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Episode 7: PCOS? Hormone Imbalance? Fatigued? Let's Chat!

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Episode 7: PCOS? Hormone Imbalance? Fatigued? Let's Chat!

PYP 7 | Health Team

 

You are the only one who can truly take charge of your own health! In this episode, Haylie Pomroy explains the importance clearly defining what you expect from the practitioners on your health team. Haylie brings on one of her community members Melissa, who is struggling with hormonal imbalance and chronic fatigue. Together they talk about Melissa's health wishes and what talk about when she goes to her physician. Tune in to learn tools and tricks from Haylie as she teaches you how to advocate for yourself while speaking to your health care practitioner.

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Listen to the Podcast here:

PCOS? Hormone Imbalance? Fatigued? Let's Chat!

I have a very special guest that's joining me. She is one of our community members and I asked Melissa to come on to share with us and walk through the process of filling out your health wish list, your self-assessment questionnaire, and then ultimately all of us getting to what we call your request for care. You'll see me a lot of times call it a Dear Dr. Sanders letter. For years, I worked in a multidisciplinary practice where we had OB-GYN, nephrology, cardiology, internal medicine, GP, you name it, and we engage with a lot of clients together. The biggest thing that I found was that there was a lot of lack of communication when an individual felt like they were needing to engage some healthcare practitioner. Melissa, it could be anybody from an OB-GYN to an acupuncturist, to a cardiologist, bringing someone else into your world. What we're looking for is for them to be in a place of service to you.

I want you to make sure that you've printed out your own request for care. It's in your member section. You should also have to create your health wish list and your self-assessment paperwork. The creating health wish list and your self-assessment help us fill out the request for care. This all came about for me with our community. Melissa, I think this can be super effective and helpful for you because I find it helpful with my clients. I had a client that came in that saw a physician that I had referred them to. They came in and they said, “I don't like this doctor. They were horrible. I didn't get any of the tests run that I want. I wasn't listened to.” I thought, “This is interesting because from a practical perspective, they're a very good doctor. Talk me through this.”

We talked through it and I said, “What did you tell them you wanted? What did you tell them you needed? What did you tell them that was going on?” They said, “He’s the doctor. He should know. I'm not going to go in and tell them how to be a doctor.” I went, “There's a bridge that we need to gap here between what you recognize is going on with yourself, where you'd like to be, and how you communicate with a new team member.” That's why I look at all of our practitioners as a new team member and how to communicate with a new team member effectively. The self-assessment is a sheet, and Melissa, thank you for filling that out. Some people attach pages and pages. It's about finding out where you are currently.

Sometimes until you start filling one of these out, you might not recognize that you're not sleeping well every night or you maybe don't sleep well every night. Maybe that's happened for so long that you start to go, “That's just me.” Assessment is where are you currently and your wish list is where do you want to be? Where do you see your future? It’s important. Melissa, this is with you and also with all of the community members out here reading. Whenever you reach as high as you can reach it through your health wish list, I'm always going to be there pushing you a little bit further. What I find people say is, “I want to have enough energy to get through the day.”

I want to change that mindset and that verbiage for you to say, “I want to have enough energy to have a glorious day and give some away to anybody else in need.” I want that much for you. As you guys are filling out your self-assessment, I want you to be brutally honest. This is the time with the self-assessment questionnaire to be cathartic. I always say, Melissa, the chair that you're sitting in, if you were in my actual office, that's the narcissistic chair. It is 100% about you right now. When you're out there in the community and you're filling this out, you can keep this private to yourself. I have people that come in and I say, “Do you deal with constipation?” They say, “Not really.” I said, “Are you having 1 to 2 bowel movements a day?” “No. One to two a week.” I say, “That's constipation.” Sometimes again, that’s communication. It was interesting.

Melissa, one of the reasons why I was so happy that you agreed to do this was I had an actual client that came in that was having seizures and had been to the emergency room with seizures. I said, “Let's pull together everything that they've run so far, labs that have been run, what's going on.” She was almost going to abandon her doctor because we looked at everything and literally, they had run like a basic chem panel. They basically said in the emergency room, “It doesn't look like you're going to die right now. We're going to send you home.”

That's good, emergency intervention. She went to the doctor and she says, “You're not in the middle of a seizure right now so we're going to send you home.” Nothing was pursued with that except for seizure medications. This particular client wanted to understand if there was a possibility of figuring out the why. We went through and filled out the self-assessment questionnaire. We filled out the wish list and I found out that she had a few desires for her health that she had never even told her doctor about and she had never even thought about. We then filled out the request for care. We got back all the labs and found some cool things in it. I get a chance to talk to her doctor.

She was like, “I didn't know all this was going on with her. I didn't know that this is what she desired.” Maybe it doubled down again and feel like everybody in our community needs this. Melissa, if you could share with our community maybe two things on your health wish list that you would like to see and have realized in your health going forward. It can be your future self tomorrow or your future self six months from now. Remember, when you sit in a chair and when you're part of my community, I have this magic wand that anything is possible.

Two things for me would be to get my hormones under control. I’ve noticed it's been a long time. After I give birth to my daughter, everything has been out of whack and that is the biggest issue that I have. Other than that energy, that would be amazing.

Are you waking up with energy or are you draggy all day?

I’m tired all day. There's fatigue all day long and I substitute with coffee, which I'm trying to not do as much. Caffeine is not what I want to be on. I feel like a lot of times it's a necessity for me. Other than that, just more energy, less anxiety. It’s a long list.

Let's start there together for a second and let's start formulating particularly what we want to ask for. A good book to have when you're doing this is the Food RX book. The reason why I love that book is in the back of it, it has a lab request in each chapter and what those labs are for. It'd be important if we're going to say we want our hormones balanced, the doctor's going to say, “We’ll set your hormones on this tight rope and let me help you balance them.” How do we talk that to a practitioner? Whether it's an acupuncturist or it's OB-GYN or fertility specialist, we want to communicate and articulate that.

 

 If you go and you have your Dear Dr. Sanders letter, we want to fill in the first thing, dear doctor, and Sanders is the one that I use a lot. It starts with, “I'm having some health issues that are very concerning to me.” In addition to the normal labs, I always say that that is an as if. You're going to walk in and say, “Of course, we're going to run labs. This is either my annual physical or I'm coming to you because there's a problem. I'm assuming you're not going to use psychic powers to determine what's going on with me.” We're going to use some physical science. That's why I like to start it that way. It’s acting as if. The confidence to be the advocate for your healthcare. “In addition to the normal labs we would run at this visit, can we please run some diagnostics so that I can help define what's going on with me? The reason I'm requesting these is because I'm experiencing.”

You can use this exact letter. My clients use this exact letter. It is funny in the Burbank area because I work with so many doctors there. They know who wrote this. You can use your own words or your own verbiage. This is a start, but please feel welcome to do it. Right away, we've said, “I'm not coming in here because I need a flu shot. I'm not coming in here because I’ve got a corn on my toe. I'm coming in here because I have some concerns.” The word concerns will elevate it, turn on some listening ears no matter whatever practitioner. Let's take and articulate what you told us already. “The reason I’m requesting this is because I'm experiencing.” I liked the word that you used when you said fatigue. “I'm experiencing fatigue.” We're going to define these in a couple of words. We're experiencing some anxiety and I'm going to say some signs of hormone imbalance. We're filling out a paragraph for our fifth grade essay writing. When you say signs of hormone imbalance, can you give me 2 to 3 signs of those hormone imbalances?

I'm an open book, so I apologize in advance. I have irregular periods. I have heavy menstrual bleeding. I have facial hair. My daughter tells me I have a beard. That is one thing that I would like to rectify.

I'm going to help you help your doctor a little bit. We're going to think about this like fifth-grade paragraph writing. You gave me three main topics. I want you to do this. I don't want you walking to the doctor saying, “I'm tired.” I want you to walk into saying, “My energy level was an eight. I always wanted it a ten, but now we're talking a six and that's unlike me. I'm super concerned.” You have to articulate your story in a way that gets them to feel as passionate about your wellness as you do. If you got a good doctor, you got seven minutes. On average, you're seeing your doctor for 3 to 6 minutes. This letter's going to go to the nurse. You're going to send it to the doctor's office when you schedule your appointment. You're going to have a copy for you and you're going to have a copy for your doctor. Let's give 2 to 3 things that tell you about irregular periods. Are they every 28 days, but short and scanty? Are they every seven months? What do you mean by irregular periods?

I got a tracker so that I could figure out what was going on more so because every time I would go, they would ask me those questions and I didn't know how to explain it or to tell them.

I'm holding your feet to the fire because this is what I do with my clients so that we have a clear, concise story and we get exactly what we want. Irregular periods mean are they coming every month?

No. Not every month.

Sometimes you're skipping a month.

It’s like a month and a half. I'm always late.

I'm going to say not every 28 days and they're not usually shorter. They're usually longer. This is an important thing when we're talking about hormones. If they're coming every seven days or you’re having 2 to 3 periods of what we call breakthrough bleeding a month, it means something totally different. We look at the lining of the uterus. If we're looking at early, maybe you’re bleeding fibroids if you're having them more frequently. We're looking at more ovary nurturing and support if they're stretched out further. It’s super important that we raise that flag. We're going to say not every 28 days. They're longer. When you say irregular, the actual act of your period, how short is it? Are you bleeding one day?

They’re usually five days.

 That falls into our irregular period. The next one is heavy bleeding. Is that encompassing a lot of clotting?

I feel like it depends on the month. One month, it’s worse and more clotting. One month, it's a lot of heavy bleeding.

Heavy bleeding, every other month clotting. If you guys are having periods or if you're still cycling through menopause and you're having the symptoms associated with it, try to journal and get as much data as you can. Let's go quickly to the fatigue. You've already told me that it's all day long. Are you sleeping through the night?

No. I have a little bit of insomnia, which may be anxiety.

Do you have trouble falling asleep or waking several times?

Both.

I'm going to put both falling asleep and staying asleep. I want to talk about the anxiety quickly. I want to get a little bit of color on that. I'm going to show you how to pull this whole story together where you can get somebody that can come in and have a lot of data before they interject stuff. A lot of times when we talk about sleep and we talk about anxiety, one of the big things that a lot of my clients say why they don't make a doctor's appointment is because, “I have anxiety or not sleeping.” No judgment if you want to do this, but this is what clients sometimes reflect to me. I said, “Why haven't we gotten in and had some labs run?” They say, “It’s because I go in and I tell him I'm not sleeping and I'm having anxiety. They give me Ambien and they give me an anxiety medication.”

To the point literally where I have to beg clients sometimes to get back into their physician or their practitioner because they're not looking for a fix. They're looking for a why, and that's the power of this letter. When you get your Dr. Sanders letter, we get it all pulled together at the end of this, you're going to highlight those little things. You're going to make sure that you have it in front of you and you communicate because it can be intimidating. Whenever you're going to a chiropractor, you need to say, “I'm having fatigue, anxiety. I'm having alternate month heavy bleeding and clotting. I want you to know that my periods have now lengthened. They're irregular. I'm not falling asleep well. I'm not staying asleep and I'm having anxiety that looks like this.” Let's define that. Talk to me. When you wake up, this anxiety, does it feel transitional? Meaning, is there a low level all day long and it surges, or does it come out of nowhere? It can be both, but more like a panic attack. I'm going to ask times of days too.

I think for me, it's more like an anxious mood swing. For me, I get snappy. Sometimes I get panicky but not overwhelming points. I feel like it's not debilitating to my life and controlling me, but it's not ideal.

That goes back to your health wish list. I want you to tell your doctor that it's not okay. You want to say, “I'm having anxiety,” then reflect back to what I heard. You tell me if I'm hearing you correctly. “I'm having anxiety that feels like it accompanies mood swings. I feel like I'm holding my shit together, but it doesn't feel the way that I know I can feel, which is a sense of inner peace and joy that's like when I sweat, it comes out of my armpits.” If you don't tell them what you want, you are dragging your doctor, he or she, up a very large hill. It’s a lot of work for you. You set the pace and you set the goal always. This is what I tell my clients. What can happen is if you say, “It's okay,” you're telling someone, “Don't give me appropriate care or adequate care.”

That's the big conferences or the conversations that I have with a lot of the physicians that I work with. I do a lot of consulting for doctors that want to start integrative healthcare practices. One of the things that I’ve always say is, “You have to get them to dream big, and then you have to be their biggest cheerleader if you do nothing else for the client. You have to be a diagnostician, like a hound dog on a hunt.” What I heard you guys saying is that she's having anxiety that feels like it accompanies mood swings. My other question with anxiety is, do you feel elated or giddy? Let's talk about a real strong anxiety surge or do you feel tired?

Probably more tired.

sleep-anxiety

 

A lot of times with anxiety, when we're looking at which metabolic pathway can we nurture, we like to look at the aftermath of an anxiety surge. Some people get an endorphin surge afterward and they get hyper afterward. We see this a lot with our kids that get anxiety and they'll bite or they'll break things, or they'll cut things. An adult, they'll bite, meaning they'll tell you to buzz off. They'll act out. That's a lot of the endorphins. Some of those neurotransmitters, when you see a lot of serotonin, the person or the kid will retreat and seem tired. They can even look like they have dark circles and adults will retreat. Instead of biting your head off, they'll wait until you turn your back and stab you in the back. That energy is a little bit different. It's good to know all of those kinds of things. Note that. You said something interesting to us all that you have a daughter. We're talking hormones. The onset of menses are critical times for hormone fluctuations. Is there anything during your pregnancy that was remarkable or since your pregnancy or having a hard time getting pregnant? Do any of those fall true to you?

It's funny you bring that up. I was told I could not have children because I have PCOS, endometriosis and cervical cancer. Those things happened before her and I was shown the FMD and I did about three months on that right before I got pregnant. All of a sudden, I was pregnant. I thought the doctor had the wrong file when he came in. He came in and was like, “Congratulations.” I was like, “No, that's somebody else's. I can't have a baby.” That was incredible. I was on bed rest.

Talk to me about those complications during pregnancy like bed rest.

They thought that I was not going to be able to carry her at the term.

I'm going to try and keep myself together because I didn't know that. One thing I love about our community is we're all in this together. You're not alone. Thank you for sharing that. I appreciate it. I know everybody will also. If you went in to go to a new doctor, an acupuncturist or a chiropractor, do you think that that would something that you would share with them right away?

Probably.

Let's articulate it here. “Also, please note that my daughter is six and I was told I couldn't get pregnant because of PCOS diagnosis, endometriosis diagnosis, and a history of cervical cancer.” I don't care if this is the doctor you've seen for 48 years. I don't care if this is the doctor that did the cervical cancer diagnosis. They see many people and you want to always stand out during that appointment. You want to tell them something remarkable about your health. You said, “I was told I couldn't get pregnant. This is why. I had a successful pregnancy with bed rest and my hormones have not stabilized since delivery.” Would you say that?

Yes.

I don't know about you guys, but if Melissa walked into one of our offices and she had this very succinct, compelling story and she were to say, “I want to go see an acupuncturist,” we're going to define what we'd like. “I'd like to start an herbal process.” You're going to see a chiropractor. We have the protocol for the progress sheet that you can fill it too. I'd like to understand what I should expect and when I should expect through my adjustments. You're going to see a nutritionist. “Let's set together what we should expect and what our goals are for my nutritional progress.” This letter specifically says this is about running some labs. I'm a lab junkie. We're going to tell her story. “Because of blank, I'd love to run blank,” if you're looking at your request for care. The first thing that I'm going to always do when I'm filling these out with my client is the ones that sound the most medically scary. Melissa used the C-word. She said cancer.

Melissa used endometriosis and PCOS. My first thing would define it down, “Because of my history of cancer, PCOS, and endometriosis. Because of that previous diagnosis, I would like to run blank.” I can tell you what I'd like you to run, Melissa, but in your Food RX book, if we're not sitting here together, I want you to go into the hormone section and it gives an indication of what hormones to run and why to run them. There are insurance reasons. Doctors need to have justification depending on if you're in a PPO or an HMO. If you have this in writing, it's difficult. You've told your story. It's difficult for anybody to justify of not running it. “Because of cancer and PCOS, I'd like to run,” and we're going to run a hormone panel.

We're going to run FSH. I got all this FSH, LH. We're going to run fractionated estrogen, testosterone free and total sex binding hormone globulin. It's all in here. If you go to your membership section under the hormone guide, you've got all these written down for you if you feel like this is compelling to you. I'm going to try and define my sex hormones from my thyroid hormones when I run those. It helps the doctors check the box for you to get coverage. The next thing that we're going to tackle is fatigue and a little bit more of a medical form. We’re going to say fatigue and exhaustion. We're going to use the word unexplained.

Melissa, if you told me that you had run a marathon, grab groceries, cooked for 27 people, wrote a term paper, then diapered octuplets and you said, “Haylie, I'm tired.” I'd say, “Go take a nap, sweetheart.” This is unexplained. We want to use that word. It's something that I learned a long time ago when I was working with a large group of physicians that there's that chronic fatigue, there's fatigue. Chronic fatigue is a very particular diagnosis now. Unexplained can help broaden things. This would probably fall under the thyroid category. All of this is in the book Food RX. I know we're going to do more of this. If you have questions, I want to get us all started.

We would run TSH, T3, T4, reverse T3 and uptake. We want to look at metabolically, one of the superheroes for energy, which is fatigue. The other thing is we want to look at some of the adrenal output. There's a hormone called ACTH, adrenocorticotrophic hormone. That's another great one that would not be a bad idea to have a good baseline for you. This is under the fatigue chapter. I think these are great labs to run annually for everybody that's had any hormone imbalance or episodic events with hormone fluctuations, but you want to give them a reason why to do this. Notice that with the sex hormones being tested. I didn't say because of my bleeding and my periods. A lot of times you can get your hormones run, but if you can hierarchy it with a stronger diagnosis, it's easier to plead your case.

I hate that and it's frustrating, but it's easier to define your case. We're going to talk a little bit about asking the doc. Here at the end, you're going to have a couple of blanks. One thing that I do is I’ll say, “This is what I'd loved. What additional labs do you think we should run?” Don't ever ask if you're okay with these labs. Don't ever ask, “Do you think we should run these labs?” We value opinion. However, you’re the 24/7 expert in the body that you are walking around with. The word you is at the beginning of it. You ask people that have empathy for other people, ask people how they feel but don't ever ask anybody how you feel. We haven't mastered that science yet. We're going to use this last one and we're going to say, “In addition to the labs above, what would you like to run?”

Melissa, because of the PCOS diagnosis, there are a lot of inflammatory markers that we typically run in our office with an individual that has PCOS. We should probably do a good episode on this. We have a great episode on the thyroid hormones to make sure that you get run. Until then, if you guys don't have that episode yet, run the ones that are under the autoimmune category. Polycystic ovarian syndrome, which is PCOS, can or cannot have multiple cysts on the ovaries. There is usually some inflammatory or autoimmune coupling that happens with that manifestation in the body. We want to look at things like sedimentation rate, C-reactive protein, ESR and ANA titers. Where you guys would find that is in the Food RX book. If you don't have the book, I think you should have the book.

This is probably my favorite thing I ever wrote. As a member, go to your section and look at your autoimmune guide. It tells you power foods to eat but also gives you the labs and what they are. If you have a diagnosis of lupus, PCOS, Hashimoto's thyroiditis or ITP, that category is important. Melissa, we're going to put those on yours also. With this, what we want to do is always keep one with you. You guys will all have your labs written down. This happens more than you can imagine. This happened to my husband at UCLA. When you go see the phlebotomist and you guys have agreed on these labs, they're going to write you a lab requisite.

You need to take this to the phlebotomist and say, “Before you draw my blood, can you confirm that everything I asked for is on your lab requisite?” This happened to the client that I told you that had seizures. We wanted a viral profile done on her. She is prone to fever blisters, but Valtrex, the herpes antiviral drug, don't do a darn thing for her, which made me suspicious of an alternative virus as opposed to herpes simplex. We had cytomegalovirus, we had EBV, we had a bunch of other viruses run on her. She went in and there's a way to run viruses, which is, is it acute or is it historical, immunoglobulins? There's a different way.

The doctor had only checked one box and she went in with her little Dear Dr. Sanders letter and asked the phlebotomist. The phlebotomist says, “Yes, I ran a CMV IgG.” She had her little list. She said, “Do you run an IgG and an IgM?” She goes, “I had no idea what I was talking about.” The phlebotomist says, “No. He didn't call for an IgM.” She texted me. I said, “Ask her to call the doctor and approve that.” This happens a lot. We said, “Go in with our list.” A week or two weeks later, we get our labs back and half of them weren't run and we're in the same spot that we were in. Does this feel like it's a little bit knitted together for you?

Definitely. I feel like I have a little bit of a blueprint on what I need to do when I go speak to them, because I don't know. I assume that they do and I know that they have your best interests at heart, but as you said before, you're the advocate for yourself and you're about the best. I think that it makes me feel a bit more confident when I go in knowing how to navigate a little bit better.

You're going to have your definition guide. Let's say you come back and your CRP, or C-reactive protein is 48. In the lab stage, it should be somewhere between nine. You're going to be able to understand what that is in your body and communicate effectively. It's not about medicating the lab that's off. It's about understanding the chemistry so we can learn how to nurture and nourish your body more. In general, when we talk about identifying these things with a hormone perspective, with the PCOS, the programs that I want you to look at. It's because you're very dynamic, we're all dynamic beings having this biodiverse experience.

I want you to look at some of the Food RX plans. I want you to look at doing like maybe an H-burn. We do the cleanse with us every month. We've got to get the hormones back into homeostasis. When they're in homeostasis, they can start repairing effectively. Every day, our bodies are creating new cells and they're in the repair mode. We cut ourselves, put a Band-Aid on and take it off a couple of days later and it's healed. The quicker we can create a homeostasis and get the chemistry balanced, it's easier for us to not be trudging up a hill to get the repair. In my opinion, at least annually, these labs should be run. When we're creating a protocol for progress and we want to see change, the ideal is every four months.

There are some peoples whose insurances won't cover them every four months. What we do is we run the annual, the big one. We pick our targeted ones that are off and we recheck those more frequently, but because they all work together, we still run the holistic panel annually. You are going to take this. When you get your labs back, you're going to take your yellow marker. You're going to say, “These are the things that are off.” You're going to take your book. You're going to define what the heck do those things mean. You can ask in the membership section, too. What you're going to do is you're going to grab your protocol for progress sheet. You're going to fill it out.

I'm predicting here. “My FSH is through the roof. My sedimentation is off and may reverse T3 is 298.” We're going to go month by month or if you do quarterly by quarterly and we're going to track those. The other thing to inquire with the physician is, let's say we have one thing that's way off like a CRP. You can inquire with the lab. If I do cash pay and we do this every 30 days, what would that cost me? You can also inquire with alternative labs. Let's say your CRP is through the roof. We want to know if our nutrition protocol is effectively creating a homeostasis. It's got to work. I don't care whose name it has on it, it's got to go. That why we don't have one plan.

Let's say, for example, we can identify a marker that significantly out of balance. We have had where it's $24, $22 if the doctor writes a requisite for it or you can go to an independent lab. Sometimes Quest or Lab Corp will have those that you can run. The biggest thing that we want to do is we want to say our health wish list is going to be a health checklist. I'm going to start banging those things out and checking those things off because I'm not going to feel like okay and not moody. I'm going to have an abundance of energy I’m going to be swinging from the chandeliers. In order for us to get to that protocol for progress, we have to define where we're at concisely for anybody that we're going to bring into the fold.

blood-lab

 

We have to give them a super clear vision of where we're going. We have to define markers that we can change and change only comes about through nutrients. How do I know this? I can't tell you how many people take cholesterol medication and then they go off cholesterol medication and their cholesterol goes higher. It can be lifesaving medication, but it will not alter or fix a problem unless we're talking about something pathogenic. Antibiotics were the last invention in pharmacological usage that isn't symptom-only supportive. Thank God for the ones that are symptom supportive. We need to get out of pain. We need to address depression. We need to address anxiety. Even if we are doing that pharmacologically, it will only be nutrients that come back in and create the homeostasis so that our body can work at the optimal.

We have clients that come in that are on eight medications. Maybe our goal is to take that 8 to 5. Maybe our goal is to keep the eight. We have people that are going through chemotherapy and they want to stay on that med. We've got to keep them as healthy as possible so that the drug can do what it's supposed to do. There is no judgment on where you want to go. The only thing is to know that I'm always going to push you a little bit further towards that outrageously. Melissa, do you have any questions for me before we wrap it up?

I had noticed when I’ve gotten labs done before, they always will say that I'm within normal range and it's super frustrating because I feel like my body's not functioning the way it should be but to them, it's within “normal range.”

One of two things is going on with that. One, we have not run the right labs. The reason I say two things is we say, “That's interesting.” I'm going to use an example. They've got ginormous welts, their knees are swollen this big. They should have elevated eosinophils. They should have elevated CRPs. We get a CRP and an eosinophil that's totally normal. I go, “That's weird because that's the traditional inflammatory pathway that we would see the chemistry going off with those kinds of symptoms.” We have to take a step back and say, “What is our body telling us? What are alternative pathways of labs that we can run?” In that particular case, it was a parasitic issue. We were thinking it was like a rheumatological arthritis issue and it wasn't.

We need to broaden the net. We need to keep looking. We say, “Check. These are normal.” The other thing that can happen sometimes, and we've seen this question in our community. Sometimes our body is manifesting so much dysfunction outwardly in order to try to keep the chemistry at homeostasis. Your labs are normal because you're growing a beard. When I have a person whose labs are normal and they shouldn't be, we say, “We're going to start unraveling this mess here. We're going to start unknotting this yarn.” More than importantly, we talk the doctors into a six months recheck on those labs. Anytime we see more than a 10-pound of weight loss change or 10-pound of weight gain change, it's a great time for a recheck on labs.

With those people that have normal, I say, “Let's do this. We've got this normal here.” Obviously, things aren't normal. Let's say 1 or 2 things happen. The doctor's willing to run more or the doctor's not willing to run more. Either way, let's see if we can't shake things loose. Let's see if we can't change the chemistry by shrinking the fat cells that will change the hormone cascade. We did this when I was working in the fertility world strongly. We could alter LH and FSH when we did a drastic 10-pound weight loss fast. We're pulling labs every 3 to 5 days on that. I was like, “That's fascinating,” then I started studying adiponectin, leptin and why that happens and all of that.

I would say it's okay. It doesn't mean things are normal. It means your body is creating a new normal and we're not okay with that. Don't walk away when that happens. Lean in even more and say, “How awesome are you that you can manifest a beard as a woman, that you can manifest highs and lows in an emotion that no one's ever seen before.” You got to be gentle, to be in awe and to be the biggest cheerleader. Think of how you handle your daughter. You know that when you double down in having faith that goodness is going to come tomorrow, that that's the only way you're going to get it. I want you to fill out your sheets. We'll do more of this. Melissa, I can't thank you enough. I know that everybody in this community is going to be so grateful for you being so vulnerable and sharing with us. This is awesome. I hope this helps you. I love you all.

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