Candice Craig and Dr. Aliabadi on PCOS Awareness and Self-Diagnosing

Mary Alice:
Hi, I am Mary Alice Haney.

‍Dr. Aliabadi:
And I'm Dr. Tais Aliabadi. On today's episode, we're having a conversation with my dear patient, Candice Craig.

‍Mary Alice:
She's been a dancer for some of the biggest names in the music industry, and is very vocal about her experience with PCOS.

‍Dr. Aliabadi:
If you're having symptoms, I want you to be able to self-diagnose at home.‍

Mary Alice:
Stay tuned.
‍
This podcast is for educational and entertainment purposes only. It is not intended as a substitute for a physician's medical advice. You should regularly consult your medical provider in matters relating to your own health.
‍
We're going to talk about everything PCOS. It is something that Dr. A has been passionate about for so long, she spent 20 years educating women, trying to get the word out on this. And we have one of her amazing patients, Candice Craig, and she's here to tell her journey, how you got to Dr. A, how you were diagnosed, the treatment, everything. We're so excited. Thank you for being here.

‍Candice Craig:
Thank you so much for having me. I'm so honored.

‍Mary Alice:
Will you just tell us a little bit about, how did you start in the dance world? Just give us a little scoop about, and how'd you meet your future husband? Are y'all married yet?‍

Candice Craig:
Yeah, we got married.

‍Mary Alice:
We want to hear the juicy stuff.

‍Candice Craig:
Oh, well, I started in the dance world a long time ago. I came from Miami, I danced for all the biggest artists you could ever imagine, all the Latino artists over there. And I was just like, I love the music industry and I love acting, and I love being able to be creative, so I want to make it to the big leagues. And LA was that for me. I also came over here and I loved the health, the way that health was prominent here in LA. Like free hikes, we don't have that in Florida. You know what I mean? Or picking a balsamic rather than a ranch dressing. Those little kinds of things really got me over here between. And the industry just was just bigger here, so I got to dance with some of the most amazing artists in the world.

‍Mary Alice:
Tell me, [inaudible 00:02:02] give us a few of them.

‍Candice Craig:
I got to go on tour with Nicki Minaj. I danced around the world with Pharrell. I got to dance with Sierra, Chris Brown.

‍Mary Alice:
Who do you think is the best dancer that you've ever worked with?

‍Candice Craig:
The best dancer? As far as artist-wise, Chris Brown is the ultimate for me. He's amazing. We got to perform once with him. And Pitbull is just a part of my heart because he was the first person to be like, "Okay, come on, let's go do this thing. And let's go do multiple shows." And Pharrell Williams, shout out to Pharrell Williams. He was just always like, "You know what, our orders were just do what the music tells you to do." And we would just go on stage and perform. And-

Mary Alice:
And now what he's doing at Louis Vuitton.‍

Candice Craig:
Yeah. I mean-

Mary Alice:
His career is so amazing.
‍

‍Candice Craig:
‍Exactly. And being around the greats, you learn what you like, learn what you don't like, and become the artist that you want to be. And I did that by just staying creative and taking dance as a tool, but using that and knowing that I wanted to continue on in that entertainment space but also expand. I don't want to just be limited to just dance steps. I think that taking it from there and moving on to entrepreneurship and having a book, creating my own dance apparel line, it all connects. And just being creative has really led me to the point where I'm here now, I'm an author now. And it's about something that has nothing to do with dance-

Mary Alice:
With dance.

Candice Craig:
... but it got us here. And even the aesthetics in the book, it's called Living With PCOS: Road to Reversal.

Mary Alice:
And Dr. A wrote the Forward.

Candice Craig:
Yes, she did, she has an excerpt in there. And she specializes in the field, so I wanted specialists, and I reached out to different specialists. And also using my contacts to really spread awareness about PCOS. Like we said, nobody talks about it.

Mary Alice:
You obviously got some good diagnosis, because you are very pregnant right now. And I can't wait to hear about your journey. Tell me about how you and Dr. A met.

Candice Craig:
Well, I was feeling really crazy. My body was going out of whack. My PCOS symptoms were going nuts, should I say, but I didn't know they were attached to PCOS. My menstrual cycles were off, my skin was breaking out. Mind you, I'm 30 years old and I was getting acne. My irregular periods, mood swings. And I was just feeling out of body experiences with my weight. I come from a dance background, a performance background, and I'm used to just being able to just lose it in a week too. When you have control over your body, things happen.
‍

Mary Alice:
And you're in your body when you're a dancer.‍

Candice Craig:
Yeah, exactly. We learn in the mirror. I couldn't control anything anymore, everything was getting out of whack. And I went to different doctors, flew to different doctors. I went to Florida. And I was telling the doctors, "Hey, I'm feeling this and I'm feeling this, and I'm feeling that." And everybody just gave me back my test results. And they were just like, "You're fine, you're good. You're healthy. Good luck. Oh, go work out and-
‍

Mary Alice:
Stop eating.‍

Candice Craig:
.. eat clean." Yeah, like I didn't eat clean. Thank God, I finally found Dr. Aliabadi here in Los Angeles, and it was the most life-changing experience of my life. She diagnosed me with PCOS. She asked me a whole bunch of questions that I didn't know had anything to do with one another. Especially with, I didn't say this one before, but irregular hair growth. I was just always like, oh, I'm a Haitian girl. I grow a lot of hair in different places, like the unsexiest places you could ever imagine.‍

Mary Alice:
Well, we all get a few on our chin. I'm like, what? You know when you're in this... You're making out with your husband, all of a sudden you're like-‍

Candice Craig:
Oops, I forgot the tweezer.‍

Mary Alice:
... right on my chin. It's awful.‍

Candice Craig:
PCOS is just so unsexy.‍

Mary Alice:
That happens a lot.‍

Candice Craig:
Yeah, of course it does. And my wax lady knows about it, she's known about it for years. But we didn't ever put pieces together. Really, what took me over the edge was the weight gain. I just really couldn't lose it no matter what I did. I went on eight week programs at a time, two workouts a day, and I wasn't losing. I was working out the same time as my friends, we were eating the same exact thing, and people were losing weight and my weight would go up. I knew something was wrong. I was diagnosed, it was one of those feelings of, wow, this is so amazing that I finally got diagnosed because I know I'm not wrong and I'm not crazy. And she made me feel like I was being heard. But at the same time, I also heard that it's the number one reason for infertility and that it hadn't been fixed yet. There's no cure for it as of now. It was a whirlwind of feelings, but I'm just so thankful that I found you. And [inaudible 00:06:48] changed my life.

Dr. Aliabadi:
I know. I was going to say, and you're pregnant.

Candice Craig:
Oh, and by the way, I'm five months pregnant. And that was another thing. We went into gear, we kicked into gear. And she gave me the plan and I stuck to it. And I also was really adamant about adding a holistic lifestyle to that too, so a lot of herbs, a lot of eating clean, and making sure I'm staying active. Kind of not just letting it take over me, but kind of-

Mary Alice:
Taking control.

Candice Craig:
... taking control of the health.

Mary Alice:
Can I ask you, Dr. A, so she comes in. And this is very typical, she's been misdiagnosed. Walk us through what happens when a patient comes in.

Dr. Aliabadi:
In her case, patients with PCOS present differently with different symptoms. She was the poster child of PCOS. I can understand when someone just has the acne or maybe just the irregular periods. She had every single symptom.

Mary Alice:
Check, check, check.

Dr. Aliabadi:
Check, check from top to bottom, from irregular periods, PCOS looking over is on ultrasound, elevated testosterone symptoms, mood changes, weight gain. You had not tried for pregnancy, but thank God you showed up when you did. She was a poster child. And I just want you to understand that even someone like her, with every single symptom of PCOS, still gets dismissed.

Mary Alice:
Right, and misdiagnosed.

Dr. Aliabadi:
Yes, or not diagnosed. Forget about misdiagnosed, not diagnosed. And the one common comment that I hear from my patients is they feel validated. You go through all of this, your irregular periods are the same reason you also have acne, it's the same reason you have facial hair. It's the same reason you have hair loss. It's the same reason you might have mood disorder and weight gain. They're all connected. They all fall under the umbrella of PCOS. Now, different patients might have different symptoms. She was a poster child for it.‍

Mary Alice:
Yay.‍

Candice Craig:
[inaudible 00:08:42]. So crazy.

Dr Aliabadi:
‍But it doesn't matter what symptoms you have, if patients get diagnosed correctly, we can fix it. The problem with PCOS is 75% of patients don't get diagnosed. Can you believe that?

Mary Alice:
And then they have problems with fertility. It's like, and, and, and, and, and. So she comes in, you diagnose her, then how do you fix it?

Dr. Aliabadi:
It depends on their symptoms. Irregular cycles you have to fix. So you have to-

Mary Alice:
Did you do that with her?

Dr. Aliabadi:
Of course, that's why she's pregnant. When you have irregular cycles, you have irregular ovulation. It makes it harder. There are PCOS patients who don't get a period for six months. If you don't have a period for six months, that means you're probably not ovulating for six months. How are you going to get pregnant? You need to ovulate every single month. In her case, she had insulin resistance, which a lot of patients with PCOS do. And I want to make something clear, not all PCOS patients have weight issues. I want to make that very clear. I have patients that come to my office, they're like, "Well, I'm skinny, so I don't have PCOS." Well, no, that's not true.

Mary Alice:
You have these other symptoms.

Dr. Aliabadi:
You have these other symptoms. I want to make it clear that you need two out of three symptoms to get the diagnosis of PCOS. A, irregular period. Two, elevated testosterone symptoms. It could be acne, it could be hair loss, it could be facial hair, it could be body hair, it could be body acne. But you don't need to have all of it, some patients just have the acne, other patients have the facial hair. So elevated testosterone symptom, one of those symptoms that I just named. And PCOS looking ovaries on ultrasound. Polycystic ovarian syndrome doesn't mean you have these big giant cysts on the ovary. There's a certain look to the ovary, we call it sac of pearls. There are all these follicles inside the ovaries. So if you have two out of three, you get the diagnosis. Mood disorder, weight gain, history of eating disorder, they just add to that diagnosis, but they're not part of the criteria to diagnose someone. Does that make sense?

Mary Alice:
Yes. So then she comes in, you're like, poster child. What did you do?

Dr. Aliabadi:
When she came in, her weight was a big issue for her. And mind you, when did I meet you? This was-

Candice Craig:
Years ago.

Dr. Aliabadi:
This was years ago before this Ozempic and Wegovy talk. What did I start you on? It was Ozempic or Saxenda?

Candice Craig:
It was Ozempic.

Dr. Aliabadi:
It was Ozempic. This is years ago, people didn't even know about this.

Candice Craig:
No, they didn't.

Dr. Aliabadi:
And life was so good at Dr. Aliabadi's office because I had access to any medication. I was probably the only person in California prescribing these medications. Probably a handful of us in the country. I was competing. I was the only OB-GYN prescribing these medications years ago because I was diagnosing my PCOS patients with insulin resistance. Other doctors, cardiologists, and everybody else was doing it to drop their patient's weight, I was doing it to get my PCOS patients healthy. So I started her on Ozempic. And as she lost her weight, because of her insulin resistant, I added Metformin. Metformin increases your insulin sensitivity. These patients usually have insulin resistance, which we should do a separate podcast on that, [inaudible 00:11:50] that's the whole podcast on its own. But you fix their underlying condition. And by doing that, she started losing all her weight, her period started becoming regular. Acne, hair loss, facial. I mean, look at her. Look at this beautiful woman right now.

Mary Alice:
And with this gorgeous [inaudible 00:12:10] belly. This gorgeous belly. Okay, so the Ozempic, and then that helped the insulin resistant. But how did you fix her irregular periods? How did she get rid of the acne? How did the hair loss? What was all that?

Dr. Aliabadi:
That's the insulin resistant part. As insulin resistance, means that our body cannot process the sugar we eat, the carbohydrate we eat. In a simple term, when we eat sugar, our body breaks it down into glucose. Glucose stimulates our pancreas to release a hormone called insulin. The job of insulin is it opens up the receptors on the surface of our cells. The cells grab the sugar. The sugar goes into the cell where it turns into energy. This is what's supposed to happen. PCOS patients have insulin resistance, their cells don't respond to insulin. So the sugar's in the blood, but the receptors don't open to grab it in. That's the easiest way I can describe it.

Candice Craig:
And it turns into fat.

Dr. Aliabadi:
As sugar goes up in your body and your insulin goes up, your body stores that sugar as fat.

Mary Alice:
And did that fix your periods or did you have to do something else?

Dr. Aliabadi:
As your insulin goes up, high insulin is associated with increased release of androgens from our ovaries. As your testosterone, for example, goes up, then your periods become irregular. Your ovulation becomes irregular. You get acne, you get male pattern hair loss. So by lowering their insulin, you lower their androgens. By lowering their androgens, they start ovulating regularly, their acne clears up.

Mary Alice:
It's amazing.

Candice Craig:
It is all connected. When she sat there and explained this to me, I was just like... And you had that graph.

Dr. Aliabadi:
[inaudible 00:13:47]. You have to. That's why I said I need a whiteboard to teach it to you.

Mary Alice:
Give me a whiteboard. We're going to have to get her a whiteboard.

Candice Craig:
Get her a whiteboard, she needs it.

Mary Alice:
She's great with a whiteboard.

Candice Craig:
She's great with a whiteboard.

Mary Alice:
How did that feel? All of a sudden you have... And how long did it take for it to work?

Candice Craig:
It took about-

Mary Alice:
Again, every patient is different. We're not saying that this is the right thing for every patient.

Candice Craig:
It started working around a month, I started noticing the difference. And then around four months... She was just so positive about it. She just tapped me on the shoulder and she's like, "In four months you're going to be back to normal. Just trust me." And I was just like, I had walked out of there just like... I cried. I did all the things. I get in the car, I'm just calling my mom. "You wouldn't believe what I just experienced. Somebody actually heard me. Someone understands me and actually is going to fix me." I felt over the moon.

Dr. Aliabadi:
Every single time, even as of this morning when I was in my office. Every time I have a PCOS, undiagnosed PCOS that walks into my office. Every time I walk into the exam room the first thing I say, I say, "I'm Dr. A, nice to meet you. I'm going to be your new best friend in life." And every single time, when they come back in four months, I'm like, "Have you ever had a friend like me?"

Candice Craig:
I came running in at four months, just came, I tackled her down. "How are you? Thank you so much. You did it."

Dr. Aliabadi:
Back then I was dropping patient's weights, 24 pounds in four months, but mostly by fixing their hormones from inside. You have to fix it from inside. Ozempic really helps these PCOS patients. Well, right now we have all these other medications, but back then I had Trulicity, Saxenda, and Ozempic. That's all I had to work with. Or Victoza. She responded really well. But it's a combination of things. You can't just throw Ozempic at a PCOS patient, they're not going to respond. They might respond with their weight, but their other symptoms need to be addressed. So you have to-

Mary Alice:
Holistically.

Dr. Aliabadi:
Bravo. You have to recognize each symptom and treat it accordingly.

Mary Alice:
And we know one of the major things that happens is fertility problems, if you have PCOS. How long after this whole thing happened did you decide you were going to have children? Were you thinking about it then? How soon did you get pregnant? Did you get pregnant naturally? Tell us everything.

Candice Craig:
We were not trying at the time, we just wanted to regulate this weight. It started working after four months, but I kept it up, I wanted to just feel myself. And we weren't ready yet, I was newly engaged. And then we finally decided to get married the year after. It was about a two-year process, and we just took our time with it. We literally said that we wanted to be pregnant this year, right after our wedding, right before Christmas. And it happened two weeks into us trying. I want to tell you it happened the second try. We tried two times, you guys.

Dr. Aliabadi:
Do you mind telling everyone how old you are?

Candice Craig:
I'm 33 years old.

Dr. Aliabadi:
I want you to understand this, PCOS is the top cause of infertility. A, these patients have irregular ovulation, so it's hard for them. If you're having two periods a year, it's going to be hard to get pregnant. B, these patients have a lot of eggs. They go to their doctor and the doctor says, "You're perfect. You have so many eggs in your ovaries. You have all the time in the world." False.

Candice Craig:
That's literally what the doctor told me.

Dr. Aliabadi:
I know. But you don't have to tell me, I see it every day. PCOS patients have a lot of eggs, sometimes a lot more than other patients do at their age, but the quality declines.

Mary Alice:
Faster than me, who was a geriatric mother. That's what they said when I went to the hospital and had my baby, I'm like, "What? I'm 35. I'm a geriatric mother."

Dr. Aliabadi:
I was 41 when I had my third. And I always tell patients, "Yes, geriatric, but I didn't have an underlying condition." I have patients who come to my office and they say, "Well, my aunt's had her baby at 41." I don't care, you're not your aunt. Do you know what I'm saying? We have to prepare for that. You might get pregnant at 41, but we need to optimize everything. If I have a PCOS patient, usually between 28 and 30, I have them freeze eggs if they don't have a partner. Why? And a lot of times they go to the doctor and the fertility doctor calls me, "Why are we freezing this early?" "Well, the patient has PCOS." "Oh, okay."
Do you know what I'm saying? Instead of them diagnosing and telling me, a lot of times I have to tell them. So that's why the reason I started this podcast, Candice, you know my passion for PCOS, but I want women to be their own advocate. If you're listening to this podcast and you have symptoms of PCOS, you're single. You're, I don't know, 30, and you don't have frozen eggs, you have to go freeze eggs. The problem with egg freezing is it's so expensive.

Mary Alice:
So expensive.

Candice Craig:
Yeah.

Dr. Aliabadi:
That's why if you diagnose, treat your patients just like Candice, when they start trying for pregnancy, they're not going to get into the hands of the fertility doctors. Had she not come to me, her weight would've been... I don't know. How much... You lost-

Candice Craig:
I was 35 over. I was 35 pounds over.

Dr. Aliabadi:
Imagine her, 35 pounds over right now in pregnancy. She would've been at risk of preeclampsia, big babies, gestational diabetes, complications with childbirth. There's so much that goes into that. Not only she's healthier, she got pregnant right away. And I didn't do much, I just diagnosed and treated her. This is what women deserve.

Mary Alice:
So wild. Like most women, my friends and I sit around all the time and talk about our skincare. And I've found that red light therapy is one of the best ways to take care of things like wrinkles, eczema, acne, scar tissue, and much, much more. Bon Charge is a holistic wellness brand with a huge range of evidence-based products to optimize your life in every way. They have an extensive range of premium wellness products that help you sleep better, perform better, have more energy, recover faster, balance hormones, and reduce inflammation. The list is endless. Does insurance cover Ozempic or any of these drugs for PCOS?

Dr. Aliabadi:
Well, back then it did because I had no competition. Now, everyone and their cousin is on it so I have to fight for my PCOS patients. The problem is, insurance companies don't think PCOS is a big deal. People don't talk about it, doctors don't diagnose it. I had a chief resident a few years ago... I did a talk show with Dr. Phil on these patients wouldn't get their periods for years because of PCOS, but they thought they were pregnant. And that's a whole other situation. But after that show I came home and I'm like, you know what, I want to do a PCOS patient on mental health and PCOS and all these other conditions. So I called my chief resident and I said, "I want to do a PCOS study." It was an evening, on a Friday evening. And you know what she told me? "What's PCOS?" I said, "Polycystic ovarian syndrome, the top cause of infertility on the planet, it affects 15% of women." She's like, "Can you spell it?" Guess what I did? I hung up the phone.

Mary Alice:
Totally.

Dr. Aliabadi:
I couldn't take it. I couldn't do it. I was like, oh my heart. And that's when I realized that the best thing I can do as a physician is to empower my patients to diagnose themselves at home. What I'm doing is not rocket science. You probably know all about PCOS now.

Mary Alice:
I've learned so much. I was on a hike yesterday with someone, and I'm not going to publicly say it on a podcast, and they were talking about a child of theirs who was suffering from this and this. I go-

Dr. Aliabadi:
This is what it is.

Mary Alice:
It's PCOS. [inaudible 00:22:38] I go, "You better see Dr. A." I've sent you a million people now, but I was like, "It is PCOS." And I said, "And it's going to be a problem with fertility." And this was a 15-year-old, so it's already-

Dr. Aliabadi:
But we can fix it. Do you know what I'm saying?

Mary Alice:
Now, is it covered by insurance? Because what we're saying is your advice is you have to fix it, and it takes medication for PCOS, and then it's freezing your eggs. And those two things are expensive. Does insurance cover?

Dr. Aliabadi:
Let me make it very clear. Ozempic is not the treatment for PCOS. Ozempic helps polycystic ovarian syndrome patients with insulin resistance and weight gain lose their weight. The main medications that we treat PCOS with, whether it's birth control, Metformin, Spironolactone, all of it is covered by insurance.

Mary Alice:
Okay. Okay.

Dr. Aliabadi:
Ozempic might or might not. But that's why I always say, if it's open enrollment, you need to call your insurance and make sure you have obesity coverage. If your BMI is 27 and above, then call your insurance, make sure you have your benefits. Because every winter they drop patients, they drop their benefits so they don't pay for it. So if you call and get yourself on that program, then at least you get your medications covered.

Mary Alice:
And what about the egg freezing, is that ever covered?

Dr. Aliabadi:
No. See, unless you work for Apple or Google or Facebook, or these big companies, egg freezing is not covered. I always say when patients are young and don't have money, they have great eggs, they can't afford to freeze it. When they're 40 years old and their egg quality and count is gone, they can afford egg freezing. So it should honestly be covered by insurances, it is so expensive. I know in the Bay Area some of my relatives paid $36,000 for an IVF cycle. Can you comprehend that?

Mary Alice:
And it doesn't always work the first time.

Dr. Aliabadi:
No.

Mary Alice:
People are just mortgaging their homes, and we talk about this all the time. That's something that we need to try to work on and fix in this country.

Dr. Aliabadi:
At least if I say my patient has endometriosis, my patient has PCOS, at least with an underlying condition their egg freezing should be covered. If you don't want to cover it for everyone-

Mary Alice:
Just because you decide you want to have children later, or whatever. If you have a condition it should be-

Dr. Aliabadi:
It needs to be covered.

Mary Alice:
Absolutely.

Candice Craig:
I had the opportunity to speak to Congress about PCOS with the PCOS Association. And same thing-

Dr. Aliabadi:
Aren't you proud of my patients?

Mary Alice:
I'm so proud. Tell me how that happened. My little soldier.

Dr. Aliabadi:
We love her, she's got all these-

Candice Craig:
The power of social media is amazing. I have over 3 million followers, through the dance world, and they've helped me get here in this process with PCOS. The minute I decided to share my story, it was absolutely insane how many people reached out to me. And they're like, "I'm dealing with this too. I'm dealing with that too." I refer them to doctor, and they go to doctors in their own cities too. And they'll come back to me. My DMs are more flooded now with PCOS patients than from my whole entire dance career on stage for years.

Dr. Aliabadi:
Isn't that crazy?

Mary Alice:
That's amazing.

Dr. Aliabadi:
If you come to my office few times a day, I have a new PCOS patient who starts crying as soon as I diagnose them. These patients feel validated. They're so sick and tired of doctors telling them, "Go diet, go exercise. I don't know why you're having acne." And I had a patient a couple of weeks ago, she's like, "Oh my God, what's happening? PCOS is everywhere on TikTok." I'm like, "Thank God."

Mary Alice:
Thank God.

Dr. Aliabadi:
I've only spent 20 years, but you know what, I don't have a platform. I don't have millions and millions of followers, but she does. Do you know what I'm saying? I have these little soldiers that go out and fight.

Candice Craig:
Speaking about it, it helped me heal as well. And also just helping women around the world, it's been insane. And after speaking to Congress, we had to sit there and explain to them exactly what it was. They were like, "Can you spell it?" There was women on there. There was men, we're talking to men about our ovaries, it was very uncomfortable. But it was a lot of us on-

Mary Alice:
Did it work? Did it help?

Candice Craig:
Yeah, of course. It's just about spreading the awareness and getting the education, and eventually getting the funding for the fertility and getting the funding for the medication. We do need medications, we do need support. Just because it's women's health and it's not something that men have as well, the government is ran by a lot of men.

Dr. Aliabadi:
In a world where abortions are being decided for us, I don't want to make this political. But [inaudible 00:27:19] I always say if endometriosis, PCOS, and breast cancer affected men, it would have been solved by now. And whoever wants to argue with me, they can argue with me.

Candice Craig:
And that's why it's important to speak up. That's why I speak up. And that's why whenever I can, I use the platform. I feel like-

Mary Alice:
It's so amazing that you do. You have a platform and you use your voice for good, and that's what it should be used for. And your book, it's Living With PCOS: Road to Reversal. Can you really reverse PCOS?

Dr. Aliabadi:
You can reverse the symptoms of it, you can get rid of it.

Mary Alice:
You're born-

Dr. Aliabadi:
You're born with it, it's in your DNA. Look at her, you would never know she has polycystic ovarian syndrome.

Candice Craig:
Yeah, I have them under control. I have my symptoms under control to a point where there's no-

Dr. Aliabadi:
I'm almost done with a PCOS calculator that will make it super easy for people at home. You basically just click on it, answer a few questions, and I'll tell you if you have it or not.

Mary Alice:
We'll let you know when that comes out.

Dr. Aliabadi:
Yeah, soon. Almost.

Candice Craig:
I need it too because [inaudible 00:28:24]-

Dr. Aliabadi:
But it's so easy. It's going to make it easy. I want patients to diagnose themselves at home and know what to do with it.

Mary Alice:
And that's why we... Again, I'll repeat what you said. That's why we have created this podcast, that's why we're creating Utera Health. We want to make women their own health advocate so that the same thing doesn't happen to you. So that the next time someone has those symptoms, they go into their doctor and they say, "I think I have PCOS, and these are the reasons why." And they're educated.

Dr. Aliabadi:
But here's the problem, you guys, 75% of patients don't get diagnosed. Let's say we diagnose them. Who's going to treat them?

Mary Alice:
Well, hopefully we're teaching the doctors too, with us.

Dr. Aliabadi:
That's why maybe I need my whiteboard to say, "If you have this, you can do this." Remember, I'm not your doctor, I'm not diagnosing you. But I'm going to have tools available for these patients so they know at least how to deal with it. And if they get dismissed, they can go find a specialist who can help them.\Mary Alice:

Mary Alice:
In terms of your new pregnancy, or you're about to have this baby, how did you meet your fiance?

Candice Craig:
We actually met, you guys, at the let out of the club. And if you don't know what that is, it's when you-

Mary Alice:
At the let out?

Candice Craig:
When the club is done, you walk outside and meet... I was waiting for my Uber, and he was fresh off of the Super Bowl. He played for the Denver Broncos for a few years.

Mary Alice:
He did?

Candice Craig:
Yes. And I had no idea who he was. And he walked up to me and he took me to breakfast the next day. And we've literally been in cahoots since then. And we've been together about six years now, we got married on August, and that was our anniversary. And it was a small, intimate wedding on a yacht with our families, with our close family. And yeah, honestly, this process, he's had to learn about the PCOS as well. It was very scary to go back home and be like, "Hey, I found a doctor that diagnosed me. She also said it was the number one reason for infertility. I know we just got engaged." But imagine that conversation.

Mary Alice:
Right. That was a hard one.

Candice Craig:
It was definitely a hard one. But he's been a rider with me. I really have no complaints. Even this pregnancy, it's our first time being pregnant. It's the first time we tried to be pregnant, so we wanted to go into it really intentional. We put a lot of effort into what we're putting in our bodies. And with the holistic lifestyle, like I told you, just everything, just from fruits to vegetables, to changing the way that I'm eating. And thinking I was doing a healthy job before. And then with the medication, I think the mixture of everything came together and it just created this beautiful harmony. And having him by my side, honestly, I don't know how I would've been able to do it on my own.

Mary Alice:
Can you take medication? Can you take Metformin? Can you take Ozempic when you're pregnant?

Candice Craig:
No.

Dr. Aliabadi:
Before you start trying for pregnancy you have to come off your Ozempic, but you can stay on the Metformin until you get pregnant. You can take Metformin in pregnancy. I don't like it, because you don't want to mask gestational diabetes. Patients with PCOS, especially with insulin resistance, obviously, they're at risk of developing gestational diabetes in pregnancy, so you don't want to mask it with Metformin. I take them off when they get pregnant, I do a diabetes test twice on them during pregnancy. Usually we do it 24 to 28 weeks. I do it once early and then once later, just to make sure I don't miss anything. And if they become diabetic, then we do diet changes. And if they don't respond, then we go to medications.

Mary Alice:
When you first start wanting to be pregnant, how long do you have to get off of-

Dr. Aliabadi:
A couple of months.

Mary Alice:
A couple of months.

Dr. Aliabadi:
Of Ozempic, just because we don't have studies on it. But Metformin is safe, and Metformin helps them regulate their ovulation so I wouldn't take them off. It's actually [inaudible 00:32:06]-

Mary Alice:
... they weren't pregnant, and then-

Dr. Aliabadi:
[inaudible 00:32:07]. But I want to say one thing. If you told me name one thing that changed in Candice, forget about the acne and the weight, because she's always beautiful. She always looks beautiful. I would say confidence. The girl I met in my office few years ago, and the girl who's sitting across from me today, they're two different people. And I don't know if you... I feel like you found yourself. I know you get emotional because I feel like I'm your mom. I'm everyone's mom. But I can tell, you're a different woman. The way you carry yourself, the way you speak up, the way your mission in life, everything changed. Your relationship. You're a different person. And that's something you cannot put a price tag on.

Mary Alice:
You can't.

Dr. Aliabadi:
I don't care about your acne, I don't care about your weight. I don't care about a lot of stuff that are just superficial to the rest of us. But all of it together gives you a very confident woman. Constantly, I hear from my patients that they get new positions at work, they get new contracts. Do you know what I'm saying? It's not like anything's changed, she always looked like this. In my eyes she always... When she walked in I was like, "Wow, what a beautiful girl." The one thing that changed significantly is her confidence.

Mary Alice:
Candice, what do you say about that?

Candice Craig:
It really was being heard by someone, and knowing that you're not crazy. If you're feeling these things, you're not nuts. There's an actual diagnosis here. There's something that we can pinpoint and we can work from there. I am obviously so thankful for doctor for helping me, and helping me get there. And the confidence, I know it was gone. When I walked in your... I was crying in your office, even the day that I met her. And four months later when I figured it out and I was feeling way better, I cried again. And I tackled you, and I apologized for tackling you. But definitely, my confidence has definitely come back. And I come from a performance background, so confidence is just something that we have. But to have lost it in my 30s didn't really make any sense. So to get it back and to be here in this place and to be sitting here with you guys, and to be pregnant for the first time-

Mary Alice:
It's amazing.

Candice Craig:
... just feel like it's a blessing. Very-

Mary Alice:
[inaudible 00:34:42] a blessing. What are the three things women can do if they're experiencing any signs that go with PCOS?

Dr. Aliabadi:
Go see a PCOS specialist, someone who's experienced enough to, A, diagnose you. B, treat you.

Mary Alice:
How do you find that person?

Dr. Aliabadi:
Good question.

Candice Craig:
She's sitting right here.

Dr. Aliabadi:
I can't see everyone. I do have a platform that I use for... We have a telemedicine, we do PCOS consultation. And my goal is with this PCOS calculator, once we diagnose patients, depending on their symptoms, we're going to give them a printout of what to take to their doctors. But otherwise, it's hard for me to say. It's hard. There are good PCOS specialists, you just have to look for them. Sometimes your primary care might be more educated about PCOS than a gynecologist, you just have to find someone who's experienced enough. B, make sure you check your egg count. And if you're getting closer to 30 and you don't have a partner, egg freezing should be considered. I always tell my patients, starting 25, start saving up because by 30 I'm going to ask you to freeze. And the third thing is lifestyle. If you're struggling with all these symptoms and you have no access to medication, you don't have health insurance, a lot of times cutting sugar out and exercising can help alleviate some of these symptoms by lowering your insulin.

Mary Alice:
Okay. Candice, what is one thing you wish that everyone knew about you?

Candice Craig:
About me? I thought you were going to say about PCOS. I'm like, there's so much to learn.

Mary Alice:
No.

Candice Craig:
That I'm just a normal girl that has a creative brain, and that you don't have to be a certain way. That even when you get older and you turn into whomever you are going to be, just staying true to yourself no matter what diagnosis comes in the way, no matter what anything happens, just stick to yourself and understand that you're here for a reason. And I personally think that if someone can learn something from me, I would want that.

Dr. Aliabadi:
Isn't this incredible? I just want to share that I have a lot of patients. A ton. You can only imagine, maybe thousands of patients have diagnosed with PCOS. It's not common for someone to come up and openly speak about it and want to make a difference in someone's life. So you know what? I love you for that.

Mary Alice:
And using your platform to do-

Candice Craig:
Thank you.

Mary Alice:
... to make all women feel better.

Dr. Aliabadi:
She's helped so many women. [inaudible 00:37:22] You've helped so many young girls. There's one more thing I want to talk about before we leave. Can I?

Mary Alice:
Yeah.

Dr. Aliabadi:
The most important thing, every single day I have a patient who walks into my office and says, "I don't have PCOS because my hormone test was normal." False. Elevated testosterone in the blood can be one of the criteria, but you don't have to have a high testosterone in the blood to get the diagnosis of PCOS. I want to make that very, very clear. I don't need my patients to do a blood test to diagnose them, but I do it because I want to know what I'm starting with. How high is the testosterone? What is their egg count? That's the one message I want to [inaudible 00:38:07] make sure.

Mary Alice:
Okay, guys, we learned today that you can diagnose your own PCOS. How?

Dr. Aliabadi:
You need two out of three of the following criteria. One, irregular period. Two, PCOS looking ovaries on ultrasound. Three, elevated testosterone symptoms or elevated testosterone in your blood. You don't need to have a high testosterone in your blood for the diagnosis. And elevated testosterone symptoms are acne, male pattern hair loss, facial hair, body hair, or body acne. So if you have any of these symptoms, you might have polycystic ovarian syndrome. Make sure you find a specialist in your area and get the right diagnosis.

Mary Alice:
Take this information. Thank you so much, Candice, for being here and sharing your story. We want to arm you to be your own health advocate. Own your own health. We love you. This was so much fun. Thank you so much.

Candice Craig:
Thanks for having me, guys.

Mary Alice:
Thank you for being here.

Candice Craig:
I really appreciate it.

Mary Alice:
Okay, we learned today that you can self-diagnose PCOS. If you're experiencing two out of three symptoms, irregular periods, PCOS looking ovaries on an ultrasound, and high testosterone, which could be hair loss, facial hair, body hair, or acne. You might have PCOS, so go to your own physician. We are not your doctors, we are here just to inform you and educate you so that you can be your own health advocate. Thank you.
Thanks for tuning in to SHE MD. For Dr. A's PCOS action plan, visit our website at SHEMDpodcast.com, and follow us on social media @SHEMDpodcast. Don't forget to click that subscribe button on YouTube or wherever you get your podcast, so you never miss an episode.