Fertility

Chances are, if you’re pregnant (or thinking about becoming pregnant one day) you’ve heard about the importance of folate for healthy pregnancies. Maybe, you’ve heard that folate is just plain good for your health. If so, you’ve probably found yourself staring at bottles of supplements wondering, “is folate the same as folic acid?”

It’s true—folate is essential for a healthy pregnancy and has many hormone benefits.

But what becomes confusing is that folate is often incorrectly and interchangeably referred to as folic acid.

Even scientists and researchers have incorrectly referred to these two compounds as the same exact thing for years, when in reality, they are two distinct compounds with different functions in the body

That creates a lot of confusion when deciding which form of this crucial vitamin to consume. I mean, when the experts are getting it wrong, where is a layperson supposed to find the right information?

So, in the following article, I’m breaking down the ins and outs of folic acid and folate. Hopefully, you’ll gain a clearer understanding of the differences between the two and which one you need to be focusing on (hint: it’s folate).

Keep reading for all the details you’ll ever need to know about folate vs. folic acid.

Folate vs Folic Acid

Folate and folic acid are two distinct compounds with two key differences in function: 

• Folic acid is the synthetic form of folate, which is also called vitamin B9. The Food and Drug Administration (FDA) requires that manufacturers in the United States add folic acid to many foods, and 42 other countries around the world have similar requirements.
• Folate is not synthetic and found naturally in many foods. 

Folate is the form of vitamin B9 that you find in foods like leafy green veggies, asparagus, and broccoli. It is an essential nutrient, critical for the growth of healthy cells and DNA creation. For this reason, it’s extremely important to get plenty of folate during pregnancy, and it’s a key component of many prenatal vitamins.

The biologically active form of folate (the form your body uses) is 5-methyltetrahydrofolate (5-MTHF). Your body takes the folate you eat and converts it into 5-MTHF within the digestive tract with the help of an enzyme called methylenetetrahydrofolate reductase (MTHFR).

When it comes to folic acid, the body is unable to convert it all to the active form in the gut and relies on other organs, like the liver to create a form the body can use. This is an inefficient and slow process, which is why some people end up with elevated levels of folic acid in their blood, which as you’ll read later, can lead to a number of health issues.

This is why you’ll sometimes hear it said that people with an MTHFR genetic abnormality should be advised to eat whole food forms of folate and avoid supplements with folic acid. The idea is to provide a form of folate, like 5-MTHF, that is more readily absorbed and utilized by the body.

Is Folic Acid Safe?

A mountain of evidence suggests that folic acid supplementation protects against neural tube defects (NTD) in newborn babies. This is why so many regarded it as a mandatory ingredient to be added to processed foods. And folic acid fortification has correlated with (not necessarily caused) a lowered incidence of NTD. However, in more recent years, information has come to light suggesting that naturally occurring folate is the healthier of the two options. Some research even suggests that folic acid supplementation may be associated with increased cancer risk.

Is Too Much Folic Acid Bad For You?

While it seems the government had good intentions when mandating fortification of foods with folic acid, the problem with the strategy lies in the fact that the body can only process so much of it. It is difficult to metabolize. The natural form of B9, folate, is much more easily processed and utilized.

When too much folic acid is consumed, you can’t use it all. So the excess circulates in the body, and this can cause issues. Even small amounts of folic acid have been deemed to be excessive. In one study, unmetabolized folic acid was found in the blood of nearly all of the participants. And in another, a modest dose of 400 mcg caused excess folic acid to appear in the bloodstream. 

Some of the potential problems that can arise from excess folic acid include:

Cancer

As I mentioned earlier, there’s some association between folic acid intake and cancer risk, especially prostate and possibly colorectal cancer. Some researchers have found that increased folic acid decreases the prevalence of natural killer cells, which help to destroy tumors. This could contribute to the increase in cancer rates. 

Cognitive Impairment

Some studies suggest that folic acid may play a role in cognitive decline. In one study of seniors, high levels of folic acid in the bloodstream corresponded with both anemia and cognitive impairment, especially in those with low levels of vitamin B12.

Mood

Too much folic acid can have an excitatory effect on those who consume it. In one study of healthy volunteers, they had to abandon the research after just 1 month. The participants had increased gastrointestinal issues, issues sleeping, and mental changes. 

B12 Deficiency

Vitamin B9 and vitamin B12 are intimately related. They both work together to make red blood cells and they team up with vitamin B6 to control homocysteine levels in the blood. Homocysteine, an indicator of inflammation, is an amino acid that can be associated with an increased risk of heart disease. 

When individuals are deficient in B12, and they supplement with folic acid, problems crop up. Folic acid seems to mask B12 deficiency, which is of special concern to elderly adults. B12 deficiency is associated with a greater risk of Alzheimer’s disease, cognitive decline, and even paralysis.

What Are The Health Benefits Of Folate?

In contrast to the synthetic folic acid, folate has many wide-ranging health benefits. Because it’s such an essential nutrient, it’s critical to consume adequate levels throughout all stages of life. The most notable benefits of folate include:

• Healthy fetal development during pregnancy
• Potentially protective against cardiovascular disease
• May reduce the risk of cancer
• Could help protect against Altzheimer’s disease
• Possibly Effective as Part of a Depression Treatment Plan

Supplementing with folate is most crucial during pregnancy — sufficient levels help to reduce the risk of birth defects, and help to ensure healthy growth and development of the baby. 

Importance of Folate For Pregnant Women

Adequate ingestion of folate is of primary importance for pregnant women. Especially very early in pregnancy. It’s been associated with decreased risk of NTD, congenital heart defects, and oral clefts, i.e. cleft palate. Some research has also suggested that pregnancy outcomes may be affected by folate intake, likely due to the role folate plays in the very early stages of the development of the placenta. 

Also, because folate is used so liberally by the developing baby, it’s important for the mother to increase folate consumption, ideally even before she is pregnant. 

For this reason, many doctors suggest taking a high-quality prenatal vitamin when you first start thinking about conceiving. As I explain in my book, Beyond the Pill, I’d love for my patients to start preparing their bodies for pregnancy well before they’re ready to conceive. Aim for a minimum of six months’ preparation to ensure the best outcomes for mother and baby. Beyond just folate supplementation, it’s also critical to get your microbiome in top form (since it becomes your baby’s foundation for his or her immune system). 

If you’re considering pregnancy, even in the distant future, I’d recommend checking out my book, Beyond the Pill for a complete fertility protocol. This is especially important if you’ve been on the birth control pill which can deplete crucial nutrients that you’ll want to build back up.

Potentially Protective Against Cardiovascular Disease

Folate has been shown to be protective against heart disease. And in a review of the data, researchers found a 10% lowered risk of stroke in individuals who supplemented with folate. While we’ve known for a while that a diet high in vegetable and fruit consumption is good for heart health, it’s possible that the high levels of folate in these foods is what’s so great for the heart. While researchers used to credit antioxidants with this protective effect, folate reduces homocysteine levels in the blood, and in turn, this could be why those veggies are so dang good for you! I recommend eating 6-9 cups daily if you possibly can.  

May Reduce The Risk of Cancer

Since folic acid may increase the risk of cancer, it comes as a bit of a surprise that folate does the opposite for us. The relationship between cancer and folate consumption has been well documented. Risk of breast, ovarian, cervical, bladder, stomach, esophageal, colorectal, pancreatic, and lung cancers have all shown an inverse relationship with levels of folate intake. Or in other words, folate consumption is associated with a lower risk. Again, it’s another great reason to eat folate-rich vegetables and fruits. 

Could Help Protect Against Alzheimer’s Disease

As with heart disease, cognitive degeneration, dementia, and Alzheimer’s disease have all been linked to elevated levels of homocysteine. Lower blood levels of folate have been associated with higher levels of homocysteine, and increased incidence of Alzheimer’s and mild cognitive impairment. While further research is needed, especially exploring the role of folate rather than folic acid is needed, it offers hope that maintaining healthy levels of B vitamins can help ward off cognitive decline.

Folate as Part of a Depression Treatment Plan

Reviews of the literature show that folate levels in those with depression are lower than in individuals without depression. In addition, folate supplementation has been shown to increase the efficacy of depression medication. In general, it is well-tolerated and few side effects have been reported by study participants, making it a prime candidate for further research in treating depression.

What Are The Symptoms Of Folate Deficiency?

Sometimes, people are unable to absorb adequate folate, even if they’re consuming enough. This is particularly true for people with digestive disorders like Crohn’s, ulcerative colitis, or celiac disease.

Other people struggle to process B vitamins efficiently due to a common genetic mutation that’s referred to as Methylenetetrahydrofolate reductase (MTHFR) gene variant. 

When this happens, low levels of folate can produce some serious side effects, including:

• Irritability
• Fatigue
• Anemia

For these people, supplementation with a highly bioavailable B Complex can restore their levels of folate to optimal.

Do You Need Folate Even If You’re Not Pregnant?

While pregnancy is the most crucial time to focus on folate, it’s certainly not the only time.

As I explained earlier, if you’re even thinking about conceiving, folate intake should be at top of mind.

But because of the many other health benefits we’ve explored, it really is a good idea to make sure you’re getting adequate amounts of folate either from diet or from proper supplementation. 

How Much B9 Do You Need?

The recommended daily allowance (RDA) for folate is 400 micrograms (mcg). For pregnant women, the recommendation rises to 800 mcg. 

Again, this is a recommendation for folate, not folic acid.

Ideally, you can get a ton of folate from whole food sources. Luckily, some of the tastiest foods on the planet contain healthy amounts of the good stuff.

What Are The Best Whole Food Sources of B9?

Some of my favorite ways to get in enough folate every day are:

• Nuts and Seeds 
• Legumes
• Liver
• Leafy greens (spinach, R=romaine, butter lettuce, greens)
• Broccoli
• Cauliflower
• Brussels sprouts
• Asparagus
• Bananas
• Papaya
• Mango
• Avocados
• Liver
• Citrus
• Eggs
• Beets
• Edamame
• Corn

Try incorporating more folate as part of seed cycling!

What Are The Best Prenatal Vitamins?

I have an entire, detailed article devoted to the best prenatal vitamins. In a nutshell, yes, you need to make sure you’re getting enough folate if you’re pregnant or trying to conceive. 

But you also need to make sure you’re getting plenty of the following other nutrients:

• B12
• B6
• Calcium
• Vitamin A
• Vitamin C
• Vitamin E
• Copper
• Zinc
• Magnesium
• Selenium
• Iodine
• Iron
• Choline

Keep in mind, your body can only absorb so much of most of these nutrients at one time, so you need to make sure you’re taking multiple doses throughout the day, rather than taking large doses all at once.

And, if you want to be sure you’re getting all of these nutrients in optimal doses, I’d encourage you to check out my Prenatal Plus which combines everything you need in one place. It’s a collection of the absolute highest quality nutrients to make sure you and baby get everything you should.  

Your Diet Really Does Matter

I’m hoping that this article will help you understand the crucial role diet and folate supplementation play in health. 

And I know it can be confusing to start from scratch to change your diet and focus on getting all the nutrients you need.

Which is exactly where my starter kit comes in. 

I’ve developed a free resource that includes a ton of amazing content and helpful resources for balancing hormones.

And it also includes a fantastic 7-day meal plan that takes the guesswork out of healthy eating and practically does it for you. You do have to buy the food. But it’s a great guideline that can help you build incredibly healthy and delicious meals that will keep you satisfied, full, and super healthy…since it’s designed to keep blood sugar stable, hormones happy, and includes all those critical nutrients we’ve been discussing. It shows you exactly what foods to eat and when, along with offers tips for making those vegetables delicious. 

It’s completely free and you can download it here. 

After you do, be sure to let me know how it’s working for you in the comments below. 

Does fertility awareness method work? This is a very common question in my practice and today I want to share with you a quick review of the different methods and what we know about the effectiveness of each. Plus I’m going to share with you what I recommend to my patients!

But you may be thinking…Who would want to learn an Fertility Awareness Method? 

Some women use this method to gain a better understanding of their hormones and how their menstrual cycle works, while others use it as a means of optimizing fertility or as an alternative for preventing an unwanted pregnancy.

It is common for women to experience side effects with birth control pills and other hormonal methods of birth control, some of which make it completely impossible to use these hormones and have any resemblance of a normal life. For these women, a non-hormonal option is the only option.

And with the recent termination of the male birth control trial, many women are questioning if they should continue on with hormonal contraception, after all, the side effects the men experienced were milder than that of women, but still warranted the study to be stopped.

There’s many reasons women choose to learn the Fertility Awareness Method and today, I want to examine how well this method really works.

Before we dive in I want to say this — many people, including doctors, are quick to dismiss this method, claiming that women are too lazy or too easily confused by their own bodies to successfully use this method.

I disagree.

My experience is that women are motivated to understand their body and prevent pregnancy. And I would argue that the only person who truly understands your body is you. Instead of dismissing women, doctors should be teaching them how their body works and the signs and symptoms of healthy hormones.

So, with that said, let’s dive in.

What is Fertility Awareness Method?

Fertility awareness method (FAM), also known as natural family planning, is a non-hormonal and non-invasive approach to birth control. It is designed to teach you how to predict the signs of ovulation based on the signals your body is providing you. While it is sometimes referred to as the Rhythm Method, these are not the same thing. In this article, I’m going to describe for you what FAM is and provide you the low down on what the research says about how effective it is.

It is based on the following concepts:

• You ovulate one egg only in each menstrual cycle.
• The eggs lives for no more than 24 hours.
• Sperm can live five to even six days in the uterus.

A woman ovulates only one day, but sperm can live for many, which means that you are potentially fertile seven to eight days out of your cycle. Yes, you are technically fertile up to six days before you ovulate because of those sperm that are swimming so diligently to reach that egg can live up to six days.

If you can NOT and do NOT want to become pregnant, you will either need to use another means of contraception or abstain from sex during your ovulatory window. Most people wanting to ensure there is no chance of pregnancy elect to use a condom or other form of contraception during this time.

But even if you don’t think this is NOT the method for you — I ask that you consider at least using it as a means of getting to know your body.

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If you’re using some form of protection other than the pill, I recommend using FAM to tune into your internal rhythms and gain greater insight into your body. After all, it is when you know how things should work that you can identify where the shifts need to happen to create harmony in your body and your life.

But to the question I am sure you’re dying to know the answer to…

Does Fertility Awareness Method Work?

It’s an excellent question and one I immediately asked myself. I want to share four common methods to help answer this question.

The Standard Days Method

Using the Standard Days Method, one clinical trial showed that out of 500 women over the course of 13 cycles, the pregnancy rate was <5 per 100 women in a year with correct use. Typical use saw pregnancy rates of 12 per 100 women.

The Standard Days Method is the easiest to use and requires the fewest days of abstinence or barrier contraception. Using this method, women avoid unprotected sex day 8 of their cycle through day 19.

PCOS, breastfeeding women whose period has not returned, recently postpartum women, and perimenopausal women are not advised to use this method as pregnancy risk is higher due to the irregular nature of their cycles. In fact, none of the FAM methods are recommended for women in these stages.

It is advised that cycles be between 26 to 32 days to successfully use this method.

Cervical Mucus or Ovulation Method

The World Health Organization conducted a large study in the early 1980’s, which included 725 women from 5 countries. They found that with correct use, 3 out of 100 women became pregnant. But with typical use, failure rate was 23 per 100 women.

The large failure rate reflects the necessity of thorough counseling by health care providers to ensure women understand how to correctly use this method. Three pregnancies per 100 women annually is a low failure rate, but when compared to the typical use we can see how important it is to use this method correctly.

The cervical mucus method requires women to evaluate cervical secretions several times daily to determine their fertile days. This method requires more time to teach than any other method, which may be the contributing factor to the high failure rate among typical users.

This method also requires that you abstain or use a barrier method during sex about 14 to 17 days out of the month.

TwoDay Method

Pregnancy rates using this method correctly have been shown to be 3.5 per 100 women per year. Typical use pregnancy rates were <14 per 100 women. It is thought that the simplicity of this method contributes to a lower typical use pregnancy rate as compared to the Cervical Mucus Method alone.

In one study, 4,000 cycles were analyzed in women using the TwoDay Method and found that the average number of fertile days was 13. This means that women need to avoid unprotected intercourse 13 days out of the month while using this method

In the TwoDay Method, users avoid unprotected sex on all the days that cervical secretions are present. There is no guessing if it is fertile cervical mucus — all secretions are considered a sign of fertility.

Symptothermal Method

When used correctly, the symptothermal method has been shown to have a first year pregnancy rate of 1.8 per 100 women when used correctly. And interestingly, the same study showed that after 13 cycles the pregnancy rate was only 0.6 per 100 women when there was no unprotected sex in the fertile window. With typical use, the pregnancy rate is between 13 and 20 per 100 women.

The symptothermal method is based on changes in cervical secretions and basal body temperature produced by hormonal changes during the menstrual cycle. In this method, intercourse is avoided or a barrier method is used:

• All days with cervical secretions
• Four days after the last day of cervical secretions
• Six days following a 3 day spike in temperature

While this method may sound a bit cumbersome, it actually provides incredible insight into your health, especially your hormonal health. Gone are the days of paper calendars and pencils (I was never very good at those anyways), new fertility devices make tracking your fertility even easier.

Do Fertility Apps Work?

A word of caution… In one study, 95 apps that claimed to be for fertility were examined, with over half (55) of the apps being excluded because they either didn’t have any evidence-based methods as part of their technology or they included a disclaimer that they were not intended to avoid pregnancy. Yes, read the disclaimers ladies!

Of the 40 apps they had left, only four accurately used the Symptothermal Method. Yes, you read that correctly — ONLY 4 were accurate. The four they that were noted were Sympto, LilyPro, Lady Cycle and nfNFP.net.

Only one was found to use the Standard Days Method (CycleBeads).

But perhaps the most important conclusion of this study was this — “Relying solely on an app to use an FABM, without appropriate training in the method, may not be sufficient to prevent pregnancy.”

Or in other words…you need to be taught the FAM in conjunction with the app, rather than expecting the app to be solely responsible for predicting your fertile window.

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Does this mean you shouldn’t leverage the lady focused technology?

In my practice, I recommend women use technology in addition to their own knowledge about their body’s rhythms. I often recommend the Daysy fertility monitor to women who are wanting to not only master the art of fertility prediction, but are also wanting to monitor their body and gain greater insights into their health.

Yes, you can use these gadgets to biohack your hormones!

What’s the Daysy Fertility Monitor and How Does it Work?

Daysy is a mini computer that contains the data from literally millions of cycles. There’s a bit of “getting to know you” time when you begin using Daysy — initially Daysy will need to learn your cycle, but in doing so, it will compare your cycle to the data it has collected from other users to begin to predict ovulation.

Once there is enough “you” data, Daysy will begin comparing your new cycle information to your previous cycles and get even more honed in on when you might be fertile. Dasys gives you a fertile window that includes the earliest day you could possibly become pregnant.

Daysy is color coded, making it really easy to decipher where you are in your cycle. Every morning (the moment your eyes pop open) you will take your temperature using Daysy and she’ll give you a clear signal via a colored light to tell you what to expect that day.

Green – Infertile days (think green light = go)

Yellow – Caution Days

Red – Fertile

Purple – Menstruation

The shift in your hormones causes shifts in your Basal Body Temperature. Daysy uses a complex algorithm to determine when your temperature spikes, which accompanies ovulation. And just like it takes 3-4 cycles to get enough data to predict your ovulation with any other FAM, Daysy also takes several months in getting to know you.

How Effective is Daysy?

To explain, let me begin to telling you about the Pearl Index. The Pearl Index is used to report how effective each form of birth control is. The lower the number, the more effective the method is and the lower the risk of pregnancy.

For example, IUDs have a Pearl Index of about 0.1 to 2.2 and birth control pills are at about 0.1 to 0.9.

As an aside, there’s been evidence that the Pearl Index may actually be higher for birth control pills than previously thought. In one review, birth control pills were found to have a Pearl Index of 4, which is thought to be more representative of actual users in the market, opposed to those who are knowingly participating in a study. Because of this, there is an expectation that failure rates for the pill will be higher than what studies report.  

Ok, back to Daysy!

Where does Daysy fall on the Pearl Index? They report a Pearl Index of 0.7.

That means for every 100 women using this method in a year, you can expect 0.7 of them to become pregnant.

Or in other words…It is 99.3% effective.

I’m liking those odds!

If you’re interested in learning more about Daysy you can check them out here.

What to Do Next if You’re Considering FAM?

Meet with a FAM Provider

This might be a doctor, a nurse, a provider at Planned Parenthood, or one of the amazing FAM educators out there. But you want to find someone who will take the time to teach you the method in detail. Remember, FAM works when women use it correctly, so let this empower you to take charge of your fertility.

Speaking of taking charge of your fertility….

Read Taking Charge of Your Fertility

This book is hands down one of the best resources out there for learning about your menstrual cycle and navigating your fertility. You can grab a copy on Amazon here.

Weigh Your Options

You’ll hear many experts say that Fertility Awareness Method is not very forgiving when it comes to user error. It’s true, the side effect of FAM is pregnancy, which can be a really big deal if you aren’t expecting it…or interested in having a baby.

But when you look at the research, you’ll find that no contraceptive is 100% effective at preventing pregnancy and that they all come with their fair share of side effects, which also include pregnancy.

At the end of the day, it is you who will need to decide which side effects you’re ok with and which method you think will suit your life best.

Weigh your options and make the decision that feels best for you. And if you decide that FAM is not your preferred method — no worries. But I do hope you will at least use it to learn more about your body.

The data your menstrual cycle, including the fertile window, provides provides a great deal of insight into your hormones and your overall health. After all, you’re period is considered the 5th vital sign!

Improving egg quality for fertility consists of increasing nutrients, reducing or eliminating environmental toxins, and addressing daily stressors. These are important steps in any preconception plan. In this article I’ll be sharing how to improve egg quality naturally, including steps you can take right now.

When couples are wishing to conceive there are many areas that I feel are important to address to ensure they are doing everything possible to have a healthy pregnancy and baby. It’s important for both partners to decrease environmental chemical exposure, reduce inflammation, and tackle any chronic health or hormonal problems before pregnancy.  

In this article we’ll be covering improving egg quality for female fertility. If you’re interested in exploring ways to improve male fertility please read this article.

As a nutritional biochemist with concurrent training in clinical nutrition, diet is always foundational in my treatment approach.

Nutrition can have a huge impact on fertility, successful uncomplicated full-term pregnancies, and healthy happy babies.  Whether you’re trying to conceive naturally or undergoing IUI or IVF, what you eat sets the stage for not only your health, but babies health in utero and beyond.

The ideal time to begin preconception care is a minimum of 6 months in advance with 2 years being the ideal. I know that can be a bit of a shocker, but when you understand that the egg you will become pregnant with took 3 months to mature then you can see why we’d want a minimum of at least 6 months.

How to Improve Egg Quality:

1. Eat foods that support healthy hormone balance
2. Increase dietary antioxidants
3. Reduce environmental toxins
4. Improve stress reduction practices
5. Consider supplements to support diet and lifestyle practices

Foods to Balance Hormones

Why would you want to balance hormones before becoming pregnant? Well, a symptom of hormone imbalance is a sign of an underlying issue. Low progesterone, high testosterone, low thyroid hormone, and insulin resistance are a few examples of imbalances that can make it more difficult to get pregnant and impact ovulation.

To Balance Hormones & Improve Fertility Eat:

• Healthy hormone building fats
• Nutrient dense vegetables
• Antioxidant loaded fruits
• Microbiome loving ferments
• Blood sugar balancing proteins

Use my free hormone balancing meal plan & recipe guide to help you get started by downloading it here.

Best Foods to Improve Egg Quality

Many women are often surprised to hear that some of the most ideal foods for women wishing to conceive are eggs, grass fed butter, wild caught cold water fish, beef heart and liver. Fats are how you build your hormones and without them, your body will have a difficult time create the hormones you need.

The importance of healthy fats cannot be understated!

For one thing, we need fats, especially cholesterol to make hormones. Your fertility and pregnancy require a particular balance of hormones and fats help supply the body with building blocks for hormones.

Quality of fats is important. You can read more about which fats are best here.

Healthy fats impact fertilization.

A newly fertilized egg traveling down the fallopian tube begins to scan its environment for the nutrients available. It does this to determine how safe it would be to implant in the uterus and if the there is adequate nutrition to grow in that environment. If these healthy fats and nutrients aren’t present it could lead to altered implantation and growth of the embryo.

Foods I Tell My Patients to Eat to Boost Fertility

• Organic eggs
• Leafy green vegetables
• Nuts and seeds
• Organic, grass-fed meats
• Sauerkraut, kim chi, and other fermented foods
• Wild caught, cold water fish
• Organic organ meats
• Organic berries
• Avocados
• Macadamia oil, cold pressed olive oil, coconut oil and other health fats

Organ Meats Are Some of the Most Nutrient Dense Foods on the Planet

Liver is one of the most nutrient dense foods! It is a concentrated source of vitamin A, abundant in B vitamins including B12 and folate, and an excellent source of iron and trace minerals. All of these are incredibly important nutrients for egg health and needed for baby’s development.

Beef heart is one of the best sources of CoQ10. CoQ10 is an antioxidant that supports egg health and is protective against free radical damage.

I know that eating organ meats might not sound appealing, but there are ways to sneak them in! For example, eating liver as a pate’ or as part of a stir fry with other proteins can help you get it in. It only takes a few ounces to get the benefit.

When it comes to beef heart, I tell my patients to ask the butcher to grind 25% grass-fed beef heart with 75% grass-fed ground beef so that they can be made into burgers or meatballs.

Improve Egg Quality Support the Mitochondria

When I am working with a woman on improving egg quality my treatments are heavily focused on supporting the mitochondria.

Why support the mitochondria?

Mitochondria are the only source of energy for the egg and mitochondrial function goes down with age. As women age, their mitochondrial function diminishes and can greatly affect egg quality.

One of the main roles of mitochondria is the production of ATP, which is the main source of energy for all of our cells. It also controls intracellular pH, which improves fertilization of the egg.

And it is responsible for spindle formation.  I won’t go into too much biology, but briefly, spindles are responsible for helping equally divide chromosomes in a parent cell.  This is hugely important, as it is the main reason doctors are so worried about Down’s syndrome and other chromosomal disorders that can occur in the offspring of women over 35.  

If chromosomes don’t separate correctly, these genetic disorders could be the result.  Older women have less mitochondria per egg so it is more difficult to do all the tasks required of it, including proper chromosomal separation.

Some of the most important nutrients for mitochondrial health are…

• B vitamins
• Fish oil and other health fats
• L-Carnitine
• CoQ10 (there’s that beef heart again)
• N-Acetyl Cysteine (NAC)
• Magnesium
• Alpha Lipoic Acid

The Role of Antioxidants

CoQ10

CoQ10 is one of the most effective nutrients in preconception because of its ability to protect the mitochondria from oxidative stress.

The best form to take is ubiquinol and the recommended dosage is 300 mg daily.  Higher doses should be taken with other forms of CoQ10.

Glutathione

Glutathione is another antioxidant that provides protection to the mitochondria and therefore, protects egg health.  It is also a cofactor for many antioxidant and detoxification systems throughout the body, which helps you eliminate toxins and give baby the best environment.

Glutathione can be synthesized from NAC (more coming soon) and also requires selenium, which is why you’ll find 200 mcg of selenium in my Prenatal Plus.

N-Acetyl Cysteine

Taking its precursor N-Acetyl cysteine or NAC, as well as eating sulfur rich foods can boost glutathione as well.  As a side, NAC can also improve insulin resistance and balance hormones.

In my clinic we use 900-1800 mg of NAC starting 6 months or more prior to conception. It is important to note that NAC will give you the most wicked heartburn if you take it on an empty stomach. This a must take with food kind of supplement to avoid that.

Preconception care, including diet, lifestyle and supplement changes should be started at minimum 6 months before trying to conceive, but again 1-2 years is much more ideal.

Reduce Toxin Exposure

In addition to taking supplements that improve mitochondrial function women and men should do their best to reduce exposure to mitochondrial toxins.

Top Mitochondrial Toxins

• Tobacco
• Alcohol
• Stress hormones like cortisol
• Pain relief and anti-inflammatories drugs
• Certain prescriptions such as metformin
• Cholesterol lowering medications
• Anti-anxiety medication
• Antibiotics

Improve Egg Quality in 90 Days

Your egg takes 90 days to mature, which means it will take at least 90 days of a focused preconceptional protocol in order for you to make significant changes in your egg quality.

I create a custom lifestyle, nutrition and supplementation plan for each of my patients based on their body’s needs. But universally, women need more antioxidant support, specific B vitamins, and many of my patients require digestive and detoxification support prior to pregnancy.

As part of this protocol we ensure every woman is taking a quality prenatal vitamin. You can read what to look for in a prenatal vitamin here.

Steps You Can Take Today

Here are 3 steps I have every patient take to improve their fertility and egg quality:

• Prenatal Plus 3 caps twice daily
• Whole foods diet with an emphasis on loading veggies, healthy fats, and protein (you can grab the meal plan + recipes as part of the Hormone Balancing Starter Kit)
• 5 minutes of daily meditation + nightly journaling

To help you start eating an antioxidant rich diet, definitely grab my free recipe guide and try this bonus recipe to boost your nutrients!

Antioxidant Smoothie

• 1 large handful dark leafy greens (spinach, kale, chard, spring mix)
• 1 cup berries of choice
• 2 TBSP pumpkin seeds
• ½ an avocado
• 1 lime, skin cut off
• 1 cup or more of almond, coconut, hemp, rice or other milk
• Optional: handful of ice cubes

Blend until creamy and enjoy

Using food based medicine, along with targeted nutritional supplementation and lifestyle medicine, I’ve helped many couples succeed in becoming pregnant and creating an amazing pregnancy experience.

Wishing you the best in on your fertility journey!

Dr. Jolene Brighten

Citations

Physiological and molecular determinants of embryo implantation – Molecular Aspects of Medicine

Adaptive responses of the embryo to maternal diet and consequences for post-implantation development – Reproduction, Fertility, and Development

Mitochondrial DNA turnover occurs during preimplantation development and can be modulated by environmental factors – Reproductive biomedicine online

The Role of Mitochondria from Mature Oocyte to Viable Blastocyst – Obstetrics and Gynecology International

Mitochondrial functions on oocytes and preimplantation embryos – Journal of Zhejiang University Science

Coenzyme Q10 Supplementation and Oocyte Aneuploidy in Women Undergoing IVF–ICSI Treatment – Clinical Medicine Insights: Reproductive Health

Mitochondrial Toxicity – MitoAction

Metformin-Induced Mitochondrial Complex I Inhibition: Facts, Uncertainties, and Consequences – Frontiers in endocrinology

Are you one of the millions of women who is struggling with chronic pain? Well, it may just surprise you to hear that your pain may be keeping you from getting pregnant. 

Headaches, gut pain, menstrual cramps, joint pain, backaches and old injuries have many women reaching of a bottles of Ibuprofen, Naproxen, Midol, and NSAIDs to get symptom relief.

And who can blame them?

Chronic pain keeps us from enjoying our life. It impacts our sleep, our work, our exercise, our mood, and our relationships. It’s absolutely miserable.

So what’s wrong with reaching for a bottle of pain meds?

Pharmaceuticals do have a time and place when it comes to symptom relief. If you break your leg, pain medication will help make you comfortable while your body heals.

But the way most pain relievers are used these days lends itself to some bigger issues. Taken regularly, these meds can cause an array of symptoms and conditions, including stomach ulcers, gastritis, Leaky Gut Syndrome and can even mess with your fertility!

Yes, you read that correctly — NSAIDs can suppress ovulation.

In a case report published in 2000, it was observed that women using NSAIDs for joint pain were also infertile.  

“During the last 2 years, four out of five women with severe arthritis and difficulty conceiving were counseled to stop NSAIDs, and they successfully conceived shortly after the withdrawal of NSAIDs.”

In one small 2015 study they found that after 10 days of use, 75% of women did not ovulate. The good news was that lack of ovulation was found to be reversible after discontinuing NSAIDs (which isn’t as easily said for your gut, as mentioned above).

Let’s talk about those 10 days for a moment.

When mapping the menstrual cycle we refer to day 1 as the first day of menses. General, if a woman is going to experience menstrual cramps, it will be a day or two before her period and maybe the first 1-3 days of her period. If this is the case, she may begin taking NSAIDs on day 27 of her cycle (let’s assume a 28 day cycle for simplicity sake) and continue them until day 3 of her period.

That’s 5 days! And happens to be the magic number for damage to the gut.

But what if she has headaches with her period? What if she takes them prophylactically (preventatively) before her period comes on her doctor’s suggestion? What if she has trouble sleeping before her period and figures this might be a 2-for-1 with regards pain and sleep?

It’s easy to see how this could become a 10 day ritual.

But what follows menstruation? Ovulation!

Which means many, many women are seeking relief and unknowingly compromising their fertility — which also wreaks havoc on your hormones!

[bctt tweet=”Common pain medications cause reversible infertility. Find the root cause & kick the meds if you’re struggling to get pregnant.”]

They can make headaches worse!

When NSAIDs are taken regularly for headache relief, women can experience headaches that are more frequent and more painful.

For other women, discontinuing the meds can cause a severe headache to arise, something called rebound headaches. This can happen just by taking them more than a couple days per week!

This can throw women into a vicious cycle where the NSAIDs make the headaches worse, cause escalation of pain when discontinued and often result in women taking way more than they actually need.

Pain meds can kill…and they do

According to the CDC data, between 1999 and 2014 there was a 400 percent increase in the number of women who overdosed on narcotics. Some of this is due to the combination of painkillers with anti-anxiety meds — which are 2 of the most common drugs prescribed to women.

They overdosed on drugs that are nothing more than a bandaid approach and never intended for long term use.

As a physician, I believe that pain takes a considerable toll on the lives of many women and symptom relief is important. But it can NOT be where we stop!

We must provide symptom relief while also addressing the root cause.

[alert type=”warning”]Download your Hormone Starter Kit – learn how to identify your hormone imbalance and bring your hormones back into harmony.[/alert]

Common root causes of pain.

Pain generally stems from inflammation. So naturally, this is where I begin to look when a patient comes to me complaining of pain.

Listening to your story and correlating your journey with your labs (the data), helps me understand where the imbalance in the system may be.

Common root causes of pain that typically see in my clinic include:

• Autoimmune disease
• Hormone Imbalance (estrogen dominance, luteal phase defects, etc)
• Hypothyroidism
• Adrenal dysfunction (aka adrenal fatigue)
• Endometriosis
• Depression
• Gluten sensitivity and other food intolerances
• Leaky Gut Syndrome
• Vitamin deficiency (eg vitamin D)
• Chronic infections (EBV, Lyme Disease, etc)
• Past injuries, poor ergonomics or poor posture
• Chronic stress
• Sleep disturbances or too little sleep

The first steps to healing…

Treat the Root Cause!

When a woman comes to my office with concern of chronic pain we begin to dig to into her history and order the appropriate labs, which may include things like a thyroid panel, sex hormone levels, inflammatory markers (like CRP), salivary cortisol, and gut tests.

We search for the root while also addressing the symptoms of pain.

Heal the Gut

If you’ve been taking NSAIDs or other pain medications for 5 days or more in a row — your gut has definitely suffered, which means you are going to need to heal it.

I often recommend my patients focus on gut healing for a minimum of 30 days, but depending on the frequency of use and if we are working to taper the pain medication we may need to work on gut repair for as long as 12 weeks.

Healing the gut is an absolutely necessary step to be free of painkillers! 

As part of the healing protocol we utilize an elimination diet (including support with a nutritionist, meals plans and recipes) and leverage supplements and herbs like L-glutamine, zinc, marshmallow, and slippery elm to speed the healing process.

Discontinue or Taper the Meds

Maybe you can stop taking them all together or maybe you need to slowly lower your dose. This is where working with a doctor can be incredibly helpful!

Keeping the pain at a manageable level is incredibly important for most people to be successful with this process. Choosing natural, non-gut damaging, alternatives can make discontinuing these harmful meds that much easier.

6 Natural Alternatives to Ibuprofen and Other Pain Relief Medications

Turmeric. This beautiful golden root works on some of the major inflammatory pathways in the body to bring down pain and inflammation. Specifically the curcumin compounds found in turmeric support inflammation and detoxification in the body. It is excellent as a beverage (see recipe below) and can be taken in capsule form.

The turmeric supplement I carry in my store contains a unique combination of three bioactive, health-promoting curcuminoids: curcumin, bisdemethoxy curcumin and demethoxy curcumin, along with turmeric oil. These three have been shown to have the strongest, most protective and best researched constituents of the turmeric root.

Ginger. This little root is a rival to NSAIDs! It’s been shown to be as effective as NSAIDs at reducing pain. In general, a dose of 1,000 mg twice daily works well for most people. Ginger is also lovely as a tea and can be combined with turmeric for double the herbal anti-inflammatory power!

Boswellia. This herb offers relief to many people struggling with chronic pain. It reduces gut inflammation in cases of inflammatory bowel disease (crohn’s and ulcerative colitis) and is effective in lowering joint pain.

Bromelain. This is derived from the core of a pineapple and is a natural way to break down the inflammation causing molecules in your body. When taken with food it acts as a digestive enzyme, so you’ll need to take it between meals to get the anti-inflammatory effect.

Topical Cayenne. Capsaicin is the chemical found in cayenne and other hot peppers that give them their heat. Applying a topical capsaicin oil or rub 2-3 times daily is an effective way to reduce and even eliminate joint pain. Yes, it definitely burns (and burns out the pain driving molecule known as substance P) so you need to be careful around your eyes, nose and other sensitive area.

Cramp Bark. This is one every woman should keep in her medicine cabinet. If you have menstrual cramps taking Cramp Bark two days prior to your period and during may be just herb you need to break up with those NSAIDs.

What If You ARE Pregnant?

Of course you should always check with your doctor first before beginning or ending any herbs, supplements or medications because what is best for some, may not be best for you.

Achy joints, low back pain and headaches are common concerns among pregnant women. Here are some safe alternatives to NSAIDs and other pain relievers in pregnancy.

Massage. Working with a skilled massage therapist that understands the unique needs pregnancy and the demands it places on the body is important for every pregnant woman, but especially those in  pain. Get body work regularly as part of your pregnancy health plan.

Chiropractic Care. You need a doc experienced and trained in pregnancy to help you really have all your prenatal needs met. Gentle chiropractic care can help alleviate musculoskeletal pain.

Apply Heat. Take care not to expose baby to heat or to apply heat for too long (no more than 15-20 minutes). Chat with your doctor about how to do this best and how often would be appropriate for you.

Note: Alternating hot and cold therapy can be very effective, but also very stimulating…and we don’t want to stimulate the wrong areas so chat with your doc!

Ginger. Safe as a food and a tea, ginger is good for more than just nausea! It is also an anti-inflammatory herb that can be consumed daily.

Digestive Enzymes. Taken between meals, enzymes like bromelain can help cut down inflammation and pain. Of course, check with your doctor first, but this may be a helpful tool to add to your routine.

Note about Turmeric: The jury is still out on turmeric and pregnancy, but for now it would appear that it should be avoided in pregnancy. This may change as more research is made available, but for now, I’d advise caution.

Magnesium. This mineral has been shown to prevent headaches. It acts as a muscle relaxant and is also anti-inflammatory. Pregnant women often need more magnesium than their diet can provide, but diet is still the best starting place.

And sometimes, you just might need a medication and that is ok. I would still recommend seeking adjunct therapies and work with your doctor to ensure you are maintaining a safe dose.

Changing the way we approach pain in women’s health

Many more doctors are recognizing that conventional pain management is not only ineffective at addressing the root cause — it’s also dangerous!

And it is easy to see how offering up a pain medication for a hormone imbalance does little to address the underlying cause. While they certainly get relief, these pain meds can make symptoms worse in the long run and cause even more hormone imbalances.

If you suspect your pain is because of a hormone imbalance, are struggling to become pregnant or just want to experience easy periods, an abundance of energy, and a better mood download your free Hormone Kit. 

Ladies, it’s time we shift the conversation away from the “pill for every ill” model and towards one that addresses the individual in their entirety with pharmaceuticals being reserved for when they are absolutely necessary.

Your pain is your body trying to communicate. Will you listen?

Download your Hormone Starter Kit Today!

Gold Milk Latte in Just 3 Steps!

You can whip this up in minutes and enjoy warm or over ice. I usually make extra in the morning and store in a mason jar in the fridge for when I get home.

Ingredients:

1. 2 cups coconut milk
2. 2 teaspoons Turmeric root powder
3. 1 teaspoon fresh ginger root or powder
4. ½ teaspoon Cinnamon
5. 1-2 teaspoons of raw honey
6. Pinch of fresh ground black pepper

Instructions:

1. Blend everything together in a blender until smooth.
2. Place in a small saucepan and over medium heat for 3-5 minutes.
3. Drink immediately or put into the fridge for later.

Enjoy!