Dr Young on PCOS & Food Choices: Insulin Resistance & Diabetes

My Naturopathic doctor, Dr. Young of Young Naturopathic Center For Wellness joins me to discuss my health and current struggles with dietary restrictions due to concerns with blood sugar and insulin resistance. Click the links below to listen to the podcast:

audio transcript

Janny:  Hello and welcome to my podcast. It's Janny Organically on the Very, Very, Quite Contrary Podcast. Today, I'm talking to my doctor, Dr. Young from Young Wellness Center in Los Gatos, California. She and I have built a relationship over the past five years and she's become somebody that completely knows my health history in and out and has gone through the ups and downs of my hormonal imbalances and now, onto some issues I've been having with blood sugar and borderline diabetes and working through my diet and in fact, coming to a place of kind of stress for me because I have, what I thought was, such a good relationship with food, having to look at food a little bit differently and learn through that.
Janny:  She's going to come on and explain all the stuff that stresses me out and hopefully, she can help you as well. Of course we are going to talk a little bit more about naturopathic doctors and how they are looking at things differently than maybe a more mainstream doctor but also, how you can use your more conventional doctor in a way to help you get where you need if they're willing to run some tests for you. We'll get into all of that here on the podcast. All right, Dr. Young. Thank you for joining me today on this new podcast of mine.
Dr. Young:      Absolutely.
Janny:  You and I have known each other for quite some time and in fact, at my first appointment with you, I didn't even know I was pregnant yet, I was just a few days pregnant and I think it was my husband's first experience with a different type of doctor, somebody who takes like hour, hour and a half intro appointments to ask all of the necessary questions that go outside of the typical symptoms and genetics of like, what did your parents have and to kind of get to the root of, I was talking to you about things that happen to me as a child that made a lot of sense into what was going on in my body hormonally but my husband became a huge fan when he started to see you because every time he went to see you, you always told him some problem he was having, he just needed more sex. He definitely is a fan.
Dr. Young:      I think he made that up a little bit, just to let you know.
Janny:  He comes home, he's like, "Yeah, it's more sex so that's the answer, Dr. Young said." Because we work together specifically for my PCOS, polycystic ovarian syndrome and a lot of hormonal imbalance that was going on in my body and bringing me back from the brink of postpartum and raging hormones in my body and so anytime I felt a surge of maybe unsolicited anger or irritation, I always chalked it up to, "I'm sorry, it's my hormones, sorry." I've got a hall pass for that but more recently, we've been looking at my hormones and they're pretty much in order and you're like, no, it's not that anymore. You have some issues with your insulin sensitivity, some reactive hypoglycemia.
Janny:  Yeah, I wanted to bring you on to talk about how my eating habits had impacted what was going on with my blood sugar levels and putting me basically, borderline diabetic and I considered myself to be eating very healthy. I had stopped eating animals products. I was eating mostly veggies but something I had never done before was count anything, like in terms of carbs or calories. I was more of an intuitive eater. I'm eating lots of veggies but I was also eating a lot of potatoes and rice to make that for maybe the heaviness of meat and so, I wanted to bring you on and kind of talk through what was going on in my body.
Janny:  Maybe some of the symptoms that might help other people recognize what might be happening in them and also, to take any of the heat for any of the people that are going to be mad that I have some meat to kind of help myself get back on track.
Dr. Young:      Absolutely. Well, I often think about our first visit as actually one of my favorite patient appointments because it was hilarious, I had this amazing plan for you to get better and here, unbeknownst to both of us, you're pregnant so it was pretty hilarious so we've been through quite a journey together in that sense and I want to like first just really commend you because when it comes to PCOS, it is one of the most common hormonal problems that women have. I mean, something like six to 12% of women suffer from PCOS. I mean, it's almost one out of 10, have some form of PCOS. First, I want to just kind of like define, when you have PCOS and you have a syndrome, it's different for each person.
Dr. Young:      It's generally a problem with too high of androgen, so testosterone, DHEA, more like male hormones in women. Some level of insulin resistance and then some problems with like ovarian function that might reduce your estrogen levels. With you, you had just done such a fabulous job of taking control of your health. I think you actually went in the other direction and I see this happen a lot with women who are really take charge types like you are and committed to being well and really taking care of themselves so I just feel like you have explored diet and everything so far that you then went to a more vegan type diet and it really messed with that insulin portion of your PCOS.
Dr. Young:      We can definitely talk a lot more about that and diet and the why's but I want to make sure that we really frame that when it comes to PCOS, there's a sex hormone aspect and then there's a blood sugar regulating hormone aspect. That blood sugar dysregulation in PCOS, it's an exaggerated way that your body responds to insulin. Insulin is like an escort service for sugar and this is why your husband loves to come and see me because I talk about things in ways you could all understand.
Janny:  Like escorts?
Dr. Young:      Like escorts so now, we're going to talk about escorts.
Janny:  Well, it's funny though because you and I can talk about hormones like really in complicated fashion but when you're talking about insulin resistance, I feel so dumb so I had to like, "Can you explain that to me like I'm a 10 year old" and then you do. I'm like, "All right, let's pretend that I'm five, let's try again," because it's so confusing to me like, wait my blood sugar is high, my blood sugar is low, what is happening?
Dr. Young:      Absolutely and it is confusing and I think it's important to break health down to people in a way that they can understand it because obviously, I can say a lot of big words and stuff and sadly people will just lose me so really important to get what insulin does. Insulin acts as an escort service and says, "Hey, sugar, let's get this cell and make some energy, right, come one baby. Let's get in there together." In most women with PCOS, what ends up happening is their body fat keeps going up so that's why typical PCOS patients have a lot of obesity within their mid sections. They accumulate fat around their abdomen because sugar is trying to help you get energy so ... and it's this process of being like, "Hey, baby, let's go."
Dr. Young:      Instead your body doesn't actually need the sugar to metabolize and that's where women starts to struggle with weight issues. Insulin resistance is essentially your pancreas' inability to understand when insulin should be secreted so it's almost like unwanted sexual advances and again, I like to make it like we can really understand it like, "Hey, baby. Let's get on and let's do this." Your body is like, "Hell no. I don't even need extra energy. I already have enough."
Janny:  Right.
Dr. Young:      That's where insulin becomes resistant and it keeps pressing and keeps telling you that you need more and more and then you just keep accumulating more weight.
Janny:  Is the goal to educate the pancreas?
Dr. Young:      To some level when someone has PCOS, it's more to learn how to eat the right way so that your pancreas can't make advances and I'm so sorry men, you have to treat it like a man. You have to take it down to the most simplistic thing like how can you not make your husband fail, like leave the laundry basket in front of the bed so he trips over it then gets it aside. "Yeah, I meant to do laundry today." We have to make it like really easy for your body to understand. This is kind of where protein balance comes in. Fiber and protein are really important in blood sugar regulation. Fiber which is part of vegetables, slows the absorption of sugar.
Dr. Young:      When you eat resistant starches or you eat high fiber foods, then your body understands, "Okay, I only get a little bit of sugar at a time so I can't let insulin just shove this all in so quickly, I'll get it a little bit more slowly," and then insulin learns like, "Okay, I can't be too eager," and I really don't know why everything turns into me like a sex conversation. It's like, if you're too eager, it just doesn't happen.
Janny:  Right.
Dr. Young:      We can't be too eager here. We have to slow down and then protein helps you to build more muscle and it also keeps your blood sugar stable so it doesn't give insulin permission to advance. That's why protein is so important and when you have ... I'm very respectful of vegetarian and vegan diets. I personally think a lot about my food which I like to get into with you a little bit today. For some people's health condition, it's really hard to maintain that. I'm not saying that you can't but it takes such a level of difficulty and especially like as a busy mom et cetera, sometimes it just doesn't pan out for you to do that.
Janny:  Right, and I think when you told me this in the beginning appointment and I like was borderline in tears because food seems to be ... what I didn't realize is the level of stress if I have to really pay attention to what I'm eating versus what I had been doing which is more intuitive in what am I drawn to today and not like, I'm going to crush the refined carbohydrates or refined sugar but I felt like I was eating a balanced diet in terms of like just tons of veggies and what I didn't realized was the problem was complex carbohydrates. When you're telling me I need to lower my carbs, I'm like, I don't even know where carbs are.
Janny:  I don't even know how much a sweet potato has versus a regular potato, versus rice and so I did understand the process of carbohydrates turning into sugar and so, the first reaction to me was, it was just very overwhelming because I felt like I had a very healthy relationship with food and now, I have to go and obsess over the nutrition label versus, I'm more ingredient and quality focused. With the carb thing ... there was initial ... I'm stressed out about, I have to pay attention to these things and then the second part was, a lot of people, what I've talked to ... some of the people who do keto or they've gone through removing the carbs from their life, they go through what's called, the carb flu or the keto flu.
Janny:  The first week was awful. I had very bad headaches. I felt like I was thinking about food all the time and I just felt sickly and then at the end of the week, I felt like I had come through it. I feel like the first week was the hardest in terms of removing the refined ... not refined, the complex carbs because there was a heaviness that was missing from my food. I would just eat and eat, and eat until I felt like something heavy in my stomach and so, I felt like it was impossible to get through that first week without eating meat but now, that I've been doing it for several weeks or even over a month I think at this point, I'm finding that it's a lot easier.
Janny:  I've been through the initial stress of the idea behind it and I've been through the carb flu and I've been ... I'm finding that I'm craving less ... I'm not even missing the carbs. I'm not missing the rice, I'm not missing the potatoes and so I'm able to focus on just eating mostly veggies and I'm able to kind of wean the meat out, if that makes sense.
Dr. Young:      Absolutely. Absolutely. Well, I want to kind of like just back up and give you a little bit of my perception of food and it's just so interesting to me because I think people have gotten ... we've gotten really, really weird about food and how we perceive food. I just kind of want to address and I know, again, the same as you, I try to be really sensitive to like people's opinions so guys, everyone has got an opinion. I'm just going to throw mine down there. I come from a very big like hunting, fishing, farming background so I literally grew up on my grandparent's farm, picking vegetables, canning, et cetera.
Dr. Young:      I think as human beings, we've completely lost seasonality, sense of food, how we should eat. We've become so obsessed with like, what's the right food. We've just kind of stopped making sense. I think I've mentioned a little bit before how I really try to just like throw it out there and I know not everyone is going to believe the same thing and think the same things but really, I think that you have to have a balanced diet, that goes within a season and seasonality. I don't walk into the woods and see piles and piles of fat everywhere. I don't walk into the woods and see bags of food. I try to be really logical about just what makes sense.
Dr. Young:      From a sensibility stand point, you have to think about green things and small animals are the things that you would see if you walked out into the woods. I know this particularly from, when I go hunting so if I'm going large animal hunting like for a deer or a moose or an elk, I first will see a load of small animals and green things. I have to believe like, a more natural diet would be to sit and snack on green stuff, maybe a couple of nuts and seeds, a little bit of fruit if I were lucky and I would have to accept that I would eat smaller things. When I'm looking at health, I'm trying not to just look at how can I manipulate food because I can afford it and because I can eat it but what actually makes sense for your body.
Dr. Young:      I have a lot of good friends that are vegans, actually one of my best friends. Her and I talk a lot about how we both feel like people that think about food, our favorite type of people, even if we disagree with what they choose to do with their food. There's that aspect of health and having a healthy relationship with what you're doing. If you're uncomfortable with the thought of eating an animal or killing an animal for food, that's going to make it more difficult for you to be healthy because of the level of stress involved in it. Does that make sense, it's kind of like ... that's the thing and stress is really a thing but you have to kind of figure out, are you person that has the genetics, the hormonal situation et cetera, that you can make choices just because you emotionally feel something.
Dr. Young:      I think that that's kind of where you came to as a place and I would like your interjection here is that you have your ethical, moral like thinking brain and then you have ... the fact that you have PCOS and the fact that you have some of these other blood sugar regulating problems and you've had to marry the two. Is that about ...
Janny:  Well, yes, and I think my daughter was the one who basically initiated us like removing meat from our diet because I've always been a big proponent of listening to kid's intuition and what I was starting to realize as I was giving her solid food, she never ate the meat and I would force her to eat it and she would like ... she's very compliant and very joyful little girl but she would spit it out. She's like I didn't want it. Then, I don't know if it was just that kind of impacted me, that ... it was chicken first. I could not look at chicken. I started to like just be repulsed by it and so then it was like a very slow, gradual, just meat kind of disappeared from our household.
Janny:  I know that ... I don't know what your thoughts are on just bio-individuality and our ancestors and where they grew up. Did they grew up hunting elk and deer or did they grew up in the arctic eating blubber and like what ... does that really affect what is best for our biology today, even though they're probably crossbred with people who ate everything, if you go back far enough.
Dr. Young:      Absolutely. I think really, when we're looking at it, it really comes down what people used to eat and people used to do isn't practical anymore because they also didn't sit on their ass all day at a computer. I mean, I'm going to kind of bring up here what everyone talks about in terms of the French paradigm. They talk about how the French can eat butter and fat and do all these things and not gain weight. Well, I was in France recently and in a day of walking under 16,000 steps was a lazy day. You have to like ... you have to marry motion with food and seasonality with food and I do think your genetics makes a difference and a great example of that is one of my really great friends, she's Vietnamese and I'm Italian.
Dr. Young:      Well, I can drink a ton wine and she can't. You can't deny that there's not a biological difference there between people. It's kind of an interesting perspective when you're looking at food and how we relate to it. Yes, I think that your genetics matter and I think that as an individual, you have to kind of figure out what that means for you. If you come to my house and I am drinking a couple of glasses of wine and your body can't metabolize that, well, that's a problem.
Janny:  Right.
Dr. Young:      For me, my HDL, my good quality cholesterol actually goes up with wine. I'm one of those people but if I drink other alcohols like Bourbon or something, my blood sugar gets crazy. You have to kind of figure out, what does it all mean and sometimes the answer isn't necessarily in a genetic test, it's kind of like you're the experiment.
Janny:  Right.
Dr. Young:      When they told me I was going to practice medicine, I thought this is complete BS. I just paid $200,000 for my brain, you're going to tell me I can't just do this. Are you kidding me? What I realized my patients, you guys are the experiment. I know we're ... in terms of talking about you here today, you're one of my people where, you build muscle like it's your job. I think you probably tolerate a slightly lower protein diet, even though you still need it than other people and at the same there are other patients that couldn't build muscle as easy as you could, even if they tried and I'll go back to like that super like yogic type body.
Dr. Young:      Well, that's not your body type, it's not mine either. You have a very athletic build. As long as you're getting a sufficient amount of protein for your body, I think that you're fine. There are other people that need an obscene amount of protein to try to accomplish goals that they have or to overcome health issues that they're having. When it comes to insulin resistance, protein and fats help to stabilize your blood sugar and carbohydrates destabilize them if they're not a resistant starch or a high fiber food. That's kind of I think what the crux of what we're talking about today is how do you resolve those issues and what is it that you can do for you as an individual to figure out what's right.
Janny:  Right. I think whenever I go and do my test I see what's going on after having removed these ... the amount of carbs complex or otherwise, I remove from my diet, I'm a little bit concerned that my cholesterol is going to ... have gone up based on my intake over a certain amount of time of meat or fat, if you will. Back to the ethical side of things, in terms of ... you're talking about, I know you well, and you hunt your food and most people aren't and a lot of my readers and our listeners are very conscious about where they're sourcing their food and they're looking for ... if they do eat meat, they're looking for the pasture raised, grass fed.
Janny:  Although, that all gets tricky too because that doesn't necessarily mean that they are not treated with antibiotics and that's a problem too, if you're not eating quality meat. If your body wants meat, the quality and type I think matters just as much.
Dr. Young:      It absolutely does and there are great meat co-ops and resources that you can get your food from. I have patients that go ... do things like going on a side of beef together and I'm not ... Obviously, I totally get, most people are not willing to do what I do. I mean, I've actually been off of commercial meat since about 2006. I mean, it's not always easy and there are some years that are slimmer than others and there are years when I have a ton of extra protein in my freezer. It's like I go, salmon fishing that's something that a lot of people actually have access to in the Bay Area. Places like Costco and whole foods and some of these places. They do have some great ethical choices for me.
Dr. Young:      I don't want to knock them because I think they can have amazing food sources. Again, like you said, understand, when you're talking about like chicken in particular, when something has access to the outside, I mean, I have chickens and they're pretty dumb. They might just have a little hole and an access to an outside area but they won't leave the barn unless something forces them out. That's ... Sometimes when they say free range, it doesn't mean, they've actually been in a range and running around.
Janny:  It's a sense of frustration for me too because people see free range or cage free and it doesn't necessarily mean anything except that they're all just wondering around inside of a barn really in each other feces and don't have access to outside but you are mentioning your bounty being bigger some years than others which seem more like what hunter gatherer days were like originally that you wouldn't have meat with every single meal and bacon at every breakfast and you've got what you've got and you made it last for a long time.
Dr. Young:      Absolutely and that's something that people just don't seem to get, is that, it isn't that you can have whatever you want, whenever you want and bacon is a great example. I mean, bacon is essentially a small little portion of the abdominal muscles of a pig. You wouldn't be able to have five slices of bacon every time you felt like it because that was what was on your keto plan or milk wouldn't spontaneously squirt out of cows to make cheese whenever you wanted either. I think that kind of food logic that we've lost is really frustrating especially as a naturopathic doctor that people don't take their bones and make bone broth out of it.
Dr. Young:      They don't do all of these extra things to actually utilize everything that you would have sourced and in that same breath, I'm a busy mom and I get, it's not always practical so you can mimic a bounty by using things that you get at the grocery store like if you can't make bone broth then buy some. If you feel you want to eat bacon, great. Do it once every couple of months. I mean, it's not a daily activity. It's just one of those interesting things for me.
Janny:  Right and yes, so the whole paleo approach seems to be ... and I think paleo is basically a version of Atkins, right? It's just mostly meat and no dairy, veggies.
Dr. Young:      Yes, but Atkins allow dairy. Atkins was kind of like a morph between paleo and keto. Paleo, if you're really doing it the right way, it's no dairy, no grains, no beans. I can't completely agree with the no beans for sure. I'm not a big dairy fan. I don't really advocate people to eat, dairy in any kind of high demand and just to kind of like aside, it's always fascinating to me from an animal cruelty standpoint that people will not eat meat but they'll happily eat cheese and eggs and I'm kind of like, I don't really know if I was forced to lactate and ovulate if I would want to just die or not but I probably would.
Dr. Young:      I'm not a big fan of those things in general but again, in small amounts I think they can be appropriate for some people especially like my husband, is of a Norwegian background and he has no problem with dairy. I'm Mediterranean and I literally, genetically lactose intolerant. It makes it easier for me to feel that way. I mean, really, looking at how your food is sourced, it's an important part of health and kind of wrapping back around to like blood sugar stabilization and other things, if you're doing paleo, the right way, in terms of eating meat and lots of veggies, that can be really great.
Dr. Young:      I like the Mediterranean diet in terms of an add in of lots of legumes and if you're going to have fats, make sure that they're good quality fats and they're not from an animal source. Keto is a little more ... some keto people are really very like cheese heavy. I'm not as into that. I think if you're going to do keto, you should do it on more of the vegan diet, than you should an animal fat diet. Use your fats from food sources that are plant based. I think that's much better for you but I'm definitely a fan of people including some animal protein and their diet, if they have blood sugar regulating problems.
Janny:  When you're talking about keto, that's ... you're eating a certain amount of carbs per day or per meal but you're also fasting.
Dr. Young:      Well, and this is where things get really confusing because everyone has their own version of a diet. In general, keto is 60% fat and anywhere from 20 to 30% carbs, 20 to 30% protein depending on who you ask. Well, ketogenic diet was originally developed for people who had epilepsy and neurological problems. It's always fascinating that then that was morphed into a weight loss program, right? If you're doing keto, keto has nothing to do with intermittent fasting or delayed food. That's a more modernized version of it and I'm definitely a fan of eating all of your calories within like about an eight hour window.
Dr. Young:      To talk a little more about blood sugar regulation, actually, I want to bring up a case I have and she's another one of my humans very much like you that I absolutely adore who is so committed to her health and she has diabetes and she decided, she would do keto and she would intermittent fasting and so, she was taking herself up to 24, 30 hour fast and her hemoglobin A1c which is a marker that shows your blood sugar over the last three months, started to go up. I explained to her that your body will go through a process of breaking down muscle tissue to make sugar ... if your blood sugar gets so ... too low. The process is called Gluconeogenesis.
Dr. Young:      Sugar from a new source so sugar will actually come from breaking down your muscle. That's not healthy either so this is where we get into people do things and that balance of not being susceptible to the marketing of health is really ... it's really hard. Even as a doc who promotes health, I'm like, "That sounds fantastic, we should do more," and I'm like, "No, we shouldn't more, we should do just enough." To me, 16 hour fast are perfect for people. Eating within an eight hour window works great for most people. If you have more reactive hypoglycemia, like you do, if you're eating all of your food in one dose and your blood sugar spikes and then you drop down, you become hungry, you're not a nice person, you're being mean to people.
Dr. Young:      Then that might not be a good thing for you to do. You might want to think about eating in a 10 hour period instead. That's kind of, you have to shift for your own health and it goes back to, I'm such an advocate, you know this about me, of people looking at their labs every six months to a year and seeing what's true for me and what strategy works for me, not what's the thing my hairdresser thinks I should do or what works for my neighbor. What should I do for you?
Janny:  Right and I think that's probably one of my bigger points from an advocate perspective is to do what works for you and all of these diets and these fads and like people are very religious about them and promote as this worked for me, therefore it will work for you and that's not how it works. How can they tell if it's working for them and maybe an 18 hour fast aren't the best for them, maybe it's more of a 14 or 16 hour fast is better for them and maybe ... like how would they be able to tell the difference without having like their blood drawn every day to see if what they were doing is working.
Dr. Young:      Absolutely. I think you kind of teed me up perfectly because there's always question I have for people like why diet in the first place, right? Why choose a diet, why not just eat whatever you want to eat. It's a real question. The why for people, I think is what you have to ask first. In your situation, the why is because you have hormonal problems, right? For other people, the why might be that they just want to lose weight. Other people might just want to live longer. There's different reasons for doing things. If we're talking strictly about for your health, like in a situation like yours, if you're gaining weight and it doesn't make sense to you then what you're doing probably isn't working.
Dr. Young:      If you're completely fatigued and you don't have energy, what you're doing probably isn't working, right? If you're in a bitchy mood, 24/7, no one wants to be around you, what you're doing isn't working. It might be that it's not working because of an underlying health issue. If you're super OCD about it, yes, you'd have to measure your blood sugar constantly and do all those things. I don't think that that's that important for people to do so I really like people to reframe their brains and start from the perspective of what are my health goals. Do I just want to live longer? Do I want to have better athletic performance?
Dr. Young:      Do I want to help a disease or condition I have and choose what you should do from that space as opposed to just coming up with something that you think is just the ... like this is just the right thing for me to do. I just have a different bent on why.
Janny:  Right, and for my case specifically, I feel like I went through that drastic kind of dietary change to kind of bring me as far back from the brink of going, over the edge into diabetes and ... because I feel like something like diabetes once you grow over the edge, you can't really reverse it, can you?
Dr. Young:      Well, and that's something that you and I have chatted about before. Can you reverse insulin resistance, can you reverse diabetes? There are autoimmune forms of diabetes and insulin resistance that are much more difficult so I want to make sure I'm being clear about what I'm talking about. If you have an insulin dysregulation induced from a standard western living is, we call a SAD diet, Standard American Diet and from overeating ... Yeah, that's actually what it's called, a SAD diet. If you're on the SAD diet, then that's something that you can completely reverse. Clearly, if you have other genetic factors or things that contribute to your blood sugar problems, then that's going to be a little bit harder for you to do.
Dr. Young:      I don't want to like totally ADD but there's like, we talk a lot about viruses like Epstein-Barr virus or mycoplasma or lime attacking different areas of people's bodies and causing it so that they can't actually regulate energy the same way or they have chronic fatigue. There are thing that can happen to people that can make it really hard, right or they have autoimmune diabetes or there's another condition called MODY, which has to do with, another like intermittent diabetic type problem. With that said, again, yeah, you have to know why you have problems. There is no way of getting around that. I like to use the analogy of retirement.
Dr. Young:      If I said to you, I want to retire but I'm not going to tell you what I make or how I'd like to live or any of my goals and I want you to help me even like this lady is flipping crazy. I feel the same way about people when they're like, I have health goals but I'm not going to bother knowing anything about my body and it's just stupid talk. I don't even want to talk to people like that, like you're just going to ignorant, I can't stand it. I just want to shake you and I'm not supposed to because I'm a doctor, I'm supposed to be a really kind human and I am but I'm like, "Get a grip people. You got to know what's going on with your body."
Janny:  Right.
Dr. Young:      You can't just like blast other people from what they're doing when you're not them and this is what gets into some of that like, you should eat meat, you should not eat meat, you should do this, you should do that. Well, it's just like a relationship or a financial situation, you're not someone else so I don't think making judgments on people for what they're doing is really helping anyone. It's not really about you, what someone else is doing. You need to make what's about you, about you and I tell my patients this all the time, don't look in other places for answers. Look at yourself. I mean, really like true success is within yourself.
Dr. Young:      If you want to succeed at a diet, you have to figure out what's going to work for you and consulting to someone that's going to help you look at some of that stuff, I honestly don't know how else someone does it. I mean, I clearly wouldn't be in the profession, I mean, if I thought that that was normal and I'm in my mid 40s right now and I started seeing a naturopathic doctor when I was 19 so I'm over 25 years into this. This isn't like I just woke up yesterday and started thinking about it and not to be rude to those of you that are writing books and other things about your experiences but I see a lot of times people taking advice from someone that's like, they woke up three months ago and decided to write this book or something.
Dr. Young:      Now everyone is following it and this person has no experience with health. They don't know much about people's chemistry and sometimes it can be damaging and I think about your condition like with PCOS and how you really ... you're right, you were at a point of pre-diabetic and then you pushed yourself to almost reactive hypoglycemia and now, you have to-
Janny:  Another thing that you and I had talked about before is, one of my reactions was I thought I had this all under control. We dealt with this in the beginning. This is like two or three years ago. My insulin sensitivity has kind of come down and now it's back. You kind of explained to me ... well, it's not necessarily back like your body it's aging, it's doing all these things and you have to kind of change with your body as you age.
Dr. Young:      Absolutely. I think I might have said to you like ... and it's kind of funny like, no matter how smart someone is, how pretty they are or how much money they have, your hormones decline. The body was made to destruct. Like it or not it starts brand new and it ends not brand new. We have to change with that. This is what I ... you and I talk a lot about genetics and Epigenomics and how you're basically given a roadmap when you're born and the roadmap is your genetics and let's just say for you, you have PCOS on your map. Whether or not you get there via highway or a slow hiking trail, depends on how you live. That's what Epigenomics are. How we choose to live, that triggers our genetics, our genes on and off.
Dr. Young:      If we were to assume that there are some genetic component to PCOS and we don't know exactly what it is but there seems to be some genetic components to PCOS, then you choosing to eat a particular way can make you take that path more quickly or more slowly. Kind of looping back around to like, insulin levels and how your body changes as your estrogen levels decline and your estrogen levels change, your metabolism changes. Women say all the time, "Oh, I went through menopause and I got all this fat around my mid section?" Well, why do you think that is, it's because estrogen is a steroid, just like testosterone is a steroid that helps us keeps muscle.
Dr. Young:      The less muscle mass that you have, the more body fat you have. The more fat you have, the more you can actually trigger insulin problems and blood sugar relating problems. That's where those two guys kind of relate in a normal aging process and you see somewhere between the early 30s and the mid 40s, most of us will start to experience some level of hormonal declines. You're always going to have your outliers and your people that don't experience that into their 50s or 60s but those are few and far between. Most of us will start to suffer that by the time we're somewhere between 35 and 42.
Janny:  I think you had told me and another hormone specialist had told me, just based on my history and how it was presenting that I would probably experience like an early perimenopause or early menopause. When I hit 35, I think psychologically, I was like, all right, let's do this. Let's just get it over with. At 35, 36 ... I think 36, my body is actually changing, like it's like that weird magical number that everybody talks about that something shifted around this age.
Dr. Young:      I've been in medicine for a long time and I really wish it wasn't true but I joke often that I wish I could go back and give people different advice, when I started practicing medicine at 27, I gave terrible advice. I'm like, "Well, you know, do you want to lose weight, you just stop drinking beer all the time, what's this lady, a boozer, what's wrong with her?" You just ... Actually just listen lady, don't eat for a day. What's wrong with you? Then, you progress and you realized, "Oh smack, this is not as easy as I thought it was and metabolism isn't as easy."
Dr. Young:      PCOS in general and people who suffer from what's referred to as androgen dominance so you have your dominant with like more like testosterone than estrogen levels often when you have PCOS, that extra hormone actually flags your ovaries and reduces them from working as well and ironically again for you and I first meeting and not even knowing you're pregnant, women who have PCOS often have fertility problems and they don't get pregnant easily. I'll also see a slightly earlier menopause in women that have PCOS. What you're saying in terms of experience is absolutely correct for women who are in their mid 30s but also I think PCOS compounds it and that's why you felt such an extreme shift.
Janny:  Me and my personality, I've never been subtle about anything and so my body is that way too. It just goes from one extreme to the next. I'm reflective of that.
Dr. Young:      Absolutely. Absolutely.
Janny:  When you're talking about like you are as well as I am a very big advocate for people to take charge of their health, so they can ... if they have somebody that they can talk to about this stuff or get some blood work done, what would you recommend they request because I do remember on our first appointment, I was on a Kaiser plan and you said, well, it's actually going to be less expensive for you to request it from them, have it run through your insurance and cross your fingers that they don't say no. I was lucky enough that the doctor there like would run all the blood work that you had asked for. I mean, this is a lot of hormone stuff.
Janny:  Either A, somebody like find a naturopathic doctor or B, kind of maybe consult with someone like you and request your labs free run or you can send them a kit like what would be like a first step for somebody who is like I want to understand what's goin on in my body in terms of hormones and food and how to eat the best way for me.
Dr. Young:      Absolutely. Well, I think if you have a great relationship with your primary care doctor, you can always go to them and say, I want to have all of my hormones checked. I want to have my blood sugar regulation checked and I want to do all of these things but this is kind of understanding that most of us, you have sick care insurance. You don't have health care insurance. To be healthy, often takes finding someone that will advocate that for you. Naturopathic doctors are great resource. There are a lot of great functional medicine doctors and osteopaths, even some chiropractors that do things that are very similar to what I do.
Dr. Young:      We do see patients remotely in my clinic. I've helped a fair number of people come up with a strategy or a plan so mine usually includes what food is best for your body. What nutrient deficiencies might you have, getting a full thyroid panel done, full sex hormone panel done and what's called a cardiometabolic profile, including all of your inflammatory markers. I mean, it's funny that I'm going to bring your husband up again. It's a funny thing like that shock of like, I can't believe you did all of these things, like, "Wow, look at all these stuff that people do and actually look at," and I see a lot of really smart people and executives and stuff and they want what's referred to as an executive wellness check.
Dr. Young:      That's really what I do and from a health standpoint, I've really realized my job is to be a strategist for people. My job is to come up with a plan that fits you and tell you how to implement it. Sometimes you're implementing it with another person and sometimes you're implementing it with other stuff in my office. Really, you have to come up with a strategy and I also really advocate that you talk to your family about family history because sometimes what you think is family history is not actually true. Remember that, it's funny it says, I didn't think the internet would even take off and I'm not that old like people didn't have technology the way they do today.
Dr. Young:      If I talk to my grandmother and said, what did Auntie Nini die of? She'd say something crazy like, "She died in the night when her cat left," and actually her husband cheated on her and she became an alcoholic and she drank herself to death but I'm never going to hear that, right? I think she had a heart attack because I'm like, "Oh, she had a heart attack. I don't know what my grandmother is talking about." Realizing anyone that's really over the age of 45, 50, your family history is only good as medicine was when you had it, does that make sense? That's why some of these genetic testing becomes so important so also test some of the genetic factors for heart disease, some of the genetic factors for stroke, Alzheimer's disease.
Dr. Young:      You can get some really easy genetic testing for, and there's some other really neat things that you can do around your genetics and your estrogen metabolism. You can do genetics and cancer markers. I mean, all kinds of cool stuff and just get like a great basic map of like, "Okay, what does my map look like?"
Janny:  On some of my blood work, there were those genetic markers that said like, the other type of person who wouldn't well on this medication, should you go into like an emergency room and they want to give you this heart medication like you won't respond well to that or that would actually be bad for you and so that's helpful. Then there's another side of the genetic ... just like mutations and we've talked about MTHFR which you cannot pay me to say the whole word but the M-F'R gene but even though like ... so you and I had share some of the same mutations like mine are more concerning than hers or I need to be more cautious of mine because of other genetic factors.
Janny:  We're all like different human beings like in terms of what our DNA and genetics look like, even in the same family, which is another stressor for me because I'm like well, that means my husband like eat different than me like we're used to like ... we share the same meals. We share the same dinners and as I've been ... during the first couple of weeks of me, like going really meat heavy because I'm like, "I'm not going to be diabetic, I'm not going to be diabetic." He's like, "I can't eat that. It's too much meat for me," and so I've been like, all three of us have been eating differently which was another source of like, "Oh my gosh, this is kind of hard to manage."
Dr. Young:      It is really hard to manage when you're all eating different ... for different people but I mean, I think if we're looking this from the stand point of, there's carbs, proteins and fats, some of us burn one fuel better than the other, right? When you're making meals, you kind of have to think about make something for everyone and make sure that the thing that's the best for that person, they're getting more of, than you, right?
Janny:  Proportions are different.
Dr. Young:      That's kind of an interesting, very, very different. I think you can do it and again, it just comes down to strategy. It's like you have to either sit down ... it's like, I think about it like cleaning your house. You don't have to sit down and do it yourself. You have to pay somebody else to do it. Either way you can't let it go filthy. If you're looking at it from a stand point of, you have to figure something out, you're a great person in terms of you are like resource lady or like, I'm going to get resources from everything. I'm going to learn about this, learn about that. Some people just don't have it in them to do that kind of stuff.
Dr. Young:      There's anything from like, health coaches, nutritionist that will sit down and help you come up with a plan for your whole family. I'm more of a ... I'm a functional medicine geek so I like to look at more of the genetics and other things and it's so funny that you mentioned MTHFR because my husband always jokes, it's the reason why I don't friends sometimes because if I've had enough to drink, I will say methylenetetrahydrofolate reductase enzymes and nutrigenomics and see who wants to actually talk to-
Janny:  It would be me.
Dr. Young:      Right, it's so funny. Those types of genetic variations and that's one that's very popular and people talk about it a lot but there's so many other influences on that genes, like if you have an MTHFR gene and you also have an MTRR gene or a BHT gene or a COMT gene, it influences it differently. This also, I mean very much like marketing and just choosing a diet, sometimes people know one or two things and they change their whole life based on it without looking at the picture like I can be confident with you, like I've looked at a lot of your stuff and you're doing fantastic and you're doing all the right things.
Dr. Young:      You're just having to work through normal like physiological changes with the roadmap you've been given, exactly. Exactly friend. Exactly. It just ... life changes and I think taking it with stride and trying to not be too stressed about it is also really important because stress will raise your cortisol level, it also affects insulin levels.
Janny:  In the position I was, I might find this overwhelming like where do I start, I need to find a doctor, I need to get a hold of this and figure out what's going on and fix everything right now, because that's where I was at and so it was causing a lot more stress in my life to like, I need to get better and I'm over there trying to research and I'm like driving myself crazy because I'm diving down into these rabbit holes so it was a sense of relief to like kind of dump it onto you and be like, okay, here's all the data like help me work through this but also through that process in running not just me but my family's blood work and genetics and I use my husband as an example again.
Janny:  I won't get specific because he's not here and I'm going to blast his whole health history on to the Interwebs but he tested positive for a specific gene that said he was going to be more likely to experience XYZ. Well, it was like a couple of years later, he started experiencing XYZ which would be concerning, would have concern me and freaked me out but I'm like, "Oh, I was expecting this so let me just email Dr. Young ang have her prescribe you this quick vitamin," and then it was all better. Because I felt like I was so prepared, I could have gone so far over the edge of like freaking out about these symptoms. I'm like, oh, no, no, I got this. I already know what's going on.
Dr. Young:      Absolutely and I mean, that's just ... you are very fortunate that you have a personal relationship with a doctor like me and I've known you guys for a long time now so it does make it easier and I think you kind of bring up something that's like really ... and really feel very strongly about, a lot of people didn't realize, having a relationship with a doctor long term, that's the way that they know you. You could call me on a dime about you, your husband or your daughter and I'm like, "Oh, boom, do this." If I only talk to someone once every a couple of years, I mean, I'm good but I'm not that good, right? You have to know somebody to really know what to do for them and I also have one of those brains where I might not be able to find my keys or remember your name.
Dr. Young:      I can remember a lot of health details about people. You have to find someone that you resonate with and I mean, finding the person that can help you is probably a first step. It might be someone local. You might consult with someone like myself on ... we do a lot of remote care for people. You have to find the right person and you are correct that not everyone has access to that. I mean, we're really fortunate to have the relationship that you and I do to be able to help you with your health to the level we can so I mean, I really encourage people to ... open lines of communication with their doctor, make it very clear that they want to be above and beyond.
Dr. Young:      Look for someone that does anti-aging type stuff and think about your health from the stand point of an investment and you need to invest in information so you can get everything that you potentially need. I mean, I like to sometimes give people list of, this is a good general idea of what you should get but it changes, right? Again, it changes with some of that health history and with what's going on with you right now but like I said, again, it's get some blood work done. You might even use a company like 23andMe to get some genetic information and then run it through a lot of these other sites that do spit out reports for you on what your genetics mean.
Dr. Young:      Some are better than others. I don't like to really advocate or talk about one particular one because then it gets to be weird and some of those sites change and someone might be listening to this down the road when it's not the same as what I said right now. There are a lot of sites that will take that information and give you some of your health risk and the one that 23andMe does a lot that I also chat a lot about in my practice is Alzheimer's disease so they do Apolipoprotein gene testing and it helps us understand whether or not you have that tendency. There are things that you can do so like you said, you weren't surprised when X problem came up and you knew what to do so that's all this information is. You just have to know what your risk factors are.
Janny:  A lot of people are hesitant to provide their DNA to a company which we've seen now partner with GlaxoSmithKline and there's a hesitancy to give that information to somebody like them. It's also really hard to go to just a primary care doctor and say, run these 500 tests on me and get these genetic results back. Tell me if you think this is good or bad but I said, well, one option you could do is use somebody like 23andMe and don't give them your real name because they don't need it. I actually was telling someone, well, use your PO Box and use a fake name and then you just know which one is assigned to who but I think like the downside to that is if you need that health information for something specific.
Janny:  You take it to your doctor and they're like, well, I can't tie this to you. Is that a problem, where they're like, "I used Susie Smith and I'm taking it to you," and like, these are my test results and you're like, that's not your name.
Dr. Young:      Totally. Well, I mean, I think one, you're generally talking about doctors like myself. Someone came into me and said, I used a fake name for my genetic testing because I wanted to keep my genetic information secret. I'm going to kind of tell you two things here. One, your genetic information as an individual isn't really what people are concerned about. It's like I'm going to open a whole paranoid can of worms right now but I'm just going to say it anyway. The concern with people having biological information about human beings is like biological warfare, putting things in our foods, all that kind of stuff. Use an individual like nobody cares about you and your genetics.
Dr. Young:      It's the pool of the whole genetic material we're providing that most people feel paranoid about. We don't want to give too much power to people. It's almost like a secret treasure map, like here's a secret treasure map and if you just alter this gene in all people, we could have all of these problems. I'm personally not that paranoid as a person. I kind of feel like, that's future Renee's problem. I'm not going to worry about it today because today's Renee has these problems and I have to worry about these problems. I'm not paranoid about it but people who are evil horrible people have been doing evil horrible things since the beginning of time.
Dr. Young:      You can't stop people from being crappy sometimes. I mean, whether we're talking about guns or biological warfare or anything else, people who choose to do negative things, we can't stop that. I don't really know that someone having your information specifically is looking to make much of a difference. That said, use a fake name if you feel like it. If it makes you feel better, great, I don't really care. I think that from a disease prevention stand point, the non-paranoid school of thought which I come from, I think we could really help people a lot. The more information we have about most people's genetics ... I mean, I'll tell you guys like a dirty Dr. Young's secret that I don't like to tell but I'm going to anyway.
Dr. Young:      When I was a student clinician, I would go out on like a Thursday night usually and I would drink a lot of booze and then I would go the next morning to the student health clinic either at my naturopathic college or at Yale which was really close by and they would pay me to give them blood and do an exam. That's who your studies are being done on. How many of you guys are freaking going somewhere and how many of you guys go to Stanford or something locally and you're like, "Oh, I'm going to get paid $75 for three hours and let students poke me, bullshit." Most studies and things are done on people who will get paid and they're tough drunk college students or we use to pull people from free clinics to do things. That's the reality of medicine. If you want someone to really practice medicine on you, you need to know about you.
Janny:  To kind of close this out, I think you were ... you did a very good like wrap up earlier and then I like interrupted, find somebody that you can have a long term relationship with, some sort of a doctor, that is invested in getting to the root of the problem who is either willing to run the blood work and the tests that you need or find somebody else to do it and take them to them, where you're doing a combination of hormonal test from them, 23andMe and just taking a good snapshot picture of what your health looks like and observing what happens to your body when you eat a certain way, when you eat at a certain time, when you eat too much carbs, when you eat too much sugar.
Janny:  Truly finding that balance and kind of happy medium and you did mention that you do see people remotely, that you can send kits to their house but that could be, as like, I can't find anybody else who will run it for me, let's at least do like ... do that picture, that snapshot helped me get started and then I'll find somebody local that can help me on the maintenance level.
Dr. Young:      Absolutely. That's being both, myself and the other doc that works for me in my office, Dr. Crystal do for patients is that we provide you with a strategy and then give you advice on how to help your health care provider help you. We act as that type of practitioner for patients and then we also act as more long term relationship care and what you kind of bring up is you know, like I as a person, I love long term relationships with people because I love to be able to really help you but that said, I have lots of lovely people that I help with a strategy, that they can then take back to their doc and say, "Here is my map," and then more long term, this is what I need you to do.
Dr. Young:      For example, if I knew that your roadmap included ... you have a tendency towards autoimmune thyroid conditions, I would give you ... here's the things that Hashimoto's patient should always test or if you had a tendency towards arthritis, these are the things you should always have tested so that you have a good idea in moving forward what do I need to monitor and what's the timing on that. My treatment plans always include with my patients a future plan, right down to get your breast exam in a year. Get your Pap smear in three years, get a colonoscopy in 10 like I'm very specific about this is the timing of what you need to do and try to do my best to give patients reminders of that like hey it's time for you to do this because you have to have health strategy, if you want to make it to a rightful age and ...
Janny:  Your doctor should be a partnership. It shouldn't be a hostile interaction and I've talked before specifically about pediatricians and I'm a little bit more like you fire that doctor, if they are trying to force things on you but you don't necessarily want to be in that position where you're like, do this or you're fired. You want to be open-minded but you want them to be open-minded as well where you guys are working collaboratively together for something that works for you that nobody feels like they're bossing the other one around.
Dr. Young:      Absolutely and I mean, that's a... Again, I mean, talk about ... I think you and I have touched like 30 subjects we could do whole things on. I mean, in medicine, again, it's like doctors ... when patients tell me, "I went to my doctor and I told them I'm going to use again, like that I wanted an MTHFR test," and they said no. It's like, okay, well, I went to Pete's coffee and I told them I wanted a hamburger and they said no, and I was pissed. I understand, these are people that have a medical license that they have to be able to say, this is why they ordered something. They can't commit insurance fraud or something and order things just because you feel like it, right?
Dr. Young:      That's what I mean about you have sick care insurance. You don't have health care insurance. Sometimes you have to go outside of that and consult with someone that's able to do that with you and spend the time doing that and then come back to your doctor and just tell them like, "Hey I found I had this gene and I did this research and this is what needs to be monitored, can you help me with that?" Instead of you need to do this for me or else, that kind of thing because a lot of docs, myself included like information moves very quickly and trying to navigate that for every person, it's just not realistic, I'm like, I'm sure if you listen to something I wrote or a recording I did five years ago, some of it is dated right now, right?
Dr. Young:      It's no longer true. Just help educate your doctor and bring them like sound information and this isn't me being judging like ... don't confuse information with talking about ... like your medical medium and your horoscope or whatever the hell is you want to talk about. Just be factual. I found this out and you should help me with that. That's what that person is. That person isn't there to help you navigate everything you think about the world, does that make sense, like I'm talking about medical doctors too. I mean, if you want to tell me what your horoscope said, you can. It's entertaining to me but I'm just saying like I'm very ... I'm paid as an individual consultant, I don't take insurance so for me, you can talk about whatever you want to with me.
Dr. Young:      I'm not offended by any of it. I have a lot of good friends that are MDs and I love, love, love them. They're just frustrated with medicine as their patients are. Honestly, a lot of them ... unless you're a surgeon or you're a dermatologist, they have easy lives but a lot of them are docs, who are just frustrated. I mean, pediatricians are a great example. The pediatric office, I was taking my son to, they started to have to act half as a concierge, practice they needed you to give them so much money per year to even be able to go and see them because their operating cost have gotten to be so high because medicine is run like a business.
Dr. Young:      I mean, particularly in California, we're required to be a corporation, right? We have to run like a corporation but we're supposed to then be generous to people because it's their health. Does that make sense?
Janny:  I was kind of using them ... well, using them to really get what I needed and what they were willing to run for me and I almost taken it over to you for interpretation and actual life application. We will go ahead and wrap it up and we'll see what, if anybody wants us to talk about in the future. Thanks so much for coming on and chatting. I hope enjoyed that conversation with Dr. Renee and I'll go ahead and link her website and her Instagram handle in a show notes of the podcast. You maybe thinking that the benefit from her expertise, someone who does a proper intake appointment to listen to all of your symptoms and take a full health history, factors in your environment and stress level and any and all of the above but don't have access to somebody locally that can do that for you.
Janny:  At least get a game plan, something in mind for you to move forward with. We know that she is available for that as well and I know that she likes to pop under her Instagram and she does her stories once a day, that she likes to share her fun tidbits and so I hope you enjoy this conversation or future conversation and just her presence and knowledge in general.