THE blog

If you want to listen to the full episode head over to: www.wellspringnutrition.co/healing-in-fertility

Transcript:

Hey there, welcome back to another episode of healing in fertility, the mini podcast series where we explore functional medicine, nutrition and lifestyle changes for naturally enhancing your fertility. I’m your host, Annabelle Clebenar. And in today’s episode, we have a really fun story, we have a special guest, who is a previous client of mine, her name is Amanda. And she’s going to share her story and some of the challenges that she had with getting diagnosed with PCOS, some of the ups and downs during that journey. And she’s also going to share some of the different things that she had tried in the past before we started working together. So different diets, different practitioners, and really a lot of the frustration and overwhelm that comes with dealing with fertility struggles. Amanda’s story is so inspiring. And I’m really excited to dive into it. So if you’re someone that’s either dealing with PCOS yourself or just struggling to get answers, or maybe you’ve tried different diets, and are also feeling confused about things, I think this episode is going to be so impactful and so insightful for you. And I can’t wait for you to listen. So let’s dive right in. All right, Amanda, I’m so happy for you to come on the podcast and share more about your story today. Why don’t we just start off with you telling us a little bit more about your fertility background, what was happening before we started working together. And a little bit like of some of the struggles that you faced.

Amanda:  

Totally, I have always had super irregular periods ever since they first started when I was like 13. I mean, I would go years without a period or I would have two in a row. And then I wouldn’t have one for 10 months. And in high school and college, I thought I was so lucky. I like to hear horror stories of my friends who are having all these painful periods or just having not having a tampon and I was like, Ah, I never have to worry about this is so great. And then as I got older, I started going to see you know, the guy No, regularly, of course, and mentioned the irregular periods. And that was never a red flag for anyone. But I started discovering that I was having cysts regularly, there’s just pain and a couple of different ultrasounds and whatnot. And I remember when I was about 25, one of the gynecologist that I’ve been working with saying something about, you know, your symptoms with the irregular periods and the common cysts, you know, sounds kind of like PCOS, but you’re, you’re too skinny for that. And so I never, I didn’t really know what she meant I had never really heard anything about it.

But a couple years go down the line. And my husband was military. So we moved a lot. So I also didn’t have the same doctor for a long time. And I think that was part of the struggle with taking a little bit longer for me to get diagnosed. So new Doctor new state new location. And you know, my husband and I am probably 29 at this point. And my husband, I know that in the next few years, we would like to start having kids. And I started thinking through like I’ve really irregular periods. I feel like maybe this is something I should look into. I had had an excellent on for a long time, even though I never had periods. And with the next one on I don’t think I’d had a period for years. years. But I think that was also normal. So I wanted to start talking to somebody to figure out what is there something that’s a bigger issue, is there an underlying issue? And so we did a little bit of testing still was on next been on and realized that I had PCOS. And I had lean PCOS because there’s not as many of us with the Lean PCOS because generally the population of those who had PCOS, maybe have a larger BMI. It’s it goes a lot more undiagnosed, I learned.

So when I came home with this information, the doctor also just basically said you need to go on a keto diet you need to be super low carb. Here’s a list of vegetables and fruits that are higher carb but look into keto s low carb diets. And it was so daunting, so overwhelming. I try you know reached out to a bunch of people found a bunch of accounts on Instagram that I’ve followed some that told you to go dairy free, some that said to go sugar free. Some said Go gluten free Some said Go keto. And so I kind of tried all of it. And over the course of probably six months or so, I lost a lot of weight. Where my symptoms really that much better, I don’t know, because I also had milder symptoms and other areas. The main one was the irregular periods, but you know, and also have some hair growth. Or I would have, you know, some mood swings here and there cramping, common cysts, things like that. Nothing super, super severe the acne or things that unfortunately a lot of people have to deal with. I was lucky enough to not have that. But through this whole process was really large time to educate myself. I also found out that PCOS can be hereditary. And one of my sisters went and got tested. And she now has we’ve found has PCOS.

So throughout this whole process, I’m kind of trying to manage my diet without really having guidelines. And a couple of years go by, and I’m still doing the same thing. And my husband and I decided, you know, I think it’s time I want to start trying to get pregnant. So let’s take out the next one on. It takes six months or so later, I still don’t have a period. And so I started going to the doctor and we decide we’re going to try Clomid to force an ovulation. So we do the first round of Clomid. And this is 2020. And around that time I catch COVID. Right? in that cycle. It was a really, really easy case of COVID I didn’t lose my sense of taste and smell. I don’t never fevers, just severe exhaustion and a little bit of achiness. But nothing crazy. The crazy thing came two weeks later, when I had severe abdominal pain, severe, severe severe abdominal pain to the point that I couldn’t stand up. And actually I forgot this had happened two years previous, I had a weird situation where I was having these increased periods of periods not the right word, because it’s not a period, these periods times of just severe pain over the course of like three or four days, but come in waves. But it was dilapidated. I mean, I couldn’t stand I couldn’t move. Just crazy, crazy painful and couldn’t figure out what it was at the time. We were in a small town. This was for the first one. The time we were in a small town and I went to urgent care thinking it wasn’t an emergent situation. They had no idea what it was set me up with an abdominal ultrasound had that. Shockingly, the next day they couldn’t discover anything was it with a abdominal so I called my gynecologist at this point, went in had an vaginal ultrasound, and at this point the pain had subsided. So they said that I had some cysts and things looked really inflamed in my uterus and my ovaries but they couldn’t really say for sure if it was an ovarian torsion or if something had burst. They had no idea but just said you know, go home and rest. That was two years prior. Go back, flash forward to take take a Clomid. I’ve had COVID Two weeks later, I have a very similar situation. I can’t stand I can’t move. It’s it was way worse this time. So we go to the hospital. All of the COVID precautions are going on since I just had COVID. They treated me like I was a COVID patient couldn’t figure out what was going on. I had a vaginal ultrasound, I had an MRI, they did all this legwork. And they were contemplating having a an exploratory abdominal surgery to just see what was going on. I’m trying to get my gyno to come in to you know, have a console, they wouldn’t let her in because of COVID things. So she didn’t even she was even able to be a part of it. But we met afterwards. And she said based on the symptoms that you had, I have to think that maybe you had some sort of ovarian torsion you assist. So I think you should go see a fertility doctor. So I went into this conversation with a fertility doctor trying to figure out what the hell had just happened. Not necessarily trying to get pregnant, but trying to figure out what happened and get my body in the right alignment. Because clearly something was going on. And the fertility clinic took it to the extreme of oh, we’re about to put you on all these medications. We want to do another out of Clomid, we want to give you all these drugs. Oh, you have another cyst? Let’s put you on birth control to get rid of this USB and this one I just said absolutely not. I don’t want any of these drugs and have anything to do with this. Like I’m gonna take some time away from all of these things and figure it out.

I have thought throughout the years when I was really kind of flailing around with my diet, and not knowing where to go that working with a dietician would have been useful, but there wasn’t kind of an urgent need. And at this point, I just wanted to figure out what was going on and set myself up for success. And so I did some research and I found you and we sort of working together. And it was a really great experience. Also, I found an article around the time we started working together about women who had gotten COVID with PCOS. And there were a lot of case studies starting to come out of women who had had almost identical experiences to me that something with COVID attacked the weaker part of you. And if you had PCOS, you’re at higher risk for your uterus and your ovaries to be attacked in this way.

Anabelle:  

I didn’t think I didn’t know that part about the like, COVID PCOS connection, that’s super interesting.

Amanda : 

I need to like, research that again, and see if they’ve done more, or if there’s more studies that have come out because it was wild reading this article, it was like I had reading my own journal. The women who had had this experience, and the doctors had no idea what was going on. And then both, Yeah, crazy.

Anabelle: 

I remember. back in 2020, you’re telling me this whole story and like this whole saga and today, when when you went to the fertility clinic, did they tell you that you needed IVF?

Amanda:  

They told me that it was likely they didn’t the doctor was I have never dealt with a more condescending doctor, as a male doctor. And not to say that male doctors are always this way. But to be and male doctor working in a fertility clinic to be that condescending and that dismissive. That was one of the reasons I walked out because I had asked him I have PCOS. Isn’t it true? Is there any like diet that I need to be working on? Isn’t it true that I need to be doing X, Y, and Z based on my own research that I had been doing because most of what I had discovered and learned about PCOS, I had to find out on my own, the doctors were not helpful across the board. And this doctor in particular was like, No, there’s no studies that there’s anything to be done. There’s no studies that you can get pregnant with PCOS easier. If you do certain things, you will likely need to end up doing IVF. And at that point, I was like, and I’m done. I you just discounted, most of the things that I had found in my own research, I’ve always been a big believer of modern medicine, obviously. But there’s something to be said about the holistic route. That’s always been like my, my thought process has always been a blend of both is kind of setting yourself up for success in the best way possible, working with doctors, but also eating the right way and taking care of your body and working out and having the whole like mind body spirit, Mental Alignment is only going to help you in your in your health journey. And so for him to dismiss that. So immediately, I was like, We are not a good partnership. 

Anabelle:  

So yeah, it’s crazy that, I mean, there’s so many great doctors out there. And there’s so many that just completely like, for some reason, just shut down any form of nutrition or supplements that can be helpful. 

Amanda:  

I had come to him saying I had this episode, I want to figure out what in God’s name happened. So I was under the impression that he had hurt me because we started doing all this testing, he was doing less testing, because he wanted to see the viability of where I was, you know, right now, and to move into the fertility treatments not to get to the root cause of anything, and I’m always the one that wants to like, let’s get to the root cause and fixing symptoms are fine, but it’s a band aid, like how can we work and, you know, fix it from the bottom up. And that was not his approach. But I remember going in and having conversations with him and he had no memory of ever talking about the episode in the hospital. And there were a lot of red flags. So I was very, I was very happy. My husband was super supportive of like, if this does not feel right to you, we’re not doing this. So it was Yeah.

Anabelle:  

Yeah, that’s, I mean, that’s good. But you went with your gut in that situation. Okay, so you said you found me what made you decide, like to dive in and work with me and go this alternative route? 

Amanda:  

I met with a couple of different people in this space. And I just felt like we clicked so well. You’re so easy to chat with and gab with but you also you know your shit. And I felt like you had a really we you’ve had a very similar philosophy that that I did about like getting to the root cause and aligning that whole mind body spirit, you know, mental mental situation the modern medicine partnered with a functional and at this point, you know, my husband and I were like why not? You know what is what if we don’t do this and in six months wish we had like, working with somebody one on one like this is only going to better you there’s no risk and so There is a risk if I don’t do anything. And I have another one of these episodes. And this one, we just had no idea what was going on. So I think the biggest thing was I’d followed you on Instagram for a while. And I recognize that you knew you knew what you were doing. And you had a really great knowledge base, and just a great demeanor. And I felt like you’re gonna be awesome to work with. And I was right. 

Anabelle:  

I love that. Okay, so fast forward into us starting to work together, we did a bunch of different tests for you, I was about to pull up like your old gi map and stuff. But if you can recall, I know this was like a few years ago now. But was there anything like surprising that happened when we started working together was anything like an aha moment for you or anything like that?

Amanda:  

I’ve shared this with so many women’s sense we work together. But what women are taught about their bodies in school is nothing like it’s so inefficient. And I felt like when we started working together, I was getting educated about my body, like I never had been before. I mean, just learning about not even just me, because I’m one who’s always had irregular cycles, but learning what good looks like learning about the different phases of the cycle, like, oh, no, I had no idea. There were different phases of a cycle, and you should feel a certain way. And there’s different signs that you can tell, if you’re really in tune with your body, that part of it blew my mind, because that’s information that every woman should know, the fact that if you are having irregular cycles are really short, in short, or really long, regardless of what it is, if you’re having cramping, if you’re, you know, getting any of these hormonal mood swings, like the fact that that’s not normal, it’s common, but not normal. That was also revolutionary for me, because that’s not what we’re taught. And so in a way working together broke my heart, because this is not information that is shared widely. And it should be a part of every every, like sex ed for women. And learning that also, fertility is not just about having babies, like your fertility is your vital sign of your health.

That was another thing that rocked my world and made me wish I had done done this years ago. Because if you’re having consistent periods, and you’re having them, you know, as normal as possible, then like, you’re healthy in a way, like that’s a huge sign of whether or not you’re doing well. And that was also just crazy. So I just feel like you’ve dropped a lot of knowledge that was really, really valuable. And I’ve shared that with a lot of people to who friends and family who also had no idea which that was really great. The meals are also bomb, I make them still regularly, I still have plenty of my go twos. And so that was always really fun learning about all of the results of my tests and walking through them about like, this is elevated, or this is lower than it should be in the symptoms, or that could be this it was like, just kind of getting a peek behind the curtain of what’s going on. And that was really cool, too. I felt like once we started doing the testing, doing the diet, doing the supplements directly related correlating to my test results, I started feeling like gut health wise, almost immediately better, and energy levels better and sleeping better. And it was just almost immediate, which is you don’t get results like that very regularly. So it was just, it was a really cool experience. Really, really cool.

Anabelle:  

So happy to hear this. Also, I learned all of this stuff really late in life too. Which is why when I learned it, I was like everyone needs to know this needs to know everyone needs to know. Yeah, we’re going to be teaching our our little boys about Oh, absolutely.

Amanda:  

I’ve already thought about that. Yeah. This is information that y’all need, as well as if we have girls. They need it just as much as the boys do. Very true.

Anabelle: 

Okay, and then so tell me obviously the big moment. Yeah, we started together. 

Amanda:  

The biggest surprise was that three months and because I think we were going to work together for six weeks. We did work together for at least six months. But I think we had signed up. I’d sign up for a six month period, three months in almost exactly. I got a positive pregnancy test, which was wild, totally wild had no idea wasn’t expecting it. We were like I said wanted to get pregnant. We were trying but not really we had kind of put it on the backburner and put my health upfront. So it was a surprise and it wasn’t at the Same time, but it was actually shocking. I never expected to get that result and to get it so fast. And now I have an 18 month old and he’s wild and thriving and so fun. And you’re such a big part of that. So no, so cool.

Anabelle:  

Can you share more about your pregnancy I remember, if I recall, it was like a pretty smooth, easy breezy process.

Amanda:  

It was. We worked together for most of it, I believe. Um, and that was really wonderful. I feel like that set me up for such success I have I know everyone’s pregnancy is so different. So some of this, I think I also just got lucky. But working together, I attribute so much to having such a healthy pregnancy and you helped me get set up for postpartum so well, too. So I hardly had any nausea. first trimester, a little bit of discomfort, you know, low energy, of course, a little bit of nausea, a really not much. second trimester really felt amazing, the only kind of struggle that I had was third trimester, just how he was sitting, my hips, and growing and low back, were not happy. But that was not anything to do with anything that we had worked on. We you helped me with meal plans throughout all of pregnancy, getting ready for postpartum. And birth was really incredible. If you gave me all these resources for different stretching, and different things you can do to kind of prep your body for birth, yoga and meditation along with just like staying active. As well as the stuff that we worked on together, I felt like really set me up at an amazing birth. It was, I mean, almost couldn’t have asked for an easier birth. And the dates and the raspberry leaf tea and the you know, all the different things we did to kind of prep my uterus. And then also you gave me all these resources for meal prepping, nesting during the nesting period to have smoothies and muffins and frozen meals and things like stashed away and I had a good stash for when my husband went back to work and for us to eat off of for, you know, probably four to six weeks after he came. So that was really great. I feel like that your hormones are out of whack, obviously, afterwards. But again, I think so much of it is luck of the draw. But I had a pretty even keel postpartum. Obviously, it was really hard. It was exhausting. There were some of those mood swings. But it was really, really balanced. And I think a lot of that was just knowing what snacks I need to be grabbing, not the super sugary ones, making sure they have protein, making sure there’s a fat like the basics of how people need to eat or another thing that I was taught through working with you that is not taught widely. And so I think all those things just help support through the whole process so much.

Anabelle:  

That’s awesome. I like forgot that we did that all the birth prep. And it’s so huge. So I’m glad to glad that we did do that

Amanda:  

I actually have one of my best friends is having a baby in October. And she was asking me the other day like what I heard something that dates what is that? And I went and found your notes about like how many dates you say, and the raspberry leaf tea and I sent her like the smoothie meal, this could be like meal prep thing to like here, this is what I did. It was amazing. Go to TJ Maxx and get the massive thing a day.

Anabelle:  

That’s all so. Okay, so last or second to last question here. So anything that you would tell someone who’s thinking about working with me or another functional nutritionist, like maybe they’re thinking about joining a program, like what would you tell someone, if you could go back and tell like yourself back when you were kind of deciding what to do.

Amanda:  

I mean, do it. It’s an investment in your health. It’s an investment in you. And it’s an investment that’s only going to make you feel better and hopefully get you the results that you’re wanting faster. While you never know what the future holds. And you never know whether what type of fertility journey you will end up having, this is only going to help you prep for whether it’s IVF or natural pregnancy or whatever the case may be. This is such a worthwhile investment. It was one of the best things I’ve ever done for myself. I mean, I have the 18 month old sleeping downstairs and I like I said I attribute so much of that to you. I think you were the first person I told that I was pregnant. I think I hadn’t even told my husband yet because I wanted to get a second one to verify it and then I got like a little gift and gave it to him later but I’m pretty sure you were the first person I met So, because you were such an integral part. So if you’re thinking about working with Anabelle do it. She’s amazing. 

Anabelle:  

Oh, thank you. Yeah, that I mean, I like remember it like, it was yesterday you sending me the picture of your positive pregnancy tests are like oh my god.

Amanda:  

I mean we’d only been working together for three months. It was crazy.

Anabelle:  

Yeah, crazy. And then last question for you for this little podcast, if you could put a monetary value on your experience and transformation, what would that be?

Amanda:  

Oh, I don’t know. Um, I mean, it’s priceless, right? Like I said, I have the little tiny human downstairs and he’s worth, you know, everything to me. I think I paid a couple $1,000 I don’t remember the exact amount. And I was really toying with is, does this make sense? You know, should we invest this what, like, there’s so many other things we could do with this money. You know, if you want to trip we could buy XYZ, you know, and I think it was my husband that was like, sometimes you have to take a step back and just invest in yourself as if that’s this is this is a straight up investment in yourself. And if it means you’re healthier, and happier than it’s, it’s worth everything. So I would definitely pay what I paid, and more knowing what I know now and working with you. It was great. And I’ve actually thought about, like, Oh, it’s 18 months later, like should I should we kind of level set and do some testing again, I’d love to see where my hormone levels are. And you know, work with you a little bit more just to make sure I’m I’m balanced like I should be. So I’ve even thought about like diving back in. And I would do it again in a heartbeat. I know it’s a lot of money. And it can be scary to put that much money into something so unknown for so many people. But I guarantee you will come away with things that you did not know about your body and yourself that will you’ll be able to use for the rest of your life. Like I don’t even think about the meals that I make at home. Now I don’t even have to think about like, is there enough protein so that you know all the things to carbs. It’s just kind of innate now and I’m sure I could be doing better. But I definitely not doing what I was doing before.

Anabelle:  

That’s awesome. And yay for supportive husbands.

Amanda:  

Yes. Yay for supportive husbands and equal partners and parenthood and life.

Anabelle:  

Yeah, yes. Awesome. Well, this was so so great. And like so wonderful to just have an excuse to reconnect with you and your story again, and I really appreciate you taking time to chat.

Amanda:  

Oh, of course, of course, anything for you. It’s it’s I can’t believe it’s been so long since we’ve really talked to which is oh, you said a couple of years. And I was like there’s no way but no, there is a way.

Anabelle:  

Yes. Babies later and here we are babies.

Amanda:  

Couple countries. Couple states later. Yeah, here we are.

Anabelle: 

Awesome. Well, thank you again. This was fun. This was great. And I hope it was helpful for everyone listening. And if you have questions, obviously, you can reach out to me on Instagram. So there you have it. I hope you enjoyed this podcast episode and the interview with Amanda. And I hope that you learned a few things and also maybe just felt that connection. And if you’re looking for more support on your fertility journey, stay tuned for the next episode because I have a really exciting opportunity for you and a special discount code as well. So head on over to the next episode, and I’ll see you soon

If you want to listen to the full episode head over to: www.wellspringnutrition.co/healing-in-fertility

Transcript:

Welcome back to the Healing infertility Podcast. I’m your host, Anabelle Clebenar, registered dietitian, functional nutritionist and your new fertility bestie. In this episode, I’m going to talk about the importance of nutrition in your fertility journey me why cutting out your favorite foods isn’t going to be the magic bullet and the real deal on weight loss and fertility. Let’s dive in. So, you may have heard that nutrition is especially important in the preconception period, and if you haven’t heard that before, I’m going to tell you right now it is. So your nutrition directly impacts egg quality, ovulation hormone health, and even the health of your baby. In fact, a 2012 study showed that a methyl deficient diet so a diet that was deficient of methylation nutrients such as B, twelve B, six B, two folate, methionine choline, and betane. So having this methyl deficient diet around the time of conception resulted in significant changes in methionine cycles within ovarian follicles, which were tied to offspring being higher weight, more insulin resistant, having altered immune responses, and elevated blood pressure.

So this study was specifically looking at how these nutrients, namely like the B vitamins and folate choline, how these specifically not only impacted fertility, but how they impacted the health of the offspring in 2020. A more recent study from researchers at the Harvard School of Public Health and Harvard Medical School published a review of past studies that looked at the impact of diet on fertility. So they found that for women trying to become pregnant naturally without IVF or any assistive reproductive technologies, that there were certain vitamins and nutrients that were linked to positive effects on fertility, namely folic acid, vitamin B, twelve omega three fatty acids, and eating an overall healthy diet such as the Mediterranean diet. In this review study. They also looked at antioxidants vitamin D, dairy products, soy, caffeine and alcohol, which appeared to have little or no effect on fertility in this review, which is pretty interesting because we hear a lot about how caffeine can impact fertility and vitamin D. So I think there’s definitely more room for research around this, but an interesting find nonetheless. They also found that trans fats and unhealthy diets, which they classified as rich in red and processed meats, potatoes, sweets, and sweetened beverages, they found that these unhealthy diets were found to have negative effects on fertility. A few other studies from Harvard School of Public Health found that consumption of sugar sweetened beverages, especially sodas or energy drinks, was linked to lower fertility in both men and women, while drinking diet soda and fruit juice had no effect.

Another study looked at women who consumed high amounts of fast food and little fruit and found that it took them longer to become pregnant than those with healthier diets. And lastly, another study looked at couples that ate more seafood were pregnant sooner than those rarely eating seafood. So most pregnant women consume far less than the recommended two to three servings of low mercury fish like salmon, scallops and shrimp per week. And we know that one of the nutrients needed for fertility is zinc, which is found in high amounts in seafood, specifically oysters. So, as you can see, diet does in fact, play a huge role in fertility. There are countless studies examining different nutrients and overall dietary patterns, and we know that diet is the best way to influence changes on both egg and sperm quality. So what this means for you is you actually have a lot more control over your fertility than you may have thought or maybe were told or convinced. I want you to think about this because the way that you eat directly impacts your fertility.

And again, anything from ovarian health, hormone health, the health of your baby, all of this is impacted by nutrition. And when we’re thinking about a fertility diet, I want you to think less about specific nutrients or specific foods, and instead, try to focus on an overall balanced diet, one that includes healthy fats, complex carbs, protein, antioxidant rich foods. Iron rich foods. Foods with B vitamins like we talked about earlier. Omega three fatty acids that are found in fatty fish, flaxseeds or other nuts and seeds, dairy or calcium alternatives and limiting overall processed foods. Added sugars, caffeine and alcohol. So let’s dive into our next topic, which is why eliminating certain foods like gluten or dairy isn’t going to be the magic bullet for your fertility. So let’s get this disclaimer out of the way.

The Truth About Dairy, Gluten, and Fertility

If you have celiac disease, if you have gluten sensitivities, if you’re lactose intolerant, obviously it makes sense to avoid these foods. I’ve also seen women struggling with acne eliminating dairy, and that being very effective. But putting all of that aside, I tend to see many women going gluten free and dairy free and starting to cut more and more foods from their diet because they’re told that it will benefit their fertility. So the most recent research around dairy seems to be that there’s actually no impact on fertility, meaning you could include it or not, but it wouldn’t severely impact your fertility by cutting it out. And when we cut out dairy, we’re actually cutting out many beneficial vitamins and nutrients, such as vitamin A, calcium, vitamin D, et cetera. Now, for some people, cutting out gluten can be really helpful in a sense that their overall dietary pattern wasn’t that great to begin with. And cutting out gluten was the thing that helped them kind of focus more on eating more vegetables, fruits, healthy fats, grains, things of that nature. But it’s really not necessary to cut it out completely in order for you to conceive.

I want you, again, to focus on overall dietary pattern rather than fixating and restricting, because these foods aren’t going to be the magic bullet for you to get pregnant. If that were the case, every single person that went gluten free and dairy free would not have any fertility struggles. And as we know, that’s simply not the case. So in this last section, I want to briefly talk about weight and fertility. We tend to focus on being overweight, but I want to also mention the impacts of being underweight for fertility. So being underweight can impact your cycle health. It can impact overall hormones. I tend to see low progesterone, especially with women who are undereating.

And this can be a major factor because not only are you not giving your body the proper nutrients to nourish a healthy pregnancy, but you’re also causing more stress on your body. So as mentioned in previous episodes, stress has a huge part in fertility and over training, and undereating can cause a lot of stress on your body. In addition to that excess exercise, any other stress that you’re carrying, it all kind of adds up. I also want to touch on the other side of this conversation where women who are overweight or obese are automatically told that they need to lose weight. And often in a fertility clinic setting, they have to lose weight in order to qualify for fertility treatments. So whether it’s from a fertility clinic or just their regular doctor that they’re being told that they have to lose weight, this really doesn’t address any other factors when it comes to fertility. So in a 2022 study, there was a randomized controlled study of 379 women with obesity and unexplained infertility. They were randomly assigned to one of two preconception lifestyle modification groups that lasted 16 weeks.

The Impact of Weight Loss on Fertility

The first group underwent increased physical activity and weight loss through meal replacements and medication, and the second group had increased physical activity alone without weight loss. They followed them for three years, and then they measured the number of healthy live births, which they classified as full term infants of normal weight without any major anomalies. And what they found in this study, that the preconception intensive lifestyle intervention. So that first group that got meal replacements and medication for weight loss did not improve fertility or birth outcomes compared to the exercise intervention without targeted weight loss. So basically what it’s saying is that the focus on weight loss did not have an impact on overall fertility and live birth rate. And I know this is one study, and I know that research continues to develop on this, but I thought this was really important to share because it was a significant study following over almost 400 women over three years and really taking a look at how weight impacts fertility. And we’re so focused on the weight loss that we forget that there’s a bigger picture. The bigger picture is overall dietary pattern, inflammation, blood sugar balance, physical activity, nutrient status, and more.

So the focus should not just be on weight loss when we’re talking about nutrition for fertility, but rather focusing instead on a nutrient dense diet that balances blood sugar and that nourishes the woman who will be the mother. So I hope you found this episode helpful. In my next episode, I’m going to be talking with a previous client of mine, a woman who overcame her fertility struggles with PCOS, who was told that she absolutely needed IVF, and she went on to have a healthy baby naturally. So I’ll see you in the next episode. If you have questions, you want to reach out, feel free to send me a message on Instagram. My handle is at TTC dietitian. Bye.

If you want to listen to the full episode, head over to: www.wellspringnutrition.co/healing-in-fertility

Transcript:

Welcome to the Healing infertility Podcast. My name is Anabelle Clebenar, registered dietitian, Functional Nutritionist and your new fertility bestie. Today I’m going to talk about the top three functional lab tests that I utilize in my practice, as well as root causes to your fertility struggles. Okay, so first, why do I even use functional lab tests in my practice? When we’re talking about a root cause approach, we’re trying to dig into why you’re experiencing certain symptoms. So if you have irregular cycles, if you have heavy periods, if you’re not ovulating, if you have PCOS, those are all symptoms. And we want to understand why that’s happening in the first place. So, for example, we want to think about are there any nutrient deficiencies that’s causing your body to feel more stress? Are there any imbalances in your gut causing more inflammation that’s impacting your hormone health? Do you have poor metabolic health? These are some of the root causes that we look at when we’re thinking about a functional approach to fertility. So I’m going to talk about just three of the lab tests that I use in my practice, which are the GI Map, which is a comprehensive stool test, the HtMa, the hair tissue mineral analysis, and I’m also going to talk about how I utilize a continuous glucose monitor for monitoring blood sugar and metabolic health.

Now, there’s other labs that I utilize in my practice, like the Dutch hormone test, iodine testing, mycotoxin mold, testing different blood labs for nutrient levels, and assessing iron status and thyroid health. I’m not going to get into all of the different labs that I utilize with my one on one clients, but I am going to zero in on those three labs that I utilize over and over again and I think are the best places to start when we’re thinking about a root cause approach to fertility. So let’s first talk about your gut health, and specifically the GI Map test. So your microbiome is a genetic catalog of microbiota, and it’s composed of 3.3 million genes, and the microbiota are the gut organisms themselves. So these are composed of ten to 100 trillion microbial cells, bacteria, fungi, yeast, and parasites. There is a lot going on in your gut. So our gut is used for a variety of things. It’s mainly for your digestion and absorption of nutrients, but it also plays a huge portion in your immune system and inflammatory responses.

So first, when we’re thinking about digestion and absorption, the food that you eat so I hear this a lot from clients that they’re already eating cleaner, they’re already eating healthy. If you have any dysbiosis or dysfunction in the gut, literally your body is unable to digest and absorb those nutrients from the foods that you’re consuming. So this is why gut health partially one of the reasons why it’s so important. It’s also said that 80% of your immune system is in the gut, and the reason for that is because most of our lymphatic tissue is in the gut lining. So if that becomes inflamed, if your gut is inflamed from Dysbiosis, whether it’s not enough good bacteria or overgrowth of bad bacteria, if you have any parasites, anything that could disrupt your gut microbiome is going to impact your immune system because that lymph becomes inflamed and congested. And when we have inflamed and congested lymph, that impacts our immune system, that impacts how our body is able to heal, and that also will impact inflammatory cascades. So when we have those higher levels of inflammation that then impacts your hormones, that then impacts your reproductive health. As a result, leaky gut is also a big topic and something to consider.

Understanding the Link Between Gut Health, Hormones, and Metabolic Function

So in a typical healthy gut lining, we have these tight junctions. We have these cells that create a very strong barrier so that the things coming through your gut does not go into your bloodstream. When those tight junctions start to separate, it becomes more permeable and that leads to leaky gut syndrome. So things like chronic stress, industrialized gluten or wheat, various other things can impact those tight junctions so that it becomes more permeable and leads to a leaky gut syndrome. The gut also produces certain hormones related to satiety and hunger, like ghrelin and leptin. There’s other hormones that are secreted in the gut like CCK, gastrin, insulin and hormones that regulate hunger, like GLP One and peptide YY. So all of these different hormones that are either produced or regulated through the gut will also impact your metabolic health. Another function of the gut is waste elimination, which is impacted by stress, metabolic health, hydration, gallbladder function.

All of this impacts waste elimination. The third step in estrogen detox or estrogen metabolism is that it’s excreted through the gut. So if you have any constipation or anything that you’re not able to eliminate regularly and normally, that’s going to impact your estrogen levels, which obviously will impact your hormone levels and your ability to conceive. So we’re starting to understand more and more about how the gut impacts our hormone levels, our mood, all these different things. And lots of research coming out about this. When we’re thinking about mood, there’s a certain class of bacterial strains that are called psychobiotics. These actually impact the neurochemicals and neurotransmitters in our brain, like dopamine and serotonin. These are directly related to specific strains in the gut.

So our gut can impact our mood and our brain health, and similarly, our brain impacts our gut health. So this gut brain axis is a huge area as well. When we’re thinking about just overall health, mood, anxiety, stress, all of that plays a role with the gut. And if you’re curious, like, how does the gut actually impact your fertility? When the gut microbiota is imbalanced, it can trigger chronic low grade inflammation, which we talked about throughout the body. And this includes reproductive organs. So inflammation can disrupt hormone production and signaling which can lead to irregular menstrual cycles, ovulation problems, and decreased sperm quality as well. So obviously, there is a lot to talk about. We could do an entire series just on gut health.

The Significance of Gut Health in Fertility

But I wanted to introduce you into why gut health is so important when we’re thinking about functional approaches to fertility. Because as you can listen and hear, it has wide reaching effects. So in my practice, I utilize a test called the GI Map, and this will test for a bunch of different bacterial strains, parasites, worms. It tests immune health in the gut. It’s so comprehensive. And especially if you’re someone that deals with autoimmune diseases. IBS or IBD. Any digestive complaints, brain fog, skin problems like Acne or psoriasis, mood disorders like depression, anxiety, diabetes, weight loss issues and fertility struggles, then you are someone that would benefit from using a GI map to get a deeper look into your gut health and how that’s going to impact all these other symptoms that you’re experiencing.

Okay, so the next test, so to speak, or thing that I utilize in my practice to help get at deeper root causes, is a continuous glucose monitor. So a continuous glucose monitor measures your blood glucose throughout the day. It’s a really cool little device. And if you have diabetes, you probably know what this is. But it’s often used in people with diabetes, either type one or type two diabetes, to monitor their blood sugar throughout the day. More and more people are using this CGM device because blood sugar imbalances are so pervasive in our society. So it’s estimated that 80% of people will experience blood sugar in the prediabetes range for at least one meal per day. So again, even if you’re someone that eats really well and eats healthy and eats clean, it’s more common than we think.

And with diabetes being one of the bigger chronic diseases in our lifetime, it’s just important to monitor this while you’re still young and while you are eating a healthy diet, because you get that feedback and know exactly that what you’re eating is actually doing its job. It is impacting your metabolic health in a good way. A CGM can help you basically refine your diet to a much more specific degree. So I can tell you eat this amount of protein or eat this amount of carbs, but without specific data to your body, you’re just getting generalized information, which is great. But if you’re looking for deeper root causes, if you’re struggling with infertility, it’s time to really get down to the nitty gritty, right? You want to see how your body responds to certain foods. Because if you’re on a blood sugar roller coaster all day long, where your blood sugar is going way up high and then dipping back down low, you are causing more inflammation in the body. It takes a lot of energy for your body to be on that blood sugar roller coaster day after day after day. So I recently hosted a 30 day blood sugar reset program where everyone in the group received a continuous glucose monitor.

Success Stories from the 30-Day Shift Program

We provided them with custom macronutrients, we provided them with meal plans that were blood sugar friendly, and the results were absolutely incredible. So some of the results from the 30 day shift program included improved meal scores, improved daily scores, improved morning fasting glucose, improved average glucose, improved glucose variability, cycles became more regular, decreased feelings of hangriness and moodiness, increased energy levels and weight loss in that 30 day period. One woman in the group got her period naturally for the first time. So she previously had needed to take a medication prescribed by her doctor to induce a period. She was seven months postpartum. Two clients got pregnant, one person lost over 16 pounds, and that person also had their insulin decreased. So they were diabetic and their doctor was able to decrease the amount of insulin that they needed after this 30 day program of using a continuous glucose monitor paired with coaching from me and the meal plans that we had created for the program. So these were some of the findings that we were able to gather from the 30 day shift program.

And as you can see, we had absolutely incredible results. I knew that using a CGM was beneficial, but to be honest, I was really pleasantly surprised to see how quickly those changes impacted people. We also had people reporting that they had more energy, improved mood, weight loss, and this was all, by the way, by increasing their food intake. So I know for a lot of us, we think that we have to be on a 1200 calorie diet, that we need to be keto, all these really extreme things. But when I gave them their macro prescriptions, many of the women were shocked because they were undereating for so long. They didn’t know that they needed to increase the amount of calories that they were eating and increase the amount of protein and carbs and fat that they were eating to actually support their hormone health. So again, I see this time and time again where people cut out gluten, they cut out dairy, they cut out sweets. And yes, sometimes cutting those foods can be helpful for you in the short term.

But long term, if you’re undereating and not supporting your body in a way that promotes good metabolic health and good hormone health, that’s going to create more stress on your body and long term impact hormone health. Okay, so the last test that I want to talk about is the HtMa or hair tissue mineral analysis. And to be honest, this is a newer lab that I’m utilizing in my practice. But because I’ve seen such incredible results by using this test, I think that really everyone needs this in their life. So the hair tissue mineral analysis is a test that analyzes the mineral content and heavy metals in your hair so a hair can represent your tissues. And when we typically test in the blood, your blood can borrow nutrients and minerals from other places so that it remains in homeostasis. But when we use a hair tissue mineral analysis, first of all, you’re cutting your hair. So it’s non invasive.

The Importance of Minerals in Hormone Health and Fertility

You don’t have to go for a blood draw, but it also gives a snapshot of the past three months of your mineral levels. So there are certain macro minerals like sodium, potassium, calcium, and magnesium that often need a lot of support when we’re thinking about our hormone health, because these minerals think of it as like the spark plugs to hormones, to other systems in the body. So there are a number of things, obviously, that can contribute to someone having fertility struggles. And I want to talk about how that relates back to minerals. So, for example, if someone is experiencing recurrent miscarriages, which is due to often sluggish thyroid or low progesterone, research is finding now that proper nutrition has a tremendous impact on pregnant women. So lack of specific vitamins and minerals can not only cause premature births, but can also interfere with a woman’s ability to ovulate and conceive. So we need adequate amounts of and balanced minerals in both men and women. And thyroid specifically is one of the most important factors when we’re thinking about infertility.

It can impact ovulation energy production, immune function, and egg quality in women. So even when we’re thinking about testing the thyroid, how do we go even one level deeper? Why is your thyroid sluggish or not optimal? In a not optimal state, it’s often due to iodine. We need adequate amounts of iodine for thyroid hormone to work. So there are different minerals connected to different parts of the body, so to speak, that we have to look at to understand the deepest root cause of why someone might be struggling with their fertility. Another mineral that I often see depleted in women is magnesium. So we need magnesium again for proper thyroid health. But magnesium also gets depleted because of our stress response. And because so many of us are dealing with chronic stress, I often see magnesium being tanked.

And when magnesium is tanked, that actually causes more stress. It’s kind of like this vicious cycle that’s going on. And due to our food system, to our depleted soils, a lot of our food that typically would have magnesium in it doesn’t have as high magnesium content as a result of mass producing items and factory farming and all of those things, which I’m not going to get into. But just know that magnesium, we don’t get enough of it through our food due to those reasons, and because we don’t have enough, it causes more stress. That stress has an impact on metabolic health, on gut health, on immune health, and so much more. Another mineral that I like to look at specifically for fertility and also metabolic health is potassium. So we talked before about macronutrients and blood sugar balance, but the importance of potassium when it comes to blood sugar is also really important to discuss. So potassium can sensitize our cells to thyroid hormone, which means we need potassium for our cells to receive that thyroid hormone.

And if we don’t have enough, then they become less sensitive to insulin. Potassium also has insulin like effects, so it helps the blood sugar get into the cells. So if glucose can’t get into the cells, whether because you have insulin resistance or a lack of insulin, it ends up hanging out in the blood, creating higher blood sugar levels. And potassium is also involved in the conversion of glucose into glycogen, which is your stored blood sugar. So not having enough glycogen in your liver can mean that our bodies are forced to use alternative fuel sources in between meals, which will raise the risk of blood sugar dips. So we’re just zooming in on a few minerals here to start to give you a picture, an idea of why this is so important. As you can see, our gut impacts our stress, and minerals impact stress, and stress impacts blood sugar, and blood sugar impacts mineral status. All of these things are connected.

That’s because our bodies are not silos. What happens in your reproductive organs is not happening on its own by itself. We have to take a bigger picture and look at the different body systems and how they’re working together to create an environment that is safe and healthy for a baby to grow in. So I hope this podcast episode helped you get a better understanding of some of those functional lab tests that we utilize, and also some of the root causes when we’re thinking about functional fertility and how to approach your fertility from a whole body standpoint. A holistic way that looks at not just what’s going on with your hormone health and ovulation, but also your nutrient status, your gut health, your mineral status, your metabolic health, your nervous system. All of these things play a huge role on your fertility. And that is why you have to be thinking about these deeper root causes when we’re thinking about fertility struggles. So I hope you enjoyed this episode, enjoyed recording it.

I would love to hear your feedback. If you enjoyed this, please share it with a friend, tag me on social media, and I will see you in the next episode. Bye.

If you want to listen to the full episode, head over to: www.wellspringnutrition.co/healing-in-fertility

Transcript:

Hey, everyone. I’m Anabelle Clebenar, registered dietitian, functional nutritionist and your new fertility bestie. In this episode, I’m going to cover why some of the things you’ve tried in the past haven’t been working for you, what a conventional approach to fertility looks like, and why you need to start thinking about a different approach to your reproductive health. All right, let’s dive in. So if you’re like many of my clients, you’ve probably tried a whole bunch of different things on your fertility journey. I’m guessing you probably started tracking your cycles. Maybe you’ve used ovulation predictor kits. Maybe you cut out some of your favorite foods.

Maybe you cut out sugar, alcohol, gluten, dairy, grains. Maybe you’ve tried a whole bunch of different supplements because you saw an influencer talk about them. Or maybe you got an Instagram ad and you thought, hey, why not try it out? And maybe you even went to your doctor and you were met with some really terrible advice like lose some weight, or just wait another six to twelve months and then come back. So let’s break down why some of these things are not working for you, and also why this approach to fertility doesn’t make that much sense. Okay, first let’s talk about period tracking apps and ovulation predictor kits. The issue with period tracking apps is that they use an algorithm to determine when you’re ovulating. So if you’re simply entering data into an app and it’s going to tell you when you ovulate again, that’s based off of a typical 28 day cycle with ovulation happening on day 14. And if you veer away from that, which many women do, then you’re missing your timing, right? So if you’re relying solely on a period tracker algorithm, you may be missing out on the cues that your body is giving you.

So every cycle, our body has certain hormonal cues and signs that it gives you to let you know when ovulation is coming. And you can also confirm ovulation by tracking your temperatures. If you’ve gone up one step and you’re using ovulation predictor kits, this can be helpful for many women, but for others, it’s not. So, for example, if you have PCOS, ovulation predictor kits are not a good use of your money because ovulation predictor kits measure luteinizing hormone or LH. And in women with PCOS, they have higher levels of LH throughout their entire cycle. So if you have PCOS and you’re using an OPK or ovulation predictor kit, you’re likely getting a positive test. But that doesn’t necessarily mean that it’s a positive LH surge that’s associated with ovulation. And if you don’t have PCOS and you’re using ovulation predictor kits and you’re timing things accordingly and you’re still not getting pregnant, there’s likely something else going on that needs further investigation.

The Balancing Act of Elimination Diets: Navigating Health, Social Life, and Fertility

Now, if you’re like many of my clients, you’ve probably tried a bunch of different elimination diets. Maybe you tried going gluten free or dairy free, sugar free, grain free, or maybe you tried all of those all at once. You may have felt a little bit better, you may have even lost some weight. But the issue with cutting out all of these different foods is that you’re depriving yourself of enjoyment, of experiences with your friends and your family. You’re depriving yourself of entire food groups, and you may actually be putting more stress on your body than actually necessary. So, for example, dairy products have a lot of nutrients that are needed and beneficial for fertility. So things like vitamin D, vitamin A, magnesium, and calcium, these are all necessary for fertility to occur. And often these nutrients are depleted in women who are struggling with infertility.

I had one client who had to eliminate fruit because she was told that fruit has too much sugar in it and she had PCOS. And when I told her that she could actually eat fruit, the smile and the joy that came to her was so amazing, because I have seen so many women depriving themselves of healthy foods, things like fruit or oatmeal or dairy products, that it’s just not necessary. So if you’ve been doing that to yourself, I want to give you the permission right now to scale back and start to incorporate some of those foods that you love and enjoy and are actually healthy and beneficial for you. All right, now let’s shift gears and talk a little bit about what a conventional approach to fertility looks like, especially if you’ve already gone to your doctor or to your OB. And you were told to just keep trying for another six to twelve months before any lab work could be done, and you felt like it was either dismissive or just not good enough. I totally get it. Let’s talk about what this approach is and the reasoning behind it. So first, if you go to your OB and you’re over the age of 35, they’re going to tell you to keep trying for another six months.

And if you’re under the age of 35, they’re going to tell you to keep trying for another twelve months. Now, if you are trying to get pregnant ASAP, which I feel like for many people, once they decide they want a baby, they’re like, it’s go time, and you don’t want to wait that full twelve months. Wait till the end of the episode, because I’m going to share a little bit more about what you can do to be proactive during this time. So in a typical conventional fertility setting, they’ll first do an initial evaluation with a thorough medical exam, physical exam, and look at the health of both partners. They’ll ask you about ovulation, about your cycle history, any previous pregnancies or miscarriages, and hopefully they’ll also talk about lifestyle factors like smoking, alcohol, and exercise. Then a semen analysis will typically be done to assess sperm count, motility, and morphology. So this is to help determine male fertility potential, which about one third of all infertility cases are male factor, and then they’ll do an ovulation assessment. So for the female partner, ovulation is assessed through blood tests to measure hormone levels like progesterone and ultrasound monitoring.

Fertility Tracking and Treatment Options

To track follicle development, you may do an HSG, which is an X ray procedure to check for blockages or abnormalities in the fallopian tubes and uterus. There may be testing to check ovarian reserve. So this is a blood test to evaluate the quantity and quality of a woman’s remaining egg supply or ovarian reserve. They may look into some underlying causes. So any additional tests that are needed for hormonal imbalances like PCOS, endometriosis or structural issues, and then typically what is recommended is to start on ovulation induction medicine. So typically clomid or letrozole are prescribed and those are used to induce ovulation. If that doesn’t work on its own, the next step is to do an IUI or intrauterine insemination, which involves placing a specially prepared sperm directly into the uterus around the time of ovulation to increase the chances of fertilization. And then IUI is typically done anywhere between three to six times or three to six rounds.

And then if that’s unsuccessful, typically the next step is IVF or in vitro fertilization. So this involves retrieving in eggs from the woman’s ovaries, fertilizing them with sperm in a laboratory, and then transferring the resulting embryos into the uterus. It’s important to note that infertility treatments can be complex and not always successful. So the approach taken between different fertility clinics, between different couples is going to be different depending on unique circumstances and decisions made by the doctors and by you as a couple. So to recap, you would go from doing initial tests to being prescribed ovulation induction meds to trying IUI, and then if that didn’t work, to try IVF. So let’s look at some stats on IVF for a moment. One round of IVF typically costs anywhere between $10,000 to $25,000, depending on the state you live in. This is for the United States, and IVF success rates really vary from clinic to clinic.

But the most recent stats that I pulled up was that the overall success rate was between 25% to 30%. So this changes depending on the age of the woman. So if we’re looking at women under the age of 35, for the first embryo transfer, the success rate is 41.4%. And for women between the ages of 35 to 37, the first embryo transfer success rate is 31.6%. I don’t know about you, but if I was spending upward of $25,000, I would want something that had a higher success rate than 41%. In the best case scenario, that’s less than a 50 50 shot if you think about it. And I know for many couples, IVF is truly their only option. Whether you have a blocked fallopian tube, if your partner has a history of testicular cancer, or any of the other hundreds of situations that would lead a couple to doing IVF.

The Power of Functional Medicine and Addressing Root Causes

But it’s certainly not the answer for all couples, which what the current conventional medical model directs couples to. So for many people, addressing underlying factors like hormone imbalances, blood sugar imbalances, nutrient deficiencies, gut health all of that has a profound effect on their fertility. And I know this because this is the work that I do and I see it firsthand every single day. So if you’re thinking, okay, if it’s not IVF, what other way is there? Well, Functional Nutrition or Functional Medicine is the approach that I’m going to talk about because it’s what I use with my one on one clients as well as inside my group program, the Holistic Fertility Method. So, Functional Medicine is a holistic approach to healthcare that aims to identify and address the root causes of health issues rather than just treating symptoms. So it focuses on understanding the underlying imbalances and dysfunctions within a body that could be contributing to disease or a health condition. And while specific root causes can vary depending on each person, there are some common root causes that are typically addressed in functional medicine. So, the first is poor diet.

Nutrient poor diets that are high in processed foods, sugar, unhealthy fats, and artificial additives can lead to nutritional deficiencies and imbalances. And this contributes to various different health problems, including infertility. The second is chronic inflammation. So, prolonged inflammation caused by things like poor diet, stress, lack of exercise, environmental toxins, gut health this can all disrupt the body’s natural balance and lead to chronic disease and impair reproductive function. Third is gut health imbalances. So an unhealthy gut with an imbalance of beneficial and harmful bacteria can lead to digestive issues, immune system dysfunction, and systemic inflammation, which also leads to fertility struggles. Fourth is stress and adrenal dysfunction. So chronic stress can impact the adrenal glands, which leads to imbalances in stress hormones like cortisol, adrenaline, epinephrine, norepinephrine.

And these directly affect sex hormones like lowering progesterone, which is needed in adequate amounts to sustain a pregnancy. Fifth is hormonal imbalances. So think about disruptions in hormone levels like your thyroid hormone or sex hormones. Estrogen, progesterone, testosterone, insulin and others can lead to a range of health issues. So it’s estimated that one in eight women will develop thyroid problems during her lifetime. And having poor thyroid function can interfere with the release of an egg from your ovary, which is ovulation, and it impairs fertility. In many fertility cases, subclinical hypothyroid has been found to be a root cause. The 6th root cause is toxin exposure.

Unraveling Fertility Challenges: Toxins, Infections, and Immune System Factors

So exposure to environmental toxins, heavy metals and pollutants can accumulate in the body and cause harm to organs and tissues, including reproductive organs and tissues. The 7th root cause is chronic infections. So, hidden or recurring infections can trigger chronic inflammation and disrupt the immune system function, which makes the body feel unsafe for pregnancy. We have a few more to cover. So the next one is immune system dysregulation, an overactive or underactive immune system can contribute to autoimmune conditions and increase susceptibility to infections, which then leads to fertility problems. Mitochondrial Dysfunction so, mitochondria are the energy producing organelles inside of your cells. Think of it as like the battery or the powerhouse of the cell. This is what creates energy.

Dysfunction here can lead to decreased cellular energy and impact overall health, including fertility. Sleep disturbances, so, poor sleep quality inefficient sleep, not being able to fall asleep, having a wired but tired brain at night, these can all negatively impact your overall health and contribute to a range of health issues that will impact fertility as well. And then there’s also psychological and emotional factors. So mental and emotional well being can influence your physical health. So any unresolved trauma or chronic stress can actually contribute to fertility struggles. So, functional medicine practitioners use all of this comprehensive data, patient history, in depth functional lab testing, and a personalized treatment plan to help you address these root causes and promote optimal health and well being. And the focus is often on lifestyle changes like nutrition supplements, stress reduction, and other therapeutic interventions to support your body’s natural healing mechanisms, restore balance, and make your body feel safe for pregnancy. So, as you can see, a functional approach to fertility is very different from the conventional approach.

In a conventional approach, it’s basically taking some pills to try to induce ovulation, and then if that doesn’t work, IUI or IVF. And in a functional approach, we’re looking at underlying factors to help get your body into a healthy pregnancy state. And while making these changes to your diet and tracking your cycle are all important first steps to take, if you’re currently struggling to get pregnant, it’s probably time you look into some of these deeper root causes and work with a practitioner who can help guide you through this. So, that’s all for this episode. In the next episode, we’re going to dive deeper into some of these root causes, and specifically which tests you can take so that you know what is contributing to your fertility problems. If you enjoyed this episode, tag me on Instagram at TTC dietitian or send me an email. Let me know what you thought of this episode. If you found this helpful, please share it with a friend.

And thank you so much for listening. I’ll see you soon.

If you want to listen to the full episode head over to: www.wellspringnutrition.co/healing-in-fertility

Transcript:

Welcome to the Healing infertility Podcast. I’m your host, Anabelle Clebenar, registered dietitian, functional nutritionist, and your new fertility bestie. Today in our first episode, we’re going to explore the reasons why you may be struggling to conceive and take a look at some of the causes that I typically see when it comes to clients struggling to conceive naturally. Now, for some, getting ready to start a family is this really easy dragon process. But for many, many couples, the challenges of trying to conceive take a huge mental and physical and emotional toll. And today, I really want to cover some of those contributing factors that I tend to see with clients and hope that this can give you some insight and to take some proactive steps to addressing these things and hopefully improve your chances of conceiving naturally. Now, obviously, there’s many reasons why a couple may be struggling to conceive. There could be things like chronic diseases.

There could be issues with sperm quality, structural issues like a tilted uterus or blocked fallopian tube. And today, I’m going to cover some of the most common things that I see with clients when it comes to not being able to successfully conceive naturally. So the first contributing factor that I want to talk about is excess stress. This is the type A girlies, the women who thrive off intense exercises like Barry’s Boot camp or Orange Theory. Five to six times a week, these women need their morning coffee, an afternoon coffee. They tend to worry a lot about the future and possibly have anxious tendencies. These women are expert multitaskers. They have their work piled high, they strive for perfection, and they tend to put a ton of pressure on themselves.

So if you’re nodding your head yes to this, definitely continue to listen on. So being in a constant state of stress actually triggers the release of cortisol, which is a hormone that can suppress other essential reproductive hormones, specifically progesterone. So with these women, I see a lot of imbalance in cortisol, whether that means that their cortisol is sky high or it’s actually tanked low because it’s been so high for such a long time that now the body is not responding to that signal. And they have chronically low cortisol. So these stressors can come from a variety of things like over exercising, undereating mental stress, the stress of high expectations. All of these can be contributing factors to infertility. So why does this happen when we push ourselves too hard in the gym? Or if we’re not giving our bodies enough fuel that can actually throw off our balance of hormones? So this can impact your menstrual cycle? It can affect when we push ourselves too hard in the gym or not giving our bodies enough fuel. This can mess with our menstrual cycles and throw off the delicate hormone balance.

How Do Intense Workouts Impact Fertility?

So intense exercise like Orange Theory without proper rest can disrupt hormone production and our menstrual cycle. And the same thing with not consuming enough calories or essential nutrients. This can also lead to irregular ovulation, your period going Mia, having a short luteal phase, or just periods that absolutely suck because they’re so freaking painful. And all of this comes back to stress. So it’s been shown in research that chronic stress can impact everything from your digestion, your immune system, detox systems, hormones, memory. It can cause brain inflammation, and it can also impact your gut health. So stress really touches all parts of our health, which is why this is one of those main contributing factors that I tend to see come up over and over again for so many women. So addressing that chronic stress is going to be so important for not only conceiving, but also maintaining a healthy pregnancy and preventing early loss.

The second contributing factor to infertility that I see quite often is poor blood sugar management. So if you’ve ever experienced a sugar high after having too much soda or candy or cookies or anything like that, you know exactly what I’m talking about. So unstable blood sugar can cause things like insulin resistance, delayed ovulation, irregular periods, and it can even affect egg quality. So for women with unmanaged diabetes or insulin resistance, they’re particularly at risk for fertility challenges because of this reason. This is also true for women with polycystic ovarian syndrome or PCOS, because their body has a harder time digesting and breaking down carbohydrates, and that leads to more insulin resistance. This is often a root cause to a lot of fertility struggles, even in women who don’t have PCOS or insulin resistance. Because the way that we tend to eat in general, making a generalization here, but the way that we’re taught to eat isn’t necessarily the best way to improve our metabolic health. So for many women, they’re undereating protein and overeating carbohydrates or overeating fats.

And not having a proper grasp on how to eat for blood sugar management can cause a cascade of events that will make it harder for your body to conceive. This also causes inflammation, and blood sugar imbalances are so pervasive. That’s why it’s so important to make sure that you’re eating a real good balance of macronutrients and not relying on your carbs. Scratch that last part. Okay, so not only does blood sugar imbalances lead to inflammation, but it also impacts egg quality, increases your testosterone, and delays ovulation. The third contributing factor to infertility that I run into a lot with clients is excess inflammation. Inflammation is the body’s natural response to injury, infection, or any harmful stimuli. So, for example, when we get a cut or an infection, inflammation is your body’s way of sending healing agents to the affected area to fight off those invaders and initiate the repair process.

Unraveling the Impact of Chronic Inflammation

It’s like an alarm going off and then someone coming in to address the person trying to invade. What happens when we have chronic inflammation that persists for a long time? Is it can cause health issues, including those related to fertility. So we have good biomarkers to be able to tell when someone has high inflammation. So, for example, Creactive protein, or CRP, this is a marker of inflammation. However, if someone comes back with high CRP, we need to figure out where that inflammation is coming from. For some clients, this can be inflammation from a parasite in the gut. It could be from bacterial overgrowth, or it could also be from not having enough beneficial bacteria. So, especially for women who have had multiple rounds of antibiotics, I often see their gut results being really low.

And having low beneficial bacteria can also cause inflammation. So, how does this impact fertility? So, when we have inflammation that’s chronic, it disrupts our hormone balance, which, again, is crucial for ovulation and conception. Chronic inflammation can also affect the health of egg quality and sperm quality, making it harder for fertilization to occur. Inflammation in reproductive organs can lead to scarring and damage, which can also further complicate things. And when we’re thinking about a functional approach to fertility, we’re always looking for the root cause. So, why is there inflammation and where is it coming from? That way, we can address it, calm down the inflammation, and make our bodies a safe place for reproduction to occur. The last bucket of a possible the last category that I want to talk about is micronutrient deficiencies. I tend to see this a lot with my mamas, with secondary infertility, after going through pregnancy, birth, breastfeeding, there tends to be a lot of nutrient and mineral deficiencies.

But even if you aren’t dealing with secondary infertility, the way that our food system is set up, the way that our medical system is set up, there’s so many ways that this can cause nutrient and mineral deficiencies in our bodies. Whether you’re taking certain medications or coming off of birth control, all these things impact our nutrient levels. So I’m sure you know that our bodies require a wide range of vitamins and minerals to function optimally, and fertility is no exception. So, micronutrient deficiencies like folic acid, zinc, iron, vitamin D, vitamin A, magnesium these can all impact reproductive health. And these nutrients play a critical role in supporting the development of a healthy fetus and a successful pregnancy. Mineral imbalances also impact fertility. So, for example, when we’re thinking about zinc, an excess of copper in the body can interfere with zinc absorption, which leads to hormone imbalances. So we’re always trying to see what the possible root cause can be.

And for some women, it can be all four of these things together. For some, it’s just one thing. But we’re always trying to figure out what is the cause of someone struggling to conceive and how can we address it? So, as a functional dietitian, I often recommend these comprehensive tests, whether it’s a stool test or a mineral test, a micronutrient test to really tailor personalized nutrition plans to support women on their preconception journey. And the upside to all these causes of infertility is that there’s a way to address them naturally using a combination of functional lab testing, supplements and nutrition protocols. So I’m really excited to share more with you in the coming episodes. And if you found this episode to be helpful, please share it with a friend who’s also on the road to Motherhood. I’ll see you in the next episode. Bye.

As an expecting mother, despite all the excitement and the anticipation, there are indeed many things to worry about and proper nutrition during pregnancy might be one of them. Aspiring to give your baby a strong healthy start to life and to ensure their flourishing growth, you might be wondering what types of food or nutrients to actively incorporate in your diet throughout the duration of your pregnancy.  

If this is your situation, you have come to the right blog post! Wellspring Nutrition is here to clear up any confusion and steer you to the right path of healthy eating for you and your baby.     

While doing your research, you have likely come across recommendations regarding the different B vitamins, vitamin D &C , calcium, omega 3 fatty acids, iodine, iron, folate, choline and so on…  

Some of these may sound familiar while for the others not so much. This might become a bit overwhelming. 

Thus, in today’s blog post, we will specifically breakdown the importance and the purpose of choline, a potentially overlooked but critical nutrient that pregnant women are highly encouraged to consume adequate amounts of and how you can add them to your prenatal nutrition repertoire.   

What is choline?

Choline is a nutrient that plays an essential role in the physiological process of living organisms, as it supports metabolic functions, maintains the structural integrity of cells, and aids the activities of the brain and nervous system. They are present in many of the foods that we are already familiar with (more on this later in this article!), although they are also naturally produced in the human liver. Despite this, many people, including pregnant women, do not reach the recommended intake of choline set by the Institute of Medicine (IOM). As a matter of fact, the National Institute of Health (NIH) reports that 90-95 percent of pregnant women do not consume the adequate intake (AI) of choline. For pregnant women, this AI is set to be 450 milligrams per day, while for lactating women, it is 550 milligrams per day. This is because lactation further increases the bodily demand of choline due to the rich source of choline in human breast milk, making choline a crucial nutrient postpartum as well.   

Why is choline intake during pregnancy so important?

Choline assists the anatomical development of the fetus, and consuming the sufficient intake level is associated with decreasing the likelihood of certain birth defects. Several studies also link adequate choline consumption to an improved cognitive function and development for the fetus. Let’s look at these one by one.

Development

Choline plays a crucial role in the overall physical growth of the fetus, particularly for the establishment of the spinal cord as well as the proper brain and neural pathways development especially in the hippocampal region, where its core features involve attention, learning and memory. Choline also supports cellular growth, transportation of macronutrients from the mother to the baby and provides anti-inflammatory benefits during pregnancy. Because certain  neurodevelopmental processes of the baby are completed within the duration of the pregnancy, it is important to be conscious of not being deficient in such key nutrients.

Healthy Birth

Research suggests that choline deficiency during pregnancy is linked to the increased risk of Neural Tube Defects (NTD) while the risk decreases with higher choline consumption. NTD is a serious condition where the neural tube, which is responsible for the initial development of the brain and the spine, does not go through proper closure. The Center for Disease Control and Prevention (CDC) reports that a spinal cord defect and a brain defect are the two most common forms of NTD.  

Additionally, choline supplementation may help prevent premature birth. This is because docosapentaenoic acid (DHA), a type of omega 3 fatty acid, has recently been found to be associated with decreasing the likelihood of a preterm birth, and studies have shown that choline supplementation could be a effective approach to increase the availability of DHA in our body. 

Cognitive Function 

Maternal choline intake during pregnancy is also potentially associated with the improved long-term cognitive function of the child although further research is needed to support this claim for humans (Many of the previous studies are done on rats and mice…). 

There are however several human studies that indicate a strong connection between improved cognitive outcomes such as for information processing speed, memory and learning ability of the child and higher prenatal intake of choline. This may be unsurprising considering how as discussed earlier, adequate choline intake provides the foundation for the healthy neurodevelopment of the fetus.  

What food should I eat for choline? 

So, how can we achieve this 450~550 milligram-a-day goal? 

Here are some foods that are excellent sources of choline:

• chicken
• salmon
• eggs
• beef
• milk
• legumes
• quinoa
• pork
• wheat germ
• tree nuts such as almonds and pecans
• cruciferous vegetables

For more information, we suggest checking out the USDA Database for the Choline Content of Common Foods to make more informed food consumption decisions!

Should I take supplements? 

Animal food products such as whole eggs, meat and seafood contain the most concentrated amount of choline.  If you are on a vegan or a vegetarian diet and are concerned about not hitting the daily choline intake goal, the Dietary Guidelines for Americans 2020-2025 (chapter 5 covers all of the basics of nutrition during pregnancy) recommend consulting a healthcare specialist for guidance of whether or not taking choline supplements would be suitable for you. It is important to note that many prenatal supplements contain an insufficient amount of choline if any at all. Thus, it is recommended to seek out dietary supplements that consist only of choline, or a combination of choline and B-complex vitamins. These usually contain somewhere between 10 milligrams to 250 milligrams of choline per dose.   

The Dietary Guidelines for Americans 2020-2025 reports that many Americans including pregnant women are failing to meet the recommendations for the consumption of different food groups and subgroups such as vegetables, fruits, grains, and proteins. These are food groups/sub groups that contain choline and other essential nutrients that aids a healthy pregnancy.    

We will be releasing more articles to spread increased awareness of the importance of prenatal nutrition so please stay tuned and we look forward to seeing you again! 

References 

1. Caudill MA, Strupp BJ, Muscalu L, Nevins JEH, Canfield RL. “Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study.” FASEB J. 2018;Apr;32(4):2172-2180. doi: 10.1096/fj.201700692RR. Epub 2018 Jan 5. PMID: 29217669 PMCID: PMC6988845
2. “Choline.” https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/
3. “Dietary Guidelines for Americans.” 2020-2025, https://www.dietaryguidelines.gov/food-sources-calcium
4. “Facts About Neural Tube Defects.” https://www.cdc.gov/ncbddd/birthdefects/facts-about-neural-tube-defects.html#:~:text=NTDs%20occur%20when%20the%20neural,anencephaly%20(a%20brain%20defect).
5. Irvine N, England-Mason G, Field CJ, Dewey D, Aghajafari F. “Prenatal Folate and Choline Levels and Brain and Cognitive Development in Children: A Critical Narrative Review.”  Nutrients. 2022 Jan; 14(2): 364. doi: 10.3390/nu14020364 PMCID: PMC8778665 PMID: 35057545
6. Korsmo HW, Jiang X, Caudill MA. “Choline: Exploring the Growing Science on Its Benefits for Moms and Babies.” Nutrients. 2019 Aug; 11(8): 1823. doi: 10.3390/nu11081823 PMCID: PMC6722688 PMID: 31394787
7. “Science Update: High-dose DHA influences immune responses during pregnancy, may reduce risk of preterm birth.”

https://www.nichd.nih.gov/newsroom/news/012122-DHA#:~:text=longer%20being%20updated.-,Science%20Update%3A%20High%2Ddose%20DHA%20influences%20immune%20responses%20during%20pregnancy,reduce%20risk%20of%20preterm%20birth&text=Taking%20supplemental%20docosahexaenoic%20acid%20(DHA,the%20risk%20of%20preterm%20birth.

8. Zeisel SH, da Costa KA. “Choline: An Essential Nutrient for Public Health.” Nutr Rev.  2009 Nov;67(11):615-23. doi: 10.1111/j.1753-4887.2009.00246.x. PMID: 19906248 PMCID: PMC2782876