One of my favorite parts about working in functional nutrition is that I get to take a deeper dive into the root causes of health issues. Fertility is something that is so interconnected to every system in the body, that we sometimes forget that something that may seem totally unrelated, could actually be the root of everything else. That’s why I’m excited to talk about how gut health specifically impacts fertility.
he gut impacts your entire body – from modulating risk for chronic diseases like heart disease, diabetes, and cancer, to impacting your mood, anxiety and depression. There is A LOT of research happening these days around gut health, and there’s more coming out every day about how the gut microbiome impacts fertility.
So first, let’s talk about what the gut microbiome actually is. The gut microbiome is essentially all the bacteria that live inside your digestive system, specifically the large intestine. In the gut there are 100 trillion bacteria cells – more cells than our body’s own cells!
While there can certainly be bad bacteria that cause infections and disease, there’s also a whole host of beneficial bacteria that work hard to digest and absorb our food, signal neurotransmitters to our brains, fight inflammation and boost immunity.
Keeping our microbiome happy is essential for almost everything else happening in the body! The problem is, for many of us our gut balance between good bacteria and bad bacteria is way off. Whether you’re having obvious digestive symptoms (gas, bloating, constipation, diarrhea, etc.), or something else is going on in your body – you likely need to take a closer look into the health of your microbiome.
One of the most clear connections between the health of your microbiome and fertility, is through the regulation of sex hormones, namely estrogen.
Estrogen is a hormone that the body makes, uses and then needs to get rid of. It goes through three phases of detoxification to be able to remove it from the body. The last step in the process is controlled by the gut microbiome.
There’s an enzyme in your large intestine called Beta glucuronidase, and it’s responsible for unpacking estrogen and allowing to it be re-circulated and re-absorbed in the body.
When you have high levels of B-glucuronidase, it’s usually a sign that you likely have excess estrogen in your body (estrogen dominance) and may have even experienced some of these symptoms, like menstrual cycle problems, painful periods, heavy bleeding, etc.
When our bodies can’t eliminate excess estrogen through the GI tract it actually impairs fertility because it throws off the ratio between estrogen and progesterone, and ultimately causes a higher risk for miscarriage.
Remember, any dysbiosis prior to pregnancy is also going to worsen during pregnancy, so it’s a good idea to work on your gut health prior to conceiving.
According to a recent review, without a healthy microbiome, estrogen metabolism and function becomes impaired and can lead to a number of health consequences including endometriosis, PCOS, endometrial hyperplasia, and infertility.
Authors of this review concluded that treating the gut microbiome to modulate estrogen levels should be considered as a new future treatment for estrogen-mediated diseases including infertility.
The gut microbiome has been associated with higher pre-pregnancy weight as well as more weight gain during pregnancy. We know that excess weight impacts fertility, and researchers have found that those who are overweight have a different microbiome, with different types of bacterial strains than their normal weight counterparts.
There’s evidence that higher calorie diets rich in sugar and processed foods actually skew the balance of microbes. In fact, a recent study showed that the diversity of these microbes can be influenced by diet within just 24 hours!
Diets based in fruits, vegetables and plenty of fiber support the microbiome, whereas the Standard American Diet (SAD) has been shown to be detrimental to the microbiome.
As mentioned earlier, when there is an imbalance in the microbiome, it impacts immunologic and metabolic functions. A study in 2015 found that hypo- and hyper-thyroidism was associated to small intestinal bacterial overgrowth (SIBO), and another study in 2019 found an association between dysbiosis and thyroid cancer and thyroid nodules.
Since your thyroid health is so important for not only all metabolic function, but also fertility, it’s important to take this into consideration.
An under-active thyroid can impact fertility in a few different ways:
You don’t need to have inflammatory bowel disease to have inflammation in the gut, or your gut causing inflammation in other parts of the body. For example, if you have intestinal permeability (aka “leaky gut”), there could be bacterial products entering the blood stream, causing your immune system to attack them and cause chronic inflammation.
Since inflammation is linked to so many chronic diseases and infertility, this is an important link to consider.
Research has shown the poor gut health was associated with higher risk of preeclampsia, gestational diabetes, and preterm birth. The microbiome has also been looked at for infant health and studies have shown a connection between imbalances in the microbiome with increased risk of eczema, asthma, and allergies. A healthy microbiome will also contribute to your baby’s immune function, inflammation, and healthy weight throughout their life.
So by now I’m sure you’re convinced that gut health plays a major role in fertility. But how do you know if taking a daily probiotic is enough? Ask yourself:
If you answered yes to any of these questions or you just feel that it’s time to take a closer look into your gut health, then set up a free discovery call with me to see how functional nutrition can help you on your fertility journey.
And let me know in the comments below what was surprising for you about this blog post!
Then you need to learn about Choline! Choline is just as important in helping to prevent neural tube defects as the well known vitamin folate, but unfortunately, it’s not as well known or spoken about. If you’re looking for some choline rich foods for fertility, then read on!
The research that has been done over the past 20 years, outlines very clearly the benefits of choline when it comes to both overall health during pregnancy and the development of our babies brain.
Studies on animal models have shown that Choline plays a key role in enhancing brain function and also serves to protect the brain and its various elements as it develops.
Human studies on the other hand have shown that taking Choline in doses higher than what is currently recommended by various health bodies, has multiple benefits, including:
Why haven’t you heard of Choline before?
Unfortunately, the research around Choline is relatively new in scientific terms (by this I mean the research has only really been looking into this topic for the past 20 years), and it’s not a well known supplement when it comes to fertility (well outside of the dietetic community anyway!).
The evidence while not well known, is really promising and it is well worth aiming to include more sources of choline in your diet if you are trying to conceive or pregnant.
So where do you find Choline?
Choline is found in the highest amounts in animal products.
Like many other nutrients, our choline needs increase dramatically during pregnancy with some studies suggesting that our choline needs may be almost double what is currently recommended by the guidelines.
Unfortunately, many of us don’t currently get our choline needs from food alone, and in these cases a supplement may be of benefit to support a healthy pregnancy. Not all prenatal supplements contain Choline, and some also don’t contain enough to provide you with all the benefits. Some of my favorite prenatals that include adequate choline are FullWell Prenatal and Needed.
If you’re already taking a prenatal that doesn’t have choline, consider supplementing or assessing your diet to see if you meet the choline requirements for adequate fertility and pregnancy. You can find more fertility supportive supplements in my fertility dispensary here. Remember, it’s important to ensure that you work with a professional when selecting the right prenatal supplements for you!
Looking for more 1-on-1 support on your fertility journey? Apply for a free 20 minute strategy call today. I can help you regulate your cycles, ovulate, and have a healthy pregnancy using my proven functional nutrition method. I look forward to speaking with you!
References:
Like many of my clients and readers, I was given hormonal birth control with absolutely no discussion on the side effects of the pill. I was handed the pill and never really thought twice about it. I just knew it gave me a “regular” period and would help me protect against an unwanted pregnancy. It was only in my THIRTIES that I discovered how the pill depletes certain nutrients, affects mood, weight, and so much more. If you’re curious about which nutrients are depleted on hormonal birth control, then keep reading on.
Found in foods such as eggs, seafood, meat, nuts, seeds, beans and whole grains. Zinc plays an important role in both egg and sperm health.
Found in foods such as avocado, banana, seafood, green leafy vegetables, nuts and seeds. Magnesium plays an important role in sleep, bone health and our muscles ability to relax.
Found in foods such as oranges, broccoli, kiwi fruit and guava. Vitamin C is a valuable antioxidant that keeps our eggs and sperm protected from oxidative stress caused by free radicals.
Found in green leafy vegetables and fortified breads and cereals. Folate is essential when trying to conceive and helps to prevent the formation of neural tube defects in early pregnancy.
Found in foods such as Brazil nuts, meats and seafood. Selenium plays a valuable role in our thyroid function and helps to prevent sperm from mutating or becoming damaged.
Found in eggs, meats and dairy products. Vitamin B2 is a common nutrient depleted when on the pill and is often the culprit behind those pesky headaches!
Found in foods like breads and cereals. Vitamin B6 is commonly depleted in those taking the pill. It plays an important role in fertility and the luteal phase of the menstrual cycle.
Found in foods such as fish, beef, and fortified cereals. B12 is essential for healthy cell formation, a must when trying to conceive.
Ideally you would want to ensure that these levels are checked and corrected where necessary before you start thinking about conceiving to ensure a healthy baby and pregnancy. You can start a prenatal, a few months before coming off the pill to help with the transition of coming off.
Let’s face it, coming off the pill can be a scary thought and can lead to some not so nice side-effects including:
Supporting your body through nutrition can be a great way to make the transition easier.
References:
Looking for more support with your fertility? Book your free 30 minute 1:1 strategy call with me to learn how I can support you using functional nutrition, specialty lab testing, and targeted supplements. Can’t wait to speak to you!
PCOS or Polycystic ovary syndrome is a medical condition that impacts a woman’s hormone levels. Keep reading to learn everything you’ve wanted to know about PCOS.
Those with PCOS typically produce more of the male sex hormones which can lead to:
Polycystic ovarian syndrome can also cause a range of symptoms including:
There are four main types of PCOS that we commonly see.
1. Insulin resistant PCOS
This is the most common type of PCOS. We can determine that you have insulin resistant PCOS by looking at your circulating insulin levels.
2️. Pill-induced PCOS
Unfortunately, birth control can mask PCOS and may cause symptoms once we stop taking it. When we cease birth control, there is a flood of androgens which while temporary which can cause a range of symptoms associated with PCOS.
3️. Inflammatory PCOS
Chronic inflammation in our body can see our ovaries produce too much testosterone, which we know is a common issue in PCOS!
4. Adrenal PCOS
If our bodies respond to stress in an abnormal way, we can see adrenal PCOS as a result. It is not as common, only making up around 10% of all PCOS cases. This diagnosis will see high levels of DHEAS (an androgen produced in the adrenal glands) and normal levels of other androgens.
A PCOS diagnosis is typically made by your medical team if you have at least two out of these three symptoms:
Your doctor may also:
In your quest to learn everything you’ve wanted to know about your PCOS, it’s important to consider labs! There are several helpful labs that you can ask your doctor to request if you suspect you have PCOS or if you want to gain a clearer picture of how well you are currently managing your PCOS.
There are several hormones which may be contributing to your PCOS and are responsible for your symptoms including:
It’s also helpful to understand your blood sugar levels and whether insulin resistance is an issue for you. You can ask your doctor to check your:
Inflammation can be common in those with PCOS and thankfully with dietary and lifestyle changes, we can reduce this if we know it is an issue. As your doctor to check your:
Metformin (a commonly prescribed PCOS medication) can cause B12 deficiencies, so ensure that you doctor screens for this in your bloods also!
There are two main ways in which PCOS impacts upon your menstrual cycle.
Given that PCOS disrupts your ability to have a normal menstrual cycle, it can also potentially impact upon your ability to get pregnant. It is estimated that between 70-80% of women diagnosed with PCOS struggle with infertility at some point.
The changes in hormone levels can also increase your risk of complications arising during your pregnancy including:
Thankfully dietary and lifestyle changes considerably improve your chances of conception and having a healthy pregnancy and healthy baby!
The good news is that there are many aspects of your lifestyle that can be altered that can significantly improve the free androgen index (FAI), in addition to your weight and BMI.
Aim to balance your blood sugar levels and manage your insulin resistance
Consider supplements
Manage your stress
Drink enough water
Get plenty of sleep
Avoid endocrine disrupting chemicals
Endocrine disrupting chemicals are found in:
Learn more about endocrine disruptors here.
Magnesium
The research on magnesium supplementation is not concrete at present. Some studies suggest that magnesium may play a role in improving insulin resistance due to its links to glucose metabolism.
Inositol
Inositol is often combined with metformin and can help to enhance:
Berberine
Berberine is known for having several functions including:
N-Acetyl Cysteine (NAC)
NAC is an antioxidant compound which reduces the number of free radicals that can damage cells in our body.
NAC is associated with:
References:
If you’ve ever heard that the gut is like the second brain, then you probably know that our gut health impacts our overall health, especially for fertility. Research has found that the gut microbiome impacts our digestion, immunity, metabolic and neuroendocrine functions, sleep, stress and so much more.
The GI MAP is a functional lab test that does a comprehensive analysis of your gut health. It looks at parasites, bacteria, fungi, inflammation markers, digestive enzymes and much more, and does so by targeting specific DNA of the organisms it tests.
The test looks at the DNA of pathogenic organisms like bacteria and viruses, but also the beneficial organisms (ie good bacteria) and the opportunistic bacteria as well.
The test looks at the specific genomes of these organisms that reside in the intestinal ecology. It’s a “Quantitate DNA test” – or real time test – which differentiates this test from other tests on the market.
The GI-MAP will actually measure how much of each strain exists in the gut, rather than just looking at a percentage.
Many of the consumer facing microbiome tests don’t actually give you a full picture of what’s happening in the gut – they don’t count bacteria or parasites present.
In fact, I’ve taken one of those tests in the past and just felt like I didn’t have any more answers to my questions.
The GI MAP is used by clinicians and provides the most comprehensive analysis of the gut microbiome compared to any other gut health test on the market. If you’re looking for real answers – test, don’t guess.
Some conditions that could benefit from taking a GI Map stool test would be someone with:
I’ll be spending the next few weeks talking about how gut health impacts fertility, but there are a few high level concepts when it comes to the connection between fertility and gut health:
1. Hormone Balance- your gut directly plays a role in balancing the levels of estrogen in your body. If you suspect you have estrogen dominance, taking a comprehensive stool test would be a good place to start investigating.
2. Inflammation- your gut can cause some serious inflammation in the rest of your body. I love that the GI MAP can test for Zonulin, which is a marker of intestinal permeability or “leaky gut.” When toxins from the GI tract can leak into the bloodstream, this causes an immune response by the body, and triggers inflammation. When we work on fertility issues, the broad goal is to reduce overall inflammation so the body can prioritize reproductive health.
3. Insulin Resistance – A 2012 study found that dysbiosis and intestinal permeability impacted insulin levels, which then affected egg and sperm development.
The researchers also found that leaky gut and inflammation was a common cause of PCOS, and that insulin disruption was the most common cause for menstrual disruption and problems with ovulation.
The test needs to be ordered by a qualified practitioner, such as myself. Interpreting the results requires understanding of gut bacteria, functional gastrointestinal health and experience dealing with dysbiosis or microbiome imbalances.
Interested to learn more? Book a free discovery call with me here to learn how we can use functional lab testing to address fertility.
If you suspect leaky gut or experiencing some of the symptoms listed above, we can discuss some options for you and work on your nutrition and lifestyle together to improve your microbiome.
1:1 Coaching: Let’s hop on a call to discuss what working together could look like & determine if we are a good fit
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References
You may be thinking – I don’t need to work with a fertility dietitian / nutritionist, I already eat pretty healthy (weekend margs don’t count right?), I exercise, drink my green juices … and besides, I can get any nutrition information I really need through Google.
Well, my friend… I’m here to break down five benefits of working with a fertility dietitian nutritionist, specifically one that works in a functional nutrition capacity. I think some of these may surprise you!
Okay, we all have our issues with food. To say that eating is not emotional… well it’s just not what I’ve seen in my practice and in life. We all eat emotionally from time to time, even if it’s happy emotions like birthday cake, or holiday meals.
But when our relationship to food becomes restrictive or consumes our thoughts, it’s time to work with a professional who understands what you’re going through.
For many women struggling with fertility, food can be very time consuming. We’re told not to eat gluten or dairy or cut out coffee completely. We’ve heard of different fertility diets, and can easily spiral into the trap of thinking that every bite we take is going to either get us pregnant or leave us feeling miserable.
Working with a fertility dietitian that can help you set up your meals in a way that supports your fertility, but also leaves room for enjoyment is key. I mean, what is a life without pizza anyway?
Raise your hand if you’ve ever tried to take on a new hobby or something to improve yourself only to find yourself giving up a few weeks later? 👋🏼
A few years ago, I decided I wanted to take up surfing – I bought a foam board off Craigslist, rented a wet suit, and out I went into the ocean. As I splashed around the water, and even got tumbled by some waves I felt exhilarated by the cold Pacific ocean and glimmer of water in the sun.
Maybe I went out a few more times, but soon enough, I lost momentum. I didn’t have anyone to go with, no one to learn some new moves with or a partner to go with before or after work.
We all have the best of intentions when we start something new. But having accountability is key. And your dietitian is always going to keep you accountable to what you said you wanted for yourself.
When you work with a functional nutrition dietitian (hey, hello!) – you’re likely going to be introduced to some new functional lab tests. Tests like the DUTCH hormone test, GI MAP stool test, Spectracell micronutrient testing, food sensitivity testing and more.
The reason for this is because you’ve likely already had some conventional lab tests done in the past. The problem with this is that you’re still trying to get pregnant and have no answers. By the way… “unexplained infertility” is not an answer.
This is where a deeper dive into your gut, hormones, and nutrient levels is so important. For example, most people don’t realize that they’re probably deficient in vitamin D – a key vitamin (that acts as a hormone) needed for fertility.
Or maybe you’ve had heavy periods your whole life, but didn’t realize that your messed up gut health is actually impacting your estrogen levels, causing you to put on weight, and have heavy painful periods.
Working with a functional nutrition dietitian is going to be key to understanding the root cause of your issues.
One of the most common hormone disrupting conditions for women of reproductive age is PCOS. It can feel really scary when you get the diagnosis and you may think you’ll never be able to get pregnant without hormone therapy – WRONG. Just wrong.
Instead of jumping to medications and pills, you can work with a fertility dietitian who will help you manage your diet and lifestyle specifically for PCOS, so that you can have regular periods, and optimize your chances of getting pregnant naturally.
PCOS is not a death sentence, and there are plenty of women with the condition who get pregnant (and have healthy pregnancies) without assistive reproductive technology.
Well, good on you girl for being uber prepared for pregnancy.
Did you know that the best time to start taking prenatal vitamins and working on your diet is actually 6 months BEFORE you plan to start trying?
Working with a fertility dietitian is going to be huge for you, because you’re making sure you get all the nutrients you and baby need, so by the time that first trimester rolls in and all you want is bagels and crackers- you’ve already stored up the necessary nutrients to ensure baby is getting everything they need.
So tell me, which one applies to you? If you’re thinking you might benefit from working with a fertility dietitian, book your free discovery call with me today.
We’ll talk through what your goals are and how I might be able to help you on your journey towards becoming a mama.
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