The modern world doesn't acknowledge, but in our time many yearn to break free of a prison of flat secular materialism.

Wait, wrong podcast.

But if you aren't already listening to Lord of Spirits, you definitely should be.

The modern health paradigm is just as beholden though to materialism.

We're constantly bombarded with Wellness trends, diet fads, and self optimization strategies, but very few consider health through the lens of Orthodox Christianity.

There's podcasts here to change that.

We'll dive into topics like fasting, prayer, stress, nutrition, and even physical training, and while staying rooted in the timeless wisdom of the Church.

Each episode will break down key health topics from an Orthodox perspective, bringing in guests, whether they're priests, health professionals, or experts in traditional wisdom, to help us navigate the practical and spiritual aspects of true well-being.

Welcome to Orthodox Health, the podcast.

We explore the intersection of Orthodox Christianity, physical health, mental well-being and spiritual growth.

I'm Doctor Michael Christian, joined by my Co host John, and we're excited to take this journey with you.

So grab a cup of coffee, lots of cream, coconut for fasting and let's get started.

Blessed is the man who walks not in the counsel of the wicked.

For the Lord knows the way of the righteous, but the way of the wicked will perish.

Welcome back to the Orthodox Health Podcast.

I'm your host, Doctor Michael Christian.

I'm John, your Co host.

Glad to have you with us again.

Absolutely.

So we're moving right along on our Women's Health and femininity arc.

We've already had some amazing conversations.

Episode 26 with Catherine Phillips digging into prevention and access to care.

Episode 27 with Gwyn Hopmaster sharing the realities of new motherhood and fasting.

And then just last week we have Presbyteria Marina Thornburg who helped us to redeem cycle awareness from Orthodox Christian lens.

That's right.

And we've been truly guest with such a great guest lineup so far, although we did actually have to shuffle it a little bit going forward.

Rachel Wilson is now coming up next week as Episode 30.

That's right.

And it's actually a reshuffling of the reshuffling because tonight's guests were supposed to be the openers to the Women's Arc, but here we are.

Like we said last week, we had promised as at least a bonus because this is PCOS Awareness Month and this was a major impetus for our Women's Arc.

So today we've got something special.

We are bringing it a little closer to home.

And joining us are two women who can speak to PCOS and hormonal health, both from the professional and the personal side.

And this will be our first return guest, Brendan Straka, who is a certified nurse midwife.

And joining us for the first time is my wife, Casey Kuhn, who has walked this road herself.

And Full disclosure, I've had the privilege, sure, we'll call it privilege of working with our on it.

Absolutely.

Which I suppose would mean I get to sit back a little bit and poke fun at both of you while you tell the real story of what happened.

Sure, I'll tell the real story.

I'll get nagged along the way, I don't know.

But this one's definitely going to be a mix of the practical and the personal.

What PCOS actually is, how it shows up in his lives, and what kind of rhythms can actually support healing both physically and spiritually.

And as always, we'll keep it honest, accessible, and of course, the most important Orthodox.

So let's jump into it.

Absolutely.

All right, so let's start with my lovely wife Casey, since she's sitting right here before us.

Now, it is a standing rule that first time guests has to give us a little bit about their Orthodox journey, how they got to the church.

And obviously I know that you're a convert.

What brought you to the church?

Well, in a big part, my husband, when we got engaged, you were on on your journey to Orthodoxy for quite a while.

I had went with you to a Greek church in New York when you're still living in New York.

We were still.

Distance dating.

Distance dating.

Yeah, that's a good way to put it.

And I didn't love the Greek church.

I didn't hate it.

I thought that the music was beautiful and the prayers were beautiful, but I just didn't relate to it because I couldn't understand a lot of the language.

So my answer at that point was, I'm not going to become Orthodox.

Your stance on us being engaged and getting married was we're getting married in an Orthodox Church, full stop.

And we're raising our kids in the Orthodox Church, which I was on board with both of those things.

So the plan was for me to get baptized in the Trinity so that we could get married in the Orthodox Church here that we still attend.

And we started going to church together and every week it kind of got stronger for me with all the feels and the smells and the people and what I found really between Father John and between the sense of community that I was being surrounded by, those things were just overwhelming for me.

And it felt like home and it felt right.

I'd never been to a church that felt that right before.

And so in the middle of our marriage counseling, he said, OK, let's make this catechism and marriage counseling.

So I took what, 5 sacraments in one day?

The teacher.

Got married a 24 hour period, she did her lifetime confession, she got baptized, chrismated, took her first communion and then was received in marriage.

So yeah, 5 in less than 24 hours.

It's quite the day.

And mind you, this is during the dark years.

So our wedding only had five people at it.

Father John, his wife and our sponsor, who is in fact our other guest, Brendan Straka, because as we've said before, the last time she was on, she is Casey's godmother.

So yeah, that I think you've had the most of the conversion story of any of our guests because we've definitely told most of that in bits and pieces in various episodes.

When Brandon was on, when Father John was on, when Father Jonathan was on, and probably a little bit more along with some of the other guests as well.

So that story's come about all the way.

It's good to hear it all in one succession.

If my memory serves, I believe you streamed the wedding service too, and I think my wife and I may have watched it.

So if I'm remembering correctly, we were there in spirit.

That's right.

We did in fact, stream it with a specialty service because we didn't want it going out onto YouTube.

At that point.

I was still a little bit more wary of my online presence as you are today, John.

But we got a specialty service that was allowed us to have a certain amount of people because I think Zoom had time limits and we didn't want to pay for the professional and whatever.

So, yeah, we paid for that service and it was pretty cool.

It worked out well.

And I had to assure the guests that no, I did not have a runaway bride.

It's just that after the baptism, we were able to get her hair and makeup done.

And it was a little bit of a delay and everybody was like, well, is the wedding happening?

S So to that point though, now that we've gotten to your Orthodox journey, how about we share a little bit about your journey with PCOS?

What did life look like before you even had a name for what was going on?

In a lot of cases, especially my case with PCOS, you don't necessarily know that there's a problem until you know there's a problem, right?

A lot of women don't find out they have PCOS until they start trying to have a family, and that's what happened in our case.

What's funny about that to me is that we always tell people that we had to make a choice between the wedding and the wedding party, and we chose the wedding because we wanted to start a family.

We had dated for two years and we were ready to make that next step towards the family and the Orthodox family.

So four months into being married, we realized there might be some type of a problem here.

We really need to have this looked at.

And when I went to go to an OB to have them investigate, she immediately said, well, I think you have PCOS, but we're going to do some tests.

Now, I'm just going to interject here for a moment because before that happened over that summer, I had sent her an article.

Now, let's be clear.

Personally, I am not in a position to provide diagnosis, nor am I the biggest fan of diagnosis.

I would rather treat the system and the root causes.

But for some people, having the name attached to it is helpful.

In other cases, it becomes harmful because then you start to identify with it, just like with pathological gender identities and things like that, where you start to identify, oh, I am this.

So I don't love that a lot of times with diseases and illnesses, but if you are someone where that label is going to allow you to take action on it, great.

Having said all that, I had sent an article because based on some of the symptoms she'd been dealing with, I was like, I'm not going to say it's PCOS, but regardless of what it is, working on it as if it were would be helpful.

And we love our wives dearly, but sometimes they need to hear it from somebody else.

So I thought maybe, OK, I'll send this article over and she look at and she comes back and tells me I don't have PCOS.

I was like, I didn't say you did.

I'm just saying the ideas that are in this article are probably going to be helpful.

Fast forward to her heartless story there and someone else tells her I'm like, well darn it.

Like you could be working on this for three months, but it all was in God's time.

Either way, that's be busting chops now.

Once we did an ultrasound and things like that to validate, our doctor came back and said yes, you have PCOS.

And I remember her telling me a lot of doctors would have you walk in with these symptoms and she would say go lose 20 lbs and come see me in a year if you haven't gotten pregnant.

She didn't and we were thankful for that.

What she did do was push us towards Metformin, and I remember you being very angry, very, very angry about that because you knew that Metformin would cause more hurt than good.

But I kept my mouth shut, though I bit my tongue.

I always like to joke about.

I bit my tongue so hard that I was hemorrhaging a little bit but.

And I would say one of the only the biggest symptoms that we saw was the issue of there was no fixing the weight gain.

Yeah, and you had a lot of other things like the blood sugar crashes, so you'd have a lot of fatigue and you have the brain fog when you didn't eat for a little bit.

So it was really a key of trying to focus on regulating that blood sugar.

We started changing things up, the diet and supplementation and got a little bit of movement at that point, but a lot of it really was just dialing in.

Some of the keys were things like the Berberine and the megaspore, things to help get your gut right, help improve digestion, and we'll get a little bit more into that in a bit.

But that was a key focus for you.

Now to that point of you may or may not have a baby for another year, what does it actually feel like?

Know what it did to me?

So what does that message feel like to you?

I mean.

It's it's a gut wrenching feeling got your heart set on starting your family and growing with your husband.

And you don't want to disappoint your husband.

You know, my husband started with a child number of 12 and said that he could just talk me down from there.

I just like 2 to 4.

And you were starting the conversation at 12.

Well.

That was it.

I was working on the Art of the Deal premise of you go for the big ask and then you work your way down.

I was just about to say that you got to have big ask, you got to work your way down, so you got to start high.

Exactly.

And I was like 12 is a pretty good number.

You got the 12 patriarchs, the 12 disciple, 12 is a good number.

Paul Josiah I think has 12 right?

I thought that was a good place to start.

Man, I I'll tell you what, I wish I had the courage to start as high as you.

I think I was like maybe 4, maybe she'll go for four, I don't know.

I felt like if I went higher than four that was going to be too big.

It'll be like a mind melting ask.

And I mean, let's put it this way, even the Orthodox woman during her bridal shower, my sister was like you, you just aren't crazy.

They even they were a little bit right whale.

I think right now the current highest is 8.

In terms of pressures at our church is the highest.

Trying to inspire change here.

Exactly.

The times are a change in.

We are envious of those large families at church.

We know we probably won't ever get to those 7 or 8 numbers.

We started a little bit too late is the problem.

Well, I'll tell you what, God bless them.

We have quite a few young families in our parish too.

They're an absolute inspiration to us.

Just seeing them and how wonderful it is, it's really an inspiration to do even what we can do.

It's not a race, obviously, to have the most kids.

Every child you have, whether it's one or two or whatever, 12, all a blessing from God.

So we'll have the amount of kids that we're meant to have.

Absolutely.

So I remember when we first started working on the PCOS, what do you think was the first lever that we pulled actually made a difference?

First man really changed things for you, you.

Put me on a pretty strict keto like diet.

I say keto like because no carbs for someone who has PS2 S just doesn't exactly work super well.

At least it didn't for me.

I needed a level of carbs but good carbs in a balanced diet.

So I say keto like because it was as similar as you can get to keto with still throwing some complex carbs in there.

And I would say berberine and probiotics, we learned that those they have to be together the hard way.

But yeah, I definitely think that berberine really changed my life because it really regulated some of those up and down spikes with my blood sugar.

Yeah, absolutely.

I've talked at length over time about the benefits of Berberine.

It has tremendous benefits on your blood lipids, on your blood pressure, on your blood sugar.

And in the context of PCOS, all three of those are going to be incredibly benefits official.

And what's funny is that berberine going head to head in clinical trials with metformin and it outperforms metformin on all of those and outperform statins and it outperforms ACE inhibitors and it outperforms all of these prescription drugs.

So in terms of botanical medicines, berberine is about as close to a miracle drug as you're going to get.

And it comes in the form of the classic herbs of gold and seal and bayberry.

So a lot of immune supporting ones, you might see that has echinacea and and golden seal in it.

And to that point, it is also a very potent antimicrobial kill.

It knocks out bacteria, fungi, viruses.

So that is where you're going to run into a problem potentially is that it'll knock out the bad bacteria in your gut.

But if it does so too quickly, you get some digestive upset and you end up with some bathroom problems.

So by including a quality probiotic, something like Megaspore, you'll be able to resolve a lot of that.

And it was something where, like Casey said, we learned very quickly that you need to take two of them together.

And it's not something I really want to drive at home.

There is that if you are going to go that route, if you've been directed by your position that you have to go on metformin, something to consider would be the combination of berberine and bacillus strain spore probiotic, something like megaspore.

So having addressed all of the PCOS related stuff, I want to be clear that while we want everyone to understand who is dealing with PCOS that like Saints and Nakarios implored us, do not let anything deprive you of hope.

A lot of the modern conventional medicine framework is going to tell you that you have PCOS, you're never going to have a kid, maybe you will and take the Metformin and lose the weight and etcetera, etcetera.

We are a clear living example and Presbyterian Marina last week was another example of someone who has successfully through God's grace, been blessed with some beautiful children.

Having said that, just because you have those beautiful children doesn't mean that you're not going to struggle either.

So I've mentioned briefly before, but we experienced some losses in between and it's one of those where I wanted to actually go a little bit about that timeline if you wanted to get into the story between our older girl, Marina and our younger one, Magdalena.

I would say without God's grace, I wouldn't have made it through those struggles.

A lot of people asked me when we experienced loss, did I shy away from God?

And the answer to that is absolutely not.

You have to push forward with God's grace and love and understand that everything goes back to your faith.

For us, after we got onto a supplement and a diet, that really worked for me and I was able to really hone into it.

We got pregnant with our first baby three months after being diagnosed.

Our doctor even we found out that year right after Thanksgiving and by the grace of God, we were able to get right in for an appointment with her.

We walked in, sat down and she said, didn't I just diagnose you with PCOS?

How She was blown away that we were sitting there.

I think she was even shocked when she got back the blood work because she was like, whoa, your HCG is 3500 at six weeks.

Like you're very proud.

So we had challenges with her pregnancy because I'm estrogen dominant, the progesterone really wasn't where it needed to be and we had to supplement progesterone by shots for what, 14 weeks?

Sounds about right until.

We were in the second trimester and then it pretty much flowed pretty good for that pregnancy.

But we also had struggles after Marina.

We had a loss at 8 weeks when she was about 18 months.

Old Shiloh.

Shiloh And then we had six months later we had another loss, Asher Asher.

And that one went pretty quick.

You know, it was like one day you're pregnant, two days later you're not pregnant anymore.

And those were, I think we struggled together and we struggled separately with really understanding why it was happening.

I call Magdalena our Linton baby.

Because.

Conceived her right before the lint season started.

Literally during cheese fair week.

Timeline wise we could see during cheese fair so absolutely.

So for us, we both agree that we would have loved to have those two babies, but we have two beautiful, smart, healthy children that we wouldn't change Magdalena for the world.

If we had those other babies, we wouldn't have her.

And she fits so beautifully into our family that God was telling us there will be a baby, but it wasn't going to be those babies.

He called them home sooner.

Always make the joke to you.

I remember I feel like it was right after the first loss and I'd said, well, we wanted to have our second baby by the time I was 35, so I've got some time.

You said, how old do you think you are?

And I had completely lost like a whole year in my mind.

And so I told her to call her mom because I was like, I'm pretty sure you got this wrong here.

Yeah, I definitely did.

I had lost a full year from just maybe trauma.

Trauma.

It was during the dark years and all the fun stuff.

So yeah.

Say sometimes your brain, those interested thoughts will say, well, I've had another successful pregnancy, so this won't happen again, right?

But we've had loss after Mad Delena, We've had recent loss.

So infertility is such a mind twist sometimes because you think maybe we're through the worst of it, but it's always a battle that you're climbing with suffering and you accept the suffering because it curse your faith.

So I try not to get too twisted and always put my focus back to the Lord.

Absolutely, and that really is the biggest key.

It's a beautiful testimony, and the way that you've carried that is really inspiring insofar as just staying close to God and trusting in him.

And I remember when you guys had those losses, and my heart and my wife's heart broke for you guys.

But as you said, God called them home a little bit sooner.

And both your little girls are just so beautiful.

It's such a blessing with them and everything works out according to God's Providence, so thank God for everything.

Yeah, absolutely.

Amen.

I think that I would also say that sometimes when you're dealing with infertility, sometimes women get so bound in it and I have learned how to get unbound.

If someone at church announces a pregnancy, glory to God that you have not had a struggle or you've gotten through your struggle.

I'm always like jumping for joy for someone else.

Even when John and his wife told us that they were going to be expecting, I was over the moon excited.

Without question, we've always loved John and his wife and now their son very dearly.

But with that, Brendan has entered the chat.

As mentioned earlier, we had to reschedule the reschedules and that even include this episode.

Timing didn't work out exactly how we initially planned it, but I am glad that Brendan and Casey are still going to get to have some overlap.

Welcome back with us, Brendan.

It's super exciting to have you here again.

You're our first repeat guest here to talk to us about PCOSI Suppose.

Just to kick off our conversation with you, could you tell all of our listeners what exactly PCOS is?

There's a lot of people and I know myself, I wasn't familiar with that until so we'd started discussing it here.

So could you give us a little bit of an overview?

Yes, and it's sort of a nebulous beast, PCOS, some women will actually have polycystic ovaries.

So it's the name is polycystic ovarian syndrome.

And on an ultrasound they'll have lots of cysts where monthly a woman is supposed to have one or two cysts they'll have in the teens.

That said, the way that it presents has become more of the way that it actually is, and someone will have this syndrome and not have cysts on their ovaries.

So in order to have a diagnosis of polycystic ovarian syndrome, you have to have excess of androgens, so testosterone, and that often shows up as unwanted hair on the face or the chest, ovulatory dysfunction, which we talked about at the ovaries, but also just ovulating randomly and not in a pattern.

And that's something Casey actually realized once we finally started addressing and fixing the problem.

I mean, you felt like you probably had never ovulated in your life up until that point, is what you told me.

Yes, I definitely remember when we started addressing the problems that I was experiencing, things in my cycle that I had never felt before.

So I definitely can attest to the ovulation piece.

Have you had regular cycles before?

Had your cycles been every 2830 days?

No, no.

It was never a consistent and it was, I want to say 36 days before we started addressing.

So there were definitely cycles for me that there would have been no opportunity at all to ovulate.

Yeah.

And from my perspective, what I've seen a lot of is dysregulation on the stress axis, on the HPA axis, right, the hypothalamus, pituitary and the adrenals and that having downstream effect.

And we've talked a bunch about how there is that link between the HPA, the adrenals and the HPG, the gonadal system.

So you're reproductive hormones, if you're overstressed, if you're overtraining, if you're under eating and if you are not sleeping properly, a lot of that stress system is going to throw you into the estrogen excess that we see a lot of in women who have PCOS.

It's one of those along with the androgens like Brendan was talking about, estrogen dominance is pretty commonly seen.

And in both cases, if you are stressing yourself out like crazy, then we're going to have a problem there.

And we were discussing this last week with Presbyterian Marina about sinking your cycles, your nutrition to the fast and actually being able to eat properly at but still maintain the fast to the best of your ability and provide.

You're not actively pregnant or nursing, but that's something that I think was a really smart idea.

Just in general life, how women need dedicated nutrition that doesn't over stress their body.

Well, and that's interesting because a lot of times women will come in, their periods are out of whack.

That's a big thing that brings people into the office or like you mentioned KC, they're having something else going on.

Maybe they want to get pregnant and they're like, I've never had a regular period.

But then I do lab work on them and almost without a doubt, if a woman has normal follicle stimulating hormone and low progesterone, that can almost always go hand in hand.

And I'm talking like progesterone in the toilet, like just absent progesterone, not enough to maintain the pregnancy, but even to keep the cycle of the hormones going throughout the month.

So stress eats progesterone.

That's not that's the way that I think of it.

And sometimes progesterone will be deficient if you're overly.

So you're not entirely wrong in the way that you're describing it.

It's definitely more like a Pac-Man, kind of like a mental heuristic there.

I, I like it, I do.

It's just, it's two aspects of it.

1 is that the precursors, the cholesterol and the pregnanolone, all the precursors to the progesterone are being diverted, they're being consumed.

So you're not.

Wrong there.

That's it.

Yeah, Yeah.

Right.

They are being consumed in the alternative process in the production of those stress hormones, the cortisols, the corticosteroids is all of that.

So it's getting produced there, but the progesterone is also going out as part of the anti-inflammatory and stress response.

So in both cases it's being over utilized but under produced because of a dysregulation to that stress access.

So I like that consume it, that eating analogy.

Obviously as Orthodox Christians, we are not in favor of utilizing birth control pills or anything to that extent for the most part.

But that is a overly common situation that we see in the modern world of women utilizing that was kind of prescriptions as means of regulating their hormonal imbalances, particularly in PCOS.

I mean, that came up last week as well of here's a birth control pill just like here's Metformin or here's X, here's Y Good luck.

Maybe I'll see you later.

What do you see clinically in terms of women who have been on the pill for a long time and now are looking to get into pregnancy?

And now they're finding, oh wait, I have PCOS and I didn't necessarily think I did before, but but what do you see on that front?

You know, I'll be honest, I have not done my research on that in terms of the long term implication, because the mainstream medical advice is that birth control can actually be eggs sparing that if you are taking it, you're not ovulating.

And so you're conserving your eggs, preserving your eggs, which I don't know about that.

But the way I think of it is that God designed our hormones to cycle through the month.

So the beginning of the month, if you have a period, then you will have high estrogen for the first half of the phase, the cycle, and then the second-half you'll have high progesterone.

And that's not how the birth control pills work.

And actually the ones that triphase or even I think there's a quadrophasic that are kind of older generation, they tried to do that, but it was horrible.

It was a mess.

People felt crazy.

And we just can't recreate what God does so often.

What I will advise people is that we have a diagnosis of PCOS and if they're not wanting to get pregnant, I say I really want to address this with nutrition and lifestyle changes.

And I understand, again, this is dealing with a wide variety of people in my practice.

If the bleeding is such that you just are losing your mind or you feel the need to have a regular cycle, there are hormones that we can use to do that.

And I usually, in that case, a lot of times I deal with a lot of Latina patients and they also are not big fans of birth control.

So I will say hormones instead of birth control, but then I'll tell them this is what we're doing.

So I'm going to maybe let you tell me about the downstream effect of birth control because I'm not as familiar with it.

Yeah, that's fair.

So the vast majority of birth control pills and again the technicals of the pharmacology are definitely more your wheelhouse.

But my understanding on most of them is that they're going to be high estrogen and then generally they'll be using a progestin instead of an actual progesterone.

And those don't have the same effects in the body that either endogenous that could naturally produce progesterone in the body or the bioidentical progesterones.

So a lot of the mainstream advice is that Oh well, it affects the body the same way, but it doesn't, it's doesn't have the same effects.

It's not anti-inflammatory in the same manner.

And while it may induce reproductive effects same way or inhibit in the case of a birth control pill, it doesn't have that same long term effect.

So what ends up happening then is those are still estrogens downstream from progesterone.

So that's going to lead towards that or the androgens are generally downstream from progesterone as well.

So it can go the testosterone route, which then go to the DHT, which is generally pretty high and leads to the hair issues in both men and women.

But because it's even though it's not testosterone, the high dihydroxy, high testosterone DHT has a stronger affinity for the receptor.

So it causes bigger problems downstream, the progesterone going and train as other androgens or create more estrogen and the higher dose that you're getting from that pill in general feeds into the estrogen dominance that is so common in PCOS.

That's where I'm seeing a lot of the issue of their on and then now they finally got off of it.

But their body systems, that's what we see in men when they go on to anabolic steroids, is that their body production is down regulated and doesn't know how to recoup.

Or we see people who have thyroid issues, right, with synthetic thyroid hormone.

And if they try to go off of that and now it's completely gone.

And so hormones are something that it's a very swirly game to play with because once you pull that trigger, be a really long battle to get off of that.

And so that's kind of where my head's at in terms of these poor women who are being put on the pill from a younger age.

Like I'd said, there's something to be said for after the case, maybe you need to work with your hormones a little bit as you're a little bit older.

But early on, yeah, you really shouldn't be pulling that trigger.

And it's as a society, and that's where it comes back to the Orthodoxy idea right, towards Christian values, is that maybe we shouldn't be telling women this, that you need to be on this because maybe we shouldn't be selling values in general of marriage and family and everything else.

So I don't know.

Yeah, so I have a little anecdote.

It's not related to PCOS, but it is related to the sort of messing with your hormones.

And my wife deals with Hashimoto's thyroiditis and they had her at a young age on medications for ADHD.

And lo and behold, after being on some of those for over a decade, it comes out that all these medications have a pretty negative effect on your thyroid function.

So we find out after now she has this diagnosis of hypothyroidism that this medication they've been recommending for her all these years is actually the probable cause of that.

So it's like, you don't know what you don't know.

But I mean, at least for me, a general skepticism of a lot of this stuff is a good thing.

But now we have a pretty good idea not to screw around with it.

It upsets me to know that it was something recommended by a doctor and it caused this problem that now she's going to deal with the rest of her life.

It's very, very upsetting to me.

Absolutely.

And that's my biggest thing with that is when you start messing with your thyroid because your thyroid controls your metabolism, you end up having a lot of downstream effects.

Like we just said, the HPA, hypothalamus, pituitary, adrenal, I mentioned before HPG, the gonadal reproductive hormones, but there is also the HPT, the hypothalamus, pituitary thyroid, which is the governor of your metabolism.

So to that point, we talked a little bit before about being overstressed and or overtraining.

Now in the context of orthodox fasting, right, we are purposefully eating at least a little bit less and we are restricting the types of foods that we are eating.

We talked last week about the cycle sinking.

For us though we want to dive a little bit more into hormonal effects and everything else.

Do you see that even in your general population, patients of those who are under eating, whether it be anorexia, bulimia or the others, do we start to see any of these effects, PCOS or other hormonal issues, the endometriosis or any other reproductive health issues?

Are you seeing that in practice?

Cuz we magnetically it makes sense to me, but you deal with them more hands on I.

Don't know if I have a big enough sample size of people who are under eating.

I think that over calories and it's fascinating to me.

So we live in Northwest Arkansas and, and my husband works at Simmons and worked at Tyson and there's lots of food here at Walmart.

You don't realize until you see a lot of patients what ABMI, you know.

So a normal BMI, body mass index, normal quote UN quote is 25 for women.

Then in my computer system when I'm charting, it'll go into the red.

Most women are over that and for a lot of women, they'll be morbidly obese and their blood pressure is great and their thyroid is great and they're in, they're pregnant and there are other women who are just slightly over.

I had a patient the other day, she was BMI of 30 and struggling with infertility.

And I started talking to her about nutrition and exercise and she started crying.

And I was like, what?

I'm not overweight, am I?

And I was like, well, yes and no.

I was like, I know that there are people around you and their weight is not an issue for them and they're getting pregnant left and right and even trying to shut down their fertility.

And for you, you're struggling.

I said, I'm not saying it's the magic bullet, but losing 10 to 15% of your body weight could make a difference.

It could.

And so I'm not going to not tell you that that didn't answer your question about people being underweight, but I think it's a stressor on our body to have excess calories, just as it's a stressor on our body to have too few calories.

Absolutely.

And that's really it is that we always talk on this show in particular about finding that royal path.

We don't want to be overeating, we don't want to be under eating because in both cases we are going to be over stressing our system.

So yeah, I get that.

It might just be, as you said, this area, maybe back in when I was still in New York, we might have seen a little bit more of the the other end of people chronically under eating cards might be the populations you're dealing with.

I don't know.

Think about this sometimes because not only are we fasting periodically, but we're fasting 2 times at least a week most weeks.

And so you hear all about Mediterranean diet and then the Blue Zones where people live to be 100 and you're meaning to or not.

I think there is some benefit to what we do where we eat more whole grains and vegetables and you have to replace it with something that just feels like a huge blessing that we don't maybe even know because we don't know how sick we might be if we weren't doing that.

Absolutely.

The fact that we are incorporating the fasting does create a little bit of that metabolic flexibility.

If you are following the fast way it's supposed allows you to have those times of fasting and the times of feasting and you kind of find that balance in between ideally.

So that's kind of where my initial head was at was some people might take the fasting guidelines and then go and purposely starve themselves.

And it starts to orthorexia idea of I'm going to have the perfect fasting diet and I'm never going to have anything wrong and I'm just going to eat bread and water at 3:00 in the afternoon like the monks do what the nuns do.

And that's where I can get some squirrely territory.

Sure.

Yeah.

Well, and when I think about that, I think of Saint John System.

He like gave himself some permanent damage.

He had permanent organ damage that caused him to be very weak at the end of his life because he over tested.

I really feel like so many people are in this state of chronic deficit and they don't realize it.

Not even that they're like explicitly fasting.

I'm just talking about people in general, not even necessarily Orthodox Christians.

But I actually have a good friend of mine who was just telling me recently that he works hard labor job, He's a contractor.

And it's like I eat once a day.

I'm like, what?

You're going to die.

Like you're going to really hurt yourself, man.

You're definitely in a severe caloric deficit.

You're expending massive amounts of energy all day.

How are you not like Keeling over?

Like you're definitely causing serious internal problems.

And if you don't drill into it deep enough, unless you sit down for a minute and start to think, do I feel chronically lethargic?

Do I have headaches?

Am I groggy?

Do I have brain fog?

Like what's going on?

And I mean, that's not even to get into the other types of things.

If you are being extremely active, your likelihood of causing physical injury during activity goes through the roof.

If you're under fueled, we don't realize it.

I think a lot of people just overlook how badly that's going to affect them.

Without question, and that's kind of it too, is that even in the case of individuals who are still above average BMIA, lot of times it might even be under eating that's causing part of the stress is that your body is now retaining whatever weight it can, whatever calories it can because it doesn't know when they're going to come back.

And so the stress response right there, you see those late night infomercials of stubborn belly fat, your cortisol levels are probably too high.

But you don't put the correlation of, well, I'm under eating, I'm eating 1200 calories a day and that's way below my basal metabolic rate.

And so I'm going to now need to reduce stress hormones to liberate sugar.

But then that's going to go and cause me to store fat in the longer term because my body's going to say, all right, this is where we're at.

So then your metabolic rate lowers as John was just saying, you start to become more fatigued, you expend it at a lower rate.

Now you're storing that body fat even though you're not eating enough.

So under eating with overtraining really is a big issue there.

To that point, we're actually going to have to say a good night to my lovely wife Casey.

At this point.

We've had Nana taking care of the girls.

So we will dismiss her and hopefully everybody enjoys her contributions here.

I think they were wonderful.

Great.

Thank you, Casey.

Thank you.

Thank you for having me.

Thank you for sharing your story with everyone.

Yes.

My hope is always that my story for PCOS will inspire other women's troubling with the same things.

That there is hope, there is faith, and you don't always have to listen to that doctor that doesn't want to really deal with your situation and just tells you to go lose weight and that's going to fix everything or tell you that maybe it's not in your parts because that doctor doesn't have the final say.

That's right.

At the end of the day, it's in God's hands.

Absolutely.

Amen.

Awesome.

So we will dismiss you.

You can go back to your babies.

Fasting isn't starvation, it's formation.

Seasons of fasting are gifts, but they can be really hard on a tired body.

If you want to keep fasting without burning out, then reach out to work with Orthodox Health and me, Doctor Mike.

We can help to align your meals, your protein types and timing, as well as your training to the Church's rhythm so you stay clear, steady, and prayerful.

You'll get live coaching calls and simple tools to navigate parish life, travel, and family schedule without scrapping the fast or your health.

No extremes, no guesswork, just a faithful plan that respects the wisdom of the Church.

And there.

Reality of your week.

So at the end of the fast, you're not depleted, but you're formed.

So head on over to orthodoxhealth.com to book a free call with Doctor Mike.

Yeah.

So if I may, to the point of caloric restriction, at least for me, I know.

So there's the recommendation generally for 2000 calories a day.

It's important that people know that's, that's a general recommendation that may be more or unlikely to be less, but could be a little less from some people.

And you should find out what that is for you.

Because I know for me after looking into all this, I was in a severe caloric deficit for a while, not thinking too heavy about it.

Because after I got out of like a competitive athletic setting, I just stopped thinking about food in a serious way, which is a really bad idea.

And it led to some negative things for me health wise.

But now like I feel great with like 3500 to 4000 calories a day with like pretty intense exercise.

So it's like that.

2000 is a recommendation.

You have to do your due diligence to see what your body actually requires.

And to that point, like you said, and I was saying before, is that that calorie doesn't necessarily equal a calorie based on your stress levels, your hormonal impact and just everything else going on in your life.

So yeah, if you've been chronically under eating, your body resets its basal rate.

Everybody has a different basal rate.

And just to be clear, if I've used that term a couple of times, it's basically the baseline setting.

So you're setting your body's thermostat to a certain level of OK, this is the number of calories we need.

So we either start taking in less calories or we exercise or do other things to burn more calories.

But our thyroid, which if it's thrown off number of different ways is the mechanism by which we control that thermostat.

So if we throw off the thyroid with the adrenals from being overstressed or we're having productive hormone issues in some other way, whether we're taking exogenous estrogen in the female case or testosterone antimoxides in the male case or the ADHD medication you were mentioning earlier, John, in your wife's case, that can have effects on your thyroid.

Now because it's been turned down, your base metabolic rate is going to be slower.

And so we need to do things to help improve that.

And so you need to have a basic understanding of where that level is.

This definitely went a lot further afield than what I was thinking of in the way I first started posing the question, but I love it.

I think this was actually a nice little side more.

You know, it makes me think too of we talked about the balance in our faith and so finding that balance between a fast and that kind of prideful fast of overdoing it.

I think people can do the same in a lot of ways.

Just food is God-given.

It's nourishment.

I've tried to change in my practice.

Instead of saying, tell me about your diet, I try to say, how do you nourish your body?

Tell me about nourishment for you, because I want to remind people that food should be nourishing, not a diet and or then it also becomes a comfort.

So it's like finding how this blessing that God's given us, he's given us the ability to enjoy food.

It tastes delicious.

It then like so much in the world, things get perverted, things get twisted and we're fallen.

And so we got out of food or we make it hyper palatable.

And then on the flip side, then we've totally vilify it and we're like, nothing's good for me and I'm just not going to enjoy it at all.

And that's not it either.

And that's becoming prideful, too.

And so.

Right, right.

It's funny because I got two thoughts based on what you were just saying.

Line is yeah, are you ever supposed to engage with with the trolls in the comments.

But within the last week someone reengaged with a real that I had posted from our carnivores vegans and an orthodox response to the diet wars episode and one guy was super militant vegan and saying how that we need to be vegan year round.

That's the truly spiritual thing, even though in first Timothy four one through 4, the Saint Paul explicitly warns us that in the latter times spirits will arise and one of the things that they're going to tell us to do is to abstain from foods completely.

They will command it.

So it's kind of interesting.

It's like, look, I'm not telling you never eat meat.

I'm not telling you never eat plants.

I'm saying there are seasons for everything.

And depending on what you have going on health wise and, or if you are able to participate in the fast, yeah, don't eat meat then.

But I'm not commanding you.

The church, the body of Christ is giving you that commandment.

And when it comes to the don't eat plants, well, yeah, if you have thyroid issues, then yes, it's probably going to be for the best to at least lightly cook your greens.

If not, avoid them.

It's going to be beneficial to avoid high oxalate and high phytate foods.

Again, cooking properly, preparing, soaking, sprouting, fermenting, all of those things are going to be a good idea.

If you can't manage to get all that done, then yeah, avoiding it is better.

I'm not commanding you.

2 And So what was interesting, like you were saying, is that it was becoming an ideology of becoming their God.

It was making a dog mite.

I'm like, look man, we're not going to become vegans.

We are going to be vegan esque for half the year, but that's going to also help such that we are able to appreciate the rest of the gifts that God gave us on the animal front.

So it's not an either or, it's a yes.

And the other thing I was going to add there is nourishing is an excellent word for that.

Another one though, I'm going to steal directly from Father John Wheeling and his homily that was as of recording yesterday where he was talking about sucker and not calling you a sucker like you know, I'm going to trick you over something.

But the older word of sucker, where probably we got the word succulent from, didn't look up the etymology, but I'm kind of think that's the same idea of just that nourishment.

So I kind of like that idea of reframing.

No, it's not a diet.

I usually to use nutrition for that purpose.

But yeah, nourishment sucker.

Yeah, those are some good ideas.

Sustenance, right?

Sustenance, yes.

Helping you to sustain.

Yeah, I like it.

Yeah, that's excellent.

So circling back, you were mentioning earlier about some of the lab work you do now.

I've mentioned before that I do a lot of lab related stuff.

What do you see as some of the bigger things lab wise, besides the FSH to progesterone ratio you were mentioning earlier?

What are some other things that you're looking at when you're seeing someone who you think is leaning towards PCOS?

The big one that I often add in is an A1C.

So looking at at how their blood sugar has been controlled and honestly then we might be getting into some pre diabetes that can also dysregulate your cycle or diabetes.

But I do think of those as sort of sisters and insulin, insulin resistance.

I think if you have an elevated A1C, insulin is kind of one of those that it depends on what time of the day, whereas A1C is going to check your blood sugar control over the last month.

So that's sort of a good catch all for me to see.

Okay.

Are we dealing with also some insulin resistance here?

I think those are excellent panels.

Other ones I like a lot for this purpose are your triglyceride to HDL ratio, because I think that helps give a little bit of context.

A lot of times the panel gets misunderstood, or at least from my perspective, it's misunderstood in the conventional model of, well, your lipids are high and that's our cardiovascular profile.

And we need to know, well, your LDL is too high, your triglycerides too high.

I think it's just gives us a better picture of what's happening there.

And so you triglycerides try 3 glycer is sugar.

It's basically fat is how fat is stored in the body and it's 3 sugar molecules.

So if you talk to the keto crab, they're going to tell you, oh, well, that's how we store sugar.

So you got to avoid the sugar.

You talk to the low fat crab like, oh, well, that's the fats that are getting released there and that's because you're eating too much saturated fat and cholesterol and whatever.

That's beyond the scope of this for right now.

What I'm saying is they're both wrong in terms of how they're looking at it.

The important thing that we're looking at there is if triglycerides are going into circulation a lot, it means you're liberating the free fatty acids.

There needs to be energy being used for something and what your HDL, you're good quote UN quote cholesterol is for is that it's bringing cholesterol to the liver out of circulation.

And if your cholesterol is going out there a lot, if you have your high LDLS or your VLDLS, but it's generally indicated there's inflammation out there somewhere, cholesterol is trying to deal with it there.

In the case of those who have who have PCOS, those who have the diabetes, those who have metabolic syndrome in general, or those cardiovascular diseases, they're having damage being done somewhere in the body, it's causing the inflammation.

Cholesterol is going to deal with that problem.

So if we are starting to resolve that inflammation, generally now cholesterol is coming back out of circulation to the liver to be recycled.

So in that case, your HDL is going to be going up, your triglycerides, the free fatty acids being out in circulation.

If that's too high, it's indicating there's still some inflammation.

So, so that ratio I think is a good marker for PCOS.

It's one that I like to see and I think it's a better one than just looking at, Oh well, your cholesterol's good.

How do you feel about looking at things like their ferritin, iron, B12 and vitamin D?

So do you see any correlation with anemia related symptoms there?

And again, vitamin D being a decent marker for inflammatory status.

So as we're talking, I'm like, I'm so much more conventionally trained than you.

So this is an education for me.

I I do check CBC especially if women have been having irregular bleeding, but again it may be a patient population thing.

I often see very high hemoglobin and hematocrit and normal ferritin and then vitamin D.

Yes, you mentioned vitamin B12.

B12 and or folate?

I think the folate one I.

Was going to say so yeah, that I was going to mention that I can go down a rabbit hole on that one.

They.

Do I would love it?

Because yes, I think that's a major 1, yes.

The MTHF are a mutation, so I can't even pretend to say all of it.

Maybe you know.

My the mother Fudger gene, we'll say it that.

Way yeah, I'm homozygous for that.

My mom just found out that she has it, which is funny because she was like, I have it and I was like, I know because it's hereditary, it's genetic, and I'm homozygous.

Case double heterozygous, so functionally homozygous.

OK.

I just had one of those in my practice.

Yeah.

For the clarity of our listeners, can you explain what the homozygous and heterozygous mean there?

Right.

So if you are homozygous, you have two mutations of this gene that regulates how the body processes folic acid or processes folate.

And Mike, you probably can go deeper into this because I don't actually know a lot of the nitty gritty, but then if you're heterozygous, it means two different ones.

So you have a normal quote UN quote allele and then an abnormal mutation.

Exactly.

And so to that point, as you were saying, homo meaning same and hetero meaning different or colloquially opposite, if you're homozygous, it means that you have two of the same allele on there.

And if you're heterozygous, you have different ones.

And ideally you'd be homozygous for the quote UN quote normal gene for the MTHFR.

But in people who are homozygous for the negative or deleterious quote UN quote bad gene, you're going to be having issues processing folate and that's the synthetic oxidized form.

But if you're talking about the naturally occurring, you're always going to be running into folate, which is the reduced version of it.

And without getting too deep down that rabbit hole, you really don't want to be taking or eating fortified synthetic folic acid, especially if you have that gene mutation, because beyond just the PCOS aspects, it causes problems to methylation.

And that again, is a much bigger rabbit hole than we're trying to do right now.

But methylation regulates gene expression and genome stability, with downs from effects on insulin resistance, homocysteine production, B vitamin status, creatine neurotransmitters, and epigenetic regulation, which is the turning on turning off the genes, how your genes are acting in real life.

Simply put, if you have that mutation and you're deficient in the cofactors, the vitamin B2B6B12, choline, or your thyroid or liver energy is stressed, which we commonly see in PCOS, then methylation drags.

So it's pretty important to restore cellular energy and supply the right nutrients so the system runs smooth.

Absolutely.

But I'm going to let you get back into it.

Well, and what I think is so interesting, the history, it's one of those byproducts of industrialization that we even got folic acid supplementation in the 1st place that I think it was during one of the world wars, they were starting to fortify grains so that everyone was getting quote UN quote, ideal nutrition, right?

Some scientists and some labs were like, everybody needs these elements in their diet.

And so folic acid was the cheap version, the synthetic version of folate.

And what they saw initially was beautiful.

It was reduction in spina bifida, which is a neural tube defect.

So neural tube defects are almost unheard of now.

However, we've gummed up the system for those of us who have this gene mutation, which I've heard anywhere up to 70% combination of the hetero and homozygous, which makes it funny because then it's not what's the normal, but probably more conservatively, like less than half of people in the world who've been studied have this mutation.

So I definitely for the women who have any history of, of mental illness in themselves or their family, any history of alcoholism, it's highly correlated with that.

And then pregnancy loss.

And so that's a thing that I often add on because I'm just so curious and I'm not trying to brag, but I think just because of the prevalence of this and then the people who come to see me, which is sort of self selected for people who are struggling, there's a lot of people who are positive for it, for it.

But for me, well, I don't know, I can get into a little bit of my history, but I was diagnosed with it after my son was born preterm and I was having some cycle irregularities.

And my functional medicine doctor at the time added it on to my labs.

And I had already been feeling better on a gluten free diet for years, but was not very faithful to that diet because it was like, was this one in my head?

Am I just really sensitive?

I don't know.

But man, when I got that diagnosis, it was this is a thing, this is real.

And I do feel better when I don't eat wheat, and now it's when I don't eat enriched corn products.

And you start to see that it's really pervasive.

So to that degree, how do you do with sourdough that like is actually dumped like a proper like organic?

Yeah, I've tried and I don't know that because then I'm like, well, maybe I'm gone the other direction because now it's is this just a mental thing where I'm like, I don't know about that, but I think that one does a number on my gut.

I wondered if it's the yeast.

Interesting.

Okay, that's fair.

So obviously in this context, we're talking about it for avoiding the synthetic, the fortified folate.

I have a lot of thoughts on whether or not for most people at least, is it actually gluten and glyadin or is it something that's going on with what we're spraying?

Is it the glyphosate that we're spraying on it?

So that's a side pet theory of mine, but that's why I kind of wanted a little input on that, but.

Please go ahead.

Well, and then when you.

Yeah, yeah, no, absolutely.

And then I've found that if it's organic, it doesn't have the folic acid.

So which one is it?

Is it reducing the glyphosate or is it reducing the synthetic folic acid?

I don't know but I'm doing both so.

Right.

That's where my thoughts came in there on that question.

And then I've recently I found out, I thought I was so smart because, and maybe I still am, I'm, I'm really the verdicts out on this one.

But if you get like cheap products like some like little Mexican pastas that cost $0.99 for masa harina, they're not enriched with folic acid.

Although then somebody I know who's really into this as well came in and said, actually they spray the crops with folic acid And I'm like, oh man.

So they don't have to put it because it's like pre production.

But I'm trying to choosing not to believe that from my pocketbook.

I'm just like really?

The cheap stuff can't find just.

Couldn't it possibly be cheaper for them to not enrich the grains and just leave it alone?

But whatever.

A lot of times they're getting subsidized to do it, so it's like.

Yeah, right, right.

And so, yeah, that's a whole different thing.

Don, I need to jump in.

Or is this another one of those episodes where you're like, I'm just sitting back, man.

Man, I was just going to say that.

I feel like I'm in like a lecture hall.

I'm just soaking it all in that.

Was last week's episode.

And so I'm sure at this point, I know you've been busy, you haven't been able to hear this one yet, but the Presbyterian Marina, we really geeked out deep down the rabbit hole and it was similar to them.

Like John.

You have anything to add?

He's like I, I got nothing.

I'm just sitting back here.

I've got to listen to that when I'm you keep talking about it and I'm so intrigued.

I, I really think you're, she loved your episode, by the way.

First of all, yes.

And we didn't even get into a lot of the health stuff.

And that's why we said we need to have you back.

And then Casey was like, well, PCLS awareness month is coming up, so you should do this.

And then we did our men's arc.

So we're like, well, now's the perfect time.

Let's square this all away.

So yes, she was a a fan of yours and I very much think you're going to appreciate her episode.

And her big thing is the cycle sinking.

And she really broke down some of the better ideas to do in each of the phases.

And so I was like, Oh yeah, Justin's going to be better in this phase.

So you're going to be able to do the greens and the the raw vegetables and the beans a little better.

And well, now once you start the menstruation phase, you're going to want to really up the iron.

If we're talking non fasting Adam steaks, if we're talking during the fast, maybe some blackstrap molasses.

And it was really cool the way she was writing down.

OK, this is a side note, but I think it's also really important.

No, please.

My new passion right now is herbs and teas and so because in part.

Long story short, my son was born by C-section and I was having some irregular color bleeding.

Pretty annoying and pervasive.

I have adenomyosis which is similar to endometriosis.

Basically it's about part of the uterus going into another part of the uterus it's not supposed to be in and it can happen after you've had AC section and it happens more likely when you're older.

Anyway, it has been healed and I'd like for his God for his God.

St.

Veronica is the woman with the issue of blood.

I prayed to her and I have also had an amazing acupuncturist.

But I I think that one of the game changers for me was drinking calcium rich tea in the last half of my cycle.

Nettle tea, red Raspberry leaf, all uterine tonic.

And you think about just simple muscle function and we know that muscles need calcium to function well and I think it was a dysfunction in my muscles and I'm all about it.

So now I'm like, what is going on in my life and what tea do I need for it?

Brennan's tea Bana over here.

Yeah, and a new escape hatch fantasy is maybe I could just open up a little tea shop and have a bunch of apothecary jars.

So and but for women for PCOS, back to circle back to PCOS.

Spearmint tea has had quite a lot of research behind it to reduce androgens.

It's a pretty straightforward, easy tea.

You don't have to search too far to get that.

And yeah, if you want to start growing Spearman peppermint in your yard, it'll take it over in just a minute.

So those guys will grow everywhere.

So it was really easy to get those.

I yeah, I could see that.

It's one of those along with I know lavender is another one that they try and tell men to be more mindful of because of the anti androgen effects.

So that makes sense.

I like it.

Now that's actually kind of led me into some other thoughts I had there.

Supplementally, what are your biggest go TOS for someone who has PCOS?

We touched on it a little bit earlier with Casey, but let's really.

Well, again, I'm working in a community clinic.

I work in a very low income population and so we don't always get to get super down and dirty with the supplements because just a class constraints.

But if women are really motivated, myo inositol people Pronounce It differently is my new favorite just because it's got some good search.

Now with the inositol, all right, you know it's at all or inositol, tomato, tomato.

Do you stick with just the Mayo or do you do the de Cairo as well?

Do you do?

The de Cairo, that's what I was told to do.

I haven't done the research on it but that was told that was superior.

So not that it's necessarily superior, but I believe 41 is usually the ratio that you go of the Mayo to De Cairo.

But the Inostol in general, very big fans.

We'd think that was very beneficial for Casey in our journey as well.

I think of it as sort of a natural alternative to metformin, just thinking about the insulin resistance and the ways that that can help regulate.

No, absolutely.

Did she have to take 4 pills in the morning and four pills at night?

It's a really large dose.

Yeah, so we did start with the pills, but we ended up switching.

So there is a midwife that we're both familiar with.

We ended up going at least meeting with her a couple of times, but we didn't end up working with her at the time.

She gave us a recommendation for a powdered one, but it was very expensive.

So then we then went and found both on Amazon and they have that natural food store in Fayetteville and it's called Oversense and it's the same ratio.

Same.

Yep.

And the company was one I'm familiar with.

So it's something that, yeah, the Oversense was what we have been using and whenever we're trying to be a little bit more active, we make sure that she's on that and we think it's very beneficial.

Mix it right into some milk and it blends well because right, it's a sugar alcohol like a Nasatol.

Whenever you do the all, you know, you're looking at a sugar alcohol and it works very well with the milk.

They work synergistically together so.

I never think about putting alcohol in my milk.

No, no, it's sugar alcohol.

So it likes alcohol.

Eritreal.

It makes me think I'm like White Russian guy, like big little guy.

Exactly.

Right.

White Russians, Right.

Or putting Kahlua or amaretto in your coffee.

Right.

Those are delicious.

Yeah, and there's some bad memories associated with that, so I'm just gonna.

I say that as someone who really doesn't drink anymore at this point.

Like I have a post comedian wine and that's about it.

That's probably very honest.

And it's not even any kind of teetotaler thing, which John and I will be covering very shortly once we get into this sacred diets arc, but which is coming.

Up next, well, as we've said, I'm just here in the lecture hall today as well as last week.

I'm just really enjoying the high level discussion that's been going on.

But to tie it back to some of the conversation about dealing with PCOS and how I know you'd like to do that through things like your diet, your lifestyle habits for especially.

I know you mentioned you work with some low income areas and people with lower income, maybe supplementation or different types of things like that aren't as readily available as an option.

What things that are just lifestyle habits, things that you do that don't require the purchase of anything special, what can be done now?

You just make the decision to change that habit to help out that with symptoms, the most important habit to change now.

Can I have two?

Of course, you can have three if you want.

That's pushing it.

I do say a lot gentle exercise.

I don't want people to start pushing themselves again like to the stress levels and maybe caloric restriction back to full circle to that a really strenuous exercise program.

But my baseline is like 30 minutes five times a week walking, whatever feels comfortable for them and something that they enjoy dancing would be lovely.

You know that kind of like feminine energy if they wanted to do that.

But then.

Don't you dare say yoga.

No, I didn't.

I didn't say that I used to teach yoga.

I've been there, used to, yes.

I think just the stress relief benefit.

And personally, after that, just what I preach because Andrew, and I've been trying to get more intentional about like just going on a walk at night or I go on my lunch break and go on a walk and little stuff adds up.

I say that too.

I tell patients if 30 minutes feels daunting, try 15 minutes.

And then if you are out there, you might as well stay for 10 more.

Start small.

And then I often counsel patients.

We'll talk about nutrition and they're like I'm eating protein, I'm eating lots of vegetables, I'm doing really well.

And then they have a big seven brew drink.

And I will say, don't drink your calories because it's empty of the protein that's going to balance that out or the nutrients.

I'm not to mention the stress that caffeine puts on your adrenals.

And so that's my big one.

And that's, I know, easier said than done, like I think especially in the South.

To our non orkans and there's seven brew is a popular local coffee spot that makes all the frilly fruit fruit drinks.

Now I will actually push back a little bit on that one because as well, I don't like sugary caffeinated drinks for a lot of people for a lot of purposes.

For someone who who is hypothyroid, a lot of times you see them reaching for that coffee and part of it might just be they've gotten to that caffeine cycle.

I'm going to fuel with only caffeine.

But if you are also nourishing yourself with real nutrition otherwise and providing the nutrients and the calories, having a sugary coffee could be beneficial, as crazy as that seems.

My my.

No, I'm telling.

You put me in a position here where I'm going to have to tell my wife that the Duncan thing is actually fine.

So I'm going to tell you.

Is this where we're going with this?

This is this is, I mean, you want to be careful on what else they're adding to the drink.

That's where it gets a little squirrely what other things they're adding.

But the sugary part of itself, because talking about the adrenals, yes, caffeine is a stimulant and it causes the adrenals to liberate cortisol.

But the reason it's doing that is because it's revenue metabolism.

It acts almost like a thyroid hormone.

Now, to that point, if your caloric intake is sufficient, if you are meeting your needs there, revving up a metabolism is not a problem.

Why?

What are your adrenals doing?

What's cortisol doing?

It's we talked about as a bunch on this show.

Not at this point.

Cortisol is liberating sugar to fight or flight.

That's why it's a stress hormone, right?

You need to do something.

I need that quick energy.

So we're going to have a cortisol bump to be able to have the sugar in circulation.

However, the sugar is already in circulation with that coffee and you are properly nourished.

Otherwise then it's not going to have a stress effect.

You don't need to release cortisol because the sugar is already there to that point if you are having that coffee, sugary or otherwise.

That's why I try and warn people against black coffee too much.

If you're having just coffee and it's the first thing you do before you have any other food, then yes, we're in complete agreement.

But if you had even a light meal, even an egg, even some sourdough toast, even, whatever the case may be, a little bit of food and then you have that, then it actually might be beneficial.

Especially in those who are hypothyroid, They're accidentally self medicating, but then in turn usually causing more problems because they're not doing the other things, they're not not getting food and otherwise.

But that's an area where the added sugar, as crazy as it seems, could actually be beneficial.

I can hear it already.

OK, but Riddle me this because usually when I am doing a panel to test women for PCOS, one of the things I'm ruling out is hypothyroid.

And so very few of my patients who I'm treating for PCOS are also hypothyroid.

So I still feel a little bit like I can tell them not to drink their calories.

So get to that point.

Are you doing full power panels?

No, not always.

I do TSH and T4 so tell me about that.

So there could be some conversion issues going on.

There are other factors to consider there.

And yes, you're 100% right.

Now all of them are going to be clinically hypothyroid.

I completely agree.

Functionally, most women who have PCOS are going to be, if not to the degree of hypothyroid, if the metabolism is completely derailed, they're still going to be overstressed.

That's something we were talking about again, Presbyterian Marina last week is that she was a high level high school athlete in gymnastics and was overtraining and functionally looked great, was an athlete, didn't have any reason to believe that she had PCOS from an insulin resistance standpoint, from a weight standpoint.

But she was overtrained, overstressed.

And so in that kind of instance, her thyroid was working fine.

Her metabolism was revving too well.

And so in that case, yeah, we might want to look at might not consider the thyroid being the problem.

They might have a functioning thyroid, but the hormones on the adrenal front are still too high.

So in their case, yeah, I might not go that far.

It's something why I want to look at it.

And if your thyroid isn't functioning, that caffeine with the sugar will be a means of helping to regulate those issues.

And yet the bio individual effect.

Absolutely.

That's why I said we want to push back a little bit.

I didn't say you were wrong completely.

I didn't say you should all be right in the Sutton brew.

So they're not paying us.

I don't know if they use sugar or hypertrose.

Corn syrup as ever.

Brew.

I'm not sure so.

Yeah, exactly.

That's another major thing too, is that yes, I would ideally you'd be looking at a real sugar of some type.

I'd rather them have spearmint tea with honey.

There you go, you know and like, but again.

Blackstrot Molasses.

It's sort of if you're going to have those calories, I'd rather you have something that is working for you rather than against you to.

That we are in a complete, complete agreement.

Like I said, I wasn't trying to completely overrun you there.

Yeah, for the most part we agree and Lord knows what 7 brew is actually using.

Don't sue us guys.

We're just using you as an example because it's local.

My wife is still going to hear this and go, that's my green light.

That's the green Dunkin light right there.

Dunkin is delicious and if you're ever traveling in an airport, Dunkin is almost always one of the cheapest options I really appreciate.

That that's true, Yeah, that's fair.

This has been an education for me too.

I feel like I want to pick your brain a little more on things.

So the sugar one is one that is a very taboo topic because with the exception of the fruitarian types, like the ones who are 30 bananas a day, almost everybody thinks that sugar is the absolute villain.

The same way that certain people think that's red meat and cholesterol or it's grains or it's this or it's that.

Sugar almost universally is like, no, get that the heck out of here.

But if you look at what its purposes are, it's like, we do still need sugar.

It has to come from somewhere, even if we are eating 0 carb full animal carnival doesn't matter, but your brain does still need about.

I think it's 30% of your calories still need to fuel your brain with sugar.

So either we're going to be producing it ourselves through gluconeogenesis, but it's going to show up to the party somehow.

It's funny because I don't even like coffee with sugar per SE, but I've been doing it more often lately.

Yeah, I found a really nice caramel almond Creamer that helps on fasting days when I feel like having something a little sweeter.

Yeah, I know.

I've tried to sell you on the orange juice, but I haven't won you over on that one yet.

I just couldn't get it to work for me.

I'm sorry.

I did try it though.

I know you did.

I know you did.

So have you ever put orange juice in your coffee?

Yeah.

Not on purpose.

I almost put orange juice in my coffee press one time.

I just was making breakfast.

OK, almost poured the wrong but not no.

No, that's my go to on fasting days I don't generally buy it, but during the fasts like the longer ones I will purposely buy the calcium fortified orange juice for that purpose.

There's a Mexican coffee with orange juice and cinnamon.

Oh, it's so.

Oh, good.

So actually I have.

I have.

So there you go exactly.

And so right.

And if you're really concerned about the sugar spikes, the cinnamon will help to buffer that a little bit.

And so there you go.

Builder, which is another local spot, has it on the menu.

They call it the game changer and is a coffee orange juice blend and OK yeah, no, I've it's OK.

Let's put it this way.

It will never replace my coffee with half and half as my general go to Yeah.

But as a fast friendly alternative, if you're not wanting to do the coconut milk or to that effect, coconut for fasting, orange juice I find to be an excellent alternative and it fits within that whole framework of getting a little bit extra sugar during the coffee indulgence.

OK, so actually this is Cafe de Oya is a Mexican spice coffee with Peoncio, which is like the most delicious sugar ever.

It's unrefined cane sugar, so it's almost like molasses.

OK, Orange peel and cinnamon and then it says you can also spike it with tequila.

I'm.

Going back to the ad and the alcohol is to your milk, beer and then let's get to your coffee.

It's delicious if you ever get a chance, but the calcium fortified orange juice, I like that.

So it's the same idea as the sugar.

About why you're adding the sugar to it well is that the caffeine is acting almost as if it were a thyroid hormone.

It's the same kind of idea as the sugars that it's revving the metabolism and so it's causing you to utilize more energy.

The calcium idea is not necessarily leaching calcium out.

It's like not necessarily chelating and locking up the calcium.

It's just causing you to utilize calcium more abundantly.

And to that degree, that's where the calcium in the milk buffers it the same way.

And so that's kind of what I'm looking at with the sugar.

So in the case of the orange juice with calcium fortification, I'm using that to buffer both the stress response and the calcium deficiency of that meal.

It's going to replace it a little bit.

It probably would be better to supplement calcium otherwise, but for my purposes on a fast day, I'm not going to lose sleep over it.

I'd rather just get the the fortified one for those particular purposes.

I think.

So we've kept you here for Koala and we definitely got to tackle a lot more of the health related topics this time.

That's something that we were really want to delve more into.

And Even so you still managed to throw in quite a bit of the more theological topics.

So we definitely are appreciative of that.

If any last thoughts before we start wrapping this up.

Well, this is just as a side note to people who might feel like this is a fire hydrant of information, which it is.

There is a beautiful book that I've just started reading called Under the Laurel Tree, Grieving Infertility with Saints, Joey Kim and Anna.

And the author of that book, Nicole Rochas is Orthodox and has struggled with infertility in her life.

And so it's actually a compliment, I think, to what we're talking about because it's the what do you do while you're waiting?

And if your blessing does not come in the form of a child?

And it's so beautiful.

It's a very beautiful book.

I've I've really been thankful for it.

It's part of our faith that we have faith even when we don't get what we want.

And as a mom of a six year old right now, I have to think about that a lot of the time with him.

It's like he has these total meltdowns when he doesn't get what he wants, when he wants it.

And it's getting better.

But me too, right?

If I don't get the baby I want when I want it, heartbreaking and crushing and can definitely cause you to lose face for a period and to feel deserted by God and feel like you don't have a blessing that other people have.

And I was with Casey during some of that and both of you and you guys are with that with me.

And so I think this book under the Laurel tree, she writes up, I think very beautifully about how we hold that grief in our faith.

I haven't finished it yet, but I think it's still going to be pretty good.

In the introduction, she says we're going to go right up to the point before when Joey came in, Anna's prayers were blessed or were answered by God.

That's their journey of faith.

So whether or not it ends in God quote, UN quote, giving us what we want, still this beautiful blessed journey and and checks about how they end in thankfulness, in praise of God for everything that he's worked through their lives and of it is for our salvation.

And so whether we're struggling with infertility or seven children, we're struggling.

Yeah.

But I think that the infertility piece can be very uniquely difficult because there are these beings that are hoped for and wanted and are not there.

And so nobody sees that you're struggling with that.

I completely understand what you're saying and that's something that as Casey said, just said is that we are very much on that same page there.

And it's interesting though, because we said that a lot of that is God called from home a little bit sooner than we wanted them to.

But we definitely have our faith that he's there.

And I wouldn't go so far to say it's selfish, but same thing we do when even older family member proposes where we still want them, but it's not our call, unfortunately.

And to that point, we have to trust that that's what the plan was because it's not where we are.

And the beauty of our faith and having that community is you have the people who are around you can help you get through to the degree that they can.

And as you mentioned, when you had one of your losses there, it was around the time that we had Marina and you and her have such a special bond.

I like to think it's related to Sylvie.

I think there's something there I really, truly do that beyond just you being Casey's godmother.

You and Marina have such an incredible bond, and I really do.

I do believe it's something there that you are spiritually bonded to her through your daughter.

And I know how painful that is to address.

I appreciate you being so bold and so brave to do so.

So I, I appreciate you getting into your story a little bit.

Yeah, I remember the first time I met her, Casey was like, are you OK?

Do you want to hold her?

And it was like, no question.

It surprised me.

Yeah.

Yeah, I do.

So glory to God.

Yeah, I think that might just be the perfect spot to end it.

Brennan, thank you again so much for your time speaking with us tonight.

Thank you for sharing that with us.

Always insightful, always moving, and always inspiring.

Thank you.

Thank you guys for doing this.

Thank you for having me.

Yeah, this is great.

Yeah, I mean, that's the thing.

We love having you from both the professional and the personal level.

You have a lot of great insights to add and you definitely bring a lot of newer thoughts, whether it be from the Saints like last time with St.

Olga or this time with Saint John Chrysostom, or we didn't heard out on the technical stuff on the the health related stuff.

And we also get to both have joy and grief in the daily life of it.

So no, we appreciate you.

So yeah, I think that's a good place to call it for today.

I've got to say, John, this one felt pretty special.

Having Casey here to share her story alongside trans professional wisdom.

It was both personal, It was practical.

I think a lot of women are going to be able to laugh, cry and breathe a sigh of relief hearing that they're not broken, they're not alone, and there are real steps they could take.

A mic?

Absolutely.

And what struck me is that this conversation wasn't just for women with APCOS diagnosis.

It's really for anyone trying to make sense of hormonal health, fasting, and the rhythms of life in the church.

Because let's be honest, a lot of us men could use a better understanding as well how to support our wives, our daughters, and our sisters in Christ.

Exactly.

And health isn't isolated, it's communal.

It's a reminder that healing isn't just diet tweaks or lab results, but an actual offering of the whole person to God.

Absolutely, Mike.

And to that point, in continuing our Women's Health arc next week, we're very excited to have on Rachel Wilson.

And if you don't know Rachel, she's the author of Occult Feminism, and she's been doing.

Doing some incredible work exposing the counterfeit spiritualities that target women, and we're going to talk about spiritual warfare, the reclamation of femininity, as well as physical exercise and diet, and how that ties into this whole arc on Women's Health.

Absolutely, and that one's going to hit hard.

If today was about Physiology and lived experience, next week is going to be out the battle for the soul, for the soul of the person, but the soul of society in general.

Racial for patriarchy, right?

And how the church itself and the Theatogas as a model give us the weapons to help fight it.

Absolutely.

So make sure you're subscribed, share this episode with someone who needs it, and check the show notes for links to work with Doctor Mike.

Absolutely.

So thanks for being with us and remember, true help is wholeness in Christ and we'll see you next time.

God Bless is available on Spotify, Apple Music and all of your other favorite listening locations.

And you can also find us available on YouTube at Doctor Michael Christian Rumble at Orthodox Health and Sub SAC at Orthodox Health podcast.

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Until then, stay strong in faith, take care of your temple, and keep Christ the center of your health journey.

God bless.

The.