Welcome to the Hey Mami podcast!
Our guest today is Amber Fischer, a Certified Nutrition Specialist who specializes in functional nutrition approaches to PCOS, fertility, and women’s health issues.
Her approach looks at the root causes of disease and dysfunction and uses food to improve health from the inside out.
Amber has an active presence on social media including Instagram and TikTok, a podcast called “An Amber a Day: The Functional Nutrition Podcast” and a blog where she keeps followers informed of the latest approaches to functional nutrition.
In today’s episode we are talking about PCOS, fertility treatments, endometrial cancer and early menopause.
- Amber’s story
- PCOS root causes
- Why there should not be a stigma attached to using reproductive assistance (fertility treatments)
- Amber’s diagnosis with endometrial cancer
- What is surgical menopause?
026: What You Need To Know About IVF, Early Menopause, Endometrial Cancer w/ Amber Fischer, MS, CNS, LDN TRANSCRIPT
Dr. Maren: Welcome back to the Hey Mami podcast. In today’s episode, we’re talking about PCOS, fertility treatments, endometrial cancer, and early surgical menopause. Our guest today is Amber Fischer. She’s a certified nutrition specialist, who specializes in functional nutrition approaches to PCOS, fertility, and women’s health issues.
Dr. Maren: Her approach looks like the root cause of disease and dysfunction, and uses food to improve health from the inside out. Amber has an active presence on social media, we met through Instagram. She’s also on Tik Tok, and she has a podcast called And Amber A Day, The Functional Nutrition Podcast. She also has a blog where she keeps followers informed of the latest approaches to functional nutrition.
Dr. Maren: So, she has a pretty incredible personal story of PCOS, fertility, endometrial cancer, early surgical menopause, and how it inspired her work with clients. So, I am excited to have her on and have her share that, and we thank you for being here.
Amber: Yes, absolutely. Thank you for having me. I’m very excited to be here.
Dr. Maren: So, spoiler alert, it was already there. But tell us why you do what you do.
Amber: Yeah. I, as you mentioned, have had a very interesting health journey myself. I’m a woman with PCOS, I’ve been through endometrial cancer, I’ve been through IVF, and all the different complications of those experiences. When I first realized that I had PCOS, that’s when I first started getting interested in nutrition. And around the time that I was diagnosed with cancer, I also decided to kind of leave the work that I was doing at the time and go back to school to get my Masters in nutrition.
Amber: Because I just felt that there weren’t a lot of resources for me, there wasn’t a lot of help for me, and I thought this is something that I’m passionate about, that I enjoy doing research on, and I would like to gather the knowledge to be able to help other women not go through the experience that I went through. So, that’s why I do what I do.
Dr. Maren: Yeah. Awesome. Well, we’re going to kind of dive, and talk about all that stuff. But let’s just start with PCOS. How did you figure out you had PCOS? Tell us about some root causes, and your approach with PCOS.
Amber: Definitely. A lot of women are diagnosed with PCOS either as teenagers, or sometimes later in life. But for myself, I had all the symptoms of PCOS basically from puberty, never had regular cycles or anything like that. But, I was very embarrassed about all the things that I went through, the facial hair, and the irregular cycles, and just felt so different from my peers that I kind of kept a lot of that stuff private, and didn’t really communicate with my doctors or my parental figures, or anything like that.
Amber: And so, it wasn’t until I was in my 20s that I finally realized, “You know, I think something’s not right here, and I need to go maybe see about getting a diagnosis.” That’s when I was first diagnosed with PCOS. At the time, I remember asking my doctor if there was anything that I could do, was there a certain way I could eat, or something I could take. Her response was actually kind of something that inspired me to get into nutrition.
Amber: Because she basically said that, “No, there was nothing that you could do.” Diet didn’t make any difference. She actually told me that processed foods have a lot of vitamins added to them, so I could continue eating processed food. Anyway, it was just kind of this moment where I just realized, the information that I’m getting here is just not consistent with what I feel is the reality of life. And so, that kind of led me to start looking into nutrition.
Amber: Over the years, I’ve watched a lot of this newer research come out, talking about the Mediterranean diet, and these low-carb diets, and all these different… We’re finally acknowledging that there’s a diet component to PCOS. And I think a lot of us are also starting to realize that PCOS is maybe, what I would call, a basket diagnosis. So, there are a lot of different types of people that fall under that, and they might all have different reasons why they’ve developed these issues, or different things that we would call root causes.
Amber: There’s kind of the three main root causes of PCOS that I like to talk about, which is, of course, the insulin resistance piece, which I think we hear about that a lot. But then there’s also this chronic inflammatory piece that I don’t think is talked about enough. And I see that kind of go along with food sensitivities, and women with PCOS are at a high risk of autoimmune diseases, and things like that. And then there’s the adrenal component, the stress component that I also don’t think is talked about enough.
Amber: So, all those things sort of combine. I call it the PCOS vortex. Because I’ve never met a woman with PCOS whose just solidly one of those three things. I think it’s a combination of all of that stuff. And really, what I tried to do from a nutrition perspective is figure out what’s the biggest problem here, and how can we address that so that it feeds into the other things and improves all of that?
Dr. Maren: Yeah. Awesome. Yeah, it’s a big one. And I think all of us have probably seen providers who have told us, “Diet has nothing to do with it.” But I think as we’ll talk about today, sometimes you just got to listen to your intuition and get a second opinion for the people who maybe don’t have the same philosophies as you.
- Carrasco: Or even do your own research, which is often looked down upon by medical professionals.
Dr. Maren: Yeah, totally.
- Carrasco: I’m a total advocate for my patients reading.
Dr. Maren: Absolutely. Patients sometimes say to me, “You’re going to be so annoyed with me, because I read whatever.” And I’m like, “No, I think that’s great. That’s really important that you’re reading about your diagnosis, and not just…”
- Carrasco: “Send me your questions, send me new info that you gather.” I mean, there’s a 17 year translational gap, so how do you really… It’s important that patients be their own advocates, and are involved. I love that.
Amber: Oh, yeah. Definitely agree with that.
Dr. Maren: So, I’m sure that PCOS obviously played a role in your fertility journey. But a lot of patients, a lot of our patients end up going through IVF, or different fertility treatments. And there’s still so much work we can do around nutrition and supplementation to help that be successful. And really just to help them be successful through pregnancy and postpartum as well. How you fill your cup before these experiences or before these treatments. So, can you share a little bit about your experience, and some patients that you’ve worked with who have gone through fertility treatments? What do you do?
Amber: Definitely. And this is something that I work with a lot. Because I think sometimes there’s this idea out there that if you work with a nutritionist, or you work with a functional medicine doctor or something, that everything should be able to happen for you completely naturally, and without any medical intervention. I don’t think that’s always the case. Sometimes I think it’s okay to marry those two things. Sometimes I work with women with PCOS, and we do everything right, and still they have trouble conceiving on their own. And that’s okay. I don’t think there should be a stigma attached to using reproductive assistance.
Amber: But, what I think is the most important thing to do when someone is going to be going through IVF, is to hopefully get those three, at least three months, but preferably six months before they do an egg retrieval, that we really work on supporting their mitochondrial function, that we really work on supporting their egg quality, getting their insulin resistance under control. All those kinds of things. Because all of that stuff is really important for not just their health, but the health of their future children.
Amber: And like you said, pregnancy is a very draining experience. And so, I do feel like it’s really important to get your vitamin stores up, and make sure that you’re in a really healthy place, or as healthy of a place as you can be, so that when you do have that baby is not as much of a recovery process for you as it could be.
Amber: My own experience with that was, I do credit my nutrition knowledge with how well my outcomes were in IVF. I was able to get pregnant from my first retrieval. And that’s my son, who’s two and a half now. And I see that a lot with my clients. I think there’s something about just putting in that effort to eat really well, and nourish your body, and take supplements that are going to help bridge those gaps that maybe your body isn’t quite doing on its own, that really can help improve the quality of the embryos that you get in IVF. And then that makes all the difference when it comes to actually implanting them, and having a potential live birth.
Dr. Maren: Yeah, totally.
- Carrasco: Yeah, you know, I was going to say, I think you make a really valid point. And that in my practice, and I think, Christine, in your practice as well, our goal is to help women prep their bodies for conception, whether that happens naturally or that happens through reproductive technology. And I think that there is a kind of stigma sometimes, especially in the natural health world, where women feel like they’ve failed, or their bodies failed them if they cannot conceive naturally.
- Carrasco: And I think that’s something that we should talk about, and something that should not carry shame. Because the goal is to have a baby, a healthy baby, and a healthy mom. And the work is kind of the same anyhow to prep the body, so that either experience, whether a natural conception or through reproductive technology, that the experience is equally wonderful. And also that the body’s stocked and prepped, and that the egg health has been optimized.
- Carrasco: So, I do think that a lot of women who journey on kind of the natural health side feel sadness when they have to use conventional medicine. And I mean, Christine and I are both allopathically trained, we did residencies, we were steeped into the conventional world. But we also saw that there’s this huge gap. I think that our practices serve as a bridge between both worlds. And I do agree that everything can be married together. It’s not one or the other, it’s one and the other.
Dr. Maren: Yeah.
Dr. Maren: Which I think is going to… Let’s touch on that too, with your endometrial cancer diagnosis. Tell us about that journey. How would you even figure that out at your age? You’re so young.
Amber: Yes. I am so young, thank you. So, around the time that I was diagnosed with PCOS, I kind of started experimenting off and on with taking birth control. That’s the typical recommendation for PCOS, is take hormonal birth control. So, I was told that and I did that. But I didn’t like the way I felt on it. I’ve never felt great on hormonal drugs. And so, I kept going on, and then going off. And then, of course, as soon I would go off, my PCOS symptoms would return.
Amber: And for me, I had extremely irregular cycles. So, if I wasn’t on birth control, I’d have a cycle maybe once a year, twice a year at the most. So, it was very irregular. And, I started to feel like something’s really not right with this. It just doesn’t feel like this is safe. Like you spoke to earlier, trusting your intuition is huge, I think. Because I was so young, at the time I was first diagnosed with hyperplasia I was I think 23. So, because I was so young, I was a little bit kind of not listened to, not taken seriously. Just mostly told to go on birth control. But I just didn’t feel right about it.
Amber: So, the first time that I got diagnosed with hyperplasia, I had gone to a reproductive endocrinologist, thinking that maybe there was, I don’t know, a cure, or a medication I could take, or something. I mean, I didn’t know. He kind of asked me how long it had been since I had a cycle, and it had been a wild. And so, that day, to his credit, I really thank him for this, he had me do a biopsy, and that’s when hyperplasia came back.
Amber: So, from that moment I always kind of knew that there was an issue with that, and I kept my eye on it. I started doing a lot of research on my own, looking at what is hyperplasia, and why does it happen, and one of the risks of that? And I noticed way back then that one of the risks was endometrial cancer. Of course, the risk is relatively rare. But still, it just always stuck out in my mind.
Amber: So, whenever it would go too long between me having a cycle, I’d kind of go in and get checked. I’d have to advocate for myself a lot, because a lot of times no one wanted to do an ultrasound. But I did, fortunately, eventually find a really great doctor who was the one who diagnosed me with cancer in the end. But yeah, it was a lot of just having to speak up for myself.
Amber: At the time that I got diagnosed with cancer, what had happened was that I had gotten really interested in natural health, alternative health. And I had kind of felt very unheard by conventional medicine. So, I had gone roughly in the other direction, and I was kind of experimenting around with supplements, and I did not know what I was doing. I look back on some of the things that I did, and I’m like, “Why did I do that?” But, I didn’t know. I didn’t have somebody helping me.
Amber: And so, I started to have abnormal bleeding, and I bled, I think, for a couple of months. Just kind of lightly, but it wouldn’t stop. And I kept thinking, “Something is really not right here.” I just didn’t feel good, I was pale. So, that’s when I went into my doctor and she did a biopsy, and that’s when we found the cancer.”
Dr. Maren: Yeah. That’s a scary time. It brings up a lot of themes, like you really have to advocate for yourself, and listen to the intuition. And then, really rely on a specialist. I mean, conventional medicine, there is a time and a place. Specialists who are, they’re fellowship trained, how could you know this stuff? You didn’t go to medical school, and then three years of fellowship, and then another fellowship on top of that. It’s hard.
Dr. Maren: And I think there are a lot of really brilliant physicians out there, and sometimes it means that you have to find another one, when you don’t feel heard. It’s like, “Well, there’s somebody else out there.” It’s not that the answer is not seeing a doctor anymore. But, it’s still hard.
Amber: Yeah. And that’s what I did, is I kind of moved around to different doctors until I found a doctor who, she really listened to me. And what I noticed about her was that she seemed concerned about me. Whereas other doctors kind of brushed me off, or said, “Oh, you’re so young,” she was generally kind of concerned. And I really appreciated that. Because I was concerned about myself. But, that experience was so just foundational to me as a person, that I really credit that a lot with where I am today.
Amber: Because if I hadn’t gone through that experience of having to learn to marry natural health with conventional medicine, I might be a very different practitioner today. Because being a nutritionist, of course, I often see functional nutrition help people get very healthy again, or help people get pregnant naturally. And so, if I hadn’t gone through that experience, I think I would be a lot more dismissive of that stuff than I am. And now I just realize how important both things are, and keeping an eye on all that stuff.
Dr. Maren: I grew up in Colorado, and I went to undergrad in Boulder. Before I went to med school, I [inaudible 00:17:06] everything alternative was good. If it was natural, I thought it was good. And then I went to medical school, and the pendulum swung the other direction. And really, back to the middle. Because you see the other side of things, and it’s important training.
Dr. Maren: I think it’s important when you see that other side of things. And then you can come back to the middle. But, I really do think there is a very… There’s a middle ground. I mean, I think especially nowadays, it’s just so polarized out there. You’re either one or the other. But, I think we can all take a little bit of both, and find a happy balance.
Amber: That’s why I think functional medicine is so cool. Because to me, functional medicine is the kind of middle ground between those two communities. It pays attention to research that’s coming out, but it’s also cutting edge, and of the moment, and not so just bogged down with waiting, and waiting to look at how things are changing, and all that stuff. I think it’s a really beautiful combination. That’s the main reason why I wanted to get into functional nutrition, and be associated with IFM and all that stuff. Because I just found that so just really unique.
Dr. Maren: Yeah.
- Carrasco: Yeah.
Dr. Maren: It’s a good marriage. Okay, so we’d love to hear more, if you’re willing to share, about your experience with early surgical menopause. I mean, that had to be a huge shock on your system. And I’m sure there are other people out there listening who are going through something similar, and have probably not talked to a lot of people their age who have gone through this. And there’s also people who are 40, they go through menopause at an early age, maybe even 30s.
Dr. Maren: What does that look like?
Amber: Well, it’s been a journey, let’s say that. Because, I mean, I’m 33, so going through menopause at this age obviously is not the normal thing that happens. I think the biggest thing for me with the menopause experience has been just how different I think I feel in my body than I did before. One of the frustrating things about it is that, while it was I think the right decision for me in the end, I felt very pushed into it.
Amber: And wasn’t, I don’t think, given all of the kind of facts about what it could be like. I was sort of told basically, “You’re not going to notice much of a difference. Everything will still function the same and all that.” But, the reality of it has been a lot different. My body feels like… I almost think about it this way. When women typically go through menopause, it’s later in life, when they’re kind of at that phase may be where they’re ready to start slowing down a bit. Maybe. Not everybody, but most of the time.
Amber: And to me, it does almost feel like that’s happening to me. My body’s kind of ready to slow down, and retire maybe. But I’m not. I’m 33, and I’m ready to tackle the world. I’m at the beginning of all my stuff. And so, it’s been hard, the energy has been tough. And I think the biggest thing that has been a struggle in this past year, has been just nourishing my adrenal function, because my adrenals just really, really went downhill after that experience.
Amber: So, yeah, I do get a lot of questions from followers and things like that. They find me, because they see me talking about this. And people don’t talk about it. It’s not incredibly common, but it does happen. And it’s a really hard experience. I think we should talk about it more.
Dr. Maren: Yeah. Hormones are a big deal. I’m on thyroid hormone replacement, and without it I wouldn’t function all that well.
Amber: Oh, yeah. I mean, I tried for a brief time… Because of the cancer, that’s the reason why I have the hysterectomy in the first place. And it was also an oophorectomy. And so, I was scared, of course, to be on any type of hormone replacement. And there was a little bit of like, “Well, should she, shouldn’t she?” And so, I tried for a little bit without anything, and I just… Your quality of life is also important.
Amber: So, the potential risks were worth it to me, to be able to have some energy, and just to feel a little bit more like myself. But, coming from having PCOS, and having hi testosterone all the time, a drop in testosterone I think has actually been harder for me than the drop in estrogen.
Dr. Maren: Yeah. Right.
Amber: Because I can definitely tell. It’s just really a whole different world for me. I just feel so different. But, I think once you go through menopause, it’s a lot about supporting your adrenals, it’s a lot about supporting your mitochondrial function, just like it always is, but I think even more so. And then, being really conscious of your heart health, and your muscle mass, and all those kinds of things. Because those can take a hit when you go through that experience as well.
Dr. Maren: Yeah. And for the people listening, there’s a difference. When you go through surgical menopause, it’s this very abrupt sort of thing.
Dr. Maren: It’s just like you had hormones, and now they’re gone. But, other women who go through menopause naturally, even if it’s early, at age 35 or whatever, it’s just a sort of slow… It’s perimenopause. It’s kind of over the course of a year, and things changing, and you sort of ease into it. But in your case, it was kind of an abrupt change. And I can imagine you feel really different. It’s a lot.
Amber: Yeah, it is a lot. I think that’s probably what makes it so much harder. And of course, I’ll never have that first-hand experience of what it’s like to go through menopause naturally. But, my experience with clients has been, I mean, there are struggles with it for sure, and definitely things that we can do to support that. But like you said, it’s a little bit more of a gentle process, which helps ease you into it.
Dr. Maren: Yeah. Right.
Amber: The surgical thing is just from one day to the next, you’re like, “Ahh.”
Dr. Maren: Yeah. I don’t think I’ve ever known somebody who’s done really well with that. I can’t say it’s [inaudible 00:23:59] a huge part of my practice. But when I was doing my OB/GYN rotation, and we would do an oophorectomy, we knew how to counsel a patient, like, “It’s going to feel very different when you’re done, because you won’t have ovaries anymore.” And I think when it is natural menopause, some women do just tolerate it fine, and some women don’t. I don’t think we really know the X factor there. I think adrenals and cortisol plays a huge role.
Amber: [crosstalk 00:24:23].
Dr. Maren: But, some women do just get through menopause no problem at all. But for some women, it’s really hard.
Amber: Yeah, definitely.
Dr. Maren: Well, thank you so much for sharing that story. I think all that you’ve been through is obviously going to help patients a lot, or clients. It’s a big one.
Amber: Yeah, I hope so. The main reason why I do what I do is because, like I said, everything that I’ve been through, I just feel it’s very important for women to feel heard. And I just really feel like a lot of times we don’t feel heard or taken seriously. Especially when it does come to our hormone balance. I think that there’s not enough appreciation for how important that balance is, and how when things are off even slightly, it can really affect you. Not just physically, but mentally as well.
Dr. Maren: Yeah. Totally. So tell us, where can people find you if they’re interested in working with you, or connecting with you on Instagram?
Amber: Yeah, so I’m on a lot of different platforms. The main place where you can find me on social media is Instagram or Tik Tok. So, Instagram is @AmberFischerNutritionist, and Tik Tok is @AmberFischerNutrition. And then, I have my website, of course, where I blog, which is AmberFischerNutrition.com.
Amber: The other thing that I do is I have a podcast. It’s called An Amber A Day, The Functional Nutrition Podcast. And we talk a lot about these kinds of issues, PCOS, IVF, endometrial cancer. All that kind of thing is what I talk about a lot. So, yeah, they can find me there.
Dr. Maren: Cool. And then tell us about your new course that’s launching in February, right?
Amber: Yes. So, I really felt like I was maybe spreading myself a little thin trying to work one on one with clients. I wanted to have a way where I could disseminate a lot of the bulk of the nutrition kind of approach that I take to PCOS into something that people could take on their own. So, I created a course called Functional PCOS. And I’m really, really excited about it. It launches February 22nd. And you can find more information about that on my website. But, it goes into all the different root causes of PCOS, and nutrition perspectives for how to approach that. Walks you through a couple phases of meal planning, and just kind of gives you all the tools to start your journey with them, with health in PCOS.
Dr. Maren: That’s awesome. What a good resource. Well, thank you so much for being here, and for sharing your time, and your expertise. We really appreciate it. And we’ll see you on the Interwebs.
Amber: Sounds great. Thank you.
Dr. Carrasco: Thank you so much.