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For high-performing women who are exhausted by weight gain, hormonal chaos, and vanishing energy — this is your reset. I’m Dr. Ade Akindipe, a DNP, obesity + hormone specialist, and health coach.
On this show, we demystify metabolism, gut health, hormone balance, longevity, and the root-cause mindset behind lasting transformation.
If you’re ready to stop fighting your body and start living with more clarity, energy, and confidence — this is your space.
hello and welcome back to the Elevated Women's Podcast
I am your host Dr. Akindipe
and I'm so glad you're here
so last week we really got into it about PMOS
polyendocrine
metabolic ovarian syndrome
and we talked about what it really is
why it matters
and why this is about so much more than ovarian cysts
if you didn't catch that episode
please go back listen
it is a good one episode 28
today we're gonna go a little bit deeper
because after that episode
I got a lot of messages I also heard from you in clinic
and you know I love hearing from you
and the theme was now what do I do
Dr. Ade what do I do
my doctor said my labs are fine
so what do I actually do
and this is exactly what today is about
we are talking about the labs
that actually tell the story
what the numbers should look like
what it means when they are off
and then this is the part that I feel like
you should walk away with is
what do I do at home
what do I do in my daily life to move the needle
because sometimes we feel like
it's just up to
all the things that your provider gives you
yes we are there to support you
but you know the lifestyle
really is what gets to
fix a lot of the imbalances that happens
there are tools there are nutraceuticals
there are medications but if you
know how to live your lifestyle
for better metabolic health
that is what makes the sustainable changes happen
so I'm going to also share
some of the supplements
that I personally use in my clinical protocols
with my patients that have PMOS
or metabolic dysfunction or insulin resistance
because some of you are ready to start doing
something right now and I get it
so today I want to give you that
let's go so
I want to start by saying something that I think
a lot of women need to hear
you were not wrong okay
your instincts about your own body
that something was off were correct
there was something going on in your body
and you felt it
so the system just wasn't looking in the right places
and we talked a lot about that in the last episode
here is what happens when a woman goes to the doctor
she's exhausted
she's gaining weight around her midsection
even though nothing has really changed
her periods are unpredictable
her hair is coming out in the shower
she can't think straight past lunchtime
she knows that there's something happening in her body
her doctor runs her labs
calls her back and says everything looks normal
and so she goes home wondering if she's being dramatic
if this is just what getting older feels like
or if she just needs to try harder
but no that's not it
that is not it here's the truth
most standard panels that are checked are checking
I don't want to say they check the wrong things
they're checking the basic standard things
and a lot of times
it's based on what your insurance will pay for
and if the provider doesn't feel it's necessary
based on what you're presenting with
may not draw those labs or checking the right things
against
reference ranges that were built on a population
that includes a whole lot of sick people
so what's normal just means you're not sick enough yet
for the system to flag it
so normal is not the same as optimal
and that gap between technically normal
and actually feeling good
is where so many of us are living
so
what I want to do today is show you what to look for
what the numbers should actually be
and what you can do when they're not there yet
because there's a lot you can do alright
I'm going to walk you through the labs that I look at
with every single patient
in my practice screenshot this
save this episode write it down do what you need to do
whatever works for you
this is your cheat sheet for the
the next provider's conversation
so the metabolic markers is where we start
when I say metabolic markers
these are the ones that tells me
how your blood sugars are doing
some of it is a snapshot of time
maybe the last three months or so
so the first one is fasting insulin
and the optimal target really should be under 5
and there's you know international units per mL
that's how they're measured
this matters because often
your provider may check your hemoglobin A1C
and your hemoglobin A1C may come back normal
but you may have been compensating for a while
so
your blood sugars are staying within the normal range
but your insulin may be higher
so standard labs skip testing this
but insulin rises years before your sugar does
so this is your earliest warning sign
the next one is HOMA IR
this is calculated from your fasting blood sugar
and your insulin
the closest thing to a direct insulin resistance score
from your blood draw that's what this is
and this needs to be under 5 for it to be optimal
when it's above 2
then we might start to think that insulin
resistance is present
and if we have your fasting glucose and your insulin
we can calculate this score
the next one is hemoglobin A1C
and the optimal is under 5.4%
that's your three month average blood sugar
a 5.6% is normal
but it's trending in the wrong direction
so we treat the trend not just the flag
you don't wanna wait until your A1C is 6 or 6.5 or 6.8
at that point
your blood sugar is already in the prediabetes
diabetes range etcetera
fasting glucose that needs to be under 90
it's included on most panels
again this may not be flagged as troublesome
because 90 technically is within the normal range
but it's meaningless without a fasting insulin
alongside it right
thyroid so thyroid markers are very important
with women that are in perimenopause
menopause may have insulin resistance
they may have PMOS
because the thyroid function may be quote
in the normal range but again
may not be optimal because women who are
exhibiting signs of metabolic dysfunction
really need great optimal thyroid support
so your thyroid stimulating hormone or TSH optimal
and to be honest I'm giving you this optimal range
but really it's important for your
the provider to really look at your symptoms
because if you're exhibiting symptoms of hypothyroidism
weight gain cold hands and feet constipation
brain fog
and all of those other things that you notice
with hypothyroidism 2
a TSH of 2 may not be optimal for you
and oftentimes this is what all doctors check
it tells you how hard your pituitary is working
but it doesn't tell you what your cells
your thyroid cells are actually looking
are actually receiving rather
so the TSH is a screener test
it's not the actual functioning of your thyroid
free T3
this should be on the upper third range of your
you know if you look at a bell curve
you don't wanna be on the lower end of that bell curve
you wanna be on the higher end
so this is your active thyroid hormone your cells use
so a low free T3 will give you some symptoms of fatigue
weight gain hair loss
brain fog even if your TSH is normal
reverse T3 think reversing the T3 right
if that's under you want that to be under 15
your body makes reverse T3
when it's stressed or inflamed
it blocks free T3 at the receptor
so high reverse T3 is why some women feel hypothyroid
with perfect-looking labs
TPO and TGAB these are antibodies against your thyroid
that should be negative
you shouldn't have antibodies against your thyroid
that is a marker for Hashimoto's
so
elevated antibodies equals autoimmune thyroid disease
this is often completely missed on standard panels
then we go to your hormones
because this is a hormonal picture
not just a metabolic one too
especially for our ladies with PMOS
or perimenopause
menopause and beyond your testosterone
your free and your total testosterone
now I have to say this so on your labs
what's supposed to be normal is between 0.1 and 0.8
now if you're listening to this
I want you to think about this
0.1 to 0.8
now does that sound like you have any testosterone
free
testosterone is a testosterone that's not bound to any
proteins that's what your body actually uses
and if you have zero point 1
you really have no testosterone
and this might be a little tricky
but women with PMOS
some women have elevated testosterone
but it doesn't and and you know
that might drive acne and hair thinning
and irregular cycles and mood changes
at the same time
women may also struggle from low testosterone
we'll get into that in other episodes
don't you worry about it hahaha
it doesn't mean that you don't need testosterone
sometimes
even a little bit of testosterone replacement
can help these women out significantly
sex hormone binding globulin SHBG
this is a protein that binds to the sex hormones
just like it says sex hormone binding globulin
the higher this is the better
now this is the one that binds to testosterone right
it binds to sex hormones so the higher that is
you may actually not realize
the potential of the hormones if
especially if you're on hormone replacement
the higher that number
so if you're in hormone replacement
you may need more testosterone
for example for you to get the benefits of that
but insulin suppresses sex hormone binding globulin
so if you have low sex hormone binding globulin
this is an indirect measure of insulin resistance
marker yes
so
rising SHBG means your insulin resistance is improving
again this is not tested on standard labs
estradiol and progesterone
now these kind of depends on your cycle
if you're a cycling woman
so day 3 for baseline day 21 to confirm ovulation
many women with insulin resistance aren't ovulating
even with regular-ish periods
so estradiol and progesterone
you can't really go by it really
depends on the time of the cycling
so hope that makes sense
now let's go to nutrients and inflammation
this is something that again
a lot of standardized tests don't check for
ferritin levels in women that are cycling
if you have heavy periods
or you may have ovarian cysts
or you have endometriosis
and you tend to have heavy periods
this is sometimes overlooked
over 70 is optimal most labs flag this as normal
above twelve but at 20
women feel terrible low ferritin can cause fatigue
hair loss poor thyroid conversion
vitamin D
I know this might sound like it's not a big deal
but a lot of women are walking
around with really low vitamin D 20s
30s I had one lady walk in with eight
a vitamin D optimal level should be between 60 and 80
and this is like so common
it's linked to insulin resistance
immune dysfunction getting sick all the time
mood disorders depression anxiety
impaired thyroid receptor function
yes
you need your vitamin D for your thyroid to function
well magnesium
over 5.5
serum magnesium looks normal even when you're depleted
but RBC red blood cell magnesium
is the real test you want to look at
magnesium is essential for so many things
it's even for insulin resistance
insulin signaling high sensitivity CRP
that needs to be under one
that is a marker for inflammation
this measures chronic low-grade inflammation
a driver and consequence of insulin resistance
if this is elevated everything else is harder to fix
alright so we went through a bunch of numbers
and this will also be in the show notes as well
if you wanted to take this
and make sure that you get checked
what do you want to do with these numbers
if they come back off let's talk about that
but wait before I go into the next steps
I want to just sit here for a second
because I think some of you listening right now
are in the middle of this
and I just want you to know that I see you
you're waking up tired
you're already tired before the day even starts
you're getting through with caffeine
energy drinks or simply willpower
cause you just have to get up
and do what you need to do
and around 2 or three PM you hit a wall
you need sugar
you need a nap and you can't figure out why
you can't just have normal energy
your jeans fit differently
your hair is not the same
your mood has shifted more anxiety
more irritability or just kind of flat
and you've mentioned it to your doctor
maybe more than one
and nobody connected all of these dots
so this ends today
because now you know what to look for
and you know what to ask for
if your HOMA IR is above 1.5
or fasting insulin is above 7
you have early to moderate insulin resistance
this is very actionable
so start immediately with nutrition
and we'll do a full episode on this
but right now reduce refined carbs
get protein into every meal
and tighten your eating window
on the supplement side
which I'm going to get into in just a minute
there are some really powerful tools
that directly improve insulin signaling
if you're free T3 which is for your thyroid
is low or your reverse T3 is high
and we already talked about what optimal is
your thyroid is not being optimized
ask your provider
specifically about free T3 optimization
not just TSH management if your TSH is normal
that may not necessarily
mean that your thyroid is functioning well
and in the meantime there are nutraceuticals
specifically selenium and zinc
that support T4 to T3 conversion
we'll talk about those let's go to ferritin
ferritin is under 50 I want you to start with iron
but choose ferrous bisglycinate
this is far gentler on your stomach
and absorbs better than ferrous sulfate
take it with vitamin C and
you know recheck it in eight to 12 weeks
if your labs look normal but you still feel terrible
then you need a provider who looks at
where in the range your numbers are sitting
not just it's normal
not just when they're flagged as abnormal
that
there is a huge difference between a free T3 of 2.4
and a free T3 of 3.8 both are normal
only one of them feels normal right
okay I want to talk about supplements
and I want to be really clear before I do
supplements are not
a replacement for working with a provider
they are not a substitute for labs
for lifestyle changes or for the kind of
individualized protocol
that accounts for your specific picture
so please hear me on that
but and this is a real but
there are nutraceuticals that are backed
by actual clinical evidence
for insulin resistance
not something that's just found on social media
because one you know
influencer is promoting it
so these are backed for insulin resistance and PMOS
these are things I use personally
in my own protocols with my clients
so for the women who are listening right now
who aren't ready to book an appointment
or find out more
here are some things you can do to start
while you try to figure out your next step
I want you to have access to it
so let me walk you through that evidence
what evidence supports
organized by what most of you are dealing with
for insulin resistance okay
this is the foundation
this is the core insulin resistance stack
so if you have insulin resistance
based on those numbers
myo-inositol is a great nutraceutical to take
4 grams per day this one is a powerhouse for PMOS
studies show that it improves insulin signaling
raises sex hormone binding globulin
SHBG and supports ovulation
in some research it performs as well as metformin
you may have been put on metformin
maybe you didn't do well on it
maybe it gave you a lot of stomach issues
this is in my core stack really for every patient
the second one is berberine
you may or may not have been on it
berberine activates something called AMPK
basically it's the same pathway that metformin uses
studies show it can reduce your HOMA IR by nearly 45%
I recommend the phytosome form specifically
because it's much gentler on the stomach
this is in every patient's core stack
that has insulin resistance or PMOS
you need to be taking about 500 mg
at least 500 mg
two to three times per day and preferably with meals
now omega-3 your EPA and DHA
2 to 3 grams per day it's anti-inflammatory
it improves your lipids your cholesterol
and it directly supports insulin sensitivity
if you're only going to add one thing this week
honestly it could be the omega-3
now vitamin D vitamin D3 with K2
2,000 to 5,000 units
some I even put on 10,000 units a day
depending on how low you are
here in Alaska I would say just take 10,000 units
of course make sure that you're monitoring your labs
making sure that you're not taking too much
low vitamin D is directly linked to insulin resistance
this is why we check it on
every single woman that walks into our clinic
you know it's linked to thyroid dysfunction
your mood so always pair this with K2
so that the calcium goes where it's supposed to go
into the bone to help your bones be strong
now if your insulin resistance is more moderate
or you're dealing with multiple symptoms at once
like brain fog fatigue
mood sleep issues
there is an extended stack
that I use with those patients too
magnesium glycinate 300 mg to 400 mg at bedtime
I love this I use
it is essential for insulin signaling
and most women with insulin resistance
are depleted of magnesium
the glycinate form specifically is great for sleep
which women with insulin resistance
women with PMOS
absolutely need
so take this at bedtime it will really help
NAC, N-acetylcysteine
take 600 twice a day oh
magnesium if I didn't say that already
is 300 to 400 mg at bedtime
NAC 600 mg twice a day
NAC is a powerful antioxidant and insulin sensitizer
so for women who can't tolerate metformin
or want a more natural alternative
NAC is one I reach for it also supports liver health
and glutathione production
selenium 200 mcg per day
this is critical for thyroid function
selenium is the cofactor for the enzyme
that converts T4 into the active T3
your cells need so
if your free T3 is low
or your thyroid antibodies are high
meaning you have Hashimoto's
selenium is definitely non
non-negotiable you need to be on that alpha-lipoic acid
600 mg per day this activates what we call GLUT4
it's the glucose transporter in your muscle cells
so it helps bring sugar into your muscles
instead of storing it as fat
also a strong antioxidant
that reduces your fasting blood sugar
now I have put together supplement bundles
based on these exact clinical stacks
there is a core bundle
and then there is an extended bundle
the core bundle is basically if it's
you have very mild insulin resistance
you have some of the symptoms
maybe your blood sugar is kind of creeping up there
and the extended one is if you have multiple symptoms
and are already maybe starting to have more moderate
higher insulin, then I recommend the extended bundle
if you wanna get started right now
the link to purchase is in the show notes
you can check those out these are the same products
the same forms the same doses I use with my patients
so you don't need another appointment to start that
but and I need to say this clearly
please do not use supplements
as a substitute for proper evaluation
especially if you are pregnant
breastfeeding or on medications
berberine in particular berberine
should not be combined with blood sugar medications
without proper supervision
that can lower your blood sugar
these are tools not treatments in isolation
bear that in mind
always work with someone who knows your full picture
okay now let's go to three things you can do this week
every episode
I want to leave you with three real doable things
so here they are request the right labs in writing
call or message your provider
and ask for fasting insulin
HOMA IR free T3
reverse T3 ferritin
high sensitivity CRP and SHBG
send it through the portal so there is a record
if they push back you know
you can just say I've been experiencing fatigue
weight changes and hormone symptoms
and I'd like a more complete metabolic picture
the other thing I want you to do is try a CGM
the other thing I want you to do
No. 2 is try a continuous glucose monitor for two weeks
you can get something like the Libre 3
there are also some other ones on
over the counter like Lingo uh
there's also Stelo
you don't need a prescription for these
you wear it on the back of your arm for over two weeks
and you can see the real blood sugar in real time
after every meal overnight during stress
it will show you things about your metabolism
that no single lab draw can show you
so you will never look at a bowl of oatmeal
the same again again
I'm linking it in the show notes for you
okay No. 3
every day this week
I want you to start a five point symptom journal
so energy level 1 to ten sleep quality 1 to 10
your mood what you ate and when
and any symptoms that came along with that
two minutes in your phone notes
whatever kind of device you want to use to track this
the patterns that emerge over just two or three weeks
are genuinely eye opening
and if you ever do come to work with me
or another provider the data speeds everything up
I love it when clients come into clinic
and they have data on their phone
either they're pulling up their labs
maybe a previous provider had drawn
or they have it in their notes
or they're pulling out their CGM
their continuous glucose monitor
and they're showing me
exactly what happened over the two weeks
the meals when they were crashing
it's it's just great to
to look at that data okay
so here's where I want to land today
your body has been talking to you through your energy
your weight your cycles
your skin your mood
and for a lot of women
these signals have been dismissed
or minimized for way too long
you are not overreacting you were right
and now you have a clearer picture of what's happening
what to look for and where to start
you don't have to figure this out alone
and you don't have to have it all figured out
before you start if you have questions about your labs
about the supplements about whether
what you're experiencing fits this picture
send an email. My email is
info@rejuvenatehealthak.com
I'm going to say that again because I don't want it to
I want you to really have it
it's info@rejuvenatehealthak.com
info@rejuvenatehealthak.com
I read my emails
I want to hear from you so
if you want the supplement bundles
I talked about today
the core stack or the extended stack
the link is in the show notes
you can get started today without an appointment
and if you are ready for the whole picture
the full lab panel the personalized protocol
someone who is going to look at your specific numbers
and build a real plan the intake questionnaire
for my Women's Metabolic Blueprint
is also in the show notes
fill it out and let's talk
thank you so much for being here for Episode 29
share this with one woman who needs this
because
there's a lot of us walking around without any answers
or maybe just looking for a little bit more clarity
and we're here to change that
take care of yourselves and I'll see you next week