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Successful Fertility Case Study – Jenny
(Part of the Case Report Blog Series)
About three years ago a woman, whom I’ll call Jenny, came to see me looking for help getting pregnant, here’s her story. Jenny was 35 Years old (pushing it..I know!), she worked as a hairdresser, was married for 5 years, but only began TTC’ing seriously over the previous year. From the beginning there was little mention of her DH so I was suspecting some relationship issues may be at play -which turned out to be the case! Jenny had been on the pill for 18 years and only came off it a year earlier to begin a family. As an aside…this is not a good plan IMO, it takes a while for the body to readjust it’s hormones after years of forced dysregulation, so you really need to come off the pill well in advance of TTC’ing. (Whether or not going on the pill is ever a good idea is a different debate!!) She was a really nice person to work with, open to ideas and in obvious need of nutritional but also emotional support. It seemed she couldn’t talk openly with her husband about the whole idea of there being ‘a problem’ and was even reluctant to talk to her friends about it as they all had kids, plus she felt they’d give her the “ya left it to late girl” speech. She was perhaps half a stone overweight…nothing too serious, and showed evidence of early skin deterioration for her age…basically there was a story of struggle in her face. To me this means she was living with a degree of stress and thus experiencing chronic inflammation in her body…which is ultimately the thing that messes up hormone cycles…and mood…and all the other ‘stuff’ we tend to not value until it’s too late. Her diet was far from ideal: Boxed cereal for breakfast for as long as she could remember, with skim milk, toast and coffee. At the weekends she would eat a fry up with sausage, rasher and scrambled eggs or else she would leave off breakfast entirely. A pretty common breakfast for sure…but in terms of using food to support your health and prepare for pregnancy this is a horrendous way to start most days of your life. Some of you might be shocked to hear that it was probably the weekend breakfasts that were keeping her afloat!! Jenny’s weekday breakfasts were a deal breaker for fertility because from this foundation alone it is well nigh impossible to get your body to where it needs to be to support the huge task of pregnancy. For lunch Jenny might have a salad roll or a sandwich, which was eaten usually quickly in the small canteen at work. Fast eating means poor digestion I’m afraid. The rolls would contain margarine (another deal breaker), white or brown bread (which is neither here nor there in terms of nutrition), ham or turkey slices, cheese, some salt and some lettuce. She would eat a bar for an energy pickup later on in the afternoon and on getting home might have a beef stew, or spaghetti bolognese, or shepherd’s pie or chops, or steak or some fish…with spuds and broccoli, or some variation of the above. Those of you who know me and my work with the Weston A Price Foundation will know that I aim to achieve far higher levels of nutrition than promoted by the standard food pyramid with its so called 5-a-day rule etc., but honestly Jenny’s diet fell far short of even the basic government recommendations for most nutrients. Jenny was taking Folic Acid in a multivitamin recommended by her doctor. For me whilst this may be better than nothing and will help prevent neural tube defects, multivitamins dont come even close to supplying your body with solid nutrition…and the form of folic acid recommended for pregnancy is, as I say better than nothing but a long way from optimal. Optimal health should be the goal in advance of pregnancy. Jenny was displaying symptoms of irregular cycles with some pain leading up to, and again during, her period. Now for sure it is not essential that a woman have regular periods in order to conceive…but it really does help…and so period timing can be used as a target to aim for. On questioning it transpired that Jenny and her hubby didn’t really know when the best window was to have sex…they were guessing based on partial understanding of timing, so the first thing I suggested was for them to talk to a Billings Practitioner, which they did. Later it turned out that this was actually the one element of the whole program that gave them the biggest confidence boost…which was a blow to my professional ego…but hey…whatever works right! I considered running a saliva hormone panel over Jenny’s cycle but figured there was a lot to clear up first so I put it on hold. This test involves collecting 11 samples of saliva spread out over the month and it shows you the exact hormonal pattern your body is working to…which is most definitely NOT what a blood test for hormones do…instead blood tests for hormones are used as a basis to take a guess at what your hormones are actually doing. A whole post on this is in the wings.!!) Jenny’s DH had never actually been checked out for sperm quality, yet here she was…assuming the problem was all her! I have an issue with this because it is now pretty easy for a man to get his seed tested so I always advocate that he should do so at the first inkling of doubt! With the rising rates of infertility I advocate that all men should have their sperm quality tested. Why? Because it’s only a few hundred quid and if something is found then it can save a lot of time and angst. Men are so much simpler to test than women so they might as well get it done and if problems show up then well and good, don’t waste another day worrying about it…let’s get to work fixing them! Sperm problems can sometimes be cleared up in three months all going well. For sure some problems are more complex and need more specialist intervention but most are just ‘functional’ issues whereby some function needs support and then the whole system comes into balance …and all is good. Anyway I suggested to Jenny that her DH’s sperm should be tested but for whatever personal reason he refused, and so my original suspicions began to take shape. Indeed it transpired there was a communication problem in their marriage (isn’t that always the case?? I hear you say), but I wasn’t in a position to broach this with her just yet. We decided to work on her diet first as she was all on for this, she was also on for the occasional eating of lamb’s liver which a lot of women balk at. This is the power food, a sacred food in many cultures and an intervention that can sometimes make the difference all on its own. I prescribed a nutrient dense diet with lots of good healthy fat, organic sources of meat and eggs, I trebled her intake of a diverse range of vegetables and made sure she include at least a small amount of rice or spuds for carbohydrates. I advocated that she use butter liberally and throw out the margarine. She would later say to me that she was worried about eating so much food…she reckoned it was perhaps three times the volume she had been used to eating…yet she lost weight. It’s actually possible she was eating more food but less calories overall, visual quantities can be deceptive…Go figure!! Once I saw a change in her eating habits and confirmed a beneficial change in her bowel habits from once every two or three days to once a day I knew we were making progress. I stepped up the program to include some herbs that are known to help the brain manage hormone levels. Lot’s of people don’t get this idea…but it is the brain that regulates our hormone patterns so supporting your hormones doesn’t just mean feeding the glands, it means clearing stress out of your brain and then nourishing it…along with the rest of the glands. I advised Jenny to enjoy a massage once a week for 6 weeks to relieve tension in her body. Looking at her from the front it was possible to see that her left ear was slightly lower than her right ear…a posture imbalance often due to the body being torqued out of alignment by chronic stress, and which also indicates a pelvic imbalance. It is plausible that such a posture imbalance has a knock on effect on ones ovarian cycle by compromising nerve conductance and or blood flow to the ovaries and or womb. I figured there are numerous ways to address this but the massage idea resonated with her so we went for that! Acupuncture or osteopathy would also have been good options. I was concerned about the potential for toxic build up in her body as a result of constant exposure to hairsprays, and coupled with the fact that her diet had been poor with generally low levels of fat, protein and minerals, I figured Jeny’s detoxification potential was definitely compromised. I suggested we run a test on her urine (called an organic acid test) to look for evidence of compromised detoxification and systemic inflammation. She declined this fearing bad results would only stress her out…which is a good reason not to do it I admit. In the absence of this I recommended a product that promotes liver detoxification, as the liver is where it is all at when it comes to detoxification. (Well…mostly!) It contained whole food B-Vitamins, milk thistle extract, N-acetyl-Cysteine, and turmeric extract. All of these activate various pathways of detoxification in the liver and can often have a very strong noticeable effect on some people. After a few more months it was clear that there was still some pain leading up to menstruation so I recommended Jenny take a magnesium supplement, which has many uses – one of which is to assist with muscle cramping. This worked a dream…the pain stopped completely. I love magnesium, it’s such a useful product and quite reliable (when you are using the right form of it), yet I sometimes kick myself for not suggesting these things sooner…but the truth is I rely on feedback from my clients to know how far and how fast to push things, so I tend to go slowly and ‘suck-it-and-see’. 10 months after contacting me Jenny was pregnant and 9 months later had a beautiful boy. As Hannibal Smith says…”I Love It When A Plan Comes Together”. Sometimes plans don’t always work out perfectly…sometimes they work out a lot sooner…it’s a very personal journey and so it’s hard to compare between different people. Buried within these case studies lies a deeper analysis that would take too long to share. It can get seriously complicated when analysing hormone patterns, detoxification pathways, toxin accumulation and dietary adherence, but it’s a job I love doing and when it works out the satisfaction is really powerful! I hope to share more of these case studies with you all regularly now that my website is finally working properly!! Thanks for reading and please feel free to pass this link on to who ever you feel would be receptive to them and may be in need of guidance. Brendan O’Brien NT MSc
A Case of ED & Sperm Morphology Issues Resolved!
(Part of the Case Report blog series)
Pat (his real name, but surname withheld), called me in early 2016 not because of fertility concerns per se but because at just 30 years old he was suffering from ED. He also wanted to start a family but hadn’t been TTC’ing for real just yet. From the get go it wasn’t known if Pat had any issue with his sperm but he clearly had difficulties both getting and maintaining an erection. With no further information I can tell you that this problem does not happen in isolation and so I was confident that we’d uncover more to the story if we looked deeper. Firstly an overview of ED is warranted: An erection is actually quite a complex affair that involves signals from the brain to both initiate and terminate the erection, blood flow to fill out the muscles, nerve sensory feedback, hormones like testosterone, and then when it’s all over there are special enzymes to turn the erection off again once the moment has passed. Men typically get several erections per day as normal, some of which are due to sensual thoughts and others which are simply to do with metabolic housekeeping and happen almost unconsciously in that they dont involve any element of desire. Of course all of these functions in turn depend on the availability of the right soup of nutrients both in the brain and in the penis (the second brain…right!!). The enzyme that brings erections to an end is called phosphor-di-esterase type 5 or PDE5, without it erections would never subside. The obvious humorous comment from the girls here would be…”Wow..if only we could find a way to turn off this PDE5 in our partners then we’d be able to prolong the fun!!” Well as it happens this is exactly what the most famous ED drug on the market does. Sildenafel (marketed as Viagra) supplies a compound that temporarily inhibits the action of this PDE5, so it prolongs erections by inhibiting the body’s ability to end them. There is also a second effect of the drug…it causes a release of a substance called Nitric Oxide in the body. Nitric Oxide causes vasodilatation, which is an increase in blood flow due to relaxing of the blood vessels. Basically if blood vessels are too stiff then blood can’t flow freely in them, but once they relax blood can flow better, thus creating an erection. (Stiff blood vessels = No stiff penis!) So Viagra causes a flush of blood to the penis and then it stops the PDE5 enzyme from ending the erection. This is interesting because most guys are never fully checked out for the real underlying cause of ED, which are many, and yet they are prescribed products like Viagra under the assumption that this is the only thing that is needed. So any given guy might be fine with PDE5 and therefore doesn’t need a PDE5 inhibitor – yet they get it anyway. This probably accounts for one of the side effects of the drug in some men…a boner that won’t subside! It might sound funny but it’s not when it happens to you. Anyway, back to Pat. The underlying causes of stiff blood vessels are many. Nutritionally speaking it is fair to say that much of it is caused by blood sugar imbalances…or basically consuming too much sugar over a number of years. This triggers a near continuous amount of inflammation in the body whilst blunting the effect of insulin. Blunting the effect of insulin has wide ranging effects on the body and one of those is to harden blood vessels! Now to be sure this is not the only cause of ED, there are some diseases that predispose a person to it…like heart diseases, obesity and diabetes. But wait a minute…aren’t those diseases also linked to blood sugar issues? You bet! Psychological concerns that cause stress and worry can also lie behind ED, and whilst these may not be directly linked to blood sugar issues it is fair to say they are indirectly linked. This is because stress causes us to release cortisol, a type of hormone known as a ‘gluco-corticoid’. Spot the ‘gluco’ part there…glucose…blood sugar. Cortisol is a potent modulator of blood sugar because that’s its job, it causes a rush of stored sugar to enter the blood. Was Pat stressed? Absolutely! Is every guy with ED stressed out? No, but from a functional point of view one needs to look at stress and blood sugar as foundational issues. So what did we do? First I analysed his diet and found that he was eating a high carb, high protein, low fat diet. How did I figure this out? By putting a week’s worth of his diet into an online diet calculator, but honestly at this stage I can pretty much tell by talking to people. I use the calculator more as a way of illustrating graphically to clients what kind of balance is in their diet because seeing it in a pie chart is a very effective teaching tool. The carb portion of his diet was very high in simple carbs…refined grains, sugars, processed foods, white rice, white bread etc. You should be able to see a pattern here already, he was eating a diet that supplies a lot of sugar in a form that easily slips into the blood, in other words ‘simple carbs’…as opposed to ‘complex carbs’! But what about the high protein component? This was coming from lean meat and protein powders mostly, it was a holdover from Pat’s training days when he used to do bodybuilding years ago. One of the negative effects of high protein consumption is that it causes a gradual depletion of Vitamin A from the body. This is because vitamin A comes in the fat not the protein part of meat, so a diet of lean meat is also lean in Vitamin A, plus it is used up rapidly when metabolising protein. What is of concern here is that Vitamin A is absolutely crucial for sperm production, but it is also crucial for maintaining flexibility in the walls of blood vessels. Now think back to what we said about ED…it’s a problem with blood flow right! How does Viagra work…it relaxes the walls of the blood vessels. Why would they need relaxing? Because they have become too stiff! Why have they become too stiff? Well there are a few potential reasons…but a deficiency of vitamin A, along with high blood sugar and the inflammation that brings are all prime candidates. So here, after just a basic investigation, we have two targets to aim at:
- High blood sugar, which at this stage is not yet confirmed by blood tests but would fit the pattern of Pat’s diet
- A potential case of vitamin A deficiency due to a low fat diet and excessive protein consumption.
A third ‘target’ showed up later on when Pat confided in me that he hated his job! That’s a tough one I admit, and whilst I don’t have a direct solution to this particular problem I do have some very valuable tools that can help. First I could and often do refer clients to various other complementary practitioners who are specialists at finding and opening the pressure release valve in people. EFT, NLP, counseling and a few other modalities are well worth trying out in these cases. Let’s be clear…when we are stressed it is hardly ever because the situation is really a threat to us…rather it is to do with our perception of the situation…and the above therapies can often help us change our perception. Or in the case of EFT in particular it can perform seeming miracles in people by simply altering the neural wiring that links the event to our stressful interpretation! It’s amazing stuff. I do tend to find guys more resistant to this idea than women…but it works just as well for both. I encouraged Pat to give EFT a go and after just a single session he had a huge shift in his perception and lost most of his job associated stress. He did continue for a few more sessions to finish out the job all the same. During this time I encouraged Pat to have his sperm quality tested and sure enough there was a problem here too…he had sperm morphology issues. Basically this means a significant percentage of his sperm are misshapen and thus can’t swim properly. A second test confirmed that his HBA1C reading was borderline high. HBA1C is a measure of how much your blood is exposed to sugar…it’s used to determine diabetes. Pat wasn’t near diabetic but his levels were heading towards pre diabetes. I tell ya…stress and a high sugar diet are terribly damaging to the body over time! We restructured Pat’s diet to one that included a lot more animal and plant fat, with less protein and simple carbs – mainly I eliminated lean meat and then added raw cheese, liver, organic bacon, salmon, eggs and a lot of vegetables. I also used a specific herb that quickly helps with blood sugar metabolism and getting the proverbial monkey off your back, and a specific supplement to supply the nutrients I estimated to be low in his diet…particularly vitamin A, D E & K2 plus zinc and iodine. Vitamin K2 helps the body lay down calcium in the right places, and one of the reasons behind ED is that the blood vessels are stiff because of calcification (in turn due to inflammation) So whilst I can’t claim that K2 reverses this calcification (I mean it could…I just don’t know for sure) it certainly will assist in preventing further calcification. Getting calcium metabolism right is also crucial for proper sperm production, so the K2 will help here also. I also prescribed digestive enzymes for 2 months to help Pat extract more nutrients from his food. This is because being stressed for prolonged times down-regulates digestion and so it needs to be coaxed back to normality. There are supplements that can boost ones nitric oxide levels, and I do sometimes avail of them, but not this time because I didn’t need to. Pat responded really well…and at that he didn’t even stick to the diet 100%. With NO OTHER intervention…no drugs…no surgery Pat was able to resolve his erection problem AND his sperm morphology issues within 6 months. By the time we parted ways he had a new lease of sex life and an obvious increase if ejaculate volume…which is a good sign. That was over two years ago as of this writing, and after I emailed several past clients looking for testimonials he did contact me to give permission for this article but also told me that his son was born in the meantime!! Love it! Life is good. Brendan O’Brien NT MSc (As a teaser to any of you interested, I did use one other supplement to drive on the process of reestablishing penile blood flow! Since I can’t be making these sort of claims openly…if you drop me an email with the subject line…What Was Pat’s Secret Supplement? I’ll send you an email telling you about it and where you can get it! 😉
Child’s brain development permanently affected by this one type of food!
Here’s a study that no pregnant mother should read unless they want to send themselves into a stress response and destroy all that lovely pregnancy Zen they have been cultivating!
Maternal dietary imbalance between omega-6 and omega-3 polyunsaturated fatty acids impairs neocortical development via epoxy metabolites
You can read it all here if you think you might want to get pregnant any time soon! http://onlinelibrary.wiley.com/doi/10.1002/stem.2246/full
It’s a pretty dense read but in a nutshell it says:
- The final positioning of our brain cells is set for life very early in embryonic gestation.
- This process is determined by nutritional factors (…Ya don’t say!!)
- One common way for the process to go wrong (common in the western world that is) is because of our very top heavy consumption of Omega 6 oils in comparison to Omega 3.
The paper also mentions the very interesting “developmental origins of health and disease” hypothesis which says that “nutrition in early life stages determines the risk of onset of various diseases in adulthood”. In other words how we are nourished as embryos and as kids has a HUGE effect on our disease risks later on.
Think about this for a minute…it is saying that if we get our kids nutrition wrong from the get-go they are going to suffer badly as they age…and there is little we can do about it after the fact.
I hate this idea but I have to reluctantly agree that it seems pretty spot on.
I do challenge the second part of the hypothesis though….the part that says there is precious little we can do about it.
Studies do indeed show that poor nutrition in early life (the now famous first 1000 days) has a big impact on us as we age. But these studies largely relate to people who continue as they started off…in other words if they start off on a poor diet they tend to continue eating a poor diet…and hey presto they eventually get a disease.
Studies don’t show that if those same people began to eat a healthy diet they still go on to get diseases. Studies don’t show this because it’s hard to find enough people to do these kind of studies on…that’s all!
I maintain that whilst a lot of harm is done by virtue of eating nutrient poor diets it is still possible to roll a good portion of it back once you become smart to the fact. I can’t ‘prove’ this of course but if you put several Nutritional Therapists is a room and hear their stories you would be filled with awe at the healing power of the human body. People do get better very often when they nourish their bodies.
But going back to the paper above…if we eat too much omega 6 oil (and most of us are) we develop a complicated imbalance that affects our whole body, but in particular if mom’s diet is lopsided in favour of omega 6 it affects the brain development of gestating embryos, and this effect will persist for life. The paper is saying that the imbalance gives rise to a complicated milieu of metabolic by-products that alter the very process that determines where baby’s brain cells end up in the skull. Think about the blob of a foetus that eventually grows a brain…and all the magic that has to occur to orchestrate the migration of those tiny cells to the exact right place in the brain! As incredible as it is the process can be disturbed by having too much Omega 6 and too little Omega 3.
Exactly what the end result is of having your brain cells end up in the wrong place is not fully elucidated in the paper but it hints at cognitive impairment.
Enough of the heavy stuff…what’s the takeaway message?
Quit eating processed vegetable oils and any foods with that stuff added to it and add some flax seeds and oily fish to your diet. That’s pretty much it!
All those so called healthy polyunsaturated oils we are told to eat to protect our heart…they are all omega 6 oils…and to boot they are all over-heated and rancid. It’s the rancidity that has some scientists questioning if it is not the omega 6’s themselves but rather the fact that they are over-heated that is the real problem, but that’s a topic for another day.
The quickest way to rectify an omega imbalance is to drop all processed oils, cut drastically back on the quantity of grains you eat (grains contain mostly Omega 6 oils), and take high quality cod liver or salmon oil for a few months. I used the words High Quality on purpose there…most of the stuff on sale is not high quality and the evidence is mounting that low quality (ie carelessly manufactured) Omega 3 oils can drive a whole other set of problems in the body. It’s serious stuff!
I’m not going to openly advertise other people’s products here so if you want my top recommendations for these supplements drop me an email with the subject line Brendan, Tell Me Where I Can Buy The Best Omega 3 Oils…and I’ll email you the answer! (I don’t sell them!)
Yours in health
“I don’t get it” said one of my fertility clients to me…”every time I get a new blood test my levels are all normal…they can’t find anything wrong, yet they still give me drugs to try and fix my levels!!”
Yes indeed it’s complicated, many factors can be conspiring together to keep your fertility system under par….but one issue that really hits me is the routine over reliance on ‘average’ levels of hormones from blood tests.
The reference ranges for various hormones like estrogen, FSH, LH and progesterone are worked out using a hodge podge of averages across the population…but everybody in the lab testing world knows there is no such thing as an average person. Yet despite this we still try to aim for average norms.
The problem with this is twofold;
- Your ideal level of any given hormone may be different from the average (and hint…it always is!)
- The way hormone levels are detected in blood tests doesn’t really give you any functionally useful reading…it doesn’t really tell you what the heck is going on inside your body.
I’m not saying that average values from blood tests are pointless, I’m saying they’re useless! They are a holdover from the old way of doing things…and we all know how long it takes to stop doing old things and start doing new things. All of us…right! We all find it hard to change old habits…so I guess we can’t exactly get off complaining about the medical system and how it’s stuck in the mud, when we can’t do it ourselves!
Anyway…here’s the science bit if you want it…
Hormones travel around the blood either bound to proteins or not…either in taxi’s or walking!
When you measure estrogen from a blood test for example, what you are seeing is the total amount of estrogen…both the stuff in the taxi’s and the stuff walking around ‘free’. We call this bound and unbound.
Typically over 90% of the stuff is bound…in taxis, and the rest is unbound…or walking around freely.
Now here’s the clincher…only the free stuff can do anything to you…only the free estrogen can go into your cells and make them do something that estrogen makes them do.
Estrogen for example makes your womb lining grow in preparation for having a baby…but only free estrogen can do this…not estrogen bound to a carrier protein (aka a taxi).
So what’s the point of measuring all the estrogen when it’s only the free stuff that actually changes anything in your body?
It’s like….you’re on holidays in Lanzarote with your family…on paper you’re a millionaire coz you own 5 properties, but you can only buy beer and pizzas with whatever money you have in your pocket. (Credit cards don’t exist in this world…just go with it!)
If you only have €1.50 in your pocket, well you’re not exactly going to get pissed are you. But imagine an onlooker commenting about you that you’re as tight as tuppence because you won’t buy your kids pizzas!! It wouldn’t be very accurate would it? Yet that’s what doctors do…they comment on your overall wealth without knowing your immediate liquidity status, without knowing how much of your estrogen you can actually spend at any given moment. And whats worse…they often proscribe drugs to you based on this reading.
Is there a way to tell how much free estrogen (or progesterone…or LH or FSH for that matter) you have floating around your blood? The answer is yes….you can get this information in saliva tests, because the only hormone in saliva is the free stuff…and reference ranges have been worked out…and to boot (at least for the labs I use) the reference ranges are not generic averages…they are ranges based on what healthy people have, therefore they offer decent targets to aim at.
Why don’t doctors use these? Old ways are slow to change.
If you’re interested in finding out how you can get these tests send me an email and I’ll let you know.