Dr. Azziz Tells MDs Be Vigilant for PCOS

One of the biggest complaints made by women with PCOS is that their doctors are uninformed or misinformed about the disorder.  I love that this video and article by one of the most well-respected PCOS experts, Dr. Ricardo Azziz, is directed to the doctors. To those of us who know about PCOS, the content seems simple, but to hear women’s stories of how they aren’t properly diagnosed or treated, this is a much-needed resource in the medical community!   I’m not sure how these videos get distributed to doctors or how many will see them but wouldn’t it be great if this kind of content started reaching our doctors! Anyway, it’s a great little video by a fantastic doctor with a great message – “Be Vigilant for PCOS”!!

Click the link below for the video – it’s only 5 minutes and definitely worth watching and sharing with your doctor!


Dr. Azziz Tells Doctors to Be Vigilant for PCOS




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Diabetes? Who Me….? Ya Me. Couldn’t Be….

Sonya's Diabetes Risk Score

Canadian Diabetes Association Risk Score

Or could it?  I was shocked to discover I was on target to become a Type II Diabetic and didn’t even know it!   It’s World Diabetes Day – a perfect time to share a personal story about my recent diabetes scare and discovery.

Amazingly, 86 million American adults which is more than 1 out of 3 people are pre-diabetic and 90% of people with pre-diabetes don’t know they have it!  I was sure surprised to discover I am one of those people!  (CDC.gov)  Doesn’t this just speak to the massive failure of our healthcare system?!  How are we failing 90% of people walking around about to develop a disease and not doing anything about it?! This is exactly why and how traditional healthcare is failing people.

I live a relatively healthy lifestyle.  I eat pretty healthy overall, I am not a couch potato and I’m averagely active, I’ve gained a bit of weight over the past couple of years but I’m not obese.  Millions of people are pre-diabetic and don’t know it but I honestly never would have thought that meant me!  Yet pre-diabetes was lurking in the shadows and I didn’t know it. My doctor didn’t know it. Look at the image showing my risk of diabetes using an online questionnaire.  You can clearly see my risk score is LOW according to the Canadian Diabetes Risk Score Calculator.

So how did I find out I was on a fast-track to joining millions of people who have Type II Diabetes and, in fact, was already severely insulin-resistant?

myAva’s Precision Medicine PCOS Program uncovered my pre-diabetic state! 

As you know, I am developing myAva’s Precision Medicine Program for PCOS and as the CEO and Founder, I made the decision to join the 10 women on our Patient Advisory Board in the screening and discovery process. I made this decision so that I could really get a sense of what we are putting patients through, how it feels to get this much data and to be able to have a real conversation with them about all of the things they are going through as they wade into this new style of healthcare called Precision Medicine.  And wow, what a great decision that turned out to be!

You may already be aware, women with PCOS are at a high risk of developing diabetes and 50% of women with PCOS will become diabetic.  I have never been diagnosed with PCOS and don’t meet the current diagnostic criteria, yet I have myriad symptoms related to PCOS.  A component of myAva’s program is to screen for insulin-resistance/pre-diabetes/diabetes due to the high risk for women with PCOS.  When I underwent our initial testing this summer, I was surprised to discover that I had already developed severe insulin resistance.  My blood work showed I was well on my way to becoming a Type II Diabetic!

My family was as shocked as I was.  To put my shock into perspective, keep in mind I have never been told I am at risk for diabetes, have no known family history, and don’t have PCOS or belong to other populations that are at risk. You see I eat quite healthy – I don’t drink soda, I don’t eat a lot of sugary or packaged foods or fast food.  My diet is mostly made up of whole foods including tons and tons of fruit. Fruit is healthy right? What I didn’t realize that many foods that we think of as healthy actually create an increase in demand for insulin. And no wonder my “healthy eating” wasn’t helping me lose weight!  Insulin blocks the breakdown of fat and tells the body to make more fat!  That’s a story for another day. Let me show you how the discovery was made.

Traditional Lab Testing:

This part is really interesting, and very relevant to you, as a patient with ONE doctor.  I am in a fortunate position due to development of myAva to seek advice from a number of medical and naturopathic doctors, lab personnel, geneticists and molecular scientists. Did you know there is more than one way to screen for diabetes, prediabetes and insulin resistance?  I didn’t know there were so many different methods that doctors use to help them assess your risk of diabetes.   In fact, what is the difference?  That US National Institute for Diabetes and Digestive and Kidney Diseases gives a good overview. 

So here’s the interesting part, when I asked various members of the group I’m working with how best to screen women with PCOS for insulin resistance and/or pre-diabetes I received a different answer from each of them!   Is this surprising?  Actually, not at all – there are several different tests to screen for diabetes risk and they are all valid. Some methods are more costly than others, some are better at finding diabetes but not as good at finding insulin resistance (pre-diabetes) and some take a whole lot of your time sitting in a lab and drinking what tastes like sugary pop.  But here’s the important thing to know, the issue is complex and although I won’t go into in detail here, some methods are going to uncover your pre-diabetes or insulin resistance and some are not going to detect the risk in everyone.  

Using HOMA-IR (Homeostasis Model Assessment-Estimated Insulin Resistance), which is a calculation that takes both your fasting glucose and your fasting insulin into account and provides a risk profile, we discovered I had insulin resistance, a condition I was completely unaware I had.  

Genomic Testing:

I was amazed to discover during my genomic consultation that I have a genetic risk for Diabetes and Metabolic Syndrome.  I have genetic variances (mutations) associated with both Type II and Type I Diabetes but they are identified as LOW. Interestingly, as far as I knew, I had no family history of diabetes but clearly I carry genetic variances associated with the risk. This was eye-opening indeed.

Molecular Profile:

As we delve further into my proteomic and metabolomic profile by measuring about 160 proteins and a couple of hundred metabolites, we uncovered a severe risk of diabetes for me which you can see below.  The most exciting part is that these are actionable measures – I can reverse these trends because I caught them early enough to do something about it!  Sonya's Diabetes and Metabolic Risk


I am forever grateful that I discovered this trend toward disease as it was sneaking up on me!  I caught it before I became diabetic. Thank God.  Thanks to myAva this is how data empowers patients.  

I can’t help but think about the millions of people walking around like me, completely unaware that their lifestyle and hidden risk factors could be pointing them in the direction of diabetes.  Today I am super happy to report that I was able to reverse this trend in just three short months.  I’ll tell you how I did it next time – it’s a very compelling story.


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We’ve Come a Long Way Baby – History of Birth Control

You won’t believe some of these methods – mostly women of course – have used for birth control since ancient times!  Paste made from crocodile dung?  Inserting partially squeezed lemons into your vagina?  Douching with Lysol? Wow…




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My Genes Just Told My Hormone Story

It took 48 years but I finally got some answers.

As a teen who was sure I had something wrong with my hormones but couldn’t get an answer and as a young woman who was still certain that there was something wrong with my hormones I couldn’t get an answer.  I couldn’t even get a blood test to find out what my hormones were doing.  Not when I complained of acne that lingered as an adult.  Not when I asked about my lack of periods. Not when I asked about my libido.  Not when I miscarried 2 babies. The years went by and I was given all sorts of reasons by all sorts of doctors. One great doctor did test me but if you aren’t specifically trained in knowing about hormones you don’t get any answers – at least she tried.  So over the years as I moved around the country I was referred to a dermatologist for acne, I was offered birth control pills, I was offered anti-depressants, I was referred to an ob/gyn for infertility, I was told to wait until I lost 3 babies before we would test my hormones, I suffered severe bouts of PMS and so did my family along with me, I suffered Postpartum Mood Disorder which got increasingly worse with each of my 3 successful pregnancies until it became severe and debilitating.

Fast forward to September 2016…I am in charge of my health – YAY me!  Times have changed and we know a LOT more about hormones.  Patients are empowered.  And of course the internet has patient groups and medical sites and so much information it’s hard to sift through it all and know what to believe.  And most of all we are embarking on a new age of medicine – the molecular age.  Science and technology are converging to provide us huge insights into our health and here’s what’s happened in my life…

A few weeks ago, along with the women on the myAva Patient Advisory Board – the first women to experience myAva’s Precision Medicine PCOS Program, I got my DNA tested.  The kind of genetic analysis I’m referring to is called Whole Exome Sequencing which is the most efficient way while still being comprehensive enough to identify the genetic variants in all of a person’s genes.  My report was delivered by two brilliant genetists from GeneYouIn who went through my mutations with me and two of my phenomenal physicians one by one answering our questions as we went.  At the end of it I was provided with my full report, including links to relevant research as well as follow-up recommendations.

“My DNA held the secrets to my hormone and reproductive health problems”

So what did I find out?  Ok so I’m a mutant – we all are – but wow it’s amazing what a ton`s of information can be extracted from those few cells they gathered.  While I found out lots of interesting information what I found to be the most amazing stuff is the information that validated my entire medical history.  It was the most profound “I told you so!” moment I’ve ever had.

All of this time, my DNA held the secrets to my hormone and reproductive health problems. 

I have 5 genetic variances that speak directly to my ovarian development and function, infertility, menstrual disorder, oligomenorrhea and anovulation, general hormone imbalance, risk of endometriosis and premature ovarian failure..  I have more that speak to my risk of thyroid disease, adrenal problems, metabolic disorder, type 2 diabetes and autoimmune disease.  And those recurrent miscarriages I had which elevate my risk for heart disease – it’s all there in my DNA too.

“I feel more empowered with the information than I ever have about my health”

I don’t mean to oversimplify this stuff – it’s all pretty complicated and it’s not all black and white.  There are lots of factors that get taken into consideration, such as do you have a family history, do you carry one copy or two, is your particular variation ‘novel” (as in do other people have it too or are you a one in a million?), is it clinically characterized, etc.  And then there are the concepts such as penetrance and gene expression to bear in mind with lots of environmental and lifestyle factors that complicate matters. 

At the end of the day, I feel more empowered with the information than I ever have about my health. I have an action plan to screen for some of these items and now my children are already part way there now that I have some answers.  I am optimistic that their healthcare will be delivered so much differently then mine! 

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One Small Step for PCOS – One Giant Leap for Patient Empowerment!

myAva Patient Advisory Board

The Trailblazing Women of the myAva Patient Advisory Board

I’m super excited to introduce you to this incredible group of women!  This is an epic moment in my life and I hope someday yours too!  This photo was taken at our first ever Patient Advisory Meeting held in Atlanta, Georgia and these ladies are true pioneers in healthcare.  Like many of you, these women are survivors and they are brave enough to join me with passion to change the standard of care for women’s health, starting with PCOS.  They have already started rolling up their sleeves to help me create the delivery system for Precision Medicine which will bring women’s health to the forefront of innovation in medicine.

We started the process by sending out a single email to 1000 Atlanta area women diagnosed with PCOS and received such an overwhelming response.  Choosing just 10 women was the hardest thing I’ve had to do so far but here we are with an incredible group of women who have made a commitment to change.  Our motto is No Cysters Left Behind, because not one of us wants to see another woman suffer at the hands of PCOS.

Women have been underserved for far too long in healthcare and as I’ve worked on this project I have discovered exactly why women’s health is in the state it is in!  It has become crystal clear to me why we need more women involved in science, labs, medicine, all the way up to the decision makers.  I am optimistic that we finally have the opportunity to do something!  These incredible women will be advising me every step of the way as I work with the myAva team to build the delivery system that brings Precision Medicine to Women’s Health, starting with PCOS.

I’ll let you in on a little secret, with all the talk you hear in the news about Precision Medicine these days you’d think it was already accessible, but the fact of the matter is that no one knows how to deliver Precision Medicine.  Clinics are not set up for it. The learning curve is steep at every step of the way for every group trying to tackle the issues with disrupting an entire heatlhcare system. People are as afraid of it as they are excited by the prospect of it.  That’s what makes this an optimal time for patients to get involved at the grassroots level – while protocols and systems are being designed. Precision medicine has the potential to level the playing field and women, as a patient group of their own, are done taking a back seat.  One thing I am certain of, 5 years from now a trip to the doctor is not going to look like it does today.

Stay tuned as these women begin their journey and help design a new style of healthcare they will be sharing stories with you along the way. Like with everything new, it might be a bumpy ride but we all think it’ll be worth it in the end!

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PCOS Sucks! Take the Lemon Face Challenge!

When women team up in support of one another they can sure get things done!!  And when it’s Ashley Levinson who is @PCOSGurl on Twitter teaming up with an entire PCOS community there is no telling what can be accomplished! Wow!




I nominate YOU to Take the Lemon Face Challenge!  

Join the Facebook Group – Lemon Face Challenge

Upload your picture or video and challenge someone else spread awareness and/or donate to PCOSChallenge.org


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Precision Medicine & PCOS Q&A on PCOS Nutrition Center Blog!

Angela GrassiI’m sure you’ve heard the saying, “The best way to predict the future is to create it yourself.

“The best way to predict the future is to create it yourself”

. I waited a long time for someone to create the kind of healthcare I would like to have access too but it just wasn’t happening and so I became a true believer in that saying.  When I first decided to tackle women’s health from a patient perspective I couldn’t figure out why no one was doing this already but it quickly became pretty obvious to me – it is damn hard!

There’s another saying that I believe in with all my heart: “Alone we can do so little, together we can do so much!

“Alone we can do so little, together we can do so much!” Helen Keller

Helen Keller apparently said it and wow, if anyone knows what it took to achieve something phenomenal she did!

Of course no one can do it alone so I appreciate all the support of the people who have helped me get this far and especially the PCOS Community.   One such amazing person is the award winning Angela Grassi from PCOS Nutrition Center.  Angela is so passionate and was excited to learn about the Precision Medicine PCOS Program I’ve put together that she featured a Q&A about it on her super-informative and beautifully redesigned blog – PCOS Nutrition Center.

Check out my Q&A with Angela: Sonya’s Q&A on Angela Grassi’s PCOS Nutrition Blog

I love having Angela’s support – she’s a trailblazer herself!  As a Registered Dietician and a woman who has PCOS, she has done some pretty amazing things to help the most underserved medical community – which I believe is PCOS. She has published 3 pretty incredible books specifically to provide women and dieticians the resources they need to help navigate their journey with PCOS.  Check them out here:


Angela Grassi - Book_PCOSdieticiansGuide_1000pxAngela Grassi 2Books_WorkBk_CookBk_1000px












I look forward to keeping you informed but even better, if you want to help create the future of Precision Medicine for women’s health, starting with PCOS, drop me a line using the contact form below or subscribe to updates at myAva.com.  I think you’d be amazed at what you can achieve.




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World Thyroid Day

Hypo Butterfly from World Thyroid Federation

Hypo Butterfly from World Thyroid Federation

There are so many thyroid patients around the world that the tiny little butterfly shaped gland has it’s own special day of significance around the world!  Actually it has it’s own week – this whole week is dedicated to Thyroid Awareness which is near and dear to my heart because I have subclinical hypothyroidism which is controversial among doctors as to whether to treat it or not.  Sometimes I feel like a ping pong ball with the different advice I get.

Thyroid Federation International (TFI) was founded in 1995 in Toronto and is now a worldwide organization that includes a network of patient organizations from a variety of countries around the world.  TFI established Thyroid Awareness Week & Day – May 25th.

As common as it is, thyroid dysfunction seems to cause a lot of confusion and awareness is critical.  One of the important aspects to understand is that thyroid disease can run in families and children often go undiagnosed.

This year the World Thyroid Federation’s theme is

“Catching the butterflies: Spotting the symptoms of thyroid disorders in children.”

To help children and their families learn about Thyroid Dysfunction TFI created these little animated cartoons depicting the symptoms of Hypothyroidism and Hyperthyroidism.

Hypo is a blue butterfly, showing the symptoms of hypothyroidism, that moves slowly compared to his friends and not growing as fast. The hypo butterfly is often tired and sometimes sluggish.


Hyper Butterfly from World Thyroid Federation

Hyper is a thin, overly active, fidgety pink butterfly reflecting the symptoms of hyperthyroidism. The hyper butterfly is irritable and easily upset.

Know the signs of thyroid disorder and if you have questions or want to learn more Thyroid Week or TFI are two great places to start.









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Mother’s Day After a Miscarriage

Do you know what is considered the shortest story ever written?  It’s a tragedy in six words and it goes like this:

For Sale.  Baby Shoes. Never Worn.

Sadly, that tiny story is the reality for more women than you may realize.  Mother’s Day brings up intense and mixed emotions for a lot of women.  You feel like you are a mother or wait you were a mother or wait, was I? Nobody else is treating me like I am a mother.   At least that’s what I went through – or something like it.  And then…one day you meet the person who knows you are, indeed, a mother.   I recall the validation I felt at being told that it was ok to consider myself a mom even if no one else did. It was such a relief.

Only those who are part of this group understand what it’s like to get through a Mother’s Day after miscarriage or stillbirth.  Sadly the cost to enter this group is high.  Having gone through pregnancy loss is the only way to become a part of this group – something I wouldn’t wish on anyone.

A lot of women face miscarriage alone.  And then they face Mother’s Day alone.  Mother’s Day is a time for celebration.  But for those who have experienced pregnancy loss, it can be really tough.  You may still spend the day celebrating with your own mother or other women in your life but no one acknowledges your motherhood experience. Lots of reasons why, such as: it was too brief, you didn’t hold your baby, your babe didn’t have a name, you didn’t even hear his heartbeat or just simply people don’t know what to say or are afraid to bring it up.

If you know someone who has gone through pregnancy loss it only takes a small acknowledgement to ease the pain of the day – just a little bit for mom’s who never got the chance to meet their babies.

This Mother’s Day I’ll be thinking of all the mom’s whose pregnancies were too brief, who didn’t get to hold their babies, who weren’t told they could name their baby, who didn’t get to experience the joy of hearing that first heartbeat, who still have baby sleepers that have never been worn. Even if you have baby shoes that were never worn, you’ll always be a mom.

Heartfelt Hugs.


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What I Want My Family & Friends to Know About Perinatal Mood Disorder

I sent a message to my family and friends today because I want to spread awareness among people who don’t need to know they need awareness!  Most people who read my blog or who have connected with me on social media are already a step ahead – they are seeking information about hormone topics for some reason or another.   I thought I’d share it with you too.  I appreciate all of your support as I try to create awareness around women’s hormone health.  Thanks!  
Today is the First World Maternal Mental Health Day! This is REALLY Important to me on a personal level.
I am spending my day spreading awareness because I suffered from Perinatal Mood Disorder, probably with each pregnancy but definitely after my baby boy. I usually reserve my oversharing 🙂 for my Hormone Soup page but this is really important to me and it is so important to end the stigma around this debilitating illness.
My kids are learning about Mental Health this week at school and my guys are already well informed about Maternal Mental Health Awareness because we talk openly about it at my house. I never want my kids to feel like their mental health is less important than their physical health. My 9 year old son asked me if I could print off the Hormone Soup Perinatal Mood Disorder jpgs that I am sharing on Facebook and Twitter so he could take them to school!  Love that kid!
Here’s what I want all my friends and family to know: (That includes the men too! Maternal Mental Health is EVERYBODY’s business.)
  • Perinatal Mood Disorders are the #1 Complication of Pregnancy!
  • Perinatal Mood Disorders are an Invisible illness!
  • Postpartum Depression is NOT JUST depression – it can manifest as Anxiety (pick me!), OCD (me again), Bipolar, Psychosis, PTSD and can involve mood swings. And in fact Anxiety is more common than depression. Perinatal Mood Disorder is a much better term.
  • Postpartum Depression is NOT JUST postpartum – it can happen during pregnancy too.
  • Up to 20% of women will deal with some form of Perinatal Mood Disorders. That is 1 in 5! You are not alone!
  • Perinatal Mood Disorder is not the same as Baby Blues. It can be a serious and sometimes life threatening emergency.
  • If you have Perinatal Mood Disorder or ANY mood disorder you MUST get your thyroid checked! And by that I mean PROPERLY checked not just a simple TSH Test. There is a specific disorder called Postpartum Thyroiditis and is treatable.
  • Perinatal Mood Disorders are treatable!
  • Perinatal Mood Disorders are considered a hormonally triggered mood disorder.
  • Perinatal Mood Disorder can happen to New Moms and Veteran Moms! Don’t assume because someone is having a second or third or fourth child that she isn’t suffering. Every pregnancy is different. Every mom is at risk.
  • Sometimes the person experiencing the PND is the last person to recognize it! Do not be afraid to reach out.
  • Many women are afraid to get help because they think they will be given a pill and have to stop breastfeeding. There is help available that does not always have to include pharmaceuticals.
  • Do not assume you or your friend will be screened by your doctor. You probably won’t be – just because it is recommended that your doctor screens does not mean it happens, it hardly ever does.
  • If you know someone is experiencing Postpartum Psychosis call 9-1-1 it is considered a medical emergency!
  • Do not share your “scary/tragic baby or mother” story with other women – it can act as a trigger and who needs to hear such devastating stories anyway.
  • There is a movement called #askher happening.  When you know someone who has recently given birth, miscarried or had a stillborn child #Askher how she’s sleeping or how she’s feeling. Do Not be afraid.
  • Sleep is one of the most important factors and one of the easiest things to do – help a new mom get the sleep she needs. 
There are lots of resources out there and I know almost all of them through my blogging and social media connections. Please feel free to reach out or send anyone you know to my Hormone Soup blog or Facebook or Twitter or Pinterest page.
#maternalMHmatters #askher

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