Episode 103 Summary
- Lipoedema is commonly found in a “triad” with lymphoedema, and obesity
- Lipoedema is associated with some common co-morbidities - ehlers-danlos syndrome a connective tissue disorder, hypermobility, thyroid disorders such as hypothyroidism and Hashimoto’s thyroiditis as well as low vitamin D as the vitamin D can be sequestered in the fat cells.
- In lipoedema, patients are said to have the onset of prediabetes and type 2 diabetes later in their life than would be otherwise expected - This is not Megan Pfeffer’s experience in her practice where she finds it to be common.
- If you think that you may have lipoedema, what is the next step? - Search for a physical therapist, a lipoedema therapist or a qualified occupational therapist who has experience with lipoedema. They may not be able to officially diagnose you but their experience with the disease can be invaluable in helping you to decide if you would like to see a doctor for diagnosis.
- These experts can also assist you in beginning management - Through various therapies - While you wait to see a specialised doctor for diagnosis, they can start you with compression garments, manual lymphatic drainage, vibrating platforms, lymphatic pump garments and complex decongestive therapy, which can all be helpful.
- Movement can be helpful - Especially in early stages while the lymphatics are still functioning, to assist in the flow of the lymphatic system, as muscle movement is required to pump the lymph around the body.
- Swimming is often recommended as the depth of the water can act as compression - Gentle forms of exercise such as walking, yoga and pilates can also help, but any co-morbid hypermobility must be kept in mind to avoid injury.
- Anti-inflammatory diets are important for managing lipoedema - Keeping bio-individuality in mind, an anti-inflammatory diet avoiding processed foods and vegetable oils is an important first step, but there is benefit to a low carb real food anti-inflammatory diet, with emerging evidence that the state of nutritional ketosis can have significant benefits in the reduction of pain, regardless of weight loss. (See podcast 101 with Dr Rowena Field for more on keto for chronic pain). Particularly for those women with insulin resistance or prediabetes or type two diabetes there is a benefit to really focusing on reducing carbohydrate intake, including that from fruit.
- Other benefits of nutritional ketosis and fat adaptation - These include relief from constant hunger. The removal of hyperpalateable sweet foods from the diet increases our ability to enjoy the flavours of real foods.
- A diagnosis of lipoedema may feel overwhelming but there is a lot that can be done to manage it - Mobility and quality of life can be protected and improved with a low carb real food ketogenic diet, with a focus on getting into ketosis for pain management. It is also important to focus on sleep and stress management as lowering inflammation in the body is key to empowering women to manage this disease.
- Lipoedema Australia: https://www.lipoedemaaustralia.com.au/
- Lipedema Project Directory: https://lipedemaproject.org/lipedema-lipoedema-lipodem-provider-directory/
Complete our questionnaire written by doctors to find out the likelihood that you have lipoedema
Megan Pfeffer:
Megan Pfeffer is an Australian-based clinical nutritionist and the founder of I Choose Health, an international online and Melbourne in-person nutrition consulting clinic. Specialising in ketogenic nutritional therapy for women with lipoedema, lymphoedema, and breast cancer, Megan helps women to take back control of their health with evidence-based approach supported by clinical and personal experience.
Megan follows a ketogenic lifestyle to manage her own health. In early 2019 she discovered she had lipoedema and was diagnosed with breast cancer in mid-2020 (she is now cancer-free), and credits intermittent fasting and keto for helping her manage these conditions.
Megan has presented at numerous international conferences in-person in Sydney and Boston, and online in New York and Italy. She is the lead author of a 2019 keto cookbook for lipedema and co-authored a 2019 peer-reviewed research paper titled ‘Ketogenic diet as a potential intervention for lipedema’.
Megan is passionate about supporting women to understand the benefits of adopting a low carb & keto way of life. With a focus on improving health minus the blame & shame approach experienced by many overweight women. Megan’s health motto is to “Eat Food That Loves You Back!”.
I Choose Health offers one-on-one consults, an 8-week online course, luxury ‘keto for lipoedema & lymphoedema’ retreats, and a private membership group for lipoedema and keto support.
Email: [email protected]
Website: www.ichoosehealth.com.au
Megan’s online 8-week keto course ‘Keto mastermind for lipoedema & lymphoedema’ runs every 3 months: https://ichoosehealth.com.au/online-courses
Keto for lipedema research paper link: https://www.researchgate.net/publication/346677939_Ketogenic_diet_as_a_potential_intervention_for_lipedema
Show notes:
Lipoedema Part 2: How do you manage it?
Dr Mary Barson: (0:11) Hello my lovely listeners. I'm Dr. Mary Barson.
Dr Lucy Burns: (0:15) And I'm Dr. Lucy Burns. Welcome to this episode of Real Health and Weight Loss.
Dr Lucy Burns: (0:23) Good morning lovely listeners. It's Dr. Lucy again and I am thrilled to have Megan Pfeffer back with me in the studio recording this episode. We are recording this in the depths of winter. It is freezing cold in Melbourne where I'm from and Megan is also in Victoria and probably just as cold as me. But by the time this comes to air, it may well be warm and sunny where you are. So I hope you are looking forward to a beautiful day. This episode we are discussing - following on from last week's episode on lipoedema where we talked about what is the condition - this week we're going to give you some absolute pearls on management. So diagnosis and management of lipoedema. Megan, welcome back to the podcast.
Megan Pfeffer: (1:08) Hello, Dr. Lucy, thank you very much for having me again.
Dr Lucy Burns: (1:11) You're welcome. gorgeous girl. You are welcome. So last week we talked about the diagnosis or bringing awareness to even the idea that there is this condition out there that people are unaware of called lipoedema. Spelled L I P O E D E M A. If you're in Australia, or L I P E D E M A if you're perhaps in Northern America, and it is completely different to lymphoedema which many people have heard of, although the two conditions can coexist. And the triad is probably the lipoedema, lymphoedema and then kind of, you know what we might call standard obesity.
Megan Pfeffer: (1:53) Yes, that's right.
Dr Lucy Burns: (1:54) Yeah. Okie dokie. So one of the things I think that I was just thinking of during the week that I have heard a lot on the forums that we didn't touch upon is bruising in lipoedema tissue. Is that something that you come across a lot?
Megan Pfeffer: (2:11) Yes, easy bruising is another that people will identify with. Another symptom that lots of people will identify with. So again, not everyone tends to have that and it will happen more commonly for some people than others. But there are certainly other symptoms as well. Things like cold skin, so skin that's cold to the touch is quite a common one as well. And also we mentioned the kind of the triad of the lipoedema and the obesity and the lymphoedema but we should mention there are quite a lot of other comorbidities that can be together with the condition. So a very common one can be hypermobility. So there's a condition called EDS or ehlers danlos syndrome. Hypermobility. And so that can be something that a lot of women will identify with whether you've had a lot of dislocated joints in your life, you find it difficult stretching, or you're just your limbs do overextend. That can be another thing that women can identify with.
(3:05) But also type two diabetes tends to develop a little later in life for these women. So it's thought that that's not a common occurrence. Although for me in clinical experience, I think prediabetes and type two diabetes is very common. And that, of course, will depend on how far along you are. So it may happen that perhaps because of the gynoid fat distribution, as well that prediabetes may start earlier for people who have a larger weight. But for women with lipoedema that tends to be a little later in life that that can come along. Hypothyroidism is a really common comorbidity with lipoedema so that that can be quite common, whether that's Hashimoto's thyroiditis. So there are quite a few different conditions that can be there, as well as of course, just metabolic syndrome, which, you know, once that weight gain around the midriff starts and triglycerides rise and blood if blood sugars are increasing, that can be there as well.
Dr Lucy Burns: (4:03) Yeah, and vitamin D deficiency. Do you see a lot of that? I mean, where I live, you know, most of Melbourne’s vitamin D deficient, but I certainly see it more commonly generally in people who are perhaps storing excess fat, but what about in lipoedema? Is it more common?
Megan Pfeffer: (4:20) It is, yes, absolutely. Vitamin D deficiency is common. And I think for anyone carrying as you mentioned, anyone carrying excess fat, you know, the fat cells can sequester vitamin D and doesn't make as much available in the bloodstream. So that's definitely a side effect and something that's really important to look at and manage.
Dr Lucy Burns: (4:39) Absolutely. Okey dokey. So if someone has been listening to this, and they're thinking, “Ah, god, that's me. I've got this, you know, I've got these “saddlebags” as people love to call them”, which is a term that I abhor anyway, “and they're cold and they're bruising and my skin, my thigh is sore and I feel like I've got grainy rice things under them. I have no idea and I've… What will I do?” So what could they do now?
Megan Pfeffer: (5:01) Well, look, I think a terrific place to start really is to see a physical therapist or a lipoedema therapist, an occupational therapist, depending on where you are in the world, that can be a really great place to start, because while they can't officially diagnose you, they are very experienced in dealing with these types of conditions. So they will recognise the condition and can be a big part of, of the therapeutic things that you will follow up after that. So they may know doctors who are familiar with lipoedema and lymphoedema, of course, you can also go to the lipoedema association of Australia support society, and that's going to be really helpful in directing you from there. So that's a great place to start as well. And they've got a lot of information you can use. But as far as I think seeing someone as far as the health professionals, the physical therapists are the great place to start. And then they can kind of direct you to some other health professionals that may be able to help you. Sometimes there are a lot of surgeons around the country who actually will specialise in lipoedema and know a lot about that. You can go there for a diagnosis and not necessarily have to follow that through with surgery. There are lymph sparing liposuction options that a lot of women choose to do to get their legs back to looking normal, that aren't responding to diet. And so that's an option as well. So getting a diagnosis from a doctor is terrific. But you can also see physical therapists to know that this is something that you likely have so that you can at least until you find a doctor who's able to diagnose you, at least start using some of the therapies that we know are helpful.
Dr Lucy Burns: (6:38) Which again, leads us into the next section of: what are the therapies that are helpful?
Megan Pfeffer: (6:42) Yeah, so firstly, before getting into nutrition, we talk about complete decongestive therapies. So that's where the physical therapists come into the picture because they will look at things like manual lymphatic drainage, which is a special form of massage that helps to move some of the fluid. And so depending on what staging you're at, on whether you find benefit from that, but a lot of women do find that really helpful. Maybe not so much in stage one, but from Stage two onwards can be really beneficial. Obviously, movement is going to be a really big thing because in the earliest stages of lipoedema, your lymphatic system is working, but it's not able to keep up with the fluid overload. So you can get this chronic sort of oedema type thing where you are actually getting that accumulation of fluid. So you really need to be moving because of course it's movements that help the lymphatics and you know, muscle movement is what pumps the lymphatic system, we don't have a heart that pumps the cardiovascular system, we need movement. And so that's going to be really helpful for any type of movement. But of course, you don't want too much exercise over exercising can be problematic. So we look at things like compression garments can be really helpful for returning some of that fluid in the system. And that can help to stop progression of fibrosis. They play a really big part in lipoedema management.
(8:04) So of course, this is where it can really differ to obesity because you're not needing to wear compression garments with obesity, whereas you really do need to be wearing them with lipoedema and some women depending on your size, can buy off the shelf compression garments some will need specialised garments made for them. Custom garments actually made for them depending on whether you have lobules and and how symmetrical your limbs are. So they're all parts of… there are things like vibration plates that women can use that are helpful to stand on that can really stimulate the body and the lymphatic system. Yeah, so lots of different things like a pneumatic pumps, which is like a body suit that you can put on, which is a pump that helps of course, again with the lymphatic system can be really beneficial, particularly for advanced and certainly for anyone with lipo-lymphoedema once they've got the lymphoedema component, and then from a nutritional perspective, we really start talking about anti inflammatory diets. The key place to start. I think it's important to talk about it outside of just being low carb and keto. Because of course, that's what I favour and that's what I use to manage my condition. And I have a lot of success in my clinic with that. But of course, not everyone wants to do low carb and keto. So if that's something that you're not wanting to do, then looking into anti-inflammatory diets is going to be helpful. But of course, that's a very broad term isn’t it.
Dr Lucy Burns: (9:32) Yep. Just going back to the physical things, so something like swimming or hydrotherapy, would that be helpful?
Megan Pfeffer: (9:39) Yes. So swimming is often cited as the number one preference for this condition, partly because in a swimming pool, the further down into the pool you go the more compression that comes with the depth of that. So that can be helpful if exercising with that kind of, you know, assisted compression, but really, I think, you know, gentle forms of exercise can be nice walking, yoga, if you don't have hyper mobility issues that can sometimes be problematic doing yoga. But Pilates for that core strengthening. I think really anything that's going to improve your cardiovascular fitness will be terrific as long as you don't overdo it. And so of course, working with your medical team, and your physical therapists can help with that.
Dr Lucy Burns: (10:22) Absolutely. It's interesting, I have a patient, she's probably listening, she gave me this fantastic tip for doing hydro. So she goes to the pool regularly. And she bought a coat, a towel coat, and it's got a shell on it. So you actually just put this towel coat on, and then you can go home and get dressed. Because I think for a lot of people the idea of going to, you know, public pools and then having to use the change rooms, and all of that creates this barrier. So if we can look at various tools to make things as easy as possible. So she puts on her towel coat and I now have one and then you don't get your car seat wet because it's like wearing a giant japara or a giant, you know, coat that's waterproof. But with the towel inside, so you’re dry and you just put it over your bathers and and skedaddle home.
Megan Pfeffer: (11:12) Perfect. I love that. And that really is a thing where you no longer just feel comfortable taking your clothes off in front of other people. And I think a lot of women can identify with that. So that's a great idea.
Dr Lucy Burns: (11:22) Yes, absolutely. So anti inflammatory diets. And this, I mean, this, I think is the key to the world. The idea that you can do a keto diet, that it can be not anti inflammatory. So you can do a “flammatory” keto diet if you like. So, I would love you to perhaps chat with us about what an anti inflammatory diet - in broad brushstrokes - what does that look like?
Megan Pfeffer: (11:51) Well, I think again, it's going to depend on who has actually coloured in the picture of that, because there's going to be different - there are certainly different versions of that for different people. So some anti inflammatory diets, or Mediterranean type diets will still perhaps include grains, as long as they’re whole grains, and so that can actually be anti inflammatory, but it can also be inflammatory for some people. So again, you know, this is really coming down to what we always talk about this bio-individuality. And you can't just really take these broad statements anymore of just saying that, “Okay, everyone follow this, everyone do this particular thing”. So I love the portion of yes, looking for something that is anti inflammatory is an important component, that you have to work out what that means for you and your particular body type. So some people may just change to doing a whole 30 diet or any one of these sort of anti inflammatory type diets. But one of the things I find with women with lipoedema is we tend to have problems with carbohydrates. And certainly when you have that carbohydrate intolerance, of course, then that can be problematic depending on the degree that that has come to - whether you're pre diabetic or type two diabetic - or perhaps your blood sugars are still okay, but you have this insulin resistance in the background, then following a food plan that's going to be really high in fruit, for example, because it has lots of lovely colours, and the colours can offer anti inflammatory benefits. I'm not sure if that outweighs what harm the sugar content and the fructose content in those foods do. So that, of course, is what we're really starting to get down into. Okay, how does your body respond to this? And also, where are you starting from? What's your metabolic health like to begin with? Can your body handle these additional carbohydrates? And obviously, eliminating processed foods is going to take away a lot of inflammatory foods and also a lot of simple carbohydrates. So anyone is going to benefit from that type of change. But then I think it does come down to how well firstly, can your body handle these types of foods? And secondly, how well can you handle them?
(13:57) So I know that myself and a lot of other people, once I start eating carbohydrates, I find it very difficult to stop. I can't moderate my carbohydrate intake. So if I'm prescribed a diet, it's a little like people who are lactose intolerant, you don't then go and prescribe a diet high in dairy. If you're not handling carbohydrates, well, for whatever reason, we don't want to prescribe a diet that's high in them. So I think for me, women with lipoedema regardless of what diet you're trying to find, we know that lowering insulin is important. And lowering inflammation is important. So you can design a diet around those things in mind, which will normally always include of course, removing the vegetable oils, and the highly processed foods but for some women it will need to also eliminate the high sugar fruits and the grains that can be problematic particularly if you have digestive upset, if you've had bariatric surgery. If your digestion isn't well, if your mental health isn't well, you know gut health is a great big portion of health and a lot of inflammatory initiators come from how well you're digesting your foods. And so that's going to be you know, do you have autoimmune conditions? Do you have leaky gut? Do you have dysbiosis or SIBO? Or any of those things that then say, “Okay, well, we do need to tweak this for you”. You're going to have to kind of avoid these particular foods that we know are problematic for people with autoimmune conditions, or people with arthritis and all of the different things in that. So. Yeah, so really anti-inflammatory means different things to different people.
Dr Lucy Burns: (15:36) Yes, absolutely. I think probably most people would agree, as you mentioned, that whole foods are better than processed foods, vegetable oils, we've done buckets of podcasts on the dangers of and when we say vegetable oils, they're things like canola or sunflower or the seed oils. Just no one really calls them that. I don't know why. But yeah, they're highly - not only is the processing the problem, but the amount of omega 6 in it is the problem as well.
Megan Pfeffer: (16:05) That's right, and they're easily oxidised. And rice bran oil is in there as well. I think a lot of people think rice bran oil is the healthier alternative. So I would like to point out that that's not the case. But yeah, that those foods are highly problematic. And particularly at the moment on researching that the type of fat that you have alters the signalling of a fat cell. So if you have a fat cell that is already hypersensitive to insulin, for example, and you have a fat that increases that, then that's going to be problematic as well.
Dr Lucy Burns: (16:35) Yeah. I think the thing to boil it down to is that for women with lipoedema, there are some things that correlate with standard. No, I was about to say standard obesity management. But actually no, what we recommend is not standard obesity, because standard obesity is still calorie restriction, which we definitely do not recommend. And calorie restriction is different to calorie deficit. And we've done a podcast on that as well. But calorie restriction, so you know, when you count 1200 a day or 800 a day, the 800 Fast diet horrifies me. But anyway. So there are some things that people can do that would be the same that we that both you and I would recommend for our patients that we treat for standard obesity, but then there's extra things that you can do for lipoedema to help stop the progression. And I think it's important for people to know that it can be progressive. So we do want to try and diagnose it early, and treat and start management early, so that we can stop the progression of it. Because I'm sure as you mentioned to people, advising people to go and look at the lipoedema website will be a great start, but it can be pretty confronting.
Megan Pfeffer: (17:46) It can because yes, you're really looking at pictures of you know, they show all of the stages. So they're showing, you know, women who can be very advanced. And I think with the message coming through that that lipoedema is unresponsive to diet and exercise, you can kind of feel like well, “Okay, is this my destiny? Is this what I'm heading towards, and I'll have no control over?” So we really want to encourage the message that if left uncontrolled - and remember, a lot of women who are very advanced at the moment have lived through the neglect of knowledge, you know, where they haven't been able to be helped. So they haven't been able to do the things that we now know can be really helpful to stop that progression. And in fact, we see a lot of women reversing the stages that they're at. So we know that that is possible. We can't yet sort of say specifically how it changes the lipoedema fat. And as we know, fat cells last a very long time, they can be around for a good decade. And so at the moment, we're kind of quite young in the keto, certainly in the keto for lipoedema, but in the paper that I co authored at the end of 2019, which was ketogenic diet as a potential intervention for lipoedema. You know, we spoke about some key highlights for women, which is that the lipoedema fat can be resistant to weight loss diets, but it may respond to ketosis.
(19:04) And also the ketogenic diets modulate pain in lipoedema, independent of weight loss. And this is a really key thing because for some women, you know, I've talked to women before who have been about to be put onto morphine patches, their pain has been so incredibly intense. And they thought, “Well, why not give keto a go?” They've heard great things about it. And you know, within weeks, and sometimes within days, the pain level will go from an 11 out of 10 to a 1 out of 10. The difference is incredible. And that in itself is life changing because it's very hard to be mobile, when you're living with such extreme pain. And women. Yeah, women with lipoedema can have very large legs, which makes it very difficult to be mobile anyway and a lot of women lose their mobility. So reducing that pain is such an incredible thing in itself. And there was a Norwegian study, a pilot study that found that they put women on - for six or seven weeks on a ketogenic diet, and then switch them to a standard Norwegian diet in the following time, and so the women lost weight and their pain levels reduced. And when they went back to their standard Norwegian diet, they lost all of the pain relief benefits. So, you know, studies like that are really showing, okay, there's something really significant and key here about being in nutritional ketosis. And so that's, you know, other benefits of things like ketogenesis positively impacts lymph vessel integrity and lymph transport. And that's obviously key in women with lipoedema and with lymphoedema. And it all comes down to we think, the main ketone beta hydroxybutyrate, that it helps to interrupt the inflammasome pathway. So that nlrp3 inflammasome pathway, they call it, and that just has this knock on effect for all types of conditions. But it seems to be really beneficial for women with lipoedema. And so we will see instances of women, “Yes, I've been losing weight from the upper part of my body, but I haven't really reduced my pain or I've reduced it some,” because taking away a lot of the inflammatory foods will reduce it some, but perhaps not as effectively as we know that women on a ketogenic diet can do
Dr Lucy Burns: (21:16) it is so fascinating. And in fact, we have Rowena Field coming on the podcast in the next few weeks as well. And she's recently produced a paper - she's a physiologist - on nutritional ketosis for chronic pain in all conditions. So you know, we, keto is not a dirty word like this is the thing people go “Oh keto”. But there are so many benefits to a well formulated ketogenic diet. And so I guess it's really about interestingly changing our language around because when you hear diet and exercise, my brain goes to calorie restriction and punishing gym routines. Whereas if we reframed it to nutrition and movement, it's not about the calories in calories out model, it's about giving your body what it needs, and that will be helpful.
Megan Pfeffer: (22:09) Absolutely. And it's also about downregulating appetite, because that is a big part of it. When you eat carbs, I know when I eat carbs, I'm starving. And I'm ravenous. And I will wake up ravenous. And so you have this appetite that's really hard to satisfy. Whereas with the ketogenic diet, we know that, you know, being in ketosis actually helps to dampen that effect. So you get this kind of natural appetite suppressant. So you can end up lowering your calories, but you're getting enough of nutrient dense calories there, your body is also able to tap into your excess fat stores for any additional calories that it needs. But as far as what you're actually eating, that tends to naturally suppress that. So instead of needing to eat three meals a day and two snacks in between, which is what a typical standard diet will prescribe. And as a nutritionist, that's what we're taught to prescribe. But we know that that really elevates insulin, which is the fat storage hormone, and that can be really problematic. So whereas keto, we tend to find that people will start cutting out the snacks, maybe not in the first couple of weeks. I don't encourage people to necessarily do that straight away, because you just want people to get into ketosis. And if you're experiencing cravings and missing your favourite foods, you don't want to be watching, necessarily, you know, restricting what you eat at the same time. So you just enjoy keto foods whenever you need them. But eventually your body - once your body starts metabolising fat well and you become a good fat burner - your appetite will start to self regulate. And that's a really empowering feeling to take back control when you actually feel like eating or when you're hungry to eat rather than your body controlling you about needing to eat all the time.
Dr Lucy Burns: (23:39) Absolutely, absolutely. We call that opening your woodshed. When your woodshed is open, you can access your stored logs, which is our euphemism for, our metaphor for fat and start burning it. But when insulin has locked your woodshed, you can't and so you are burning kindling or carbs and you're hungry and hunger again, hunger is not a character flaw. It is a biological driver
Megan Pfeffer: (24:12) And often a reflection on the quality of the foods you're eating. I think the hungrier you are typically the higher amount you're having of processed foods.
Dr Lucy Burns: (24:21) Yes. Yeah, nutrient devoid and your brain is going, “Come on, person! Get me some nutrients, I really need them.” So it just keeps making you hungrier until it's got the required nutrients that it needs.
Megan Pfeffer: (24:32) Yeah, and one of the things we know that's really important with all of this is that we do need to enjoy our food - with what we were talking about before - that it's really important that we do. So this is a way that women can find that they're able to. Yes, you have to remove some foods but often removing those particular foods gives you back control of the other foods. And so yeah, that's just, it is such a self empowering way to change.
Dr Lucy Burns: (24:21) Oh, absolutely, I think processed food steals the joy of real food. So when you've got rid of all the processed food and your taste buds have also woken up again, they're not sort of numbed by, you know, copious amounts of sugar and flour, then you can start to taste proper food again. And it's bloody awesome.
Megan Pfeffer: (25:19) Yes, yes. And I always encourage people to be curious about trying new foods that perhaps they haven't liked for a long time, because their palate has changed, will change, the more you take away those super sweet foods, the more the palate changes.
Dr Lucy Burns: (25:35) Absolutely. Well, lovely listeners. How delightful has it been having Megan on the podcast? It has been magnificent. I think she has given us some absolute pearlers of information. And Megan, if people want to make contact with you, where do they find you?
Megan Pfeffer: (25:51) They can find me at my website, which is called I Choose Health. https://ichoosehealth.com.au/ Yeah, so get in contact there, feel free to reach out. Anyone that leaves their contact details on the pop up page on my website I speak with and we can have a chat. If I can help to direct you in any way I'd be more than happy to, but also do reach out to the Lipoedema Association of Australia.
Dr Lucy Burns: (26:12) And in fact, Megan and I both attending their conference, well Megan will be speaking at it, and I'm going along to soak up all the wealth of information I can so that I can have more understanding of this condition because it is as Megan's mentioned completely under diagnosed and much more prevalent than than even I realised. Wonderful, lovely listeners. We will catch you next time. Have a beautiful week. Bye for now.
Dr Lucy Burns: (26:41) So, my lovely listeners, that ends this episode of Real Health and Weight Loss. I'm Dr. Lucy Burns.
Dr Mary Barson: (26:49) and I'm Dr. Mary Barson. We’re from Real Life Medicine. To contact us, please visit https://www.rlmedicine.com.
Dr Lucy Burns: (27:00) And until next time, thanks for listening. The information shared on the Real Health and Weight Loss Podcast, including show notes and links provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
