How To Enhance and Support Fertility with Functional Medicine | Podcast #332
There are two main methods for getting pregnant and if you’ve struggled with conceiving then you’ve likely looked into and/or pursued traditional medicine. This doesn’t necessarily make you healthier, but your doctors will try to change your hormones to encourage pregnancy. On the functional side, Dr. J would focus on enhancing health, enhancing physiology, regulating hormones, etc. Even then, sometimes measures like IVF are still necessary for the end. But before we get to that, we want to look at all the natural ways we can encourage your body to prepare for baby-making in both men and women.
Dr. Justin Marchegiani
In this episode, we cover:
0:24 Two Approaches in Fertility
7:29 Root Causes
17:20 Right Diet
30:40 Prenatal Supplements
34:54 Adrenals
Dr. Justin Marchegiani: And we are live. It’s Dr. J here in the house. Evan, how are we doing today man?
Evan Brand: I’m doing better. I had COVID Believe it or not. And that was like a five day journey. I think I’m over the hump. So if I sound a little weird, that’s why, but family’s healthy. And I’m a survivor. Now I’m going to be in the, quote, recovered category.
Dr. Justin Marchegiani: Love it. That’s good. Excellent. Well, today we chatted kind of pregame that we wanted to talk about fertility, talk about natural ways to enhance fertility. We see lots of patients that as a side effect of getting healthier through natural medicine, functional medicine, good nutrition, diet and lifestyle. They get pregnant, even if fertility wasn’t a goal, and we have some patients that come in with a goal of fertility and the nice thing is, fertility is a byproduct of getting healthy. So I mean, there’s kind of two approaches to it. There’s the conventional medicine side where they’re not really making you healthier, they may just be changing some of the hormones in your body. So you can get pregnant, right? IE via IVF therapy, those kind of things, right. And then there’s kind of natural ways that we are utilizing the enhancing of healthy and enhancing physiology to get pregnant. And sometimes IVF may be necessary. If you’ve done everything you can do on the health side, and you’re still not getting pregnant, that may be an option, right? But we want to do everything we can do on the natural medicine side, because if you do that, you know, 80 to 90% of people I think are going to get the results they want, which is getting pregnant. So I’m excited to dive into this topic with you today.
Evan Brand: Yeah, I would say that it’s pretty rare to need IVF based on some of the people that you and I’ve seen clinically, I’ve had several men and women and it’s good as a couple right. So that’s the important thing to mention. It’s important for the couple to get healthy the a lot of the blame is placed on the woman but in many cases, you know, male sperm motility or sperm concentration is a big issue. So the men kind of, you know, I don’t know why, but in general, the men get ignored in this conversation, but it’s really important for them to get optimized as well. And we’ve had couples where they looked at the cost of IVF, you know, typically 10, upwards of $15,000, depending on where 20,000 Really? Yeah, okay, so 15 to 20. And people come to us first and say, Well, you know, we didn’t want to go to IVF yet, because of the cost cost was kind of their main motivator, and maybe they, you know, hopefully had some sort of a natural minded bias. And so they said, well, let’s see what we can do first. And then 100 out of 100 times, so far, we’ve been able to avoid IVF for those people. And we’ve had, you know, between you and I alone, we’ve had four healthy children on our own. And then, you know, countless women that have had healthy pregnancies with our support
Dr. Justin Marchegiani: 100% it’s all about getting to the root cause, right? And yeah, there is that whole idea of the pottenger cats experiment where pottenger was in a medical doctor, I think, in the 50s, and he had different cats and he would feed some raw food, some processed food and and then there was, I think, within three generations of eating processed food. The cat group that ate the processed food lost the ability to reproduce. So there is this idea that we’re on like the third generation or so of this pottenger cat experiment. And there is some people that are just at that and end level where they may have reduced fertility just because they’re living out the pottenger cat experiment in real life. It’s possible some of that is the case. So we want to do our best to really emphasize a whole food nutrient dense anti inflammatory diet. We know that pregnancy involves healthy hormones. And as a starting off point, we don’t want to eat foods or toxins or hormones in our animal products that could throw off our fertility. So the first step in any fertility program, nutrient dense anti inflammatory, low toxin, that’s going to mean an organic whole food diet. that’s going to mean cutting out hormones and antibiotics and pesticides, and GMOs. A lot of these pesticides are xeno estrogens, they mimic hormones as well because they affect the insects from reproducing. That’s how they kill them. Right. And so it can also have an effect a cumulative effect on women and men on the sperm count women on the fertility side. So diet is going to be one of the first things and the second thing is going to be blood sugar stability. I think this low fat low cholesterol era, skipping meals fad dieting has prompted lots of insulin resistance, lots of reactive hypoglycemia, meaning too much sugar, too much carbs, blood sugar goes up and then spikes down, which then creates this insulin surge and high levels of insulin is really what’s behind the leading cause of infertility in women which is pcls. That’s polycystic ovarian syndrome. And that the mechanism there is high levels of insulin, insulin resistance insulin surges, thus increase androgens, and then the androgens also can throw off prolactin and then that can dis regulate a woman’s cycle. So you can see There’s a lot of different hormonal rhythms that can that can go off together and create many issues. So the major mechanism is in the beetus, insulin resistance, followed by increased level of androgens, free testosterone, testosterone, and then also prolactin issues to boost. Those are kind of the big initial sequelae that we see. And of course, usually if they’re eating a lot of crap or hydrating junky foods, people that are missing that level of awareness, tend to also be consuming the pesticides, maybe going to low fat, low cholesterol, maybe not getting high quality animal products and getting all the hormones in there too. So that’s like kind of my first two things out of the gates.
Evan Brand: Yep, well said and just want to quickly go over the conventional treatments for infertility, especially resulting from pcls. That’s what we did on our gut health podcast, kind of the conventional versus functional gut health. People loved it. I got a lot of good feedback on that. So thanks for the feedback. But it’s not pretty you mentioned it’s not root cause and it’s not so you’ve got this clomiphene which is the American College of obstetrician gynecologist recommendation that’s their primary medical medication for pcls patients with infertility, it indirectly causes eggs to mature and be released. Then you’ve got Metformin, which we just talked about the insulin resistance problems. So Metformin would come in and help. They talk about it helping just in terms of population, but that would probably be just due to helping to lower insulin. That’s what it is.
Dr. Justin Marchegiani: Yeah, Metformin, it liquefies. That’s a big one.
Evan Brand: And then you’ve got the letrozole. This is a drug that slows estrogen production causes the body to make more follicle stimulating hormone FSH, which is what you need for ovulation. And what else here they’ve got just other hormones in shot form, which are going to cause ovulation and then the craziest one, let me just read this one here and then we’ll we’ll move on into the functional you’ve got ovarian drilling. And so the surgeon makes a small cut in your abdomen inserts a long thin tool. And they use a needle with an electric current to puncture and destroy a small part of the ovary. This surgery leads to lower androgen levels, which may improve ovulation. So Wow. And if you do all those and you don’t get pregnant, then you could go to the IVF, which is where the sperm in the egg are put in a dish outside the body fertilization, fertilization happens, and then they put the fertilized egg into the uterus, and then boom, there you go.
Dr. Justin Marchegiani: Exactly. Now, I kind of want to tie back to the root cause I want everyone thinking about fertility from a root cause perspective, because when you think about it from a root cause then you can say, hey, are we getting to the root cause doing this procedure or doing this thing? So first off, like I already mentioned, pcls is a big one. Now with infertility, there’s usually going to be some level of insulin resistance or blood sugar dysglycemia meaning your blood sugar is up and down. And your body has to make a lot of hormones to regulate that flow blood sugar So when your blood sugar goes really high, right, because of excess carbohydrates in balanced meals, not enough protein and fat, you’re going to surge a whole bunch of insulin to bring the blood sugar back down. Now, women that tend to be more on the heavier side, usually that blood sugar eventually start staying higher, because that’s that’s what diabetes is right chronically high levels of blood sugar, but usually before that, there’s some level of reactive hypoglycemia where blood sugar goes up and then crashes down because the body over secretes insulin. And when the cells are still sensitive to insulin, that blood sugar will drop down really, really fast. And then your body has to make a lot of adrenaline and cortisol to bring it back up. Okay. So if we tie in prolactin, prolactin is going to go high when there’s high levels of estrogen. So when we start having more estrogen dominance, Okay, first mechanism, how does estrogen dominance happen? Well, it’s going to happen one through exposure of estrogens and the environment to with gonna happen through metabolism of progesterone. So progesterone is a really important progestational Pro fertility hormone very important. When we get stressed we’ll actually convert progesterone downstream into cortisol. So when we get chronically stressed, we’re going to decrease progesterone. And then number three high levels of estrogen, estrogen dominance, that is going to start driving prolactin issues. And when we start burning up dopamine, right, dopamine is a very important neurotransmitter. Dopamine gets used to make adrenaline so when we start making a lot of adrenaline, a lot of stress neurotransmitter, dopamine gets used, and dope means a tonic inhibitor or prolactin. So imagine you have prolactin and you have dopamine level is like the foot on the brake, right. And as you start depleting your dopamine and you start getting more stress, you’re taking your foot off the brake and what happens to prolactin, it goes up and prolactin starts to go up one of the side effects Next is loss of ovulation. Right You can go, [inaudible]. So you have a couple of mechanisms, right? You have this prolactin mechanism from dopamine, you have estrogen dominance, which can affect prolactin as well. You have this infertility through pcls. And insulin resistance and elevation and androgens, right. And then also all of the food components, all of the hormones and the toxins and the pesticides also contribute to that.
Evan Brand: Yeah, those are, I would say the biggest and most important things affecting your average american. There’s a couple other small subgroups, I want to mention what I’ve seen with infertility, one being people that are overtraining with exercise, you mentioned also the period. So I had a woman who she was, she was in the small percentage, but we have to talk about the small percentage because you know, people who are healthy and want to be healthy, listen to our podcast, and so there’s people that may be overachievers will call them and so we had a lady that was doing CrossFit like four or five times a week 45 minute sessions, and just beating the pavement. Now, typically when someone’s doing that we don’t really need to run a hormone profile. But just because I knew that it would increase her compliance. If I told her to stop exercising, she may not listen to me. So we use the testing to prove on paper what we already knew intuitively, which is that she was causing her cycle to be disrupted due to the chronic stress of the overtraining. So when we ran the hormone profile, and we showed her what her cortisol look like, it was basically flatlined, except for the time of the day when she did the exercise, she had a mild spike, which is why she felt better. You know, she said, Oh, my day is not complete until I exercise that’s because her cortisol was so low, and when she whipped the tired horse, all of a sudden she got this temporary boost of cortisol and adrenaline. She felt normal and that was it. But the prescription for her to get pregnant was simply just go down in the exercise. I just told her do three days a week Max, but do yoga, restorative, do biking, do hiking, do gentle things that are fun for you, and fun. For your family, and that’s all she did. I mean, her diet was already dialed in. We did look at her gut. We didn’t see any infections there. You know, we knew that there was no insulin problem, the carbs were not an issue. And she got pregnant just by simply reducing the training. And then another small group of people are people, women, specifically that were just going to low carb. So I had several women that were on a ketogenic diet. And some would argue well, our ancestors they could have been ketogenic, right, they were out in the prairies eating the bison, and they may not have had access to potatoes and whatever else but I do believe that some carbs are beneficial and necessary for fertility and for healthy pregnancy. So I had some women that were on keto for a long time, all we did is just add in some starch, organic white rice, we did some potatoes every once in a while and boom, they got pregnant and we didn’t change anything else. This is of course after we do the whole functional medicine workup, which you and I will talk about in a minute. That was after we did all that then we tweak the diet and then boom, she got pregnant.
Dr. Justin Marchegiani: Yeah, and I would say because information ability is primarily driven through PC OS and PC OS, the major mechanism behind it is going to be insulin resistance. I think a default template should be a lower carb paleo ketogenic template. But just because that’s our default doesn’t mean we’re not clinicians and adjusting things for the patient. So of course, with this girl, she may have done really well with that. And then she may have tapped out her benefits with it. And she may have already been at a really good place with her insulin. Because if you get insulin too low, and you’re already are relatively healthy body comp, that could also be a problem too. So this is why we have to individualize it for patients. So we’re talking about pcls and insulin resistance. And for most people, that kind of a dietary strategy is going to be a really important starting point. But for some people, you may hit the wall, and you have to adjust like you haven’t talked about others, you may have to hang out there a lot longer. So it’s kind of keep that in the back of your mind because we’re kind of having two conflicting recommendations. And that’s because everyone’s at Individual, and we have a starting point for most and then we adjust according to the patient’s needs after.
Evan Brand: Yeah, and that’s just an extreme case, but I at least wanted to mention it right? Because you always have the people that say, well, I’ve already done paleo and I still you know, had issues of course, there could be other underlying causes, you know, infections or whatever else we’ll get into, but in her case, this lady who was literally just doing like meat, and maybe a salad, you know, she literally had almost like virtually no carbs at all. So, so that’s just an extreme manifestation. But if you’re doing your, like you said, just kind of standard paleo template, you’re probably going to do maybe it’s plantains or some berries or you’re probably eventually over the day would accumulate enough starch or carbs to to fuel the fertility, but in her case, no, she was too low.
Dr. Justin Marchegiani: And again, if you’re insulin resistant, the starch or carbs may be keeping you infertile, right? Yeah, we can always do testing. We can always run fasting insulin and we can see where your fasting insulins are at. If there’s pcus. We may also want to look at prolactin, we may also want to look at free and total to stop Throw a see where that’s fitting to make sure it’s not, you know, in the top half top top 25% of the reference range. That’s pretty good to look at. So what’s the underlying mechanism? So if this person’s over exercising, it’s probably one over exercising, it can create estrogen dominance, right? So it can decrease progesterone. It can also decrease your dopamine and adrenaline which can be that driver that increases prolactin, right. And it can also just deplete hormones in general, I see a lot of women that are low estrogen, low progesterone, and they still may be a little bit in estrogen dominance because the ratio is still skewed, but their hormones are just low across the board. I see that a lot as well. So you have to this is why it’s super important to to test right because if you’re not testing you’re guessing. So with fertility cases, we may run a month long test to see where you’re at from day one when you bleed, all the way to oscillation all the way to the end of the month looking through the luteal phase to see how high that progesterone gets. We may just come in there and run a snapshot on the luteal phase two If patients have some infertility issues, but it’s not a primary thing, then we may just come in there with the luteal thing. If they’re really struggling on the fertility side, then we may do that full month. So I’ll typically do one or the other. And of course, looking at the adrenals are so important. Why? Because the adrenals interplay with dopamine and adrenaline and cortisol and estrogen dominance, ie via progesterone going to cortisol, we have to look at the adrenals because they play a major role as a backup generator with the female hormones.
Evan Brand: Yeah, absolutely. I mean, adaptogenic herbs are part of my life. They’re part of your life, you know, on a daily basis for us clinically And personally, and it’s a game changer. I would say it’s one of the biggest, one of my most favorite and biggest tools that I will use with a woman who is struggling with infertility, especially because there’s so much emotional stress. And there’s trauma associated with this, especially if a woman’s had a miscarriage or if a woman you know, has worked on this for months and months and years and been to several doctors in practice. And she feels like she’s at the end of the rope and she’s aging and she’s kind of running out of her her fertile window anyway. I mean, there’s so much stress associated with the emotional component of this as well and maybe family pressure when you’re going to have kids and that whole thing so, to me, that’s where adaptogenic herbs come in and not only help with the hormonal side, but the mental emotional stress as well.
Dr. Justin Marchegiani: Exactly. So in general, like with women and men, similar things with the diet, right men, there’s less of a hormonal fluctuation that’s going to be throwing fertility off. So keeping the pesticides, the hormones, the artificial hormones, these you know, estrogens, the growth hormones, really emphasizing good proteins, good fats, high quality cholesterol from animal products, lots of good antioxidants from leafy greens, keeping insulin in check. That’s a good first step. Of course, we can add in resistance training, we can add in mitochondrial nutrients like carnitine and co q 10, and arginine and zinc and selenium. Again, it was certain male patients will come in. We’ll run a nutrient profile and see what nutrients Their low end as well and of course, we’re going to be fixing the gut fix to the adrenals. And using a lot of those first line things, it’s also herbs we can use as well. ashwagandha is a big one tyrosine and dopa means a big one right? You see macoun as well as a big one. Why? Because dopamine helps with fertility. You mentioned earlier tongkat Ali really helps with that upstream signaling from the banana tropic releasing hormone, which then helps with FSH and LH. Lh is really important for spermatogenesis and making healthy sperm. So these are really good first line steps for enhancing male fertility. Anything else you want to add about that?
Evan Brand: Yeah, we weren’t. We didn’t press the record button yet. When we when you were now we’re talking about that. So let me just give just a quick little story on Tongkat Ali. There’s a Latin name for it as well. It’s something that’s beneficial for for men. We give it a lot to athletes, it does help with testosterone levels. And there are a couple of really, really cool papers on it. Where it’s increasing supermoto Genesis by influencing that HP ga axis the hypothalamus pituitary go Natl access. And long story short, not only did it increase the sperm count, but it increased the sperm motility. So you’ve got better swimmers. So when we talk about men, you know, having an important role in this fertility, you know, piece, that’s also a game changer. And then tribulus is another, you know, tribulus is once again kind of used in the bodybuilding community quite a bit to help with muscle mass and androgen increasing effects and all that, but it does help with the testosterone in the DHT DHT levels, which are all sex hormones that are important. And then also, what about the What about the influence of the gut? Do you want to talk about that now because I’m just thinking out loud with you here. We should probably talk about the mechanism of beta glucuronicdase issues with men and women where they would be re circulating estrogen and having issues with estrogen due to the beta glucuronicdase. enzyme being hired. Due to like a bacterial overgrowth problem, for example.
Dr. Justin Marchegiani: Yeah, so in functional medicine, right, we may look at things a little bit closer when it comes to fertility, but we’re still going to be doing the same things with the gut because if we don’t go to the six R’s of healthy gut function, we don’t go to the six R’s, removing the bad foods, replacing enzymes and acids repairing the gut lining in the in the hormones, removing the infection, repopulating rynok elating, good bacteria retesting. The gut is where everything happens 80% of the immune systems there, that’s where all the nutrients are absorbed and digested and assimilated and utilized. So if we just were to skip that and go to a hormone protocol, or a typical augmentation program with progesterone, we may miss a lot of those nutrients getting assimilated, broken down and absorbed and utilized. So we have to always assume the gut could be a major interplay. And again, most people, they’re not connecting the gut with their hormones. They just never right. But like you mentioned beta glucuronidation plays a role in hormone detox and We could be increasing estrogen dominance to the bad bacteria causing us to reabsorb estrogens. Right. We could also just have bad liver and gallbladder function because we’re not digesting fat, partly because of low stomach acid partly because of an H. pylori infection or grd infection. And that can make us hard to break down and assimilate cholesterol and essential fatty acids, which are important building blocks for fertility, right. So these things always kind of connect whether they’re one two or three degrees away from the root.
Evan Brand: Now if you’re a little brain fog, and you’re listening to Justin talk, you’re like, Oh my God, he’s talking fast. What is he saying? Giardia? What the heck pet parents Oh my god. So yes, literally, gut infections can literally make you infertile. We had several women who were infertile, and we ran their stool panel, they showed up with parasites, whether it was Giardia or krypto. As you mentioned, H. pylori being a big influence on stomach acids. So now, if we think about we always talk about good diet for mom, which is going to be a good diet to feed and grow a baby. But what if she does have these infections, and she is doing a paleo template and she’s doing her Grass Fed Whey or whatever to get her amino acid profile complete. And now all of a sudden she’s got these gut infections. So literally, just by running a gut panel and walking someone through using herbs to eradicate these infections, boom, I’ve had I lost count many women who, during a parasite protocol, they’ll email the office, I’m pregnant. What do I do? I’m like, holy crap. Yeah, by the way, this protocol by eliminating parasites, it actually increases fertility. Boom, there you go. Congratulations. And so it’s, it’s pretty nuts.
Dr. Justin Marchegiani: In general, anything else you want to say about that? So we talked about gut being really important. So HCl, enzymes, those kind of things are really important. We talked about the six hour if you’ve done podcast on that topic, so just make sure if you’re thinking about fertility, make sure we don’t ignore that right. has to be on the women has to know On the men, usually male men are easier to deal with because they don’t have a very unique symphony of a cycle. They kind of have a foghorn of hormones. And usually that’s going to be depleted by stress and poor nutrition and gut stuff. So it’s a little bit easier on the hormone side. But with women, it’s a little bit more complicated because of the cycle. So we talked about IVF. We talked about medication like clomiphene citrate or Clomid, which is a stimulates gnrh, which then stimulates FSH and LH and follicle stimulating hormone luteinizing hormone from the pituitary, which then stimulates egg maturation and oscillation. So there’s that right. But that’s kind of like a stimulator. Like Think of it as you got a tired horse. Do you really want the horse to perform by whipping it harder? Right? Is that the mindset? So for some people, that’s like an easy, you know, quick, simple, okay, I’m pregnant now. And most people who are aren’t as natural minded, that’s usually the first line of therapy that they’re going to do on the fertility side right. Then usually after that, they may go I UI which is the inter uterus insemination and then they may go into IVF or they shut down the whole HPA access using Lupron, they come in there with certain like follistim and different hormones at certain times so they can grow the eggs, harvest them, put them back in, get the whole hormone cascade going with all the injections, and then while you’re pregnant and then maintain the pregnancy with progesterone, that’s kind of what happens on the IVF side. But that may not be necessary for a lot of women. We already talked about the major mechanisms. Now, what are some deal breakers that may hold you back from getting pregnant even with doing all this? So there are certain things you have to look out for fibroids are a big one. If you have some big fibroids that are just hanging out, they could be there could be enough there where it’s disrupting blood flow, because the fibroids are a blood flow hog, and that could be preventing the egg from implanting into the uterus lining. Also, the fibroid can create a little bit of inflammation now everything we’re talking about is designed to To help prevent those fibroids from growing, the question is How long have they been growing they’re they’ve been hanging out for like years and years and years and decades. Some of the natural things just make take may take too long. And so you have to be very, very aware of that. Or it may be so big where it has so much momentum, it may need to be removed surgically. So you have to be mindful of things like fibroids. Also, endometriosis is a big one. That’s endometrial tissue, can it which is basically the endometrial lining tissue starts growing in areas it shouldn’t be, it could grow on the ovaries, it could grow on the bladder. Sometimes endometriosis, endometriosis can cause inflammation in that area. And then a lot of times with a simple procedure where you come and take a laser and kind of laser it off can be very helpful. conventional medicine won’t fix the root cause of why the fibroids there or why the endometriosis is there, but sometimes it’s gotten so bad where that may be necessary. There’s also something called a chocolate cyst, which is basically an Dimitrios in the ovary and that can Definitely be a problem as well. So that may need to be drained. So that you have to look at some of these things, some of these tissues that have grown for a long period of time, they may need a conventional intervention. Now, as long as you’re relatively young, and you have some time, try the natural stuff first and see if your body can handle it. If not, that may be the next thing to look at. And then of course, we already talked about pcls, which is polycystic ovarian syndrome. And that’s where there’s system the ovaries from all the things I mentioned, elevations and insulin and androgens, and I seen those reabsorb time and time again. So I’ve seen the body be able to handle that. I don’t see most patients that will have to go in and get those things drain per se, I find the body can handle that. The other things may need to be addressed at some point over time, but I always say wait and see work with a good functional medicine Doc, have a good ob gyn or a reproductive ob gyn kind of in your back pocket. So you’re monitoring things as you move forward. And if you have to go a surgical route, don’t throw away the functional medicine doctor keep both of them working together.
Evan Brand: Yep. Yeah, good point. And you know, it’s possible that you could find like a holistic or more natural minded ob as well, that would be good to have on hand that way they would help support you with some of the dietary stuff. But yeah, with endometriosis, you know, there’s a hormone component to that as well. So we already talked about diet and things like that, but of course, in the beta glucuronidation, so like calcium D glucose rate, for example, you know, that’s something that we may use to help with getting out these excess xeno estrogens. And that could be a game changer too. And of course, in the diet, you’re getting some like, you know, calcium D glucose, right? You’ll get some of that naturally in the diet. So whether you’re doing like broccoli, or blueberries or whatever, I mean, different. You know, cruciferous veggies, you’re going to get some beneficial stuff like that. Anyway, that will help. Regarding the hormones. It sounds crazy that broccoli could help pregnancy but yeah, but it definitely could. And then also, I mean, there’s no there’s various exercises to that can be helpful. Exercise in general is helpful. So I mean, if you have a sedentary woman, and you get her moving, but not to the CrossFit, five, you know, five times a week level, you know, that could be a game changer.
Dr. Justin Marchegiani: Exactly. So you got to look at everything holistically, like, I’ll tell you my personal story. We have two Healthy Kids, two healthy boys. And my wife and I had a hard time getting pregnant in that first year. And we found she just had a really, really, really, really, really big fibroid, very big-
Evan Brand: Was that ultrasound or how gel, figure that out?
Dr. Justin Marchegiani: Transvaginal ultrasound, and my wife before she met me, she was on birth control pills for over a decade. So I think there was that she wasn’t he she was eating a lot of conventional foods in the beginning before she met me before we tweaked her diet. So I think there was a lot of hormonal growth that was going on for decades that caused some of that growth. And you can’t just pull it away and expect it to just reabsorb all of a sudden, right? You can’t take 10 years and just expect it to go away. And so we actually tried reducing it. Now there are things you can do, they can work there. You can do things like egcg epigallocatechin is in the green Green tea you can do things like resveratrol and lipids or curcumin, and you could do systemic enzymes like Sarah peptidase and lembrar kinase, which are helped to metabolize some of that tissue and can work. The question is, can it work fast enough? And so we went the surgical road that the fibroids removed and literally within two months of it being gone pregnant, no problems. And so sometimes that can be an issue. So you have to look at, okay, what’s the root? Cause? You know, do we have some limitations of matter, right? Were those tissues just been hanging out too long? Just the body needs a little bit of a head start getting that tissue removed. And if you got time, you know, do the natural things and just watch and wait, right watch and wait. So if you’re a female listening, and you’re not in a relationship, or you’re not looking to get pregnant anytime soon, but you want to at some point, I just recommend getting good, good workup with your ob gyn to make sure there are no endometriosis or fibroids, endometriosis. This is hard. Typically the only way to figure that out is laparoscopically, little incision for the scoping. So it’s kind of tough to know that one. But you know, usually a lot of the telltale symptoms like the painful periods, like those kind of things, if you’re having those symptoms work with a good functional medicine doc to help it, but keep an eye out on bigger issues, like fibroids and those things so you can act on it early.
Evan Brand: Yeah. Thanks for sharing the story. And now you got two little boys and they’re keeping you busy. So everything worked out.
Dr. Justin Marchegiani: You got it? Absolutely. So keep that in the back of your mind. Anything else you want to add? On the supplements? I know you were kind of riffing on a couple of adaptogens earlier. Anything else you want to add? You mentioned while you listen tongkat Ali?
Evan Brand: Yeah, so that could be for the men. I would just say during during the you and I’ve talked about this idea before we kind of call pregnancy more like a four trimester thing which women like cringe at like, Oh my God isn’t pregnancy long enough, but not just meaning that there’s a kind of a pre, a preNatal phase that happens before you even get there. Right now kind of a pre, you know, fertility supporting area. So we’ll bring in multis and omegas. And like you said, maybe systemic enzymes will bring in trace minerals, micronutrients, maybe Grass Fed Whey protein, maybe some Oregon supplements. I mean, there’s a lot of things that we can do right away to kind of prep the body before you even get pregnant. It’s not I disagree with this idea of you got, you’ve got a pot of positive pregnancy test start the prenatal, it’s like, No, you could be six weeks in already, like you should have been on the prenatal six months before you got pregnant in my opinion.
Dr. Justin Marchegiani: Yeah, and most prenatals I mean, prenatal is a more of a marketing thing, like in some of the prenatals that we recommend, what makes it a prenatal Well, there may just be a little bit more calcium, there may be some extra full weight in there. And of course, everything’s active, full light, no folic acid, everything’s mthfr. Of course, everything’s methylated. There may be some extra iron in there, right? So there may be a couple little nutrients that are a little bit extra. But if you look at a really good high quality multi versus a prenatal they’re going to be about 90 95% At the same Yeah, if you’re getting a high quality couple little tweaks here and there, of course, you may want to add in some extra essential fatty acids cod liver oil, those kind of things I think are are very, very helpful.
Evan Brand: I get so mad I get so mad when you go like if you go to like Whole Foods or I mean even even places like that where you’ll go and you’ll see these little cute gummies in like a clear container. And it’s like six gummies a day and the first ingredients like fructose or fructose tapioca syrup. And it’s like, okay, here you are taking the woman who, you know may not know exactly what’s going on may not understand the root causes, and he or she has eaten these little gummies every day as a prenatal it’s like no, it’s like candy.
Dr. Justin Marchegiani: Totally 100% agree. One other thing if you have to go a surgical intervention I recommend personally, if you’re a fertility age and you want to get pregnant that you see someone that has a specialty in reproduction as well as being a gynecologist. I find that certain gynecologist have a A perspective on what’s happening surgically with the goal of removing the tissue, while others have a perspective of that while maintaining fertility. So I find someone that’s a ob ob gyn as well as a reproductive specialist, they looking at the procedure with a lens of keeping fertility intact. So I always recommend if you have to go the surgical route, try to find an OB GYN that also has that reproductive specialty as well. Yep. Good advice. Yeah, I think that’s important. I’ve just seen, I’ve heard too many stories from ob gyns, who don’t have the repro specialty, and they’re just and again, some of these are older stories. They’re too easy. They’re too They jump the gun on just doing a complete hysterectomy or doing a partial hysterectomy just removing the uterus or just removing too much tissue and and that scaffolding of that uterus can collapse and other issues can happen. So I always like to make sure you have someone with an eye Keeping fertility intact.
Evan Brand: Yep. No, I mean that if that’s their job to just remove uterus and ovaries all day Yeah, they may not care about the fertility aspect at all.
Dr. Justin Marchegiani: Yeah, it’s really, really important. And then yeah, and that’s, that’s incredibly important and of course, the most non invasive to invasive is is the best way to go. Anything else having you want to add on the topic? I mean, Today’s been really great. I think we really hit a lot of things from the nutrition aspect to some of the herbs and nutrients just to dovetail that progesterone is a big one we may be adding in progesterone we may be adding in things like chase tree and damiana and different herbs that help modulate maka that modulate estrogen receptor sites and or modulate progesterone and even support progesterone and of course, we’re also supporting the adrenal so all of those key tenants there need to be fully looked at and supported that you want to add anything else that Evan?
Evan Brand: I don’t think so. There’s a Yeah, there’s a good handful of like female supporting herbs, things that we would typically use anyway. To help with like PMS, for example, things that are going to help regulate hormone levels, those things alone can contribute to fertility. So yeah, it’s sometimes where a woman comes to us with a different problem with hormones, they may say, Oh, I eventually want to get pregnant. But right now I need to focus on this major PMS. I’m out of work every week, you know, I’m laying in bed in pain, and we just help regulate hormones using some of those herbs you mentioned there and then fix the gut and then boom, hey, we got pregnant sooner than anticipated. Cool. Let’s go ahead and kind of transition now let’s, you know, let’s get you into this, you know, maternal support phase now and it’s really fun I tell you, there’s there’s nothing better than you know, whether it’s getting a picture in my inbox of a new baby or just a mom telling her birth story. It’s It’s fun, and it’s a very, very rewarding thing. And, and, and I always, I don’t know I like to pop my collar a little bit more after I hear a good story like that, especially when a woman was dealing with the conventional medical world and she was so frustrated. And so hopeless, and then she was able to actually do it naturally. It’s like, Yes, I told you so I told you you could do it because the conventional doctors are obese will be like, nope, you can’t do it. You’re not going to get fertile. You’re too old. Your hormones are too messed up. It’s not gonna happen. And then boom, a baby comes. It’s always just like I told you, so.
Dr. Justin Marchegiani: I like it. Well, after you talked about popping the collar, I’m gonna I’m gonna join you on that one. There we go. Excellent. Very good. So yeah, I love those stories. I think that’s excellent. We always want to focus on the root cause so just anyone listening we want to make sure our goal is that you’re looking at your fertility from a root cause perspective. If you have to bring a functional medicine doctor in great if you have to bring a conventional fertility MD and great just always make sure you’re looking at the root cause. If you have to go you know more invasive on the IVF or surgery side, that’s fine. Just make sure you exhaust all of the foundational options first, nutritionally and functional medicine wise. And then also make sure your husband’s a part of what’s going on. So Make sure he’s getting tested, his nutrients are assessed. He’s doing all the right things on the fertility side, we can also get a sperm count on him as well make sure sperm numbers are good, you know, at least 50 million, make sure shape and morphology and all that good stuff is dialed in as well to assess that being okay. And of course if, if it’s not, then we have to work on all the nutrients and work on removing a lot of the toxins that we already talked about.
Evan Brand: Yep. So get off the mountain dew. Oh God, we had a friend that was an old friend who was having issue with fellow body and her and her husband both just pounded the Mountain Dew. I’m like, who even drinks Mountain Dew anymore? I mean, it’s like, it’s like 80 grams of sugar per bottle. I was like, oh, get off the mountain dew. So of course, you know, typically people would think everybody around you and I like we’re just the circle of health, our family, our friends and everybody would just listen to us and reach out to us for help. But that’s typically not how it we’re not how it is. So of course they don’t ask me anything. What do they do? They go do IVF they spent, I think it was 15 or $20,000. They did like a fundraiser raise money. It’s like how about just like, let us give you the workup, it’s going to be a fraction of the cost. And you’re going to have, you know, minimal to no risk. I mean, like with other procedures, you know, you could have risk of twins and triplets. I mean, they’re not, you know, death necessarily risk, but there are risk associated with some of these other things. So, it’s just sad. It’s sad that people just don’t know. And, you know, you always say, oh, let’s talk about the root cause of this. It’s like, why is that so revolutionary? That should be the first way people think but it’s not.
Dr. Justin Marchegiani: 100% you’re never a prophet in your own town. And also, if women have to go the IVF road, the goal remember the end goal is not just to get pregnant, right? What’s the angle? Let’s huddle up and focus on what’s the end goal the end goal was to have a healthy baby, right that’s that’s the angle and pregnancies one step in that journey. So don’t confuse the first step as success number one, and then number two, If you’re going to engage in more conventional approaches that don’t address the root cause, I strongly urge you to make sure you’re addressing the root cause. So the angle should be having a healthy baby at the end. So just keep that in mind, make sure you are really focused on what the root cause and goals are.
Evan Brand: Let me say one last thing, and then I want to get your take on this real quick. And I love the way you said that, you know, the pregnancy is not just the end all Gold’s it’s the healthy baby and all that. So, you know, what about if a woman does get pregnant, and in an unnatural method, like IVF, for example, but she still has an insulin problem. I’ve seen cases where you could argue with something else, but I would argue that the elevated insulin and the sugar and the carbs and all the crap in the diet could potentially make the baby get too big. And then the doctors are saying, Hey, you know, now you’ve got a nine pounder, we’re gonna have to do a mandatory c section, for example. You know, there’s other complications there.
Dr. Justin Marchegiani: Yeah, I mean, just having that high amount of insulin, gestational diabetes. kind of thing going on, which a lot of times the Hopis don’t even acknowledge, really being a diet thing. I mean, I remember going in and my wife was getting testing on the blood sugar, and we were monitoring her blood sugar at home. And the nurse practitioner said, you know, hey, you know, the gestational diabetes is a genetic thing. And I’m like, I literally pulled up a study of like, literally says more grains, and trans fatty acids can actually increase it. And it was like a, it was just, it was like a paradigm thing. It’s like, even though like, if people are conventionally trained, and have to pass all these, you know, mainstream boards for their licensing, they’re not really up to date with the conventional literature in the conventional literature isn’t really injected in the first line therapies for what these doctors and nurses need to know. So it’s kind of sad. So we just want to bring that information everyone on the forefront now so they’re aware of it, and also test the blood sugar and if you’re at high risk for a miscarriage, then you’d want to keep an eye on your progesterone levels. As soon as you get pregnant. One of the easiest first things is using progesterone, an inter-vaginal progesterone probably 200 milligrams or so a day throughout that first trimester can be a godsend for a lot of women. So if you’re at high risk for miscarriage, make sure you keep an eye on testing those progesterone levels, you know, 15 to 20 or so in that first week, couple weeks of getting pregnant and to be important, so keep an eye on that with your ob. So you’re monitoring if you’re high risk.
Evan Brand: Yup. Well said. Well I’m sure I could break off a few of the things but let’s wrap it up and keep on reaching out clinically. We’d love to help you. Justin is available around the world at JustinHealth.com. Me, EvanBrand.com and we’ll be back soon to talk more.
Dr. Justin Marchegiani: Phenomenal chatting with you all. Have a good day.
Evan Brand: Take Care.
Dr. Justin Marchegiani: Bye.
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DUTCH Sex Hormones Metabolites
Dr. Lauren Noel – IV Nutrition, Female Hormones, and Leaky Gut – Podcast #37
IV nutrition is very vital to female hormones and preventing conditions like leaky gut and others. Find out how these additions to your nutrition can help your hormones become more balanced, prevent yourself from having complications and adverse conditions, and help your reproductive health.
Intravenous Nutrition (IV) is basically securing that your body is thoroughly nourished. We need food. But not all of us can eat enough food because of certain circumstances like illness, or lack of access. Sometimes, even if you think you have eaten enough, a lot of the nutrients from the food might not be absorbed by your body.
Your digestive system might have some certain problems that make you unable to absorb these vital nutrients that keep your body working to its optimum performance. With IV Nutrition, you make sure that you get all the vitamins and minerals needed and they surely will be received by your body. It’s a lot better than taking oral supplements because, well, sometimes you might have some absorption problems.
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Dr. Lauren Noel is a Naturopathic doctor who has helped thousands of patients with their digestive disorders, thyroid, and reproductive problems. She also has great knowledge about functional medicine and overall wellness.
Dr. Justin Marchegiani: Hey there! This is Dr. Justin Marchegiani and welcome to another awesome episode of Beyond Wellness Radio. Again, we have a great show in store for you. Before, go to BeyondWellnessRadio.com, click on the Newsletter Signup button and you can sign up for our newsletter and get show updates right in your inbox before anyone else. You can also click on the questions button and even speak questions live, and we’ll be able to answer it on the air for you.
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Also, check out JustInHealth.com, which is my personal site. And I have some complimentary functional medicine consults available. You can also sign up for the Free Thyroid series and Female Hormones Series as well.
You can also go to ReallyHealthyNow.com. That’s Baris Harvey’s website where he has some great articles and blogs and videos for you there as well. And even some consultations.
Again, we have an awesome show in store. Stay tuned.
Hey there it’s Dr. Justin Marchegiani with Beyond Wellness Radio and we got Dr. Lauren Noel here in studio. Well, kind of. At least over Skype. And we’re really excited to have Dr. Lauren here. She actually rescheduled on me twice because she’s so busy but I’m so happy we’re able to get her in. Dr. Lauren, how are you doing today?
Dr. Lauren Noel: I am lovely. So excited to finally be here. Third is a charm. Thanks for asking.
Dr. Justin Marchegiani: No problem. So tell me, what’s going on with your clinic? I know we chatted a little while ago and your clinic’s been off about, I think, a year and a half, and you’re rocking it, helping lots of people. Can you tell me about how the clinic’s doing?
Dr. Lauren Noel: Oh man, it is-. I am beyond amazed at how it’s taken a life of its own. It’s just so amazing. I started the clinic Shine Natural Medicine a year and a half ago and my vision was creating a place that is not only empowering to patients but also to the staff, and a place where we all get to come together to and really just develop ourselves personally, with our health. I wanted it to be a hub of community and it’s completely done that. We have events here at the clinic. We just had our anniversary party a few months ago and it was so much fun. And we had a photobooth. Patients were coming in and taking pictures and we had healthy foods and drinks, and music, and a DJ playing. It’s just become a place of so much fun and health, and it’s exactly what I envisioned and more. So, I’m pretty happy about it.
Dr. Justin Marchegiani: That’s really good. Awesome. And I see you got a new website up at ShineNatural Medicine.com. Site looks super awesome and I see you got a newsletter on there. So are you starting to send out blogs or videos every week now?
Dr. Lauren Noel: Yep. We are sending out weekly tidbits, recipes, health tips. Just keeping people in the loop of what we’re doing at the clinic. And we send out fun videos – just something to inspire you and give some good little pearls for your health. We like to keep it simple, but also some useful information. So, yeah. It’s a lot of fun.
Female Hormones, Libido, Sex Drive, and Fertility
Dr. Justin Marchegiani: That’s awesome. Really cool. Well, now I have you on here, I’ve really wanted to talk about female hormones and especially the area of libido, sex drive, and fertility. So I’m just going to open it up there. And why don’t we touch we touch upon fertility right now? Just [talk about] some of the things that you know need to be in place with the patients to be really fertile and have the best chance of having a healthy pregnancy.
Dr. Lauren Noel: Yeah. God, don’t you see so much in your practice? There’s so many issues with fertility nowadays. It’s amazing.
Dr. Justin Marchegiani: All the time.
Dr. Lauren Noel: All the time. And I think couples are embarrassed sometimes to talk about it because they think that as soon as they start to try to get pregnant, boom. It’s going to happen and they’re going to have this beautiful joyous pregnancy and no stress. And a lot of times it doesn’t necessarily go that way. Infertility is on the rise a lot more than it’s ever been before and I think there’s a lot of things that are involved with this.
But the first thing that I start with patients is a pre-fertility kind of cleanse. So, we’re getting the hormones balanced. We’re getting space created in your life so you actually could have a baby. I just had a patient the other day, about a week ago, came in. She’s very, very busy lawyer and she works like 70 hours a week and she’s like “I want to get pregnant!” and I go “You have no room for a baby right now. You’re not going to get pregnant because you just cannot actually take this on in your life right now.”
And with our follow-ups, she’s been creating more space in her life to do this. She’s getting acupuncture. She’s taking more time to cut back on her hours and meditate, and relax a lot more. And her hormones are starting to get a little more balanced and it’s been just basically cutting back and saying No. And I think that’s one of the biggest takeaways for women, especially, because if you’re stressed, you’re going to have a hard a time getting pregnant. So, we live in a very stressful day and age. So much on our plates now. And, you know, cutting back and really balancing out life is really huge for fertility. I’m sure you see a lot of this too.
Dr. Justin Marchegiani: Yeah. Absolutely. And you know we know from like a lifestyle perspective, like the meditation, sleep, blood sugar, like these are kind of foundational. But what are some the things that you’re doing from a functional medicine thing? You mentioned hormones. I know you do a lot of IV nutrition in your office too. What are some of the extra things that you do that you find really help improve a woman’s fertility?
Dr. Lauren Noel: Yeah. So, first thing is getting a baseline to see where we’re at. So, definitely looking at Hormone Testing, doing a good Day 21, seeing where your progesterone is looking at, your estrogen, adrenal panels, to doing a salivary adrenal test. And if you have healthy adrenals, you’re much more likely to get pregnant. If you have that flat line adrenal, your body is just trying to keep up with life right now. You’re just not going be able to sustain a pregnancy as easily. So, doing the salivary cortisol test is really important. I use bio health. I think that’s probably what you use as well.
Dr. Justin Marchegiani: Yeah, exactly.
Dr. Lauren Noel: Just really good hormone testing and then also looking and seeing if you have any nutrient deficiencies. So specific ones. Magnesium is huge for fertility. B vitamins, you know, the Methyl H. And you probably touch on something higher. Your foliate levels, your B12. B6 is especially important for hormones for women. And so, getting your nutrient levels on track before you get pregnant. Because once you get pregnant, that baby’s going to be sucking up those nutrients for you. So, you’re going to get just the leftovers. So getting to a point where you’re just optimally well, you can get pregnant and stay healthy during pregnancy. You’re not going to have the post-partum and just feel so depleted after having your baby. So, testing for nutrient levels, I run labs with Specter Cell. I like them a lot. You can also use the nutri-Eval from Genova. And just getting on a good program.
Typically for my patients, I do a 10-week plan retests to see where we’re at. And oftentimes, within like one or two plans, I mean, it’s a big difference with how the nutrient levels are looking, how a patient’s feeling a lot more energy, feeling like sex drive is a lot better. You know, cycles are more regular. But I love using IVs for the reason of absorption. You know we know that there’s so many digestive issues for patients nowadays. So getting a good dose of those nutrients right in the bloodstream is so much more effective than a supplement.
Dr. Justin Marchegiani: Well, that’s great. So kind of hit upon two different topics I really want to touch upon. So, let’s hit the first one here. Let’s hit libido and sex drive. We can talk about it from a male perspective. We can talk about it from a female perspective. But why don’t you address some of the underlying hormonal imbalances that you see in a lot of your female patients with low libido? And is it just about getting the hormone to fix that, or are there other things you’re doing in conjunction with just maybe hormone support?
Dr. Lauren Noel: Yeah. Yeah. And this is one especially for women, I think, they kind of have some shame around this. They go “Oh I have this amazing boyfriend, amazing husband. It doesn’t make any sense. How can I not have a sex drive? And yet I just don’t really feel it. Yes, I’ll have sex because I want to make him happy but I’m just not really enjoying it”. And it’s just so common seeing this, even in women in their 20s and 30s sometimes. You know, who are younger and having regular cycles will just feel like don’t have this kind of sex drive happening. So, one of the biggest things I see, I know you see it too, is stress hormones. Cortisol is the best killer for sex drive. You wanna kill your sex drive, get your cortisol levels out of balance. I mean it makes a lot of sense for when women say they’ve gone on a vacation and then they feel more sexual, because they’re relaxed. They’re in a place where they’re able to then, you know, be in that more sexual kind of space. And so that’s first and foremost you want to help this sex drive, you’ve got to balance your stress. You’ve got to cut back on what you’re doing.
You know, if it’s meditation that’s going to start your day in a more mindful kind of way. I started doing meditation recently and it has completely changed my life and I’m able to have a sense of calm in the midst of chaos. It’s crazy.
Dr. Justin Marchegiani: That’s great.
Dr. Lauren Noel: Yeah. I’ve been trying to meditate, literally, trying to meditate for years.
Dr. Justin Marchegiani: Are you using an app? Are you using one those apps right now?
Dr. Lauren Noel: Yeah. I use an app called Headspace. Have you heard of that one?
Dr. Justin Marchegiani: Yeah, I use Calm and Headspace. I’ve got to go back and forth with them. Headspace kind of has the Ozzy guy and the Calm has the cool English girl in there.
Dr. Lauren Noel: Ooooh! I haven’t heard of Calm. Is it just C-A-L-M? Calm?
Dr. Justin Marchegiani: C-A-L-M. Yeah. It’s a good one.
Dr. Lauren Noel: Okay, cool. Yeah. Headspace has been amazing for me because I think before, I would use different mindfulness apps and I would get a little ADD trying one and trying another. But I like how Headspace was like you build one day at a time. And that really worked for me. So, yeah. I’ve on, I think, Day 40 (Dr. Marchegiani says “Wow”), and I’ve been actually really consistent with using it. And I tell you I have more in my plate now than I ever had and doing that has made it to where I can keep up.
Dr. Justin Marchegiani: Very cool.
Dr. Lauren Noel: So building in more of that, kind of stress report is especially important. And then get your hormones balanced. So low testosterone? Huge for women. Most women typically think, “Oh, that’s a male hormone. I know I don’t need testosterone”. But no, women do need testosterone. So, that can be really, really helpful for getting your sex drive on track. And then DHEA too.
So DHEA for sex drive, also for the quality of the eggs, actually. So doing kind of a higher dose of DHEA for women can improve the quality of the eggs in order to get pregnant.
Dr. Justin Marchegiani: And won’t DHEA also affect testosterone that kind of flows downstream and eventually increase it?
Dr. Lauren Noel: Yep, exactly. So, I won’t really put a younger woman on testosterone typically. We’ll do some pregnenolone and some DHEA to give you those, you know, kind of the precursors and they have that flow into the testosterone. But huge, huge benefits.
Dr. Justin Marchegiani: That’s the same approach that I have. Cool.
Dr. Lauren Noel: Yeah.
Dr. Justin Marchegiani: What about herbs? What kind of herbs do you do? Do you like maca, like Peruvian Ginseng? I’ll let you kind of just touch upon some of the herbs that you like.
Dr. Lauren Noel: Yeah, Maca’s a great one. I’ve recently started using Mighty Maca. You know Dr. Anna Cabeca?
Dr. Justin Marchegiani: Yeah.
Dr. Lauren Noel: Yeah, she’s put together a really good product in Mighty Maca. I love that. It’s a good Adaptogen blend. It has some greens in it too. And then the specific kind of Maca that she’s used is just of very good quality. And so we just start with one scoop and ramp up to maybe three or four scoops. You can put a little water and drink that down and that’s awesome for sex drive. And I’ve used that.
Also Femanessence. I love using that as well. And that’s also for men and for women. I know that NHI has put a good product with Femanessence for women. I think men’s is called Revolution Pro. But Maca’s so great. Because it works on the HPA axis. So it works on that whole, you know, stress kind of loop. It’s not all about, you know, we’re just going to boost your testosterone, right? We want to have your brain, your adrenals, the ovaries all communicating with each other. And so Maca really works on that kind of axis in a great way to firm up those pathways.
Dr. Justin Marchegiani: Very cool. What’s your experience with Horny Goat Weed?
Dr. Lauren Noel: (laughs)
Dr. Justin Marchegiani: Have you tried that one for him?
Dr. Lauren Noel: Ha ha ha. I just love that it’s called ‘Horny goat weed’.
Dr. Justin Marchegiani: I know, I know. It’s hilarious. There’s a story about this.
I was 22. I had like, chronic fatigue. I was in college. And the naturopath-slash-chiropractor I was seeing recommended it to me. And I remember like “what the heck is this?” And I just, I thought I got amazing results from it for me personally. So what’s been your take on it?
Dr. Lauren Noel: Um, I’ve found the same thing, actually. There was one patient who [is] on it. We had to take him off because it was like too much for him. Hahaha. So, I don’t know if you had that experience. But yes. I haven’t used it as much for women. I don’t know if you’ve used it for women. But for men, it’s been really good results, actually.
Dr. Justin Marchegiani: Okay. Alright. Very cool. Any other herbal secrets you have?
Dr. Lauren Noel: Uh, let’s see. For sex drive, um what do we think about this one… Um, yeah, I think those are the biggest ones – the Maca, the DHEA, the Pregnenolone, cutting back on stress is the biggest one. I work mainly with women and then getting into the feminine, I think is huge. So, the more that a woman really works on her masculine and just trying to be that forceful kind of masculine nature. I think that’s a big killer for sex drive too. So getting more into your feminine, getting more into your body, whether that’s, you know, using more dancing, or you know, belly dancing actually. One of our new doctors in the clinic, she’s actually a professional belly dancer. She actually does workshops on that. And she’s very vibrant and has this very sexy kind of nature and it’s inspiring. So I think for a woman, really getting into your body. And one think I say is dance naked to music every day. Pick one song and dance naked to it every single day and you’ll get used to being in your body a lot more.
Because I think we have a lot of body issues. We see a lot of images of how a woman should look and that’s a big killer for sex drive too because you see yourself in the mirror and you go “I don’t match up. I’m not pretty. I’m not sexy.” And that’s just such BS. Get into your body, and really own that. That feminine power.
Dr. Justin Marchegiani: Very cool. And especially, talking about fertility, a lot of women that have these super skinny body types – a lot of them, they may not even be fertile because their body fat is so low.
Dr. Lauren Noel: Yes.
Dr. Justin Marchegiani: Can you touch upon low body fat and fertility as well?
Dr. Lauren Noel: I’m so glad you said that. Eat fat.
Dr. Justin Marchegiani: Yeah.
Dr. Laurn Noel: Huge. For me, it’s such a no-brainer. I almost forget to mention it sometimes. Low-fat diets, that will give you a low sex drive, because you’re not gonna be making the hormones that you need. So the building block for your hormones is cholesterol. I’m sure your listeners know this. But, it’s like if you think of legos – the big main lego piece is cholesterol. And you add one little piece onto it, you get, you know, progesterone, and estrogen, testosterone. It’s all with that main piece of cholesterol. So, you want to have those good healthy fats in your diet. If you’re eating some chicken, eat the skin. If you’re having some meat, eat the fat. Have butter. Have coconut oil, ghee. I mean, these kinds of fats are so incredibly helpful.
And I’m going to say from experience. Back in the day when I was a vegetarian, my hormones were crazy. My cycles were, I mean, I was having a period every two months. And now, my cycles are right on track. At 34, my cycles are more regular than when I was 24.
So, nutrition is really fundamental for fertility, and fats is really where it’s at.
Dr. Justin Marchegiani: Well, that’s really cool. I never knew you were a vegetarian. That’s the first time I heard that.
Dr. Lauren Noel: I think all of us, at some point, were. But were you a vegetarian?
Dr. Justin Marchegiani: You know what? I was on this super low-fat kick for a while, thinking fat was bad. And that like, screwed me up and I was super gluten-sensitive because I have autoimmune conditions. So I’m eating light. I remember being in my Exercise Science class, Freshman year in college and they gave us this, like, nutri-calculator, and they would basically give us these assignments and they would track all of our food. And I remember coming in so proud to the professor, being like “Look! I ate 12 servings of grains yesterday” and I was so proud. And everyone’s like high-fiving me and I was like “Yes! 55% of my carbs are grains. This is perfect. And then I looked back, and I’m like “Oh my gosh, no wonder why I had all these health issues and brain fog.” So I’ve made mistakes on the other side of the coin there for sure.
Dr. Lauren Noel: Oh my god. I totally relate to that. Yeah, I mean, back in the day. Those days I was vegetarian, lots of grains. I had raging acne. I was on Acutane twice. I had irregular cycles, you know, digestive issues, a sorry condition and so much of it was related to diet. And after even being on Acutane twice, my skin still did not clear up. It wasn’t until I cut gluten out of my diet, cut out the grains, added in more fats, and then boom. My skin is clearer than it’s ever been, my cycles are regular. Nutrition is so powerful.
Dr. Justin Marchegiani: It is. It totally is. And on the topic of fertility, can you touch upon digestive health? How important is digestion with fertility? Can mal-absorptions and digestive issues drive fertility and libido issues?
Dr. Lauren Noel: Oh my gosh. Well, as a naturopathic doctor, I’m always saying that your digestive tract is the center of the universe. It controls so much. Not only in your absorption but in your immune system, your neurotransmitter balance, your hormone clearance. If you have chronic constipation, you’re going to have issues with balancing your estrogen. So there’s a big connection there that most people have no idea about. You also activate your thyroid hormones, a good percentage of that in your digestive tract.
So if you’re having continual constipation, diarrhea, absorption issues, you know. Again, you’re not only going to have deficiencies, but your hormones are going to be majorly affected by that – testosterone, and your thyroid, estrogen levels for sure.
Dr. Justin Marchegiani: That makes sense because you’ve mentioned cholesterol being a building block of our hormones and if we can’t break it down and metabolize it, well then, we’re not going to be able to make the hormones. And so, I think you talked about zinc earlier, and zinc’s so important for our sex hormones too, right?
Dr. Lauren Noel: Exactly. Zinc is important for sex hormones and for your thyroid. You need sufficient zinc levels. Yeah. And actually zinc for fertility. Hello! Zinc for sex drive! Right? That’s why oysters are an aphrodisiac. It’s just loaded with zinc. I personally prescribe oysters all the time. I don’t know about you, but I’m always telling my patients “Low in zinc? Eat some oysters.” And that’s my regular routine at the farmers’ market – have maybe five or six oysters, and I’m good to go.
Dr. Justin Marchegiani: Very cool! Do you ever do a Zinc tally test with your patients?
Dr. Lauren Noel: Yeah. You know, I did that a lot in medical school. I haven’t done it as much now because I do run the Specter cell. But I think I’m going to bet back to using that. Yeah, it’s a fascinating test and it’s so easy and it’s so interesting because it’s like if your zinc levels are good that zinc is going to taste nasty. But if your zinc is down in the dumps, you’re not going to even taste it. It tastes like water. It’s so amazing.
Dr. Justin Marchgiani: I know. It is really cool. So, people that are listening to Dr. Noel saying “the better it tastes means the more deficient you are, the worse it tastes, less deficient you are, and the faster it tastes good, mean the more deficient, the slower it tastes bad, and it’s kind of in the middle”. So, the faster it’s good, the more, the slower it’s bad, that’s the best. Cool.
Dr. Lauren Noel: Yeah. So if it tastes nasty to you, that means that you have a good amount of zinc in there.
Leaky Gut
Dr. Justin Marchegiani: Yes, absolutely. Very cool. Well, Doc, I know you do a lot of IV nutrition and we know today with leaky gut and chronic gut infections. Can you talk about, you know, leaky gut a little bit and some of the things that you’re doing in your office with IV nutrients and even B12 and intramuscular injection work as well?
Dr. Lauren Noel: Yeah. So, nowadays, I mean, so many of us are having digestive problems. The culture that we live in, the standard American diet, and the environment that we’re in with environmental toxins, we just have the kind of life setup right now that is very conducive for leaky gut, unfortunately.
Antibiotics, medications, birth control pills, all of these we know can really set up the digestive tract to have inflammation and permeability. So I think, especially that we’re kind of in a Paleo sphere, we hear leaky gut so much. It’s almost like this buzz term. I think some of these people kind of roll their eyes at it. They think that it’s not a real thing. But it’s super real. And now, finally conventional doctors are coming on board and actually seeing it as something that’s legit and medically sound.
So finally, the gastroenterology journals are now being at the information for that and it’s translating over to the conventional medical realm and it’s just great. Not fast enough, but it’s starting to happen.
So leaky gut is really huge and like I said before, leaky gut contributes to everything else – nutrient deficiencies. If you have leaky gut, you’re going to have some nutrient deficiencies. And if you have leaky gut, you’re also going to be more likely to have issues with low enzymes, low stomach acids, dispiarosis of your gut. So imbalancing the flora. And this also contributes to things like parasites. Candida, you know, infections in the gut which kind of worsens sort of this whole cycle because you get these infections and then it feeds back into damaging the digestive tract even more.
So, the benefit of injectable nutrition is it completely bypasses the gut. We don’t have to worry about, are you going to get this supplement absorbed? Are you going to get the benefits of changing your diet absorbed? So, going right into the bloodstream, it’s a hundred percent absorption. So we use both intramuscular shots, and also IV nutrition. And we decide to go one or the other based on the patient, based on the condition, based on cost. But I live using it on patients especially like with inflammatory bowel disease. So ulcer, Crohn’s disease, Celiac. I mean it’s just really especially good for those kinds of situations, autoimmune disease. I’m such a believer and I’ve done IVs in about 5000 patients now. I know how to see what works, what doesn’t work, and for those specific patients it can be pretty miraculous.
Dr. Justin Marchegiani: Yeah. I remember seeing you back in the fall at the Bulletproof conference and you were with lines of people and you were doing IVs on back then.
Dr. Lauren Noel: Well, that was a perfect crowd for that because whatever Dave says to do, they’re like Sign me up! We said “Okay, do you want a Bulletproof” which means do you want an I-Glutathione, and they would be “Yes. Whatever you want, we’re going to do it.” And so, yeah, it was a very captive audience. But I think we did like 50 or 100 IVs in 2 or 3 days we were there. It’s a lot, yeah.
Dr. Justin Marchegiani: That’s cool. Very cool. So can you talk about why you would do an intramuscular injection over an IV and what the benefit is?
Dr. Lauren Noel: Yeah. So most things we can put on an IV. There are a couple of things not so good in an IV like something that’s fat soluble. So Vitamin A for example tends to do better in a shot. You don’t really want that droplets in your IV. Doesn’t really absorb as well. And also Vitamin D is one we don’t typically do in an IV. But generally speaking, in an IV we can do magnesium, which is very important for female hormones, we do zinc, we’ve talked about that. Selenium, we can throw in there too. All B vitamins, so B1 through 12. Uh, trace minerals calcium, Vitamin C, and then we can get really specific and throwing in things like glutathione which is hugely important for autoimmune and for anti-aging. Amazing detoxification stimulator. And so the IVs we can do a lot higher dosage in the bags but with the shots again, so things like Vitamin A or Vitamin D, I resort to a shot because it’s more of a fat-soluble nutrient. Also, there are some things in an IV you cannot put in a shot. Like, Vitamin C tends to hurt because it’s ascorbic acid and it doesn’t feel as good. Zinc, I’ve never done in a shot. I think that would probably be pretty tender.
So, it just depends on the comfort for the patient, the way that the delivery would go. But for most people, I usually use IVs and shots because we can get really strategic on what can go on each one.
Dr. Justin Marchegiani: Oh, that’s very cool. Regarding, like, an IV, if I were to get an IV, is just your basic Meyer’s Cocktail good enough, or what would you recommend to the average person that’s just stressed and just wants to get a little boost?
Dr. Lauren Noel: I would probably get our Toes in the Sand formula. So, our clinic Shine Natural Medicine kind of has a beach theme. All the different formulas have a beach name to it and so Toes in the Sand is really geared towards stress relief.
So I know you’re a busy guy. You’re running a clinic. You’re a husband. You’re doing a lot with Real Estate. So, you have a lot on your plate. So I would, for you, probably add in a little bit more magnesium, and also Vitamin B5. B5, dexpanthenol or pantothenic acid. You know, B vitamin for adrenal function. I’d probably do double Vitamin C for you because the adrenals love the extra vitamin C. Um, yeah, but I’d do basically do sort of a modified Meyer’s cocktail for you and do more stress support.
And then also things like L-carnitine is great for something you know, like fat burning and for the muscles. And probably extra taurine too. Taurine is a great amino acid that really works to drive the minerals into the cells. So, even though we’re doing some good minerals, helping to drive them into the cell with taurine can also be really useful for that.
Dr. Justin Marchegiani: That’s cool. So, Toes in the Sand. What are other awesome names that you have. I look forward to hearing these. What are they?
Dr. Lauren Noel: We have our lifeguard formula. That’s for immune. So if you’re getting sick, that’s an amazing formula for that. We also have the motion of the ocean. That’s a sex drive formula.
Dr. Justin Marchegiani: Hold on, we have to stop for that. So what’s in the sex drive formula. Is it Maca and zinc or what do we have?
Dr. Lauren Noel: Yeah, we have extra zinc and also we have extra B6. Because that helps to support your estrogen level. So, yeah. And then for the Motion of the Ocean, we have clear waters, that’s our detox formula, so we do extra glutathione with that. We can also add in molybdenum, it’s an important mineral for detox. And then, going off the top of my head, we have, what was the other one? We have Toes in the Sand, Motion of the Ocean, Clearwaters, and there’s one for energy… Oh! Uhm, Seas the Day.
So S-E-A-S so Seas the Day. That on is a lot more for energy. So definitely, it has some extra B5 and some homeopathic so we can add in to do that too.
Dr. Justin Marchegiani: Very cool. So whoever’s doing your branding is doing a really good job.
Dr. Lauren Noel: You’re talking to her! Hahaha.
Dr. Justin Marchegiani: Awesome! Very cool!
Dr. Lauren Noel: Thank you!
IV Nutrition
Dr. Justin Marchegiani: And do you still have your little bus thing where you kind of drive around and give the happy hour shots?
Dr. Lauren Noel: That was on my previous practice. We’re not doing that right now. But you know, the IV therapy laws have been taking some changes. I don’t know if we’re going to be able to do that. It’s unfortunate but if we can get around to doing that again, we definitely will. But I love doing the mobile IVs and the shots just coming to where you are, it’s just more convenient. So, yeah, we may visit that again.
Dr. Justin Marchegiani: That is so cool. So let’s talk about B12 injections. So, we have lots of stuff out there. We have Ben Lynch, we have all these people talking about methylation and folate and B12. Should you do B12, cyano B12, adenosine B12, you know? Should you activate folate? What’s your take on that and how are you essentially giving it the injection?
Dr. Lauren Noel: Yeah. That’s a really good question. I test patients for methylation defects. I’m doing testing to see what their MTH or potential mutations would be. And then from that point, we can see, okay, is it important that we do methyl nutrition for them. So for people listening who are familiar with this, for example folic acid, we hear of that being super important for fertility. And the women, when they want to get pregnant, they take folic acid, but unfortunately, folic acid is a synthetic form of the vitamin. It’s not something that your body really recognizes. So it’s important to use a methylated form of that and so in any supplement that we use at the clinic, we’re always using methyl folate.
But the cool thing is that’s the kind of folic acid or folate that you get in dark leafy greens. So if you’re eating a really good diet, you’re eating a lot of dark leafy greens, you’re already going to get that in your diet anyway. Now when it comes to using methyl, versus non-methyl like for example, B12, what I typically do, I will use methyl B12 on most people. I find in my practice most people do best with that. Occasionally there is someone who will go say “That kind of made me feel a little bit, maybe too anxious, to have me feel just a little bit overstimulated” if that’s the case, then we’ll switch to doing the hydroxocobalamin. I’m typically not using the cyanocobalamin. It’s not even something I carry because I find we don’t usually need to use it.
What about in your practice? What do you find with the methyl B12 versus the cyano? I’m curious what you’re using.
Dr. Justin Marchegiani: Well, a lot of times with patients that have methyl issues, we’ll use the methylonin where it’s a B12 and AL-MTHFR and LMTHFR. And we’ll do it sublingual but we’ll run the organic acid from time to time and we’ll see people needing Adenosil B12 and then we’ll use Zymogen It makes it really good.
Well, I think Ben Lynch’s company Seeking Health has a really good Adenosil B12. Allergy Research has a good one but they messed it up because they put a little bit of folic acid with it in there. I’m like “ah, you guys gotta pull the folic acid”.
Dr. Lauren Noel: Amateur move.
Dr. Justin Marchegiani: I know. So, typically, the methyl, the MTHFR, the L-form will do and then if it says, we’ll do the adenosil.
Dr. Lauren Noel: And what percentage of patients would you say are doing methyl versus adenosil?
Dr. Justin Marchegiani: You know what, I would say a smaller percent. I would say maybe a quarter to a third are coming back with adenosil. But most of the time, you can’t go wrong with the methyl and I think cyano isn’t as good. Methyl is, I think, the best way to go. Would you agree?
Dr. Lauren Noel: Yeah, totally. I concur. And I’ve been wanting to run more of the organic acids. That’s on the organic acids panel, right?
Dr. Justin Marchegiani: Yeah, that’s on the methylation site which is really cool.
Dr. Lauren Noel: Okay, yeah. You sold me on that. Yeah. And I love zymogen. I think it’s a good product. So it’s – what’s the specific product by zymogen that has the adenosil?
Dr. Justin Marchegiani: It’s the—it’s actually Seeking Health. Again, I think Ben Lynch uses a lot of Zymogen stuff it’s the Seeking Health adenosil product.
Dr. Lauren Noel: Okay. Awesome. Thank you.
Dr. Justin Marchegiani: If I find it after the show I’ll show it to you.
Dr. Lauren Noel: Thank you. Yah. That’s very useful. It’s very rare that I see an issue with the methyl but occasionally, they’ll say “I just felt a little bit kind of sort of jittery or wired with that shots”. So I think that might be that subset of people that could use the adenosil.
Dr. Justin Marchegiani: Yeah. There’s actually been a lot of patients coming in this week, myself. We were testing them and they’re coming back anemic. And not the B12 folate kind that we just talked about but iron-based.
Dr. Lauren Noel: Oh my gosh. Huge.
Dr. Justin Marchegiani: And what’s your experience using IV Ferritin or IV Iron?
Dr. Lauren Noel: Miraculous. Miraculous for patients who especially have maybe tried the oral iron before, and it can be very constipating and just caused a lot of digestive upset. And also too, with like the whole leaky gut thing. If they have leaky gut, getting their iron levels turned around, it can take a long, long time to do. So IV Iron is like the clouds part, you know, angels are singing opera. Huge, huge difference. And some patients just tend to need a little bit more support on going with that. So what I’ll do first thing is do an iron panel, see where they’re at starting point, look at the ferritin. If I see a Ferritin below a 20, I’m probably going to be looking at doing some injectable iron. So I’ve seen it as low as, I think, 4. So, what’s the lowest Ferritin you’ve seen?
Dr. Justin Marchegiani: I’ve seen like right around there, where like Lab Core will highlight it in red and say “Alert”.
Dr. Lauren Noel: Yes. Yah. And the important is when you’re starting IV iron or iron shots, starting very, very low, and working up because it does have a higher possibility of allergy. So we’ll start with just a fourth a milliliter in IVs. Start very, very low and just gradually work our way up and we’ll even get up to 1 to even 2 milliliters and within 1 to 2 months we see the levels, like, completely different. And usually maybe once or twice a week, occasionally I do three times a week if they’re really, really anemic. But it’s my favorite thing that we have for people who are really anemic.
Dr. Justin Marchegiani: And do you ever do injections for Ferritin?
Dr. Lauren Noel: Yes, yes. So we’ll do. Um, what I use is Dex Ferrum in the clinic. That’s what I’ve used and I found that it works best in terms of pain. We used to use something called Iron 59 and that was really painful. So switching to something that’s a little less painful is expensive so that the cost can be a little issue to some people. But yeah, so we’ll do the iron shot – it has to be done in a specific technique called a Z track just to prevent any bruising or iron stain marks. So make it sure, the doctor is really trained to do that. But yes, we’ll do it either in the bum, kind of like in the hip area, or in the IV.
Dr. Justin Marchegiani: Can you go in to what that Z track was again? I’m really curious.
Dr. Lauren Noel: Yah. So, normally when you get a shot, you basically do perpendicular. So, just insert the needle right in and you have a lot more cushion back there than you might think. You can actually use pretty much the full length of the needle.
With the Z track, what the goal is to create basically a traction where you’re-. How can I explain this? So basically, you’re going into a patient, I’m going to use, say, my left hand, let’s say it’s on their right butt cheek, so I’ll my left hand to traction up. It’s sort of like stretching the skin up and then I’ll insert the needle. And then, I will insert the contents of the shot and then once the shot is done, I’ll actually keep it in there for 10 to 20 seconds or so. And then as I release the needle out, I let go of my left hand so that basically what happens is it sort of like traps the contents of the shot deeper in the skin so that when I release the hand the skin that is going back to its normal place its uh–. How do I explain that? Am I explaining that okay?
Dr. Justin Marchegiani: Yes. That sounds good. Yeah.
Dr. Lauren Noel: Yeah, so it traps the contents of the shot so it doesn’t leak back out from where it was injected from. Sometimes when you give a shot, you’re going to have a little bit of the vitamin, you know, you’ve got to kind of wipe it with a little cotton. So you do that Z track, it’s much less likely to get that. So it traps that deeper and so you’re not going to get that staining, basically.
Dr. Justin Marchegiani: Very cool. I know that was a very nerdy question. I may have caught you off guard with that.
Dr. Lauren Noel: It’s probably easier with the video, which we do to show patients. But it’s something that we do ourselves. I mean, I don’t even let patients take iron shots at home. For many patients, they’ll take home the B12 shots. We can show them how to do it. But that one we just do in the clinic, so we don’t get the staining.
Dr. Justin Marchegiani: Very cool! And I’ve been seeing a lot of patients come in at me, like I just mentioned we had a couple of different causes. You know, maybe if you’re a vegetarian, it could be one. It could be a malabsorption from low stomach acid. It could have been even just a leaky gut thing. But one of the things I’m seeing a lot especially with my female patients that are estrogen-dominant is excessive menstruation. So when I’m interviewing my patients and I go into this area about how many tampons? How many pads are you using? How many days are you bleeding? They’re always kind of like “Wait a minute. You’re a male doctor. How do you…” So it kind of like freaks them out a little bit.
So now that I got a female doctor that’s skilled in this area, I want to get your take on, hey, you know, if you’re going through this many tampons per day and bleeding this long, maybe it’s too much. Maybe that’s a sign of estrogen dominance that could lead to anemia. Can you touch upon that?
Dr. Lauren Noel: Yeah. That’s a huge one. So if you’re continually having a period, you’re obviously going to losing a lot of blood. And with blood goes iron. So, another clue that you could sense from estrogen dominance is maybe spotting between your periods. Also, if you have really difficult periods like cramps, maybe breast tenderness, just also issues like maybe some emotional things before your period. You feel more weepy and just feel like a lot more kind of irritability. Those are just potential clues that your hormones could be a little out of balance.
And the reason why estrogen dominance can lead to heavier periods is that because estrogen is a proliferator of tissues. So it makes the lining of the uterus become thicker and progesterone works sort of like a, uhm. I see that estrogen builds it up and the progesterone kind of pats it down. So if you are too dominant on estrogen you’re gonna be building too much of a tissue and if you’re low on progesterone you’re not gonna pat that down so you can get some spotting.
So really working to balance out the hormones is super important. It goes back to, like you said, the digestive tract, also the liver is your main filter for hormones and doing some work on resetting the liver pathways doing the methylation support. Multisol would be a great herb to add in to help with liver clearance. And then also looking at maybe doing some specific supplements like Dim or I3Cs, doing some specific estrogen balancers. Have you talked about Dim on your show before?
Dr. Justin Marchegiani: I haven’t really talked about it but I will leave the floor open to you here.
Dr. Lauren Noel: Yeah, so one of the great benefits of broccoli or the brassica family is that it helps balance your estrogens actually. It helps to clear excess estrogens from the liver. So that’s something I’ll use in my practice a lot when there is some estrogen dominance kind of picture, and typically just a capsule twice a day of Dim. I use Estro Dim from Orton Molecular but there’s some great supplements from various companies. But, it’s taking one of the ingredients from broccoli in a highly concentrated form and you’re doing that for about three to six months and you’ll see that those dominant estrogen issues oftentimes gets resolved. So that’s hugely important. And then, I don’t there’s anything else about estrogen dominance.
Dr. Justin Marchegiani: It’s also helping that 2 to 4 to 16 ratio, right?
Dr. Lauren Noel: Yeah, so preventing that potential breast cancer risk.
Dr. Justin Marchegiani: How does that ratio flip? I always mess it up. I don’t really get the specifics. Is it we get less of the 16 more of the 4 and the 2?
Dr. Lauren Noel: You want more of the two. I think you want to be 2 good. That’s it. 2 good.
Dr. Justin Marchegiani: I always confuse those. So more of the 2. 2 good. I’ll never forget that now.
Dr. Lauren Noel: You wanna be 2 good.
Dr. Justin Marchegiani: Haha. 2 good. Perfect. Love it. So, looking at just objective markers here, because I always kind of ask my patients this every time they make a patient call. So what would you consider too much for tampon usage? Like it’s market that you know you’re bleeding too much. 4? More? Maybe kind of that threshold?
Dr. Lauren Noel: Yeah. I would say 4 is a good threshold marker. But it’s more than that. I look in to see what’s going on with the hormones.
Dr. Justin Marchegiani: And then 3 days would be kind of more like your cut-off?
Dr. Lauren Noel: Yeah. I mean, you want maybe your first 2 or 3 days to be typically more in the heavier side. But if you find that after three days, you’re still going through like 4 or more tampons, I would look into things. Yeah.
Dr. Justin Marchegiani: Got it. Alright. That really helps. I see a lot of patients that are anemic and then you also got some patients that may have fibroid issues and they’re anemic and they’re also taking iron with the fibroid. Can you talk about why taking iron might actually make that fibroid grow bigger?
Dr. Lauren Noel: Well, it can affect your estrogen levels, your hormones. Is that the pathway you’re thinking of?
Dr. Justin Marchegiani: Well I’ve just seen some patients where the iron will actually fuel the growth of the fibroid and the fibroid will continue to grow. And you can give all this around and this will get sucked up by the fibroid so it never really gets into the blood where it needs to go. Have you seen that before?
Dr. Lauren Noel: Right. Yeah. That’s a good one, Doc. I haven’t seen that one as much but that makes a lot of sense. I mean, iron can contribute to growth and we know that iron can feed dispiosis and infections. So that’s why I’m always testing to see that it’s not one of the things that I give very casually. You don’t really want to take iron unless you really need it.
Dr. Justin Marchegiani: Right. You’re gonna give iron and then you’ll follow up with like a ferritin or like a saturation or a UIVC kind of thing, am I right?
Dr. Lauren Noel: Yup. Every time. We’re doing ferritin, iron saturation, total iron binding capacity, and transferrin, I mean the whole thing. I’m looking at the blood cell count, if you have healthy counts. If you’re anemic, you tend to have lower red blood cells. Your hematocrit tends to be lower which is basically what percentage of your total blood is made up of red blood cells. And if that’s low, that’s also a clue for anemia or low iron. And then your hemoglobin. So your iron is attached to oxygen in the cell and if you are deficient in iron, you’re also going to be low on oxygen too.
One little trick to see if you might be low on iron, for you guys listening, you want to look in the mirror. You want to look at the inside of your lower part of your eyelids. That’s your conjunctivus. So just go ahead and look in the mirror. Pull down and look at the inner part of your eyelids, if you see that it’s actually really pale, it should be a nice pink color. If that really pale, it’s a clue that you could be anemic. Also looking at your fingernails, if you push on your fingernails and then release you want it to turn pink again really quickly, and if it stays white for a while that’s a clue that you may be deficient in iron.
And then another little trick too is that if you find yourself yawning a lot, like let’s say you’re doing a workout and you just yawn all the time, that could be a clue that you’re just not getting enough of that oxygen and that it might be a clue of low iron too. So, just something to pay attention to.
Dr. Justin Marchegiani: That’s really cool. I love the little clinical takeaways, the physical exams. The takeaways are so great.
Dr. Lauren Noel: Really helpful.
Dr. Justin Marchegiani: Yeah, one of the best parts of natural medicine are those little pearls right there.
Dr. Lauren Noel: Mhhmm. And also one for zinc that we didn’t mention before is the white spots on your fingernails. That could be a zinc issue. Or if you have vertical ridges or just ridging on your nails, that could be a mineral issue. So another thing to check out.
Dr. Justin Marchegiani: Very cool. And also one last thing that I learned to is if you take your hands and you extend your fingers back like if you’re pressing them so that you’re extending them back, that lifeline across there should start turning more read and if it doesn’t turn red and if it stays white, that’s another sign of anemia too.
Dr. Lauren Noel: Oh yea. I like that.
Iodine
Dr. Justin Marchegiani: Very cool. Awesome, Doc. You’re giving us a lot of information. Last question here. I want to touch upon. It’s such a hot question, especially with thyroid patients and such. Can you talk a bit more about iodine and how you use it with your patients and how you kind of be a little more ginger about it with autoimmune patients. What’s your take on iodine?
Dr. Lauren Noel: Yeah. It’s such a hot topic and it’s so confusing for people because you hear of iodine being so good for the thyroid. But then you hear that most thyroid conditions are autoimmune related. So is it okay with autoimmune is it now okay?
The camp of people that say “Never ever get iodine with autoimmune”. To me, the way that I go about it is I always check a full thyroid panel including antibodies. And if I see that there’s autoimmune issues and there’s elevated antibodies I tend to not do iodine like that.
Sometimes I will. You know when I do iodine or have some C vegetables, I feel really good. I listen to that. So sometimes I will make an exception for patients but I tend to not especially if I’m seeing elevated antibodies. If I over and over check antibodies and see that the levels are very low, and the patient is still having thyroid issues, then I will add in some iodine and just very, very slowly work up to it.
For myself, I had a very bad experience with iodine. I did too much of it and it really affected my thyroid very negatively. So you don’t want to take iodine unless you need it. So for many of my patients, I will do a blood test and see where their levels are at. But I’m a little bit cautious about using just a lot of iodine.
For women who have fiber-cystic breasts, it can be very helpful for them to actually apply iodine unto the breast. Dr. Jonathan Wright, he says to apply on the bottom of the feet, which is kind of a funny place. But that can be very helpful for those fibrocystic issues of painful breasts with your cycles.
But that’s how I tend to view iodine. I’m curious about you though.
Dr. Justin Marchegiani: Yeah, very, very similar. I always look to see if there are antibodies. Again, with iodination which is the process of making thyroid hormones – the body binds some thyrosine to the iodine molecule. And in that process, it spits off a whole bunch of hydrogen peroxide. And if we have Selenium deficiency, well, selenium normally comes in there and it pulls off some of the oxygen molecules and making it water and O2. And if we don’t have the selenium there, then the hydrogen peroxide can stimulate that immune system to go attack it.
I think really focusing on, especially when they’re autoimmune, really the selenium first. It’s really the best way to go. I’m totally in sync with exactly what you’re saying there.
Dr. Lauren Noel: Yeah. And are you testing iodine?
Dr. Justin Marchegiani: You know what, I don’t really test it too much. Again, I’m familiar with Doctor Status, got a really good 24-hour iodine test. They got a spot test as well. I don’t do it too much. I kind of start with the potassium iodide and I just start up very gently and I just load up very slow with patience. And it tends to work. I’ll also look on the tests if their T4s and the lower end of the range, you know that’s a building block for T4. So then, we’ll start using just a little bit of iodine there as well.
Dr. Lauren Noel: And you’re using it as the potassium iodide?
Dr. Justin Marchegiani: Yah. I’ll use potassium iodide and iodine. I like the new Lou Gaal Socket Generation because it’s got the Selenium and the B vitamins and the folic minerals and the vitamin C. And I like that because the thyroid really wants the iodide but a lot of times the breast tissue really wants a lot of the iodine so I really give it both together because a lot of times that breast tissue will take it all up and clogs it.
Dr. Lauren Noel: Because you were giving pearls. I just wrote that down. Thank you!
Dr. Justin Marchegiani: Well, I got little pearls written down for myself. So I’m super stoked.
Dr. Lauren Noel: Sweet. Give and take.
Dr. Justin Marchegiani: I love it, I love it. So Dr. Lauren, today’s interview was awesome I want to have you back real soon. I just want you to talk about a little more about your clinic. I know you’re seeing patients abroad via Skype and the phone. I know some have the happy hour specials for shots and IVs. And I’m actually looking forward to coming down at Salona Beach for you clinic and get an IV really soon.
Dr. Lauren Noel: Yeah, so I work with patients all over the country. That’s the benefit of how really with this radio show we can reach people all over the world. It’s such a good bonus that I get to work with patients out of the state and out of the country. So, I do that. About half my patients are not even in California. But for local patients, we do have the local IV therapy program. We mentioned we have the whole IV menu, shot menu, and on Wednesday afternoons, we have the happy hours. We call it happy hour. It’s really about getting patients in the door it’s kind of catchy. But then we can really do the work of doing the full naturopathic care. So yeah, we’re doing that every week. Like I said, we finished our website ShineNaturalMedicine.com. But I work with patients over phone and Skype all the time. So for anyone listening, if you feel like you’re not jiving with your doctor, maybe it’s been a while since you’ve looked into things, and you resonate with some of the things we talked about. I’d love to talk to you and help you feel a lot better.
Dr. Justin Marchegiani: Plus, how could you not love those happy hour IVs? Those names are awesome, like the motion of the ocean? How could you not want that?
Dr. Lauren Noel: They’re pretty awesome. I love them. They’re so addictive.
Dr. Justin Marchegiani: How about your podcasts. I know you’re like almost over a million hits and stuff. How’s that going?
Dr. Lauren Noel: Yeah. So Dr. Low Radio. I’ve been doing that 4 years. And it started as a hobby and it turned into my main patient generator. It’s amazing. It’s sort of taken a life of its own. But yes, every week, I do my show. Every week is a different topic. You can find me on itunes. Search in the podcast directory Dr. Low Radio. And we have had you on the show a few months back. And we have to get you back on because that was an awesome show. So yeah, it’s amazing. It’s free content. I think about 133 shows. It’s so much information. I have listeners who listen to every single show and I swear they probably know more than most doctors at this point.
Dr. Justin Marchegiani: Yeah. I know you had some good naturopathic doctors out there. You had Dr. Sherry Ten Penny on there. That’s a really high-quality show and you do a great job hosting it too.
Dr. Lauren Noel: Thanks. Thanks. Takes one to know one.
Dr. Justin Marchegiani: Well, I look forward to seeing you next month at Paleo FX. Super stoked and looking forward to hearing you talk and I love the new site. It looks so good.
Dr. Lauren Noel: Thank you so much. I’m looking forward to catch up with you and seeing you in person.
Dr. Justin Marchegiani: Great, Dr. Lauren. I’m looking forward to chatting with you really soon.
Dr. Lauren Noel: Thanks guys. Thanks for listening, you guys.
Dr. Justin Marchegiani: Thanks. Take care.
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Natural Remedies for Hormonal Imbalance, Infertility, PCOS and PMS
By Dr. Justin Marchegiani
There are many natural remedies for hormone imbalance in the functional-medicine world, yet they tend to the be the last line of defense most women reach for. It’s easier to get a birth control pill or antidepressant to fix the symptoms of hormone imbalance, but this does nothing to address the underlying cause.
If you’re a female and suffering from infertility, PMS, polycystic ovarian syndrome (PCOS), or other hormonal symptoms, this is a strong sign your body is out of balance and not expressing optimal health. Fertility and hormone balance is a natural by-product of health, and without it, our species wouldn’t be here today. I urge every woman to dig a little deeper into what’s driving her infertility and/or female hormone imbalances.
Just 30 to 40 years ago, women would routinely get pregnant on their honeymoon. Today, women are spending upward of $15,000 per in vitro fertilization (IVF) treatment, some needing multiple treatments to conceive.
Why can’t I get pregnant?
It is possible to mimic your hormones with Follistim, Lupron, or Clomid to manipulate your brain into thinking you are healthy enough to get pregnant. Your body is wise, and is not letting you have a child for a reason; it knows the hormonal environment is not optimal to produce a healthy baby.
The hidden chemical stressors in your body can activate certain genes epigenetically. When these genes are activated, it predisposes you and your child to autoimmune/chronic inflammatory conditions, like asthma, heart disease, allergies, and learning disorders (1, 2, 3).
When we look at the underlying cause of infertility, 40% is on the woman’s side, 40% is on the man’s side, and 20% is unknown.
Both men and women should adhere to similar dietary and lifestyle principles to help support and nourish their bodies. A diet that is nutrient dense, anti-inflammatory, and low in toxins is essential for optimal health and for a growing a baby.
Factors to Consider
Women who are trying to get pregnant need to make sure their diet has adequate fat for the formation of their soon-to-be child’s nervous system; adequate meal timing to stabilize blood sugar; and the avoidance of all toxins from pesticides, grains, and refined foods.
If you are trying to get pregnant, you need to form a cohesive team with your partner. There needs to be a combined effort of the couple engaging in health-sustaining habits. Though the female grows the child inside her body, the quality of the sperm and the support regarding nutrition and lifestyle habits are just as important.
One Caveat
As long as your partner’s sperm count, motility, and morphology have been assessed and there are no issues regarding the female’s reproductive anatomy, then you are a great candidate to start a natural female-hormone-balancing program.
There may be 5% of women that need IVF treatment to conceive. I personally would recommend IVF last. The natural hormone-balancing diet and lifestyle programs can work over 90% of the time. IVF may help you get pregnant, but it does nothing to ensure a healthy pregnancy and optimal health for your child.
According to research, as well as my clinical experience, women that have IVF or go into a pregnancy unhealthy to begin with tend to suffer from more hormonal related issues post pregnancy, have a more difficult time losing weight, and have an increased risk for postpartum depression (4).
To All Men out There
Sperm counts have been dropping over the last 40 years significantly and so have the reference ranges regarding what normal may be. Due to these drops in the reference range, I urge men to be in the top 25% of the range to ensure adequate health. Consider anything in the middle of the range inadequate to standards just 30 to 40 years ago. (5)
Women’s Cycle: The Two Phases of Your Cycle
The first half of your cycle is the follicular phase. This is where estrogen predominates. The second half of your cycle is the luteal phase. This is where progesterone predominates.
The Domino Effect of Healthy Hormones and Pregnancy
Step 1
Progesterone and estrogen drop at the end of the cycle, which signals bleeding, or your period. The sloughing off of your endometrial lining is important to reset your body so it has a chance for pregnancy the next time it ovulates.
Step 2
The bleeding that occurs during your period stimulates FSH—a brain hormone. FSH stands for follicle-stimulating hormone which stimulates the follicle to start growing.
Step 3
As the follicle starts growing, it stimulates estrogen to increase. As estrogen increases, it starts to thicken the endometrial lining. Estrogen stimulates growth, which is needed for the uterine lining.
Step 4
As estrogen reaches its peak around day 12 or 13 of your cycle, ideally, it stimulates an increase in LH (luteinizing hormone).
Step 5
When LH increases, it stimulates progesterone to increase around day 15 of your cycle.
Step 6
The rise of progesterone, which was preceded by a rise in estrogen, signals ovulation. This when you can get pregnant, and it’s only about a three-day window. Progesterone causes the uterine tissues to mature (to grow up), which provides the right environment for the egg to implant into it.
Step 7 (optional)
The egg is ejected into the fallopian tube where it has the potential to come in contact with sperm as the egg makes its way down to the uterus.
Step 8 (optional)
The fertilized egg embeds itself into the uterine lining as the corpus luteum (the scar from where the egg formed in the ovary) stimulates progesterone through the production of human chorionic gonadotropin (HCG).
Step 9
Progesterone and estrogen drop out around day 27 or 28 of the cycle, which then signals menstruation (your period). The whole process then repeats itself again.
Fun Fact: HCG is what is typically tested to confirm pregnancy. Elevated HCG will get you a positive on your home pregnancy test.
Problems in the Luteal Phase
The luteal phase needs to be at least 12 to 15 days long to ensure there is enough time for adequate progesterone to be made. If progesterone levels fall off early in the luteal phase (symbolized by the red lines above), it’s because of stress. Stress comes in physical, chemical, and emotional factors. Essentially, progesterone, your pro-gestational hormone that holds the egg in place, actually can get converted downstream in the cortisol.
With chronic stress we see progesterone falling out early in the cycle, which can make it very difficult to sustain a pregnancy. This progesterone deficit makes it very difficult for the egg to stay implanted, and it will eventually slough off causing a potentially thicker period that particular month, or maybe even no period at all. Low progesterone over time can cause your cycle to be anovulatory (without a period), or you may have even been told you have premature ovarian failure.
Throughout our cycle, on average, we have 22 to 25 times more progesterone than estrogen. This is a normal, healthy balance. When stress occurs and progesterone gets converted downstream, we start seeing a state of what’s called estrogen dominance. We start seeing an excess of thickening of the uterine lining. Women may notice fibroids, endometriosis, and fibrocystic breasts.
These hormone imbalances may manifest themselves at the end of your cycle as PMS, headaches, fatigue, migraines, breast tenderness, and uterine pain. All these symptoms are primarily driven by a state of estrogen dominance.
PCOS
PCOS (polycystic ovarian syndrome) occurs when androgens in the female cycle become elevated. As androgens elevate in the cycle, it throws off the upstream brain hormones, so communication from the brain to the ovaries becomes disconnected (6).
One of the most important triggers of PCOS is chronic ups and downs in blood sugar (reactive hypoglycemia), or insulin resistance. The elevation in insulin up-regulates certain enzymes in the body (17–20 lyase), which can accelerate the conversion of female hormones to male hormones (testosterone). That’s why it’s common to see acne, abnormal hair growth, and ovarian cysts as a by-product (7, 8).
What’s the Deal with Birth Control Pills?
When we take birth control pills (BCPs), we shut down the upstream signaling to our brain known as the HPG axis (hypothalamus, pituitary, gonadal axis—see picture below). FSH and LH, essentially, are the conductors of this beautiful hormonal orchestra. In this orchestra we have the strings, the flutes, and all the different instruments you can imagine. If the conductor of the orchestra goes on vacation, it’s very easy for this beautiful music to sound like noise.
Taking this analogy back to hormone land, as hormonal imbalances occur due to physical, chemical, and emotional stressors, they essentially mug the conductor. They knock the conductor off the stand, and the hormones start to go awry.
Women who take BCPs do see a benefit. Their hormones may stabilize, which may help their mood, PMS, and skin issues in the short term. The ups and downs of the hormones in the cycle are somewhat leveled out by this artificial, yet steady, bombardment of hormones.
The symptom-relief experience from BCPs is real. There are ways to produce the same results, if not better, through natural hormone-balancing protocols that address the underlying cause of the issues. When the underlying cause is addressed, there is less chance of the typical side effects of BCPs, including weight gain, blood clots, increased risk of a breast cancer, and potential difficulty conceiving down the road.
“Women who were on oral contraceptive birth control pills may experience a few months of being infertile while the synthetic hormones work their way out of their body. Women who were on the Depo shot on the other hand, can experience infertility between six months to a year.”
~Dr. Lauren Streicher of Gynecologic Specialists of Northwestern
Other Available Methods
If you are using a BCPs to prevent pregnancy, there are other natural non-hormonal methods out there. My favorite is the rhythm method (if you are in a stable long-term relationship). Other methods can be used, including a non-hormonal IUD (ParaGard). This can be used in conjunction with a diaphragm and/or a condom for extra security. If your hormones are stable, there is only a small window in your cycle when pregnancy can occur, so make sure proper precautions are made.
What You Need to Do!
If you are struggling with hormonal-related symptoms and are looking to get pregnant, there are some action items you should make ASAP!
Step 1
Make the right diet and lifestyle changes to stabilize your hormones and blood sugar for success.
Step 2
Avoid common toxins that may come from pesticides in your food and chemicals in your makeups and hygiene products. The toxins in these products are xenoestrogens in nature and can mimic the hormone estrogen. Most women are already in a state of estrogen dominance, and this bombardment off additional synthetic estrogen only makes the problem worse.
Step 3
Get assessed! If you are not assessing, you are guessing! If you are having hormonal issues and you want to get pregnant, you need to see where the root of your hormonal issues are coming from.
Are the hormonal imbalances coming from a thyroid issue, adrenal issue, female hormone issue, or chronic infection? It may even be a combination of all of them like I see with most patients.
Step 4
Step 5
In this episode with the brilliant Dr. Lauren Noel, we cover:
4:00 Female Hormones, Libido, Sex Drive, and Fertility
20:00 Leaky Gut
27:18 IV Nutrition
43:04 Iodine