Dr. Gina Neonakis, ND

06/07/2022

I've been meaning to design a comprehensive PCOS course for years, and it's finally here! 🎉

The purpose of this course is to provide educational content to anyone who has been diagnosed with PCOS, and wants to understand the condition and their options better. This is a 6 Module video-based course that is done on your own time, with access to a Private Facebook community where you can ask questions and engage with me and other women with PCOS.

What's included:
▪️Comprehensive knowledge of PCOS, how it works and treatments options to manage symptoms
▪️The basics of PCOS and what is required for a proper diagnosis
▪️A thorough review of lab testing
▪️Education around the menstrual cycle and the hormones involved
▪️Conditions that can look like PCOS and need to be ruled out
▪️The underlying driving factors that contribute to PCOS symptoms
▪️Treament options including diet, lifestyle, supplements and medications + the research associated with these.
▪️How to track ovulation
▪️PCOS fertility support
▪️A recipe guide with 30+ meal, snack and dessert ideas
▪️Handouts on diet, lab testing and more
▪️Access to a private Facebook group for community support and to ask questions.

I hope to educate and empower women to understand their bodies and their options in order to better manage PCOS symptoms.

Here is the link to enroll:
https://understandingpcos.thinkific.com/courses/understanding-pcos

Leave any questions below! ❤️

A comprehensive educational course on Polycystic Ovarian Syndrome (PCOS). This course includes information on symptoms, diagnosis, lab testing, the underlying driving factors of PCOS, researched-based treatment options and fertility optimization.

09/01/2021

happy PCOS awareness month! 🤍

This is the condition that I treat most commonly in my practice and something that I personally experience.

It’s my life’s mission to support as many women with PCOS as possible because frankly, the medical system really fails in this area. 👎🏼

PCOS affects around 10-20% of women, and many are told that their only options are birth control, metformin or weight loss. The diagnosis can feel isolating, confusing and hopeless.

But there are options for you! We can improve your symptoms, fertility, quality of life and long term health. ☺️

Through further investigation and lab testing we can determine what the main driving factors are for YOU specifically and where to target your treatments.

PCOS is something that we manage life long. But educating and understanding your body is key. 🔑

I’ll be posting educational content and answering your PCOS questions all month long, so leave any that you have below! 👇🏽

I’ll also be sharing my story and maybe even opening up my free webinar for you again. Stay tuned 😉

08/20/2021

It would probably be a lot, right!?

How many times per day do you look in the mirror and think about all the things you wish you could change?

What if you took that time to acknowledge all the things you love about your body instead? ❤️

It’s not an easy shift. But we need to stop tearing ourselves down. Stop comparing yourself and engaging in activities like extreme diet and exercise in order to look a certain way. What if we made it about how we feel and did the things our body was actually asking for?

I bet your body would start to give back to you to. The bloating reduces, your mental health and relationships improve, your cycle becomes more predictable.

But we tend to throw away health when we focus on appearance.

Next time you find yourself nit picking your body, counting all the calories you ate that day or stretching your skin to get rid of your wrinkles, stop. Acknowledge what you love about yourself. And move on with your day.

07/03/2021

I see a lot of “well my doctor ran bloodwork and it all came back normal, but I feel terrible” in my practice. And then I take a look at the bloodwork and though everything may be in the normal range, its often FAR from optimal.

When it comes to health, we’re striving for optimal. Not just normal.

You might feel terrible, but because your labs are in the “normal” range (which is based on the average populations health), nobody investigates further.

Let me give you some examples.

1️⃣The range for TSH (a thyroid health marker) goes from 0.32-5.04mU/L. But people tend to feel best when their TSH is

07/01/2021

I get a lot of questions about lab values for hormones and fertility, so here they are! 🙌🏼

These are some of the basic labs I run in patients who are trying to conceive.

▪️ESTRADIOL - a form of estrogen that’s released from ovarian follicles. Helps to build the uterine lining for implantation and is required to trigger LH for ovulation. If you aren’t ovulating or getting a period, low estrogen may be the cause. Estrogen that is too high (above 294pmol/L) can inhibit FSH and follicle production, which leads to lower IVF success.

▪️FSH AND LH - these hormones come from the brain. FSH supports follicle development and LH triggers ovulation. They should be around the same value. In PCOS, LH is higher which leads to anovulation and irregular periods. If FSH is high and estrogen is low, fertility should be expedited.

▪️PROGESTERONE - released after ovulation to help maintain the uterine lining and pregnancy. With low progesterone, there is an increased risk of spotting and miscarriage. This is very low if ovulation hasn’t occurred.

▪️TSH - a marker of thyroid status. This hormone comes from the brain and talks to the thyroid gland. When high, it indicates hypothyroidism and when low indicates hyperthyroidism. When this is higher than 2.5 there is a decreased chance of getting pregnant and an increased risk of miscarriage.

▪️Prolactin - a hormone that comes from the brain that supports lactation. When high, this inhibits follicle formation and ovulation. It tends to be higher than 20 in autoimmune disease, and out of range (high) in cases of prolactinoma.

▪️Vitamin D - this is important for ovulation and implantation. When vitamin D is >95 there is a reduction in miscarriage risk, but when it’s >112 we have a 4x increased chance of live birth rate. This one is easily missed - don’t forget about it as most Canadians are deficient!

Most fertility testing should be done on day 3 of your period. The exception is progesterone which should be tested 5-7 days after you ovulate. I often give my patients 2 requisitions so they can go to the lab at the appropriate times in their cycle.

Have you had fertility lab work done!? Leave your questions below! 👇🏽

06/28/2021

IT’S OKAY TO BUY A BIGGER SIZE.

The size of your jeans doesn’t matter.

We spend so much time picking apart our bodies and focusing on the things we hate, or the areas we wish we could change.

We constantly compare ourselves to the unrealistic norms of society and social media.

We diet, restrict and push ourselves harder just to fit into a specific size of clothing.

But why? 🤷🏽‍♀️

You are the only person that knows the size of your clothing.

Maybe at one store you’re 4 sizes larger than another. But if you’re comfortable in your clothes and your body, does the number on your tag matter? Absolutely not.

Bodies fluctuate. Sizes change. And that’s okay.

The size of my pants are 4-5 sizes larger than they were 7 years ago. And I’m a whole lot healthier and happier in my body than I was back then.

When my body changes more, I’ll buy a bigger size.

Because I choose to buy clothes that fit my body rather than trying to fit my body into a certain size of clothes.

06/04/2021

I see a lot of patients who feel relieved when I tell them I’m not going to put them on a diet or take away their favorite foods. 🙅🏽‍♀️

Why? Because we don’t need to, and this never actually works long term. I’m not about dietary restrictions or removing food groups. Instead, we add in the good stuff and create balance that is sustainable long term.

Way too many women with PCOS experience body shaming by the medical community. They are told to “just lose weight” to get their periods back or to get pregnant. When in reality, your body size isn’t the cause of your irregular cycle.

There are metabolic issues at the cellular level in PCOS (such as insulin resistance) that leads to irregular cycles and difficulty conceiving. You need to address THIS, not the number on the scale.

I’m here to support you where you’re at. And cookies are here to stay. 🍪

06/02/2021

It’s easy to get caught up in the hustle and bustle. To think 3 steps ahead.  To continuously have a growing to-do list with not enough hours in the day to complete it. To continue to push yourself to achieve more.

I see these women in my practice all the time. And I can relate. But the go-go-go lifestyle is never sustainable.

Your energy suffers. Your productivity declines. You can’t stay asleep. Self-care is put on the back burner. Your cycle goes off track. PMS worsens. You experience weight gain. You’re irritable and emotional. You crave sugar and quick carbs. Your body is screaming at you with more and more symptoms.

And at this point is when I see these women sitting in front of me, completely burnt out.

Of course there are ways to support the stress response. But the first step is to take a step back. Prioritize self care and down time. Don’t take on too much. Say no when needed. Ask for help. Go for a walk. Take a bath. Connect (without your phone). Soak it in.

Live in the present. And less in the future.

05/28/2021

This is a common misconception that I see.

Either ☝🏼people think they have PCOS due to ovarian cysts or ✌🏼they think they don’t have PCOS because their ultrasound was negative.

The “cysts” in PCOS aren’t true cysts (like the ones that burst and create significant pain). So if you have these types of cysts, it doesn’t mean you have PCOS.

The PCOS “cysts” are just a collection of immature follicles in the ovaries that aren’t undergoing ovulation. Everyone has multiple follicles growing every month, but in PCOS we just have more than the average person. An o***y with more than 12 follicles is called a “polycystic o***y”.

But you can have PCOS without having multiple follicles (or “cysts”) in your ovaries.

How?

Because the criteria for diagnosing PCOS are based on meeting 2/3 of the following:
1️⃣ irregular periods that are more than 35 days apart. This means from day 1 of your period to the next day 1 of the next period is more than 35 days.

2️⃣high testosterone on bloodwork OR signs of this such as acne, hair loss on the scalp or abnormal thick hair growth on the face and body.

3️⃣ ovarian “cysts” (more than 12 follicles per o***y) on transvaginal ultrasound. This is an ultrasound that goes inside the vaginal canal, not over the abdomen.

So, if you meet number 1 and 2 you technically don’t need to have “cysts” in your ovaries to have PCOS.

However, it’s also important to rule out other conditions that can lead to irregular cycles and testosterone symptoms ❕

Confused? Leave your questions below! 👇🏽

05/27/2021

Educating my patients is very important to me. 👩🏽‍⚕️

I want you to feel empowered and understand every step of your health.

I often get patients who tell me that I’m the first person to ever explain their monthly menstrual cycle to them. Unfortunately, we don’t learn these things in grade school but I’m happy to be the first person to encourage you to know your body.

I often walk my patients through the hormonal fluctuations of the menstrual cycle. Why I test certain hormones at very specific times. We talk about what insulin resistance actually means and the cellular biology behind it. The connections between your brain and ovaries. How your thyroid works. What’s happening with cortisol throughout the day and how this correlates to specific symptoms.

When we understand our bodies, our symptoms and treatment plans make a whole lot more sense. 🧐

I’m not here to just do the work for you.

We’re in this together. Piece by piece. 🧩

05/15/2021

There is no “diet” that works for PCOS.

You do not need to remove food groups, gluten, dairy or fruit.

You do not need to feel restricted. 🙅🏽‍♀️

When I talk about diet with my patients, I ask them what they typically eat. Then, we work from there by adding in a few things or making slight tweaks. I’m not going to tell you to remove food groups or stop eating your favorite meal. Because, you don’t have to.

Every single person’s recommendations will be different.

General guidelines that tend to be helpful:
▪️Eat enough protein – this should be included at every meal to help keep you full and stabilize blood sugar
▪️Include healthy fats – helpful for hormone balance and blood sugar
▪️Colorful fruits and vegetables
▪️Higher fiber carbohydrates (swap white for brown, oats etc)
▪️Try soy protein or plant-based protein once per week
▪️2 tbsp ground flax can help improve insulin and testosterone

Remember: the diet that you can sustain will be the one that works the best. If including pasta, cheese and chocolate keeps you on track with eating more veggies, protein and healthier fats – then great!

But you should never feel deprived or restricted.

05/11/2021

Is your PCOS actually PCOS? 🤷🏽‍♀️

I often have women come into my office who tell me that they have PCOS. But they actually haven’t gotten a proper workup.

A lot of other conditions can look like PCOS, such as:
▪️Non-congenital adrenal hyperplasia
▪️High prolactin (prolactinoma)
▪️Hypothalamic amenorrhea
▪️Cushing’s
▪️Regular hormonal changes within the first year of starting your period

I need to rule out every other possibility before I can confidently treat you for PCOS.

When did your symptoms start?
What were your cycles like when you first got your period?
Have you had extensive lab testing?
Have you had a transvaginal ultrasound?
Does PCOS run in your family?
Have you experienced drastic weight changes?
How rapidly did your symptoms come on?

Your doctor may not have time in your visit to ask all of these questions. But I do.

A proper assessment allows me to give you a proper treatment plan. And this is where we see results.

Just because you have irregular cycles and acne doesn’t mean you have PCOS (even though you meet the criteria).

Let’s make sure your symptoms aren’t a result of something else. 👩🏽‍⚕️