Show notes
In this episode, I’m joined by Dr. Melanie Cree—physician-scientist, pediatric endocrinologist, and one of the leading researchers redefining how we understand and treat Polycystic Ovary Syndrome (PCOS). PCOS affects millions of women, yet it's still underdiagnosed, misunderstood, and often mistreated. Dr. Cree cuts through the confusion, offering a deeply scientific yet compassionate look at what’s really driving this complex condition—from insulin resistance and mitochondrial dysfunction to skeletal muscle quality and fertility trajectories across a woman’s lifespan.We cover:Why PCOS isn’t a single disease—and what two phenotypes may explain the full pictureHow muscle, liver, and fat interact in PCOSThe misunderstood role of testosterone, insulin, and SHBG in diagnosisWhat muscle biopsies reveal about teenage girls with PCOSIntramuscular fat, mitochondrial impairment, and the true cost of sedentary muscleHow early lifestyle and exercise interventions could change the future of PCOS careWhat GLP-1 agonists and amino acid supplements might offer for treatmentWhether you’re a clinician, patient, or advocate for women’s health, this episode will give you a whole new lens on PCOS—and why skeletal muscle may be the most overlooked (and powerful) organ in the conversation.Who is Dr. Melanie Cree?Dr. Melanie Cree is a board-certified pediatric endocrinologist and Associate Professor at the University of Colorado and Children’s Hospital Colorado, where she directs a leading multidisciplinary PCOS clinic. Her research bridges metabolic medicine and muscle physiology, with clinical trials exploring semaglutide, amino acid therapy, liver metabolism, and insulin resistance in adolescents.Forever Strong Summit 2025: The Forever Strong Summit is a live event on April 27, 2025 in Houston, TX, designed to help you build strength, resilience, and longevity from the inside out. Featuring top minds in medicine, military, and mindset, you’ll walk away with practical tools to upgrade your health, sharpen your focus, and take ownership of your life. Whether you're a clinician, athlete, or simply ready to step into your next level—this is where science meets action. Get your ticket now! https://drgabriellelyon.com/forever-strong-summit-2025/ This episode is brought to you by:LMNT – Get your free LMNT Sample Pack with any purchase → DrinkLMNT.com/DRLYONCozy Earth – Get up to 40% off with code DRLYON → cozyearth.com/DRLYONOneSkin – Get 15% off with the code DRLYON at → OneSkin.coTimeline Nutrition – Get 10% off → timeline.com/LYONFind Dr. Melanie Cree at: University of Colorado - https://som.cuanschutz.edu/Profiles/Faculty/Profile/22449Find me at:Instagram: @drgabriellelyonTikTok: @drgabriellelyonFacebook: facebook.com/doctorgabriellelyonYouTube:youtube.com/@DrGabrielleLyonX (Twitter): x.com/drgabriellelyonApply to become a patient – https://drgabriellelyon.com/new-patient-inquiry/Join my weekly newsletter – https://institute-for-muscle-centric-medicine.ck.pageGet my book – https://drgabriellelyon.com/forever-strong/Timestamps: 00:00 – Introduction to PCOS: Why most women still don’t get real answers03:00 – Dr. Melanie Cree’s mission: Advocacy, research, and uncovering a new liverpathway07:00 – PCOS is not one disease: Metabolic vs. reproductive phenotypes12:00 – Why lifestyle changes work—and why the messaging around “just lose weight” isall wrong16:00 – Fertility, follicle congestion, and why some women with PCOS conceive moreeasily at 35+21:00 – Diagnosing PCOS in teens vs. adults, and why ultrasounds often mislead26:00 – Testosterone testing: The lab mess, SHBG, and how women are misdiagnosed36:00 – Muscle in PCOS: Why women with high testosterone don’t have more muscle41:00 – Mitochondrial dysfunction and insulin resistance in teen girls with PCOS46:00 – IMAT, marbled muscle, and early signs of cardiovascular disease53:00 – How fat inside and around muscle impacts insulin signaling and metabolichealth59:00 – Targeting IMAT: What biopsies reveal, and why location of fat matters morethan total %1:06:00 – Muscle protein synthesis, amino acids, and resistance training response inobesity1:16:00 – Lifestyle vs. semaglutide: Surprising diet findings from Dr. Cree’s recenttrial1:22:00 – Low glycemic diets, liquid sugar, and reactive hypoglycemia in PCOS1:26:00 – Protein, GLP-1s, and lean mass loss: What matters more than the drug itself1:30:00– Why GLP-1s may eventually replace metformin—and the organ-wide benefitsemerging1:37:00 – Can PCOS be reversed? Why Dr. Cree says “lifestyle managed” is more accurate1:40:00 – Brain remodeling, hunger signaling, and GLP-1s in adolescents vs. adults1:43:00 – Compounded GLP-1s, insurance gaps, and what's coming next in PCOS careDisclaimer: The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions.