Alexandria DeVito discusses the importance of nutrition and lifestyle in pre- and post-pregnancy health, debunking common misconceptions and emphasizing the need for nutrient-dense diets and toxin avoidance. She highlights the significance of addressing both male and female fertility issues and stresses the impact of stress on reproductive health.
Highlights:
🥦 Nutrition and Lifestyle: Proper nutrition and a healthy lifestyle play a significant role in pre- and post-pregnancy health. A nutrient-dense diet, toxin avoidance, and stress reduction are vital for optimal fertility.
🌍 Toxin Avoidance: Avoiding toxins, such as pesticides and plastics, is crucial as they can disrupt the endocrine system and hinder reproductive health. Filtered water and reducing exposure to harmful substances are essential.
💧 Water Quality: Water quality, including filtration to remove toxins like fluoride, is important for fertility. Choosing glass containers and reducing exposure to plastics can also minimize toxin exposure.
😌 Stress Management: Chronic stress negatively impacts reproductive health. Implementing stress reduction techniques, maintaining a healthy work-life balance, and addressing chronic stressors are essential for fertility optimization.
🩺 Comprehensive Testing: Comprehensive testing for nutrient deficiencies, hormone imbalances, metabolic function, and immune health can provide valuable insights into fertility issues and guide personalized interventions.
👥 Partner Involvement: Including both partners in fertility discussions and lifestyle modifications can lead to better outcomes. Partner support and shared lifestyle changes can improve overall reproductive health and chances of conception.
Dr. Justin Marchegiani: Hey guys, it's Dr. Justin Marchegiani. Welcome to the Beyond Wellness Radio podcast. Feel free and head over to justinhealth. com. We have all of our podcast transcriptions there, as well as video series on different health topics ranging from thyroid to hormones, ketogenic diets, and gluten. While you're there, you can also schedule a consult with myself, Dr.
Dr. Justin Marchegiani: J, and or our colleagues and staff to help dive into any pressing health issues you really want to get to the root cause on. Again, if you enjoy the podcast, feel free and share the information with friends or family. Hey guys, Dr. Justin Marchegiani here. I am with Alexandria DeVito. Today we're going to be talking about pre and post pregnancy nutrition, how to grow a healthy baby, how to get pregnant too.
Dr. Justin Marchegiani: So we're going to dive into this topic today. Alexandria, nice to meet you. Welcome to the podcast. Dr. Alexandria
Alexandria DeVito: DeVito So nice to meet you too. Thanks so much for having me. Dr. Justin
Dr. Justin Marchegiani: Marchegiani Awesome. Well, first off, how did you get into this field? I mean, this is a. You know, unique field because fertility issues and pregnancy problems are on the rise.
Dr. Justin Marchegiani: Conventional medicine doesn't really have a lot of options outside of, you know, IVF and full of people full of Lupron and Follistim and Clomid and there's not really a focus on avoiding toxins and getting healthy and nutrition and diet and the general diet recommendations tend to be, you know, kind of more of that conventional food pyramid, which we kind of know tends to be, Compromised by big food industries that sell a lot of processed food and junky fat.
Dr. Justin Marchegiani: So how did you get into this field? This focus?
Alexandria DeVito: Probably in a fairly non traditional way, which is that, you know, I started working in and around health care first as a health care consultant. So I worked on the corporate side with a lot of pharmaceutical and med device companies. And that was kind of where I started my career.
Alexandria DeVito: And then I fell in love with health care From that experience and I felt like I wanted to switch from a more reactive model of health care than what I was observing to a more proactive one. So that was the impetus to go back to school. I went and got my MBA from Harvard and then I also did a part time master's in nutrition.
Alexandria DeVito: On the side to add more tools into my toolkit was the, was the goal. And then I transitioned into clinical practice. I did training as a functional medicine practitioner and ended up working with a lot of clients that were struggling to conceive and, you know, was on the receiving end of a lot of the recommendations that you're, you were talking about, you know, where people were struggling to conceive for years and years, and they had no idea why.
Alexandria DeVito: And they were kind of being given the run around between a variety of different providers and they still weren't able to get pregnant and they had no idea why. And it was just, it was just gut wrenching to watch.
Dr. Justin Marchegiani: And you kind of focused on nutrition the last 30 or 40 years in the 80s and 90s, we kind of had this low fat era.
Dr. Justin Marchegiani: And then we've kind of brought in the last. 10, 20 years, a lot of junky fats, and then there's a lot of calorie counting, and then, you know, lower animal proteins, bad, and then too much carbs, you know, or, you know, a lot of the carb recommendations have gone up over time. What's your general dietary approach?
Dr. Justin Marchegiani: I mean, people have kind of been pulled in a lot of different directions the last 10, 20, 30 years. How do you navigate that? What's your general dietary framework that you're trying to outline for the patients that you work with?
Alexandria DeVito: Yeah. So I would say, you know, like a, to me, a fertility friendly diet is generally speaking higher in fat than most people would anticipate.
Alexandria DeVito: And that includes animal fats to the point that you were making earlier. Usually moderate carbohydrate and moderate protein. And there may be some instances where we need to modify that depending on your particular instance, right? If you're having trouble with blood sugar regulation, we may need to make some modifications.
Alexandria DeVito: If you know you are post surgery for some reason, right, you know, then we might need to make some protein, changes But generally speaking, that's what I like to talk about opting for whole foods balance nutrition, right? And nutrient density in particular, right? Getting pregnant, sustaining a pregnancy is the most nutrient intensive time in a female's life.
Alexandria DeVito: And so it's really important that what we're doing in the, you know, the couple of months in particular, prior to conceiving is what's actually going to be feeding the baby. The development of of that baby. So being particularly conscious about nutrient density in the, you know, the period of time in preconception, but then also in pregnancy and postpartum, I think it's something that doesn't, you know, get enough attention.
Alexandria DeVito: And I think in in nutrition, we send so much time. Talking about what not to have, we don't actually spend a lot of time talking about the upside and the things to include in. So, I like to talk a lot about kind of, well, what are the sorts of things we want to be including and nutrient density being one of them.
Dr. Justin Marchegiani: That makes sense. And if you look at hormones, right? Almost all your hormones with the exception of growth hormone and insulin, one. They're all going to be cholesterol based. So, all your steroid hormones, progesterone, estrogen, they're going to have a cholesterol backbone. Cholesterol, so important your body will make it.
Dr. Justin Marchegiani: Ideally, if you get it from food, it'll save your body a lot of resources having to make it themselves. And that's the backbone for everything. It goes cholesterol, and then you go downstream to pregnenolone, and then it trickles downstream to your estrogen, and your progesterone, and all your, your DHEA, and all your fertility supporting hormones.
Dr. Justin Marchegiani: So, cholesterol, very important. And then, of course, adding in lots of synthetic hormones, glyphosate, pesticides, antibiotics, a lot of that probably has a big impact as well. So, talk about like the food quality. You mentioned, you know, nutrient density, which is important. If you look at a lot of the nutrient kind of counters, a lot of times they penalize the saturated fat in animal products.
Dr. Justin Marchegiani: And so, when you actually, you know, You can look at the equations and how they base the nutrient density. Once you factor out a lot of the saturated fat egg yolks are amazingly nutrient dense, like grass fed liver, amazingly nutrient dense. Talk about, like, what food, like the food quality aspect and what toxin, talk about the toxins that could be in food, maybe they could impact fertility.
Alexandria DeVito: Dr. Justin Marchegiani I think you get, already gave such an incredible summary and I think it's so important. I don't think people realize this cholesterol saturated fat point that you are making, which is that, you know, our sex hormones are being made from cholesterol. So we've demonized cholesterol.
Alexandria DeVito: We've demonized saturated fat for a really long period of time. And I think that's caused people to shift their consumption away from fat, but it's incredibly important to maintain appropriate hormone levels. And if we don't have the raw materials to make our sex hormones, we're definitely not making you know, getting regular cycles, nevermind making a baby.
Alexandria DeVito: So I think it's such a foundational principle that you, that you just mentioned that I don't think is really well understood. You know, and then I think, you know, a lot of the other pieces around, you know, nutrient density is, you know, we're, we tend to be eating more food like substances and less actual food, right?
Alexandria DeVito: So things in their, in their raw form or their real form and not only raw, right? Because. We want to get a combination between like raw forms and cooked forms because certain nutrients are more bioavailable when they're raw versus cooked. And so you're just being conscious of these different things.
Alexandria DeVito: So balance in a lot of different ways, I think is an important piece of this puzzle. You were also making a point about like, what do we want to be conscious of not including? Yes. I mean, if we're trying Balance our own hormones, getting a huge exogenous source of hormones from another animal is probably not a good idea, right?
Alexandria DeVito: It's going to mess with our own system. So if we just think about it simply right, we don't want other hormones messing with our own. So minimizing any hormone, like products that have added hormones. minimizing products that have added pesticides and herbicides. Right. All of these things, I mean, there's, there's thousands of known endocrine disruptors and they do exactly what they sound like.
Alexandria DeVito: They mess with our endocrine system. And so, you know, when you're trying to work with your own hormones and then you have all of these things that are basically competing with your own hormones for You know, to for binding and signaling that confuses your body and then your hormones that are produced in your own body don't function as optimally as they could.
Alexandria DeVito: And that makes it harder to get pregnant, stay pregnant, right? Nurture virtual appropriate menstrual cycles and so forth. Dr. Justin Marchegiani
Dr. Justin Marchegiani: Yeah. I mean, absolutely. You're going to have hormones in animal products if it's synthetic or if you have a lot of, you know, conventional type of animal products.
Dr. Justin Marchegiani: So, getting grass fed, pasture fed is going to matter. Also, water and plastics, too. Let's dive into that because, I mean, I've seen an article by the Texas Tribune, I think in 2018, that 10 million households have elevated levels above the EPA safe threshold of atrocy, which is an herbicide that can really mess with the endocrine system.
Dr. Justin Marchegiani: And so I recommend everyone, they should be drinking out of that home, a reverse osmosis filter that's going to at least pull a lot of those toxins and microplastics and things out. Obviously, you got to add additional electrolytes out because they can lower the electrolytes. But hey, I'd rather have toxins out and add electrolytes back a lot easier to add those things back.
Dr. Justin Marchegiani: Let's talk about water and plastics a little bit.
Alexandria DeVito: Yeah. I mean, so the. These are such important pieces because we're, we're drinking water and we're showering in water. I think a lot of times people think about like the water that we're drinking, but, but there's shower as well. And we're like kind of dousing ourselves in, in chemicals.
Alexandria DeVito: And so I did it in you know, one of the things is I, you know, I looked at all the, the compounds that were in the drinking water of the town that I grew up in. And I was. I mean, it's just, it's just, you know, all of these different, different compounds and, you know, people can check their, their own local water sources.
Alexandria DeVito: And so we can't necessarily control all that's going on outside of our homes necessarily. But our homes, you know, and potentially workplaces depending on kind of where you're working, maybe places that we have agency over. So installing, you know, You know, water filters, installing both water filters on your, on your drinking water, but then also your shower water as well is just a first step in minimizing these, these compounds so that you're not bathing in them and drinking them all day every day.
Alexandria DeVito: Same thing for, for air as well, right? Air filters is another place, right? You know, as you think about air. Food, water. Those are big ones. And, and, and the, the air quality in homes is another, you know, place that we want to be conscious of. And so, you know, especially like when I'm cooking, right, I see all of these things are, you know, being kicked up by, by cooking.
Alexandria DeVito: So making sure that you have an appropriate air filter is important as well. And then plastics, right? That's a big one. Because plastics are known to mess with our endocrine system as well. So, I mean, you have like phthalates, these are in fragrances, these are in, you know, the product, water bottles, right?
Alexandria DeVito: But I think the more insidious ones are ones that we don't really know about. Plasticizers are used, you know, to make things flexible. So they're used in a lot of different places. And in small quantities you know, there's a lot of plastic in the world and it's maybe not that big of a deal, but they're, they're so pervasive that it's, you know, really, really can be really hard.
Alexandria DeVito: So watching our own consumption of, you know, are we conscious of, you know, what we're drinking or eating food out of? Can we remove the plastic and replace it with glass in as many places as we possibly can? Can we minimize the places where we're heating plastic and then either consuming it or putting it in and around us?
Alexandria DeVito: So I think, you know, there's like some of these general precautions to be conscious about when we're thinking about these things. External sources of things that can mess with our hormones.
Dr. Justin Marchegiani: Yeah, if you're going to a store and you're getting some water because you're thirsty and you're on the go I always recommend doing glass whether it's like a topo chico or a cheryl steiner or a mountain valley These are all going to be good options just because of the the heat releasing plastics I mean, the worst place you can go I find for plastics is like general stores or convenience stores because it's very frequently you walk by and you have a pallet of plastic out in the hot sun.
Dr. Justin Marchegiani: It's like, oh man, or just is that truck that brought them over there like 100 degrees in the back, right? Those are all the questions you have. So go glass whenever you can. If you're going to buy plastic, probably go to a health food store that's more likely to keep it inside and keep it cool. But general.
Dr. Justin Marchegiani: Thinking on that front, that's good, simple ideas. I know what you're saying. Like, you can't do it right all the time, but you try to make good, healthy choices. Anything else in the toxicity realm you want to highlight? We have plastics, we hit some of the xenoestrogens. Oh, also, if it's BPA free, well, guess what?
Dr. Justin Marchegiani: It just means it's BPS in there, not BPA. Like, it's still going to be a problem. So, ideally, you still want to have plastics out. I mean, if you have a plastic cup in the morning and you're putting like your RO water in there and just drinking it, like, not a problem, right? It's more of like the The stories, the longterm, the UV, the light, any other big chemicals you're worried about?
Alexandria DeVito: Well, so I think about a bunch in in personal care products and even in home care products. So the ones that I think of that are, you know, kind of non specific, but are, can be a big problem or just fragrance. Like what does that mean? Fragrance. You know, very nonspecific, but a lot of times you know, there's lots of stuff that goes into fragrance.
Alexandria DeVito: And you know, it's, it's so interesting cause I noticed like the more that you take these things out of your environment, generally speaking, I find the more, the more sensitive you become to them. Like I was just, you know, like a lot of times I'll get into like get into Uber or just like that.
Alexandria DeVito: They have
Dr. Justin Marchegiani: I'm
Alexandria DeVito: just like, oh gosh, I have to open the windows. Right. But years ago when I wasn't as conscious about this, I didn't notice this as much, my body wasn't as sensitive and aware. And so I think you're, you know, we, we get bombarded with these things and we almost get adapted. to, you know, all of these fragrances and chemicals.
Alexandria DeVito: And then once you start to systematically remove them, your body actually becomes more sensitive to them. And you can, you can pick them up more so than you may have previously. Dr. Justin Marchegiani
Dr. Justin Marchegiani: Totally. Yeah. You can get like the best thing, the Uber thing drives me nuts, right? Because you can get these charcoal air filters on Amazon, these little bean bags, or you can get these little ones you put in like the air.
Dr. Justin Marchegiani: Kind of with the ears coming out, it's a much better way because then it soaks up the odor and absorbs it versus like, give some like fake smell off, right? Worst. No, I totally get it. They're
Alexandria DeVito: overpowering.
Dr. Justin Marchegiani: I think there's some companies that have little small little HEPA filters It'll plug into the 12 volt and also do a little filtering.
Dr. Justin Marchegiani: So yeah, I totally agree. That makes sense what else on the toxicity side? We talked about food. We talked about plastics talked about hormones I mean, we could probably talk about, like, Roundup and Glyphosate. I mean, that's a big one because that's was originally patented as a herbicide. And that can negatively impact the microbiome.
Dr. Justin Marchegiani: And that can also impact, I mean, that can also impact you know, at a, at a toxic load to your body as well. Let's kind of go into maybe some of the pesticides or some of the Glyphosate and, and maybe the microbiome.
Alexandria DeVito: So, I mean, I think what's, when we think about microbiome, one of the things that I didn't realize until I kind of started researching this was that mom's microbiome is passed to, to baby.
Alexandria DeVito: And so when we think about our lifestyles, our lifestyles are kind of like a modern buzzkill to our microbiome, right? When we're, we're, we're stressed out. So a lot of times we're depleting our, a, our ability to digest and assimilate nutrients. You know, the, the foods that we're eating might not be as healthy.
Alexandria DeVito: Or diverse, therefore we're not getting as diverse of a population of bacteria than we know previously had or ideally would like to or maybe we're getting the overgrowth of certain species at the expense of other species. And then we have, right, if we're eating For stressed out and we're, you know, eating foods that aren't great for us.
Alexandria DeVito: Then we also have this issue of contributing to Essentially leaky gut or you know issues where the gut lining is being thinned and then you can start to have water issues Around immune function. So when we think about this we think about okay Well ideally right and then we also know that birth control can contribute to, and, and, you know, many females are on birth control for many years, can contribute to perturbations in microbiome function as well.
Alexandria DeVito: Yeah. So you have all of these assaults that can be happening from a microbiome perspective and that, microbiome can then be passed on to baby. If we're not thoughtful about, you know, balancing some of these things beforehand. And again, like the one thing I try to be conscious about this is I feel like whenever we talk about kids, you know, we can I try to stay away from blame and shame, right?
Alexandria DeVito: Like if you haven't done this stuff previously, right, there is no blame and shame around this. It's, you know, we learn when we learn and then we try to do this as well as we can with the, with the information. So you know, if you've had a previous child and you weren't aware of these microbiome changes like that, Ideally, right?
Alexandria DeVito: Take a breath and like, be kind and gentle with yourself. Like, I think that's really important. And especially when we're talking about all of these toxins and all these things, it can be very overwhelming. And so, I mean, I think you do a really good job of giving people practical suggestions of like, okay, well now that we know this information, like what the heck can we do about it?
Alexandria DeVito: So I just say that to say like, we're talking about all these things that can mess with our microbiome and Right. A lot of these things are infinitely fixable, right? Like there is, you know, there've been some studies that, you know, said like, if you, if you just adopt an organic diet, for example, for a couple of weeks, like immediately, right, your body will will shift both in terms of like, you know, getting rid of a lot of these pollutants that we're talking about are are non persistent.
Alexandria DeVito: Some of them are persistent, but many of them are non persistent. So once you stop. including them into your diet, your body will get rid of them. Your body's incredibly resilient. And the same thing with microbiome. If we start shifting our stress load, if we start shifting the composition of foods that we're eating, our microbiome will respond very quickly.
Alexandria DeVito: So there's, this is, there is a message of hope here as well.
Dr. Justin Marchegiani: I agree. You got to have the Dr. Justin Marchegiani. my first thing is, alright, let's just get everything organic. Alright, that's organic. Alright, let's focus on good proteins and good healthy fats. Alright, great. Awesome. Now, let's adjust the macronutrients.
Dr. Justin Marchegiani: Make sure you're not overly carving it because just over the last hundred years, we've gone from four pounds of sugar to a hundred and thirty pounds of sugars. We know carbohydrate and sugar has gone up like crazy. there is more gestational diabetes now than it's ever been. And so, you can get a blood sugar meter.
Dr. Justin Marchegiani: My general recommendation, even if you're not pregnant, you can do what's called a functional glucose tolerance. The regular glucose tolerance involves giving somebody 75 gram sugary drink. Well, unless you're a woman that's drinking sodas while you're pregnant, that's not gonna have a real world application to your day in, day out life.
Dr. Justin Marchegiani: So, get a blood sugar meter. test your fasting blood sugar before you eat a meal or in the morning and then do a one hour, two hour, three hour after your meal and see how your blood sugar goes. Ideally, we want to be under that 120 or so and back below 100 within two to three hours is a pretty good recommendation.
Dr. Justin Marchegiani: What's your thoughts on that and the blood sugar aspect of pregnancy and carb recommendations?
Alexandria DeVito: Oh yeah, I mean, I'd love to get your thoughts on kind of what you think is going on with with gestational diabetes in general. But I, I think what we see is certainly more blood sugar dysregulation.
Alexandria DeVito: And in addition to looking at a hemoglobin A1c and fasting blood sugar, we're also looking at insulin because that tends to be a more sensitive and earlier marker of change. And you know, what I'm observing is that, you know, there's, there's a lot of folks that are coming in with blood sugar dysregulation.
Alexandria DeVito: And they're being told by, you know, in traditional medicine that they're fine. You know, but they're not feeling fine. So I think it's really important that, you know, we, when we think about like, you know, I love the introduction of continuous glucose monitors, or even kind of like, spot tests of, of glucose monitors.
Alexandria DeVito: You know, I was, you know, as a nutritionist, I was testing my own blood sugar before the kind of CGM movement came out. And it's fascinating to see because, you know, you, I was actually shocked at the impact that stress can have on blood sugar. And it makes sense when you think about the physiology behind it.
Alexandria DeVito: But right when you're not getting enough sleep, right, you're, then you're, you're, you're much more sensitive to blood sugar fluctuations. When you're more stressed out, your release, your cortisol is kind of encouraging the release of more blood sugar. So there's, you know, a lot of these other components that we don't even think about when we're talking about blood sugar, rather than you have just the points that you were making around the consumption of blood sugar.
Alexandria DeVito: But there are things that we can do to blunt the impact of blood sugar. And that's, you know, making sure that we're including fat and protein when we're having our carbohydrates or, you know, including carbohydrates that have more fiber in them. So there are, there are things that we can do to still have whole food carbohydrates in our diet.
Alexandria DeVito: But being conscious that highly processed, hyper palatable carbohydrates are the ones that tend to a not, not initiate our satiety mechanisms. Therefore we want to eat more of them and more of them. And then the more we eat of them, the higher we kind of see our blood sugar flying.
Dr. Justin Marchegiani: Yeah, I agree. When people talk about like, well, calories in calories out, like calories don't matter or calories do matter.
Dr. Justin Marchegiani: Well, the issue with calories is it comes down to nutrient density and appetite regulation. And if you're eating foods that Hiring carbs and more process, you're gonna have less satiation, less nutrient density, less appetite regulation. And so anytime you start eating foods that have more, better cholesterol, better fats, you eat slower, you get good nutrient density from your vegetables and healthier carbohydrates that are more appropriate glycemically, you're gonna have better satiation.
Dr. Justin Marchegiani: And it's. It's easier to eat less, right? That's a thing. And so, calories do matter, but they're at the end stage. If you get the good nutrient regulation, the good apostatic type of signaling from the parts of the pituitary and hypothalamus that control appetite, that transverse nuclear part of the hypothalamus that controls satiation, you're gonna naturally be more in control.
Dr. Justin Marchegiani: So, I think that's a, a really important component. And then, you talked about blood sugar earlier. As a female, in the middle of that pregnancy, right around week 20 to 30, you're gonna be more insulin resistant. And so, partly because Your body is trying to shunt more nutrients to the baby over you, and estrogen and surges in cortisol are going to make you more insulin resistant.
Dr. Justin Marchegiani: So you're going to be surging tons and tons and tons of insulin, and that insulin is going to affect your baby, cause it to grow, increase obesity, genes, epigenetically. It's going to trigger these genes, allow that baby to be bigger, which is going to allow for potentially more hospital interventions, C sections, etc.
Dr. Justin Marchegiani: So, as a female, you got to be very careful of your carbohydrates as you get deeper in, and that's where a good blood sugar meter and testing, A couple times a week, test your meals. And you kind of know, like my wife, when she was pregnant, she had to be very careful because her blood sugar would sail up above 140 and stay for a couple hours.
Dr. Justin Marchegiani: And she had to be like meat, veggies, good fats, and then even a little bit of a walk after her meal, or it would be sky high. So that's a thing to keep in mind, I think, too.
Alexandria DeVito: Mm. I think that's a really good point because there's like, I think there's, you know, the general things that we can do for that are relevant to most, you know, people.
Alexandria DeVito: But then I love what you're talking about is like, there's a bit, there is this kind of bio individuality aspect to it. And we, I love the data feedback loop because I think inputs don't always result in the outputs that we anticipate. So right, like, you know, for, for one person having a, you know, a sweet potato may, Okay.
Alexandria DeVito: Cause a different reaction than another person. And so even on the same person on different days, right? Cause we're talking about sleep and stress and all these different things. So monitoring blood sugar, monitoring lab testing can give us an understanding of, okay, well, we're doing these certain inputs.
Alexandria DeVito: We're acting, we're, we're sleeping a certain amount. We're moving a certain amount. We're eating a certain diet. We suspect it's going to cause certain outputs, but when there's a disconnect between the inputs and the outputs, then we can ask the question, okay, well, what's going on here? What, what else might I need to modify?
Alexandria DeVito: And so keeping a pulse on both of those things I think can be really helpful. Dr.
Dr. Justin Marchegiani: Justin Marchegiani Yeah, I think so too. And the nutrient density aspect I think is really important. Let's talk about some micronutrient stuff. I want to get your take. I mean, iodine is one of these things I think is important.
Dr. Justin Marchegiani: There's a lot of studies on low essential IQ in the baby if we don't get enough iodine during pregnancy. But I also worried about from an autoimmune standpoint, getting too much and potentially triggering Hashimoto's issue. So I think iodine is an important thing. And also I worry about fluoride too because I've seen a lot of low IQ studies with getting too much fluoride during pregnancy.
Dr. Justin Marchegiani: And so you got fluoridated water that could potentially be a problem too. Those are just my kind of two things out of the gate. Fluoride, you know, be careful of it. RO water should kind of pull it out. And then making sure you're at least getting a couple hundred, maybe 500 or so micrograms extra, maybe in your multi or in supplemental iodine.
Dr. Justin Marchegiani: Thoughts on that and what else do you think we should be on top of as well?
Alexandria DeVito: Dr. Julie Kravis Those are really interesting ones. I, you know I'm curious to look into more about the, the autoimmune component, because I'll talk about that in a second. But we are seeing a pretty meaningful indication of early autoimmune markers.
Alexandria DeVito: And the literature that I've seen is suggesting that this is pretty meaningfully on the rise, and it's disproportionately present in the female population. So I certainly think it is something that we want to be keeping an eye out for. But when I think about other like nutrients of concern, one, you know, big one, and this is going to seem super obvious, but like why are you talking about is, is iron just, right.
Alexandria DeVito: I mean, we're, we're seeing, you know, run tons of CBCs, but like, I'm consistently seeing low ferritin. So CBC may be normal, but we're seeing low ferritin. And I think the stats that I've seen are like 15 to 25 percent of pregnancies are characterized by anemia. So iron deficiency anemia. Which is a pretty large number for, you know, like when we think about just how prevalent a CVC is for screening.
Alexandria DeVito: And as I just said, right, like CVC might not be the only thing we want to be looking at, right? We might, might want to look at iron storage. So maybe that's part of the reason why we're under diagnosing low iron. And then you also have blood volume that's increasing pretty meaningfully in pregnancy.
Alexandria DeVito: And so if you're kind of on that, that cusp you know, between iron deficiency and, you know low iron, you might be crossing over as you, as you move into pregnancy. But iron is a really big one that I consistently seeing that I'm, I'm surprised by.
Dr. Justin Marchegiani: Yeah. And if you go into pregnancy and you're feeling really tired, that's going to be a big concern because that's going to make a quite a miserable pregnancy if you are anemic the entire pregnancy.
Dr. Justin Marchegiani: And you're saying that the CBC, the red blood cell hemoglobin hematocrit, so you're conventional or your OB may not even pick you up as being anemic essentially. Correct. And so what are your strategies? Just more high quality grass fed meats would you recommend like a good iron chelates? Would you recommend like a liver, grass fed liver kind of glandular support?
Alexandria DeVito: I love any one of those. I mean, I think there is heme iron, non heme iron. So from like animal sources versus plant sources,
Dr. Justin Marchegiani: right?
Alexandria DeVito: I think, you know, you're, you're alluding to this, but yes, generally speaking, our body is able to process heme iron from animal sources much more easily than we can from non heme sources.
Alexandria DeVito: And if we're using non heme sources. we have so much more of it. And so, you know, just for me, I'm a big fan of like minimum effective dose and biggest bang for your buck. So when we think about iron sources, generally speaking, it's it's, you know, eating it with from, from animal sources largely.
Alexandria DeVito: And then I think, right, there's certain things that you can do dietarily that, you know, kind of. Increase uptake. It doesn't decrease the, the uptake. So like vitamin C paired you know, with, with iron. So as much as possible. And then, you know, being conscious of like, you know, things that could inhibit.
Alexandria DeVito: So we think about like teas and things like that. So, you know, being conscious about what, what you're having iron with, we can be, we can be thoughtful about one, like, you know, little hack that we use is there's something called a lucky iron fish. Which you can literally put in like, you know, soups and it literally like leeches into the, into the soups.
Alexandria DeVito: So that's something like that's fairly simple for people to use. So that's a like small hack that will suggest sometimes to people as you know, one additional thing that you can be doing that's fairly low lift for most people.
Dr. Justin Marchegiani: So it's like an iron fish. It's literally like put it in.
Alexandria DeVito: Yes, exactly.
Alexandria DeVito: Exactly. Oh my gosh.
Dr. Justin Marchegiani: That's so cool.
Alexandria DeVito: Awesome.
Dr. Justin Marchegiani: Yeah. And so you're talking about ferritin, right? Heme based iron has 95 percent of the input on that ferritin. So yeah, you're not going to get it with spinach and other, you know, so called high iron foods that are plant based because it just doesn't move ferritin that much.
Dr. Justin Marchegiani: We see it clinically all the time. So that's a really good point on that. Also, when you're doing things like liver, you're getting vitamin A, right? What, at what point is vitamin A a problem for you? You're like, Oh, that's a, a threshold that may be a little bit too high because vitamin A just for listeners can be tratigenic or cause birth defects when you go too high.
Dr. Justin Marchegiani: Now usually this is in and around things like Accutane which is like a synthetic kind of retin A for your skin to kind of decrease oil, oil and sebum production. What's your take on vitamin A levels and when it comes to a whole food form?
Alexandria DeVito: Hmm. Okay. So, I mean, I've, I've just, I've never seen vitamin A from a, like too high in, and I'm not, I'm not measuring it as regularly as I, as I could be, but it is, I think because there is so much caution around it that, you know, I don't generally see it, see it high.
Alexandria DeVito: In fact, I think we're probably under supplementing vitamin A right. And I think, you know, there's different types of, of vitamin A. I think when we're getting it from. Our whole food sources, like, you know, from carotenoids, right? It's like, it's pretty hard to, to overdose on these compounds if you're getting them from your diet, when you start taking supplemental forms, then yes, we probably do want to be conscious about it.
Alexandria DeVito: When you're talking about liver, liver has. Vitamin A in it as well. And even among those who are taking liver supplements, I don't generally see people overdosing on this. But you certainly, you know, we, we want to be conscious. Vitamins A, D, E, and K are all fat soluble. And so they're going to be absorbed differently depending on your body composition as well.
Alexandria DeVito: So these are things that you probably do want to keep an eye on. But generally speaking, I, I think if you're getting whole food sources of, of these, nutrients it's pretty hard to overdose on them. It's usually through supplementation that we, we see any sort of overdosing.
Dr. Justin Marchegiani: I mean, usually you're going to see it typically above 30, 000 IU, usually around 10, 000 is probably safe.
Dr. Justin Marchegiani: Again, like vitamin A in the form of liver with other B vitamins and vitamin D and other nutrients that's a little bit different because you have all these synergy nutrients versus a synthetic retinol. That's a great point or something that doesn't have, you know, if you're getting a good whole food or a good multi that has like mixed carotenoids from like a good like palm fruit or something like that, you can get whole food sources with other nutrients that are probably going to be less problematic.
Dr. Justin Marchegiani: But if you're doing. you know a retinol vitamin A drops at high doses or you're doing obviously Accutane, then that's going to be a problem. If it's like cod liver oil, you know, just probably try to keep your supplemental load of vitamin D or vitamin A under probably 10, 000 is my general recommendation.
Dr. Justin Marchegiani: I think, you know, get tested, like do a intercellular nutrient test and see what you're sitting to.
Alexandria DeVito: Yes, because I think, you know, I, I think I'm glad you bring this up because I think, I think most people are more at risk of being under vitamin A, under vitamin A, than over. And I actually think it's, I think it's Weston a price who's done some really interesting studies around this and, you know, kind of like vitamin A nutrient levels and so forth.
Alexandria DeVito: And you were trying to talk about cod liver oil, which I know is something that the, their foundation really advocates for. So I think that testing, as you're saying, is a really good way of seeing, okay, well, you know, maybe I'm, I'm not over supplementing, maybe, maybe underneath the, the recommended guidance and this could, you know, could be a nutrient to, to optimize and it has, is, you know, really important implication.
Dr. Justin Marchegiani: Yeah. One study talking about safety and toxicity of vitamin A. They talk about, you know, 10, 000 or less, right? Really no issues. There's a mild increase as you start to go up to 000. But, you know, vitamin A from synthetic sources versus a whole food cod liver or beef liver, you know, probably a little bit on the different side there.
Dr. Justin Marchegiani: So, yeah,
Alexandria DeVito: it's a good distinction.
Dr. Justin Marchegiani: Yeah, absolutely. Now, what about husbands and wives that are trying to get pregnant and they're having fertility issues? What are the things you look at? I mean, we know Women tend to get, you know, the finger pointed at us, Oh, it has to be the woman's issue. But we know it's usually 40 percent the women, 40 percent the men, and 20 percent just unknown causes.
Dr. Justin Marchegiani: And we know a lot of these same toxins and microplastics and pesticides and glyphosate can also impact men and their sperm count and motility and morphology and all that stuff. So, how do you look at that and sit down with a couple that's having fertility issues? Like, what's your, what's your kind of like process?
Alexandria DeVito: Mm. So I mean, I think you first, you said a great staging, which is that it's, you know, biology doesn't care about our cultural construct that fertility is a female problem, right? It's literally a 50 50 biological equation. And so I think it's, we've been doing a disservice by just looking at the female reproductive partner.
Alexandria DeVito: And I think if it's just mathematically, if you're only optimizing 50 percent of an equation, it is less likely to work. That you're going to get the outcome that you want. So I think it's really important that we start inviting our male reproductive partners into this conversation in, in, in much the same way that you were just talking about.
Alexandria DeVito: And you know, as you were saying, many of the same things that affect, right our fertility is true for males and for females, right? Fertility is an extension of our overall health. We oftentimes treat it as a below the waist conversation, not on this show, but I think in, you know, in broader medicine, we do, right.
Alexandria DeVito: We, we look at fertility are, you know, below the waist or we look at hormones and those are absolutely part of the equation. But our fertility health is, is an extension of our overall health, like our immune health matters, our metabolic health matters, our nutrient status matters, many of the things that we're talking about.
Alexandria DeVito: And that is true, whether you are the male reproductive partner or the female reproductive partner. And I think on top of that, not only do you have the biological side, which says, you know, if you're only optimizing 50%, you're, you're less likely to be effective, but there's the social side, which is people are much more likely to adopt health changes or sustain a healthy lifestyle if they're doing it with the people around them.
Alexandria DeVito: So right, if you're cleaning up the products in your home, like we talked about, if you're upgrading your diet, if you're, you know, modifying your movement levels, it is so much easier to do that and to stick with it. You know, then Then if your friends are and in particular the person that you happen to be living with is also doing it So I think there's just a practicality side of it as well
Dr. Justin Marchegiani: 100 percent and you know, you can look at male testosterone and male sperm counts.
Dr. Justin Marchegiani: They've dropped precipitously the last hundred years That's a big factor and you know, we know toxicity we know, you know, whether it's pesticides, you know nutrient density we also We also can just look at the big driving factor in most female for infertility tends to be PCOS driven. And we know that's insulin resistance.
Dr. Justin Marchegiani: So insulin resistance negatively impacts men because it basically turns them into women via aromatase. Aromatase takes testosterone and goes more into estrogen. But with PCOS and insulin, it's actually the opposite. Women become more androgenic, and that throws off their hormones, too, because it decreases, throws off prolactin and causes aberrations in the cycle.
Dr. Justin Marchegiani: So we have these enzymes that upregulate in each sex that cause our sexes to almost switch in a way, which is kind of ironic, if you will.
Alexandria DeVito: It's fascinating to look at the biochemistry in the way that you talked about it. And I think, you know, the other thing that I think about in terms of, you know, these factors is the movement factor or the lack thereof movement factor, right?
Alexandria DeVito: A lot of our jobs used to be physical in nature, like physical labor, right? And we've now moved to many, many, many more sedentary jobs. And if we just think about that, right, when we're sitting for long periods of time, I'm sitting right now, you're not, so I love that, right? Yeah. But right when we're sitting for long periods of time, we literally just compress our entire reproductive area.
Alexandria DeVito: And that's not great for females, right? Because you cause stagnation, right? If you don't have blood flow, you don't get nutrients, you don't get oxygen. But for men, right? There's, I think there's like the, the double whammy, which is you create heat. Right. And we definitely do not want to be increasing the temperature of our testicles.
Alexandria DeVito: So, you know, I think there's this element as well. that, you know, sedentariness in addition to kind of the cardiovascular implications for it. There's also like the heat implications of sitting for long periods of time. So getting up and moving separate from just exercise alone is an important factor that I don't think a lot of people are, are, are even considering.
Alexandria DeVito: Dr. Justin
Dr. Justin Marchegiani: Marchegiani 100%. And so when you're working with a couple, I mean, what are the big tests you like to do out of the gate?
Alexandria DeVito: So at Poplin, we test across five categories and it's essentially meant to be a screening test. So we look at blood status. We look at hormone status, metabolic status, nutrient status, and immune status.
Alexandria DeVito: And essentially what it does is it looks at, you know, I designed it by looking at the clinical literature and said, okay, what are all the things that we know can interfere with fertility? And can we actually start to, instead of waiting until someone is struggling to conceive, can we actually get early indicators?
Alexandria DeVito: So that once you start the journey, you can get flags for, are there any potential red flags or yellow flags that can interfere with my ability to conceive? And it looks at a lot of things that we've talked about already. So, you know, do you have any nutrient deficiencies? The big ones we see are vitamin D right?
Alexandria DeVito: Omega three is, we see, you know, we see a lot of that folate B12. Do you have any hormonal imbalances? And we're not just looking at. You know, we're looking at thyroid function. We look at sex hormones. But we're looking at the binding proteins as well, right? Because whether or not you have a, an ample amount of hormones, but high binding proteins, the way you would address that is different than if you have just a low hormone state.
Alexandria DeVito: Right. So understanding that, you know, that dynamic as well as really important looking at metabolic function. Like you were talking about, right? Do people have indicators of hormone dysregulation, right? And 50 percent of people that we're testing you know, have integrators of hormone dysregulation, whether that be elevated estrogen or elevated testosterone or.
Alexandria DeVito: you know, decrease testosterone and then immune function, right? And we were talking about that. So we're looking at anti nuclear antibody and that's being, you know, flagged in a lot more pieces. Dr. Justin Marchegiani
Dr. Justin Marchegiani: Makes sense. And Alexandria has a book called nine months is not enough. The ultimate pre pregnancy checklist to create a healthy baby.
Dr. Justin Marchegiani: So we're going to put that link, the Amazon link right below in the description. So if you guys are listening, feel free to click down below and support her there. Also, Alexandria, are you seeing patients?
Alexandria DeVito: I'm not, I'm, I'm working with people through my company, pop one.
Dr. Justin Marchegiani: Got it. And what's the website there?
Alexandria DeVito: Get poplin G E T P O P L I N. com. We'll
Dr. Justin Marchegiani: put the link in the description there.
Alexandria DeVito: Thank you. We do pre pregnancy testing. So it's it's a way for people, like what I found when I was working as a Many doctors would not run the requisite testing that I was suggesting. And I think there's, you know, now been an influx of, of, you know, much many more functional integrative doctors who are looking at these broader panels.
Alexandria DeVito: But you know, I think it's really important to rather than waiting until we're having a problem, right? Infertility in many cases is a symptom. It is not a diagnosis. So how do we get an indication of what is going on with your health and your reproductive partner's health? early on in the journey so that we can start to intervene with many of the things we've talked about diet and lifestyle and supplementation.
Alexandria DeVito: Sometimes you may need medications and procedures in partnership with your doctor, but many times we can move the needle pretty meaningfully with, you know, with these simpler and less invasive and less expensive interventions.
Dr. Justin Marchegiani: That's great. And the website is G E T P O P L I N. Okay, good. We'll put the link down there.
Dr. Justin Marchegiani: Get poplin. And then also, is there anything else you want to leave the listeners with in regards to, you know, enhancing pre pregnancy fertility or healthy fertility while you're pregnant? Any other big strategies you missed?
Alexandria DeVito: I think we've covered most of them. I think the only other thing I would say is we didn't touch too, too much on stress. And I think that Stress is like such a nebulous word and term, but what I think is important to understand when it comes to fertility is that your sex hormones and your stress hormones are in the same biochemical pathway.
Alexandria DeVito: And so
Dr. Justin Marchegiani: your body will
Alexandria DeVito: always prioritize survival over procreation. And so if you're In a, you're, you're physiologically, you know, stressed or you're psychologically stressed. Your body will perceive that as an unsafe environment to bring a baby into, and it will downregulate reproductive function. And it will shift from making your sex hormones to making your stress hormones cortisol.
Alexandria DeVito: And so you literally will not have the raw materials that are necessary to conceive. So I think that's just a really important thing. And that, you know, physiological stressors can be mold in your house. It can be a chronic infection that you're not aware of. Or it could be psychological stressors.
Alexandria DeVito: Like I don't like my job or my commute every day is very, very stressful, right? So there's lots of different ways that our body can experience these stressors. And so systematically going through and trying to figure out, okay, well, what are chronic stressors, not acute stressors because our body was meant to design those, but what are the things that we're consistently interacting with that could be draining our resources?
Alexandria DeVito: Dr. Justin Marchegiani
Dr. Justin Marchegiani: Okay, great. I want to just kind of leave listeners with maybe three more things for me and then I want you to comment if you don't mind. I saw a woman, she's had a baby, I think it was her third or fourth baby and she had group B strep and they had to amputate three out of four of her limbs.
Dr. Justin Marchegiani: It was very sad. And she's still going through this now and it's just a sad situation. And the literature shows Being on a high quality probiotic, you know, lactobacillus, acidophilus, bifidobacter species, a good high quality one during pregnancy decreases group B strep by 80%. So I think being on a good probiotic during pregnancy is essential to decrease your risk of group B strep, because if there is an issue there, it can be devastating.
Dr. Justin Marchegiani: Number one making sure you're on a good quality multi that has activated folate LMTHF folate good whole form vitamin A a good fish oil with extra DHEA and EPA to build healthy baby's brain, and then also making sure the nutrient density is there because mother nature will always pull from the mom to give to the baby and You'll be left with very little.
Dr. Justin Marchegiani: So make sure there's a lot of nutrient density coming in, egg yolks, grass fed liver, a little bit if you can grass fed meat, you know, maybe some extra enzymes or bile salts if you're having a hard time digesting or if you're more nauseous during pregnancy or some ginger. That'd be kind of the last couple of little things I would throw in there.
Dr. Justin Marchegiani: What are your thoughts?
Alexandria DeVito: I love that. So yes, so prenatal or a multivitamin. A fish oil I think is, you know, incredibly important and you know, probiotics, prebiotics. I think these, you know, any sort of gut support can be incredibly important for, for all the reasons that we talked about earlier. And then the, the one other thing that I usually encourage people to add in is some sort of egg health support or sperm health support, and that's essentially mitochondrial support.
Alexandria DeVito: So, you know, really thinking about kind of like, what are, you know, antioxidants that can, can support egg health and sperm health, and especially as people are getting pregnant older. And especially as we have more assaults coming at us, right? Supporting our mitochondrial health is incredibly important.
Alexandria DeVito: So I usually recommend kind of adding a mitochondrial support supplement in as well.
Dr. Justin Marchegiani: Great. Any other thoughts on essentially groupie strep prevention?
Alexandria DeVito: I don't have any other thoughts besides what, what you share. I actually didn't even realize that that there was a study out that there was talking about a simple probiotic intervention, reducing it by 80%.
Alexandria DeVito: That's wild.
Dr. Justin Marchegiani: I mean, I mean, it's, there's a bunch out there that vary, but yeah, having it in there is going to definitely reduce your chances and, you know, obviously avoiding things that are going to have a pesticide or antibiotic like effect, like Roundup. I mean, that's a antibiotic essentially it was patented as an antibiotic when it came out decades ago and that can negatively impact that beneficial bacteria in the gut.
Dr. Justin Marchegiani: Yeah.
Alexandria DeVito: Yeah, the one thing I will just say with probiotics is I think that they're, they can be very helpful. But what I want people to realize is that if you're putting probiotics in right live bacteria, it's also important to nourish them. And so we can just like, we can put, you know, these probiotics in and then we can eat crappy food and then they're not going to take them.
Alexandria DeVito: you know, they're not going to take seed. So I think it's really important that we're cycling basically like either probiotic based foods or probiotics through supplements. And then we're nourishing with additional prebiotics because then I think it's important. And then I also think cycling through probiotics, if we continue to take the same probiotics over and over, we don't necessarily get the diversity that we're looking for.
Alexandria DeVito: So, you know, there's some nuances with probiotics that I think like allow you to get the biggest, you know when you're thinking about introducing them into, into your diet and then supplementation regimen.
Dr. Justin Marchegiani: That's great. What do you say? What are your favorite foods that have a prebiotic benefit like safe starches, vegetables?
Dr. Justin Marchegiani: What do you like for that? And, and what other probiotics do you like to kind of mix in there outside of just your healthy fermented foods like maybe sauerkraut or kimchi or good healthy pickles kombucha? What other thoughts on that?
Alexandria DeVito: Oh, low sugar kombucha. Yeah. So I think depends on what what you can, you know, digest and assimilate.
Alexandria DeVito: But I think like, you know, onions, garlic, these are, you know, great for prebiotics foods, like just add them to a whole bunch of different products. You can even do those in like, in oils. And that's simple. Like you can, you know, You can season so many different foods with, with just that.
Alexandria DeVito: And then, you know, when I think about probiotics, right? I think about kefir. I mean, if you're not doing dairy kefir, there's also you know, coconut. So that, you know, that's like, you know, one that you can add in. Pickles are like a simple one that you just want to throw, you know, throw that in.
Alexandria DeVito: Sauerkraut even these things like I think sometimes we can make it very complicated But if you just like if you have some pickles and sauerkraut you know in your and you mentioned like I think it was kimchi you just take a little spoonful. And you know, it doesn't have to be complicated.
Alexandria DeVito: So including in your, in your refrigerator and just having a little, you know bite makes it simple as well.
Dr. Justin Marchegiani: Love that. Awesome. Well, feel free guys. And ladies feel free to link down below Amazon link to Alexandria's book and we'll put Alexander's website, G E T P O P L I N as well to get some of the pre pregnancy testing and anything else, Alexandria.
Alexandria DeVito: Thank you so much for hosting me. I would just say, you know, what I like to tell people is you have so much more agency over your, your broader health and your reproductive health, and you may have been led to believe. And so, you know, they're just, there's so many levers within your agency. And so, you know, just encourage you to to advocate for yourself.
Alexandria DeVito: And it's, it's such a pleasure to, to be on shows like this, where you're just giving people so many practical resources for how do you actually do that?
Dr. Justin Marchegiani: Awesome. Well, thank you so much for being a great guest. Thank you.
Alexandria DeVito: Thank you.
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