multiple small, tiny little cysts on the ovary is also part of the diagnosis, but it's not used as much in the United States because small cysts on your ovaries can be a normal variant. Okay. And one thing that gets confused is every month When you're ovulating appropriately, you do produce an ambulatory cyst that's about two centimeters, two to two and a half centimeters, that will collapse after you ovulate. And that will go away. And so sometimes the confusion is the Abila Tory cyst is called ASSIST, or they'll describe several of those. And that's totally different. So definitely, it's part of the criteria, but not all that helpful.

Cady Kuhlman 25:31
Okay, cool. That makes a lot of sense, then. Wow. So that's such great information. And I know we both have sitting here with us, you are big in your clinic of sending someone home with paperwork and more information for them to read and to understand if you have diagnosed them with PCOS. So maybe touch a little bit on this, because this is so amazing to me what I love

Dr. Patricia McLelland 25:55
about this. So this is a handout going over diagnosis, additional health issues, lab work that I typically recommend root causes. And then I go through these different areas of lifestyle recommendations. So looking at diet, exercise, sleep, stress management and supplements. And what's helpful for me is when I'm looking at diet, because really, even if a woman is normal weight, diet needs to be a component, changing diet. And really, losing weight is really the only way you can, if you're overweight is the only way you can effectively make PCOS no longer an issue, I've found that the two most effective ways that I've used one of them is sending my patients to your weight loss clinic with Ideal Protein. And then the other way, is putting a patient on an elimination diet, and then transitioning them to basically a medical Mediterranean based diet, which is what you guys kind of transition to as you're through the weight loss part, some women and a longer discussion would benefit from an elimination diet first. But I have all this written down here. And then the second page, which I love is basically or I should say the third page, the second and third page is looking at different supplements that are beneficial as well. A lot of women have issues with gut health. And so recommending probiotics. And prebiotics can be very helpful. That's a very confusing area. Because just going in and grabbing something off the shelf does not mean you're getting a good product. A lot of women asked me about yogurt for probiotics, there is some benefit, but most yogurt has sugar in it. And so you're really shooting yourself in the foot, meaning you get these probiotics, but the sugar level is so high, it kind of doesn't matter. But what I what I like to do as well on the supplement page is to mark the ones that I feel are most beneficial for the woman that I'm talking to. And then I like to send them over here for two reasons. One of them is I know you guys have edited your vetted your supplements. But I also have a lot of patients who don't want to take so many pills. And so if there's a way to have a careful combination, limiting the pills that they have to take, they're more likely to do it. And I think most of the people that work at nutrition world probably recognize these now. And they see where I've marked they do. And we're

Cady Kuhlman 29:04
so grateful for that. But yeah, we do. So we're able, I think to to partner on that level, because they're familiar when you when you send that person in, okay, we know what to get them we know how to help them, move them on through and thank you for mentioning, you know, our idol protein clinic that is I think that's one way that if someone's listening to this right now, and if feels overwhelmed or not exactly sure where to start. I know protein, you know, is a diet that was created out of Canada about 3334 years ago, Dr. Tran Chan, and he set up this diet for insulin resistance. That was the number one reason that he set it up now. I've coached it seven or eight years and I've kind of moved away from coaching it full time but we have two other great coaches that you know, that do the coaching and the purpose of that diet is to start teaching people about food and so as they're losing weight as they're seeing the success as they're resetting their food cravings because The diet is so easy to understand. You have a coach walk you through it every week, you're weighed in every week. So you have that accountability. You have any of your questions answered, you're given new recipes. So you're inspired every single week. So you get that, you know, that excitement of reaching goals. But then every week, you're given little tips and nuggets of what is a simple carb, what's a complex carb, you know, how much protein will I need to eat now that I'm at this level? What's a healthy fat? What's not a healthy fat? And how do I make vegetables taste good. And I love that topic. Because to me, and I was thankful that I have been raised on vegetables my whole life. So they're delicious to me. But something that I've learned in my coaching time is that a lot of people simply hate vegetables, like it's so choking down of I know, vegetables, yeah. Which is hard. I can't relate on that level. And so what I have to do is I have to kind of step back and and hear what they're saying, which is that it's nasty to them. So how can we make vegetables taste good. And I think air fryers is one way for me to kind of help them. It's simple and easy. You know, roasting them in the oven, so they get a crunch out of them, flavoring them with the right seasonings. And that's a whole topic we could probably talk a whole nother day about but people want to eat what tastes good to them still, we just have to help them see that things like vegetables can taste good. So idle protein does that. And so with that being said, idle protein is about pound and a half to two pounds a week of weight loss depending on where that person was starting in weight. If someone only had 10 or 15 pounds to lose, it wouldn't be that fast. Someone that's got more of the 40 to 50 to 60 pounds could be that fast of weight loss. But like you said, the end result of idle protein is to get us to a maintenance lifestyle where it's understood that you're going to eat more real vegetables, you're going to only rely on processed foods very, very minimally and only in kind of a pinch situation, honestly. And you're going to hopefully learn how to cook, learn how to roast those veggies. And in doing that you've done an overhaul on your bloodwork and your lab work because you've at that point, reset your insulin levels, you know, reset blood sugar levels. And so that, to me is is a huge, huge place to start.

Dr. Patricia McLelland 32:11
You know, to your to that point, one of the other things that I was thinking about when you said that was the standard approach to weight loss is cutting carbs, excuse me, not cutting carbs, cutting calories, and cutting calories doesn't work. First of all, that's why 98% of diets fail. But especially when there's a hormonal issue, cutting calories may help with initial weight loss, but definitely doesn't help maintain, and most women will gain after that. The other problem with cutting calories, is that it triggers food cravings. And it also creates more inflammation, and it's very stressful on your body to all of a sudden cut down on calories. So you're increasing your cortisol, then you're increasing your insulin, slowing down your metabolism. And it really messes with the hormones that tells you when you're full and when you're not full. And so it it it doesn't. It doesn't work that way. But most women will eat a standard American diet, cut calories, lose some weight, go back to eating the way they did regain that weight. And then unfortunately, a lot of times more so it's kind of a life, vicious cycle. And so helping get past that ingrained belief that cutting calories is all we need. Because we still see that and read that everywhere. I know. And it's hard to kind of get past that because it's just not true.

Cady Kuhlman 34:02
That's not true. No, I'm so glad you touched on that. Because I do know that there are still some people out there that practice with that mindset and that it can be found on the internet, if you're going to search how to lose weight. It's a very outdated system and it you just kind of debunked all that it just does not work and it's not something that's going to be sustainable and get us to a place of maintenance where they ultimately will be able to keep that weight off long term. So to me that's not successful. And so that is not what we would ever want to set up, you know, a client or a customer on. You know, another big thing I think with weight loss is is actually seeing on a scale like that we have upstairs which is looking at fat mass muscle mass hydration and more numbers and maybe just what the scale is showing, because oftentimes that can be a frustrating place to just look at one number that you're hopping on. This way we can look deeper. Okay, you did lose some visceral fat which is the fat that's in and around your organs. Oh, you did lose some. You gained some muscle mass. That's why we didn't see you actually go down and wait that much this week and muscles, healthy tissue methyl muscles Wonderful. So if we can go into a deeper dive with them on those, those readings, I think that's always a beautiful thing too.

Dr. Patricia McLelland 35:13
I love that because you really need one more than one thing to really follow. Because if you're eating healthy, your weight will stabilize. And it may not be exactly where you want it to be. But it'll stabilize in a healthy way. Oftentimes, we get so focused on numbers, that it's not really as much about health, it's more about a specific number, and the way somebody wants to look, that is a goal. But it's a different goal. If our first goal is health, and a lot of women are more motivated when they are monitoring several things like muscle mass and the things that you described. So I'm glad you brought that up.

Cady Kuhlman 36:00
Yeah. And I was thinking, you know, as we kind of finalize our discussion here, stress levels and your tips on some lifestyle tips and changes and how does stress play a component and all this, I know you've touched on it. But if you want to dive a little deeper into stress, and PCLs,

Dr. Patricia McLelland 36:16
well, one of the things that I'm always listening to is that most women are trying to put a 28 to 30 hour day in a 24 hour day. And most of the things they're trying to shove into that day, are really good things. So it's not like, Oh, here's some bad things you need to pull out. Now. For some women, that's the case. But the first thing is if you're trying to shove 28 hours into a 24 hour day, it is not sustainable exclamation point, underline, and your body will eventually tell you. And sometimes the first way you realize it is you have PCOS. And so most women, it would be very beneficial to kind of sit down and look at what they do. And what can they offload. There's a lot of things that are great, but we definitely don't need to do all of those things. So that's kind of a general. Another thing is sleep. Sleep is where we restore ourselves. And if you're not sleeping, your body isn't going to do the right things with this anyway. So I could give you a great diet. But there's evidence that even if you're exercising consistently, eating healthy and really eating healthy, if you're not sleeping, you won't lose weight. And so sleep is so important, really trying to protect that figuring out ways to improve sleep. And with stress, it's it's offloading, and then focusing on different self care. And I think I heard listening to a podcast about six months ago, I heard a woman say, the 15 minutes of walking was better than the hour at the gym. I didn't get to. Yeah, so I loved that. Because sometimes it's a 15 minute day. Yeah. And sometimes it's an hour day, my preference would be to go hike with my dog out in the woods for an hour. But that doesn't happen every day. So 15 minutes, not the same. But I've created that space. I've carved that window. So sometimes that window is smaller. And sometimes that window is is bigger.

Cady Kuhlman 38:41
I like that even last night that kind of comes to my mind, I was hoping I could go for a walk around the neighborhood. But it was too hot. And the kids went to bed later and things of that nature. So I had to figure out some way to carve the me time. So it was 15 minutes of yoga time stretching once the kids had gone to bed. And it was just 15 minutes, but it actually helped me unwind, decompress. Maybe the dishes didn't get done in the sink. So they either have to wait till tonight, but at what level, you know, I had to weigh that out and stress management. So I think that's a big part of my practice even is helping people see what's vitally important, what's less important and what can wait, which you were just speaking about. We kind of see I think females, everything has to be done and it's all equally important. But I don't think that's actually true. I think there are things that could be carved out. And so sometimes it takes someone else to help, you know, help with that. Yeah,

Dr. Patricia McLelland 39:35
well, I I had an example. Probably about six months ago where or a year ago where I was realizing how many times I went to the grocery store because I just stopped planning, stopped writing a list stop planning meals and kind of going by the seat of my pants. And this is all while my kid is eating more and more and more so it was always one one step behind. And then I started planning, I started writing a grocery list. And I dropped from four times a week, stopping at the grocery store to two. And all of that together. When I looked at the time, it saved me two hours a week. I believe that. So people say, I don't have time to plan. Well, look at the amount of time that you're at the grocery store that you're trying to find something at home. And I was so much more efficient. And I did I'd save two hours and it's like, okay, with those two hours. Now I can walk more. Exactly. Now I can hike now I can go do you know, I can go lift some weights? Yep. if I so choose.

Cady Kuhlman 40:47
Exactly. That's a great example. I love that. Yeah, I love that so much. And so as we finish a last tip on sleep that you may have, is there something that you know, not looking at your phone? Is that something that you think is important? Or trying to? You know, is there a supplement you like for sleep? I know sleep is, is lots of factors going on? Is it trouble falling asleep, staying asleep? But if we need sleep so vitally, what can we do? Maybe one little hack or tip?

Dr. Patricia McLelland 41:15
Well, I have a couple because there's no one size fits. All right, most of us need a wind downtime. Yeah, so you can't be going 100 miles per hour, and then fall into bed and actually fall straight to sleep. And for a lot of women, reducing screen time in that hour or eliminating screen time that hour, even up to two hours before bedtime. is so wise, there are supplements, probably the two most common supplements, I'll recommend more for the wind down. One is L theanine, or lovella, which is it's a type of lavender oil. And both of those really seem to help relax and transition someone to be able to fall asleep. Magnesium is another one that I recognize recommend a lot, especially in women with that have any hormonal issue, those would be my top three. Now there's other ones like melatonin that women hear about that all the time. But out of the supplements, those are typically the top three that I recommend, like and the wind and figuring out how to wind down Yeah,

Cady Kuhlman 42:30
yep, the wind down. Totally. This was so so helpful. I hope our viewers feel that and, you know, got some actual tips from what we discussed with PCOS. And you know, I'm just grateful for your partnership and grateful for all that you do in our community and you're truly in my eyes a one of a kind, Rockstar OBGYN in our town, but also just really care about your patients and bettering their outcome. And so I'm grateful on a personal level and then grateful on a business level. So

Dr. Patricia McLelland 43:00
well thank you so much. I have been very thrilled with our partnership to this has been wonderful. Thank you

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