the ins and outs of pcos and acne

pcos, or polycystic ovarian syndrome, is complicated. it’s an endocrine condition that affects 8-20% of women of reproductive age worldwide1 and it is characterized by at least two of the following three symptoms: cysts on the ovaries, elevated male sex hormones and/or absent or irregular periods. pcos is a highly misunderstood condition whose symptoms manifest differently among women. many women with pcos gain weight while others have thin body types, some have acne and regular periods while other haven’t menstruated in months. because almost all women with pcos test high in androgens (male sex hormones), many symptoms include infertility, male-pattern hair loss, oily skin and acne along the jawline, and facial hair growth. these symptoms can be frustrating to deal with because they are persistent and can often make women feel like they have no control over their bodies. but these symptoms appear for a reason. and usually that reason is that our bodies are chronically stressed and something about our lifestyles needs to change. women with pcos are at increased risk for developing type 2 diabetes, hypothyroidism and cardiovascular disease, so acknowledging these signals from our bodies is key to keeping ourselves healthy for a lifetime. 


what causes pcos? 

  • genetics – while pcos is not a genetic condition, per se, predisposition to pcos can be passed down through generations. those who are exposed to higher androgens by their mothers while in the womb are also at greater risk of contracting pcos later in life.

  • stress – both physical and emotional stressors can contribute to pcos. some examples of physical stressors include over-exercising, eating foods you are intolerant to, not eating enough and constant blood sugar issues. many women who suffer from pcos are stressed to the max in their everyday lives – they take on extra work at their jobs, juggle familial responsibilities, endure harrowing breakups and family stress and then often criticize themselves for not working or trying hard enough.

  • blood sugar imbalances – this is one of the most common root causes of pcos and often stems from excessive intake of refined sugars and carbs, or the standard american diet. it often leads to weight gain and involves chronically elevated blood sugar. these blood sugar imbalances cause systemic inflammation in the body and directly influence the production of testosterone, which then inhibits ovulation and fertility.

  • over-exercising and under-eating – our society places a tremendous amount of pressure on women to look a certain way. many women internalize the pressure to be thin and spend years of their lives under-eating while engaging in excessive (usually cardio) exercise. high-intensity exercise always causes testosterone spikes, but they are usually temporary, subsiding when we refuel our bodies with calories. but when women exercise for too long without replenishing their energy stores, their hormone balance starts to suffer.

dealing with facial hair growth and acne

if you struggle with facial hair growth, you are not alone. this can be particularly frustrating if it accompanies hormonal acne – they often show up in exactly the same places along the jawline and chin. because of the cultural expectation that women maintain hairless faces, this type of hair growth can be embarrassing – but there is absolutely nothing wrong with you, there is no reason to feel shame, and there is no reason for you to change in order to appease the people in your life. having pcos is hard enough without having to navigate gendered cultural expectations.

if you are a client here at sS and you to decide to undergo laser hair removal or electrolysis, we just ask that you wait at least two weeks between those treatments and our acne face treatments – we don’t want to stress your skin out too much! if you have hair on your face that you want to remove by shaving, try the tinkle razor, which we sell in the clinic. these razors are more gentle than conventional razors. as for waxing, we don’t recommend it! the heat can be irritating to the skin and who knows what kinds of comedogenic ingredients are lurking in those waxes! 

if your doctor diagnoses you with pcos, they will most likely send you home with a prescription for one or both of two medications: metformin for insulin regulation and spironolactone for decreasing testosterone levels. it is entirely up to you whether you decide to take these medications or not, and whatever your decision, here are a few herbal, dietary and lifestyle changes to implement to keep pcos symptoms under control (and, as always, ask your doctor before making any major changes to your health plan):

  • two cups of spearmint tea each day has been shown to reduce free testosterone levels in women with pcos and has resulted in reduced hirsutism with none of the side effects of pharmaceutical-grade drugs.2 

  • 400mg of saw palmetto, a plant native to the americas, has been found to inhibit the 5-alpha reductase enzyme. the inhibition of this enzyme helps reduce the conversion of testosterone to dht, which is the male sex hormone that leads to oily skin, hair loss, acne and facial hair growth.3

  • balance out your blood sugar by reducing your consumption of refined sugars and carbohydrates – ditch the morning cereals for eggs and greens; instead of a sandwich at lunch, try a salad with tuna or grilled chicken. and pasta for dinner? no way! zucchini noodles will do the trick. eat plenty of good fats and protein and aim for three square meals a day to get your blood sugar on track and to give your digestion a break.4 and supplementing with chromium picolinate has been shown to decrease insulin resistance in women with pcos.5

  • dial in your digestion. take a test to determine any foods you might not tolerate or try an elimination diet to get to the bottom of any digestive woes. this is hugely important because digestive distress is another physical stressor on the body that can ultimately contribute to elevated cortisol and testosterone levels. similarly, make sure your elimination is on track – we flush excess hormones out of the body through our stool, so eat your fiber!

  • practice stress management. this is absolutely huge. take up meditation, improve your time-management skills, see a therapist to work through emotional stress, start a gratitude journal – do what you can to reduce chronic stress in your life as this is often the root cause of pcos.

  • cut the coffee. this is a double whammy – not only does coffee contribute to acne, but it also elevates cortisol levels and contributes to systemic inflammation. instead, try green tea, which has a healing effect on the skin due to its high anti-oxidant polyphenol content.

  • ease up on the exercise. instead of intensive cardio like running or hiit several days a week, switch these out for yoga, walking or light swimming. this will give your adrenal glands a break and will allow your body to more readily recover from stress. 

  • sleep. give your body a chance to do its healing work by getting a solid eight hours of restful and uninterrupted sleep each night. try to make this a priority – this can have a huge impact on the health of our hormones!

  • find a support group near you to work through your emotions around pcos. it’s a tough condition to deal with so finding support in different areas of your life can be a huge relief. 

 further reference:

8 steps to reverse your pcos by fiona mcculloch

paleo for women

pcos diva

pcos awareness association

soul cysters


1. sirmans, s. m., pate, k. a. (2014). epidemiology, diagnosis, and management of polycystic ovary syndrome. clinical epidemiology. 6, 1–13.

2. grant, p. & ramasamy, s. (2012) an update on plant derived anti-androgens. international journal of endocrinology metabolism. 2012 Spring; 10(2): 497–502.
3. hudson, t. (2008) polycystic ovarian syndrome (pcos). dec 8, 2008.
4. liepa, g.u., sengupta, a & karsies, d. (2008) polycystic ovary syndrome (pcos) and other androgen excess-related conditions: can changes in dietary intake make a difference? nutrition in clinical practice. 2008 Feb; 23(1):63-71.
5. rabinovitz, h., et al. (2004) effect of chromium supplementation on blood glucose and lipid levels in type 2 diabetes mellitus elderly patients. international journal for vitamin and nutrition research. 2004 May; 74(3):178-82.

part 5: kim’s adrenals – success! (so far – it’s a lifestyle thing)

quick disclaimer: all the stuff i write about in my adrenal blog posts are relative to my own personal experience and recommendations.  what was recommended to and worked for me may not work for you, so please proceed with caution and enlist the help of a naturopathic doctor in your area for the best + safest results!

after seeing dr. day for my consultation on 11/20/15, she ordered some tests – one of them, in particular, that would find out what kind (and levels) of brain chemicals were running in my body.  we thought for sure that i was low on dopamine and seratonin, which would make sense of my low moods and irritability.  but, when we got the results back late december 2015, we were both surprised.


it turned out that out of the 12 hormones that were tested, 2 were on the high end of normal, 2 were just over the high end of normal, and 5 were just about double what the high end of normal should be.  a total of 9 out of 12 hormones were high (or way higher) than what they should have been!

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my visit notes with dr. day said:

Overall I’m seeing that your nervous system is quite flared up, but is trying to compensate with high levels of Serotonin and GABA to calm things. Your adrenals/cortisol are overall high, but with a strange dip at 6pm that we’ll need to discuss. Assuming this was a Day 21, your sex hormones actually look quite good, and your melatonin is rocking so I hope you are sleeping well 🙂 

i also got some bloodwork testing done at kaiser, and the results showed:

Blood sugar improving but still high (stress plays a role, also diet/exercise), Ferritin (iron) high end – organ meats, oysters and cast iron are factors.  D and B12 levels ok but could be higher, cholesterol ok but keep up the good fats, thyroid is ok (primary focus is adrenals).
dr. day gave me some homework, with lots of supplements.  i straight up told her that my max was going to be 4 supplements a day, and she respected my boundary, but of course encouraged me to build upon my limit of 4, for best results.  🙂
supplements aside, she emphasized the lifestyle changes i needed to make were going to have the biggest impact on my success (read: stress management. sound familiar, sSer’s?).  she thought that the stress of the strict dietary restrictions was a bigger deal than i thought and surprisingly, also said that food reactions weren’t necessarily the first place she looked when addressing her patients imbalances – which was a great relief to me.
here is/was dr. day’s rx for me:
  • More vigorous exercise in the mornings – try this and see how it feels, may help to burn off the excess, and feel more calm and alert through the day.  (ps – for some who are super energy depleted, vigorous exercise may not be the best course of action – restorative yoga or walking may be a better choice; consult a professional for the best + safest results!)
    • done! i got a personal trainer because there was no way i was going to self-start exercise torture.. but am really enjoying the strong empowered feelings from sweating and breathing heavily after said torture 🙂
  • Calming, centering activities in the evening
    • still hard to get off the electronics, but doing the ny times crosswords (albeit on my phone) and putting on brainwave sleep music via youtube videos with the screen face down works wonders, and gets me snoozing in less than 10 minutes, every time)

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  • Probiotics approx 20 billion, away from meals, shelf stable for travel
    • i was already doing this first thing in the AM on on empty stomach so no big deal; but the amount of probiotic bacteria is much higher than what i was taking, a blog post about this should be up soon!  i got these from jarrow.  the kyodophilus that sS carries is shelf-stable, but only has 1-2 billion count bacteria; the jarrow ones i picked up have 25 billion each capsule, plus an enteric coating which helps make sure the bacteria get into the small intestine where it needs to get to to be effective, vs dying the stomach’s acids.)
  • Adrenal ADAPTOGEN for day time, try one of the following:
    • Herbs like Ashwaganda, Holy Basil, Maca, Eleuthero (Rhodiola good option, but caution if too stimulating)
    • Adaptogen Blends sent in Healthwave (dr. day’s online herbal dispensary): HPA Adapt or Gaia Adrenal Support (Caution milky oats allergy) – take 2 AM and another 2 between noon-2pm.
    • L-Theanine – test this out as a single ingredient supplement, start with 100mg – take up to 400mg spread out over the day (200mg twice per day for example)
      • i ended up getting new chapter’s holy basil and took this for the month of january – seemed to work well as i was less stressed and felt more centered, but i was also on vacation for three weeks at the same time so, hard to tell what really did it.  i’ve since run out and bought a tincture instead, but am having trouble keeping up with it.
  • Adrenal CALMING for bedtime:
    • Cortisol Manager – take 1, 30-60min before bed (aka “Sleep Tonight!” over the counter)
      • this i take on and off – i hate waking in the middle of the night to use the bathroom, but dr. day said i could take it 1-2 hours before bed.  for some reason though, i feel like this gives me more active dreams (thus not as restful sleep) when i take it, versus when i don’t.  still experimenting with it.
AND WITH MEALS, for GI SUPPORT – continue (And notice what it takes to maintain the relief from the swelling that was happening before)
  • Pure Encapsulations Digestive Enzymes with HCl – 2 or more as needed, with each meal
    • taking this is definitely helpful in my digesting of foods = less bloating, but what really helps the most is if i just avoid the inflammatory foods (for me, it’s wheat, corn, rice, dairy.. eggs i still avoid, but am not sure if they bloat me up; i tested highly negatively to all these foods with dr. fig so dr. day thought it best to keep avoiding, especially since i could feel the negative effects from eating them)
After you get back from Japan, add these as a foundational routine…
  • Vit D – 5,000iu total (2 in multi, 1 in fish oil so take 2 drops of the liquid), take it with a meal that contains fat/oil – retest at Kaiser in about 3 months
  • The Big One Plus – 1 per day, WITH food – contains 2,000iu of Vit D
  • B complex – 1 per day, WITH food – more B12 to help with stress/energy
  • ProOmegaD (caps) – 2 per day WITH food (we didn’t discuss this but please add along with the multi and B complex as a foundational supplement for you… source of good fats and anti-inflammatory and helps calm the adrenals – plus many other long term health benefits.)
    • i was in japan for a few weeks in january and i have to admit, i have not added these yet.  i know, i know!  but will be more accountable since i am back on writing out my experience for the world to hold me accountable!
  • Stop using the cast iron pots and retest ferritin in 3 months
  • Stay off caffeine
  • Continue to avoid/minimize any known/suspected allergens
  • Turn computer screens (and brain) off in the evenings, allow 2 hours (or at least 1 hour) of peaceful and calm time before bed.
    • for the most part, all this was no prob.  i switched out my cast iron for stainless, and an enamel coated aluminum one i got at rainbow grocery. (apparently the enamel makes it safe, since the aluminum is never in direct contact with food).
    • i’m great at avoiding caffeine, except for the VERY rare almond-milk tea tapioca drink from boba guys!  i’ve never been a coffee drinker so this is was easy.
    • allergies have actually been non-existent this year, even with an accidental eye-rubbing-after-a-cat-hair-covered-sofa exposure.  2015 was the worst allergy season i could remember in all my life (likely because my body was already so stressed out, physically and mentally).  i got a series or two of treatments at advanced allergy clinics in hayes valley.  yes, it was super expensive, and the technology + science is really out there, but i had tried everything else over the years, and this totally worked for me.  
    • the reactive foods for the most part i am doing ok with, and am occasionally cheating with a bite of the BF’s morning buttered toast, or a few corn chips at lunch.  😉  and when i do cheat, i definitely feel bloated, and sometimes i’ll even get a headache – so after feeling shitty, that i’m good for a week or two until my next time of weakness.  sigh.  it’s a work in progress.
    • a little bit of crossword and finding my sleep track on my phone, but am trying to catch up on my new yorker + afar magazine back issues more and staying off the blue screens.  i also tried using f.lux for a while, an app designed to eliminate the blue-rays from electronic screens.  i’m not sure if it helped, but it did let me know when it was getting close to bedtime, and drained my battery, which i suppose both help to support the cause?


i have to say that since switching over to working with dr. day, i have been feeling much better, and stress has been easier for me to deal with.  stress management was and still is the biggest part of my wellness plan.

i accredit many things to the stress relief i’ve gotten since the first meeting with dr. day.  she opened up my eyes to the possibility of making some drastic moves, in search of greatly improving my quality of life:

  • i (drastically) simplified my work day before it had even started.  i moved from oakland back to san francisco, and traded in my SUPER stressful + ridiculous 1 hour commute (each way, during non-rush hours mind you) to 10 minutes, to work each day.  those traffic days had me arriving to work furious and annoyed, which was not a healthy nor productive way to be, especially as a leader for an awesome team!
  • i asked for, and received, awesome help + support.  liesse really stepped up into her clinic manager role, which has immensely helped unload a lot of the day to day things that kept me from working on the higher-level projects – ones that i was always frustrated about never being able to complete.  and now that lacey is on our management team, she’s been able to help liesse with her duties so that we can all work together to tackle larger projects.  my partner, family and friends also know that i am keeping it low-key and am avoiding certain foods, and support me through the process.  prioritizing relationships that matter the most to me has helped as well; i didn’t want to years to fly by without my seeing my closest girlfriends and their babies grow up!  so i am more, now than ever, putting more effort into keeping in touch with my peeps.  being more active in my professional colleague networks also is great; i can let off steam and share stories of tough times and questionable sanity with a community i can relate to, learn from and laugh with!
  • i started working out.  i bit the bullet and hired a personal trainer.  an accountability buddy would work too, or a strong STRONG sense of willpower.  i needed to get my body moving (aside from walking to the car, and walking from the car to work) and needed someone to motivate me and hold me accountable.  nyrene garces of n-training has been great, supportive, and inspiring.  she comes directly to my house, so i have no excuse to not work out.  it’s a luxury, but hopefully i’ll get myself to a point where i will self-motivate everyday (fingers crossed!).  PLUS, my physical and mental health is not something i can put a price on.  now, when i leave town, i do my best to work out because 1. i miss feeling that positive-attitude and empowered-strength-high from working out, 2. i would like to be buff, fit and fly at some point in my life and 3. i don’t want to eat it hard when i get back into town – nyrene kicks my butt with her action-packed 45-minute exercise routines!
  • i took time off alone to rest, rejuvenate.. and work.  i was fortunate enough to score a black friday deal on those tickets to japan, so i took advantage and went for three weeks, on my own.  with liesse at the helm, i could relax in knowing sS would be ok without me physically being in the office.  being in a space where i didn’t have the distractions of my day to day life at work and home (laundry!  cooking!  cleaning!  social life!) helped me regain some energy and motivation to take care of myself.  i was able to get more fresh air and sunshine, be alone with myself, take my supplements, eat well..  and since i felt much better overall, i was able to get down to the nitty gritty of some WAY overdue projects i had been putting off, along with keeping up on emails without getting stressed out (or distracted by) the day-to-day happenings in the clinic.  when taking that much time away or finances don’t allow for that long a getaway, going camping, heading to kabuki hot springs or imperial spa for an afternoon, and/or getting massages or taking walk listening to spa music are also great + accessible ways to do you.

i have to honestly say, that i am feeling the best i ever have in the last handful of years, and am doing, thinking, and feeling positively about the future.  the stress of the last several years had definitely turned me down the path of thinking all would be better if i just shut sS down and sold donuts at the mall.  but with all the support and work i am doing on/for myself everyday, i am back on the train to growing sS’s reach, and achieving total world domination 🙂

i’lll check back after i’ve started taking the recommended supplements and retest to see if my blood work and hormone levels have changed at all, and any other tricks and tips i’ve picked up along the way to help and inspire those who may be affected the same way i was before i got better!

AAAAAND, WE’RE BACK! (episode 3: kim’s deal)

quick disclaimer: all the stuff i write about in my adrenal blog posts are relative to my own personal experience and recommendations.  what was recommended to and worked for me may not work for you, so please proceed with caution and enlist the help of a naturopathic doctor in your area for the best + safest results!

ok sorry guys for dropping off and lagging on this post.  we had some employee turnover that i had to handle, which left me little time, energy or motivation to completing and posting this post.  i am working on the mantra ‘done is better than perfect’!  here goes:

warning: this one is kind of long and boring (if you’re not into this stuff, and especially since it’s not about you! :)).  you can scroll to the bottom if you just want to skip the explanations of each test, and see a quick review of what my blood, spit and poop said, and dr. fig’s recommended plan of action for me.

so a month had gone by, and until i got my test results (which was around july 10, 2015)  been able to live like normal, more or less.  the impending doom of all the gluten i can’t eat and who knows what else is weighing on my mind, but i’m not that upset about it.  i just remember how shitty i feel and how awesome it’s going to be when i have more energy to be active, the much better mood i’ll be in, and how i’ll get to wear all my ‘skinny’ clothes again after losing 30 pounds – and i’m motivated.  when i see happy, healthy and fit and buff people out and about, it reminds me how these changes i’m making now will positively impact my longterm health and happiness, and that i can do it!

how does this not look amazing?!growing up chinese american, i never really ate much wheat.  we had bread in the house for my mom and grandparents (they’d have it soaked in their morning instant coffee) but i just never really got into it.  i suppose my body intuitively knew gluten wasn’t the best for me.  i was a rice girl.  my favorite comfort meals were (and still are) most always involve white rice at some capacity.  as i got older and started growing ‘healthier’, i switched to brown rice and quinoa – but relished eating white rice anytime i had it; what a treat.  rice bowls!  rice porridge! sushi rice and ribeye steak!  nigiri and sushi rolls!  rice crackers and rice noodles!  and of course, sake, which is distilled from rice.*

any leftovers got a fried egg on top; over easy so that yolk could sauce everything up.  especially with ones i get from local farmer to deliver free-range, organic eggs to me every other weekend**.   pastured eggs are one of our favorite, quick and nutritious forms of protein.  yum yum yum!

sure, i’d get bloated sometimes after eating rice, but it didn’t seem to happen so much (or cause pain) that it was a problem.  wheat and gluten, were on the same boat – but not only bloating, fatigue came along too.  sometimes i’d eat it and feel ok, and sometimes i’d eat it and yawn all day.  but upon discovering della fattoria’s delicious seeded wheat bread, i ate it more (and noticed feeling even more tired).  so i did my best to lay off the gluten – after all, after hearing so many tales of going gluten-free had changed lives, i suspected this would be a culprit for my body’s behavior right now.

sitting in dr. fig’s office, we go over the test results one by one.  she first started off with the adrenal test, which would have some questions the stool test could answer, which would have some questions the food allergy test could answer.  (happy to share the full reports to anyone that’s interested in seeing them, just ask! email


‘energy graph’
looking at the cortisol test, the first page had a graph.  the graph has a ‘normal range’ lime green stripe, which shows the average cortisol output of a healthy human.  my line, a dark blue solid line, showed that my levels were on the low, if not lower than normal, end of the norm.  it seemed that as soon as i woke up, my cortisol was already at the low end of normal, which persisted, until about 4pm when my energy was it’s lowest – pretty much at the rock bottom of the chart.  then, i had a tiny energy boost right around midnight before going to sleep.  (this totally made sense, as i often complained of being tired upon arising, getting REALLY tired around 4-5, but then somehow getting a bit of energy at night before sleep; i had always attributed this to just being distracted at home with ‘home stuff’ – cooking, cleaning, socializing or being on the computer’).

along with this ‘energy’ graph, a few other hormones were detected and their roles explained.

my DHEA was on the high end of what’s normal (10 out of a range of 3-10).  DHEA is a “hormone made in the adrenal glands and in the brain, and leads to the production of male and female sex hormones..  typically, those with high DHEA can have oily skin, acne, among other more serious side effects.”

diabetes runs on the paternal side of my family, and after a borderline high blood sugar test a few years ago, i had been conscious of consuming sugar (both ‘sweet’ and refined grains kind of sugar) and making sure to have veggies with every meal.  exercising was on my mind, but lately i hadn’t had the energy to even go for a walk, let alone flat out work out.

i had tested just below borderline elevated (5 out of the borderline 6-25) so that was good; but not great.  the results explained that “insulin is tested because insulin activity is affected by the stress response.  chronic stress with cortisol elevation may counteract the effects of insulin, and may lead to functional insulin resistance.”

nothing to freak out about (right now), but something to keep watch of, and to be aware that my stress was a factor in this category.

total salivary SIgA
what is this thing?  the test says that “it’s the predominant antibody found on the mucosal membranes throughout the body.  one of it’s main functions is to bind to antigens and prevent their adherence/admittance into the body.  typically it moderates the mucosal inflammatory response…” and that it “may be associated with some autoimmune conditions, diabetes, gingivitis, ulcers, and inflammatory conditions.  in addition, acute physical or emotional stress can transiently raise values.”

and since i didn’t have any ofl the aforementioned autoimmune conditions,  here was another marker that my stress was an issue – so much that i tested abnormally high on this one – 39 mg/dl out of a normal 10-20, and borderline high of 21-25.

ok.  so “gladins are proteins found in wheat, rye, barley and other grains which may trigger an immune reaction in some individuals.  a positive response to gliadin may warrant further diagnostic workup and/or dietary elimination trial in some patients. lab results should be used in context of the entire clinical picture.”  (which is why the stool and food allergy testing was such a good idea – thanks dr. fig!).

in this test, i had scored again, very high.  i got myself a 32 out of a borderline 13-15, and positive result of 15+.


interested to see what else my guts were doing with the really high gliadin response, we now moved on to the stool test.  this test was divided up into sections for each enzyme, each with its own job.

i had some good bacteria (but lacked lactobacillus, interestingly enough.  maybe because i don’t consume fermented dairy, and my probiotic doesn’t have this in it?  could also be because my gut’s environment couldn’t sustain it) and had some not so good (but not really bad) bacteria.  dr. figoski explained that this ‘not great’ bacteria could have been from any source – be it from trips involving drinking water or iced drinks in foreign countries, to eating ‘regular’ domestic food at home.  no real way to tell, but just to work towards cleaning it out and replenishing good bacteria.  luckily though, no really bad (dysbiotic) bacteria or yeast was to be found.

digestion + absorption, and all my short chain fatty acids
were all good!  woo!

lysozymes are enzymes that are excreted at sites of inflammation in the GI tract.

under 600 is normal; i had 1140 (!).

another enzyme that has to do with mucosal tissues, “secretory IgA” is the “first line of defense of the GI mucosa and is central to the normal function of the GI tract as an immune barrier.  elevated levels have been associated with an unregulated immune response.”  this meant that my body’s immune system was working extra hard, all the time, to fight off ‘invaders’, which could explain my terrible seasonal allergies (as well as responses to things like dust and molds).

the normal range of this enzyme is 51-204, and i had tested 1240.

intestinal health markers
lastly, the pH of my poop would tell us about how the fermentation of fiber by the beneficial flora of the gut was doing.  it was a little low (5.6, normal range was 6-7.8).  but dr. fig wasn’t too worried about this – we had other bigger problems to deal with.

so, what foods are physically irritating my guts, and causing so much inflammation?!  now the finale – the food allergy test.

us biotek's general food panel
the quick and easy test dr. fig administered in my office the day of my testing consult a month ago is based on a scale of 0-6.  ideally, of course, the foods we eat have little to no reaction in our blood.  the idea is that if you are constantly exposing your body to allergens that rate 4-6, it’s natural that things 3 and below are probably going to be really irritating too.   when this happens, the body treats the offending foods like allergens, and manifests in the body in different ways: rashes, headaches, fatigue, even acne, in some.

so, dr. fig’s got me on a conservative plan – not only because these foods show up as irritants, but are also inflammatory (because they are irritating my guts, but also – like for example, sugar and corn – inherently are) – but also maybe she sees it in me to be 100% compliant?

on a scale of 0-6:
0 – no reaction
1 – very low
2 – low
3 – moderate
4 – high
5 – very high
6 – extremely high.

the basic food test i took has a panel of 100 foods, and these are the only ones that showed up as irritating, and therefore are the foods i am to avoid for at least 2 months:

casein (3)
cottage cheese (3)
mozzarella cheese
milk (3)
whey (4.5)

chicken egg whites (5.5)
chicken egg yolks (5)
duck whole eggs (3)

banana (2.5)
cranberry (2)
pineapple (3)

sugar cane (3.5)


corn (4)
wheat gliadin (3)
wheat gluten (3)
oat (3)
write rice (3)
spelt (3)
whole wheat (3.5)


these restrictions sort of make up a diet close to the candida cleanse, except that i can’t have eggs.  and it’s also sort of like a gluten-free diet, but i can’t have rice or corn.  my beloved eggs and rice!  and no tortilla chips!  this makes it pretty challenging, since a lot of paleo recipes use a lot of eggs, and gluten-free alternatives are often based on rice or corn.

all the more diligent i must be, to 1. cook my own food, 2. and source responsibly.  i’ve got to read my labels even more, and have an even more watchful eye on not only cane sugar but also brown rice sugar/syrup – which is in almost everything that’s packaged.

with a bit of pinterest-ing, i found that this diet more or less makes up what’s called an “auto-immune paleo” diet – one that’s meant to be eaten for a short while (1-3 months) to allow the body to “reset and heal”, before reintroducing foods one at a time to see how my body reacts (if at all).

in many ways, it’s a mirror image journey of the clearing process at sS – allowing the 3-6 months of acne purging, while abstaining from the potentially acne-causing aggravators, before getting to a clean slate (clear skin!) and reintroducing possible triggers to see what substance causes acne-formation, if any.

on the bright side, it’s very cool that we are in this together 🙂

my adrenal test said that i indeed was low on energy, and had certain hormones that get excreted when the body is (in my case) under a lot of chronic stress-related inflammation (i tested 39, when normal is 10-20), and exposed to gliadins (proteins found in gluten – i tested 32 and 15+ is considered reactive).  my blood sugar was also borderline high, but is probably attributed to the chronic stress.

my stool test revealed that enzymes excreted when inflammation in the GI is present and when the immune system is working at capacity at long intervals were abnormally high (one was double and other was 6 times the norm) – again probably due to the chronic stress and foods that were irritating my guts.

finally, the food allergy test showed the foods that my blood reacted negatively to; which probably were directly responsible for inflaming my gut so bad, and causing my immune system to work triple-time, which stresses the body out (and inflames it).

all in all, it’s a cycle of stress (mental and physical) causing irritation that’s causing inflammation, and it’s manifesting in my body via fatigue, depression, and frequent headaches, along with allergies.

basically, i need to take a ton of supplements to restore much needed nutrients that my body needs to run efficiently and heal itself, avoid the foods that are aggravating my guts (literally), and manage my stress (probably the hardest part of the plan).

pills pills and more pillz

this picture shows the different pills dr. fig has me taking, but doesn’t include the inflammation controlling glutamine powder, or adrenal support tinctures that are also part of the mix.  my daily supplement schedule is as follows:

AM (breakfast)
2 – active vitamin b pills
1 – vitamin c capsule
1 – omega 3 capsule
1 – hydrochloric acid (stomach acid to help digest food and prevent bloating, gas, etc)
1 – squirt of adrenal support tincture
1 – scoop of inflammation controlling glutamine powder, in water

1 – hydrochloric acid pill
1 – vitamin c capsule
1 – omega 3 capsule
1 – squirt of adrenal support tincture

2 – zyflamend (taken away from food so it can work better at managing inflammation vs. digesting your food)

PM (dinner)
1 – hydrochloric acid pill
1 – omega 3 pill
1 – vitamin c pill
2 – neurocalm (or relaxed sleep herbs) – this is so that i can get restful sleep, because i have had active, stress- and dream-filled dreams for weeks which makes for even more fatigue in the morning.

8/3/2015 – 3 weeks in
i definitely felt some detoxing in the immediate 2 weeks after starting the diet (headaches, muscle tension, light-headedness after eating, and changes in bodily fluids).  after an hour or two of serious road rage while in the ovulating days of my hormonal cycle, i could slowly feel i had a mild boost of energy and a generally more positive outlook.  managing stress though, is still a struggle – and i think it will continue to be.  but in the days following, i was in high enough spirits to buy a new bicycle, and motivated enough to ride it around on errands (ok, maybe one so far).

a couple of hours’ of shopping at sf’s beloved rainbow grocery co-op and carefully reading labels, coupled with lots of pinterest-ing and google-ing, motivated me further to keep on the food part of the plan.  food has always been a big part of my life, and it sucks that i can’t go out and eat sushi, have chips and salsa, eat chinese or just a burger so easily (for now), i look at these diet restrictions as a new way to get creative with eating even more healthily.  and luckily, i’ve found some delicious recipes along the way!  in the coming weeks i’ll be posting what i’ve been cooking and eating on our blog, facebook, pinterest and instagram.

adrenal fatigue part one: running a business, is catching up with kim and wearing her down

quick disclaimer: all the stuff i write about in my adrenal blog posts are relative to my own personal experience and recommendations.  what was recommended to and worked for me may not work for you, so please proceed with caution and enlist the help of a naturopathic doctor in your area for the best + safest results!

empty on gas

i think it’s safe to say that everyone knows that running your own business takes a lot of blood, sweat and tears..  and time, patience and hard work – among many other things.  being raised by a single mom, i always knew that hard work was going to be part of the game of life.  yes, juggling all the tasks of owning a business alone is tough, but it’s even harder when you feel like poop.  all.  the.  time.

for the last two years, sS has gone through some major growth – and growing pains.  a major buildout and relocation.  running a busy clinic.  employee management (hiring, training, firing, repeat).  (trying to) write and finish the acne book.  reformulating and rebranding products, and getting them ready for distribution.  doing most (if not all) the company’s blogging, instagramming, facebooking, marketing, bookkeeping, buying, receptioning, networking.  working with a business coach.  etc etc etc.  lots to keep me busy.  the best part of all this though, is that over these last two years, we’ve been able to help over 500 clients get and stay clear.  if we go all the way back to when i opened sS in 2008, the total numbers would likely reach close to 1500.

it was only at this past new years’ dinner at bar agricole did i realize, after talking with an entrepreneur who was sat next to me at the bar, all that really was on my plate.  he asked, “how was your year?”  “to be honest,” i said, “2014 was the year of ‘what did i get myself into’.  i’m working really hard, and not only my mind but my body, is stressed out – it’s very hard to keep motivated, managing this all alone, and i kind of really wish i could just run away.”  i described all the projects i had been working on for sS and he simply said: “it makes total sense that you are overwhelmed.  you aren’t running just one business.  you are actually running four.  the clinic.  formulating and retailing products.  writing a book, and distribution of products, let alone trying to open new locations.”  that was a total a-ha moment.  this epiphany helped to alleviate a lot of my mental stress, for sure.  i still had to DO the work, but knowing that as a single person, i could only do so much, really helped me get through the winter of 2014/2015.

physically though, i was not doing great.  especially for having given up a lot of the recreational wining and dining (which was my vice) that was the ‘play hard’ to my ‘work hard.’  i felt way too tired ALL THE TIME, for someone my age (32), who was eating high quality + healthy food and living a relatively healthy, yet busy, lifestyle.  i actually felt like i had more energy when i was eating dinner late into the night, with friends and cocktails.  but now, i felt that my nervous system was very sensitive, and that my adrenals were taxed.  something benign like a loud motorcycle running past me would literally rattle my nerves, leaving me feeling like i was crashing hard after a (very long) adrenaline rush that one might get after almost getting into a car accident, or some other situation where my life was in danger.  i felt weak, and had no energy to be active.  the lack of exercise, coupled with my daily driving commute, helped me gain 30 pounds in the last year.  after a full night’s of solid, uninterrupted sleep, i’d wake up exhausted.  i had learned to just push through it, and tried seeing a functional chiropractor, got weekly acupuncture for over a year, worked with a nutritionist, got regular massages, meditated, etc etc and after all that – i was still tired, both physically and mentally.

finally, after being fed up with being both fat and tired, regular headaches and a long-term dose of low-level depression, i finally decided to step my game up and see dr. laura figoski to get control of my life back.

dr fig!

to be honest, i had seen laura over a year ago and at the time, was not 100% dedicated to her treatment plan.  in retrospect, i think i was just not ready.  this probably was because i had just gone through a similar process with a nutritionist, while at the same time relocating sS to mission and 21st.  though i was under an incredible amount of physical and mental stress, i was really strict with her protocol and actually felt much much worse on it.  this nutritionist had me do some bloodwork (which, to her credit, definitely revealed some important things) which she tried to interpret for me – she’d identified some adrenal imbalances (it was a little low), abnormally high iron levels in my blood and borderline type 2 diabetes blood sugar levels.  after a solid 6+ weeks of compliance, i was still feeling much worse on her protocol than before it, so i consulted laura for a second opinion.  dr. fig was able to give me a bigger picture of what the bloodwork was saying (that perhaps this was all due to a poorly functioning liver), and had me take a blood test which ruled out hemachromotosis (a genetic defect in which the blood stores abnormally high amounts of iron, which can cause lethargy, and also be lethal).  laura put me on a liver supplement and, with regular psychotherapy and bodywork, i started feeling a bit better.  i was still tired, but i just continued to push through.  i wasn’t as exhausted as i was during that month of the move, so i was content with where i was at.  i had much work to do, and felt ok-ish enough to keep pushing through.  at this point, kate (a former office manager) had quit, so there was no one else to run the show but i, and i felt i didn’t have the time for self-care.

so a year passed by, and then june 2015 rolls around.  i’m still exhausted, and, after realizing i only had 2 pairs of stretch pants i could comfortably wear because of the extra 30 pounds i’d gained in the last year, i finally decided to see dr. laura again.  i knew i had to exercise, but i was too tired to do it.  plus, i just felt like something was wrong – but i didn’t know what.  an email to kaiser about adrenal fatigue yielded a response of “adrenal fatigue is being thrown around a lot these days.”  at a women’s entrepreneur brunch, i met a colleague who lost weight, had vastly improved her digestion, and gained a ton of energy from taking the alcat food allergy test.  she said that by avoiding gluten and oregano, she felt a million times better.  i knew dr. fig administered this test, so i booked an appointment with her to get this done.

when i got to see dr. fig, we talked about my symptoms, and i was hopeful that figuring out the maybe 1-3 foods i was reactive to, would solve all my problems.  (yeah right!  so silly.  geez.).  she explained that taking a more holistic snapshot of what my body’s systems were doing would be more informative than just zeroing in on food sensitivities.  so, she suggested i take 3 different types of tests, instead of the 1 mondo food allergy test – for about the same cost.   the tests i ended up taking were: adrenal (saliva), gut/intestinal (stool), and food allergy (blood).  taking just the food test alone would have been only 1 part of the puzzle (like switching to acne-safe products but still drinking milk by the gallon) – and as we know, all the body systems work together, and also affect each other if one system is imbalanced.  (fyi: the tests, all combined, cost about $600 out of pocket; though an HSA or FSA would likely cover it).

it would take several weeks for all the test results to come back, and i figured, the time would pass anyway.  i would be busy with work, training our newest esthetician, liesse.  i had a couple of trips planned, and could eat and drink everything with abandon before i got the test results back that said i couldn’t.  🙂

so july 6, 2015, came doomsday.  this was the day laura revealed to me the results of the tests i had taken a month prior, and what our plan of action would be.

dun dun DUN!!!!

stay tuned for the next episode of my journey, working through my adrenal fatigue, with a naturopath.  next up: the testing process, reveal of my test results, and my action plan + dietary guidelines/restrictions!