To Health With That! MTHFR Mutations.

I have enjoyed this season so much - the interweaving of MTHFR and fertility and the ever-interesting conversation about women's health and hormones. Huge thanks to Dr. Kate Naumes, who made the season so much fun.

Without further ado, it is time for the season 4 topic announcement - because this is the #1 symptom that people with MTHFR (and people without it) complain about. This topic is tied up in everything from basic metabolism to hormones, from neurotransmitters to methylation, and from cellular energy to viral load.

Have you guessed it? Next season's topic will be: Fatigue, Chronic Fatigue, and Your Genes.

We'll keep MTHFR and other gene SNPs the whole way through while we uncover all the different facets of fatigue. As always there will be so many things you can start doing today to help your body have more energy and keep the fatigue at bay. We'll discuss:

Everything that goes into your resting energy level

Why fatigue is so damn common

What MTHFR (and COMT, and MTRR, and many more gene SNPs) have to do with it

What is really happening when fatigue becomes chronic

How toxins and toxic burden play into it

Boosting cellular energy

And so much more. Enough to fill a whole season.

I can't wait to get started. The the first episode will air the Sunday after Labour Day (that's September 10th, 2023.)

There is a new fad diet every 20 minutes, or at least it feels that way. It could be paleo, ancestral, keto, the potato diet, the grapefruit diet, the bean diet, and the list goes on. So, how are these fad diets generally, and how are they for fertility? The thing about fad diets is that they work for some people, under some conditions, and for some period of time. Often, however, they provide an unbalanced nutrient profile that is not conducive to building a healthy baby. Also, there is the sensitive issue of eating disorders, which are often undiagnosed and untreated. So let's discuss.

The best diet for fertility sounds like a big claim to make, but the science is clear about what is needed and what isn't. This episode we'll talk about:

• What part of the BMI normal range is best for baby-making
• Basic diet guidelines that are simple to follow
• Why fruits and vegetables matter so much
• Why the Mediterranean diet is so effective
• Why more good fats are a good thing in pregnancy
• The true story about caffeine and alcohol
• Which part of the pregnancy is the most important part to stick to your diet

Of course there is a perfect way to do things if you have all the money, time, and resources to throw at it, but what about what actually happens in real life? Because let's face it, we're all dealing with medicine IRL.

This week we'll talk about:

• The barriers to good fertility care including insurance or lack of insurance, time, money, location, and more.
• What you can do to maximize your fertility care even when you have some of those barriers (as we all do)
• The things you can take care of at home to boost your chances
• Resources you can have on hand to get the most out of every medical visit

Fertility medicine especially is expensive, time consuming, and extremely demanding and it can make a huge difference to your outcomes and also to how much money you end up spending if you're prepared.

Iron deficiency anemia can be a significant problem when you're trying to conceive or going into a pregnancy, but even without overt iron deficiency anemia, your iron levels can still have an effect. We'll discuss:

• Why it's important to test both red blood cell iron levels and also ferritin, the storage form of iron.
• What iron deficiency anemia feels like, normally and in pregnancy.
• The possible complications of anemia in pregnancy, childbirth, for the neonate and even for the child of an anemic mother beyond the neonatal period.
• The relationship between men's iron levels and men's fertility especially with sperm parameters.
• Iron infusions and why we love them.

Iron levels are an important factor in preconception and pregnancy and while every doctor will test basic red blood cell levels, you  may have to advocate for yourself to get your ferritin tested.

Overtly low or overtly high thyroid levels are a well known risk factor for infertility, but today we're going to talk about something a little bit less well known, which is subclinical hypothyroid and fertility. Subclinical hypothyroid is when the thyroid tests are on the lower end of normal, but still within normal limits. The patient experiencing this might have symptoms of mild low thyroid, or might be asymptomatic, but research is showing a link between this "normal" thyroid and fertility difficulty. We'll talk about:

• The effects of high and low thyroid on women's fertility
• The suprising effect of low-normal thyroid levels on fertility
• Thyroid testing
• TPO antibodies (or thyroid peroxidase antibodies) and their effects on fertility in women with normal thyroid levels
• Thyroid hormones and when they are prescribed for women in fertility situations
• The effects of hyperthyroid and hypothyroid on sperm levels and sperm morphology (that is high and low thyroid function)
• Routine thyroid screening in pregnancy
• How naturopathic doctors can help

Thyroid is a known cause of fertility difficulty, but not all doctors are aware of the link between low-normal thyroid function and impaired fertility. 

MTHFR is involved in so many processes, but it is especially tangled up with fertility for both male and female partners, as well as pregnancy for female partners. This episode we'll talk about:

• Male factor infertility, sperm count, and sperm morphology
• 5-LMTHF vs. folic acid use in this situation - what is the standard of care, vs. what might actually work better
• Repeat pregnancy loss
• The possible factor of microclotting
• Homocysteine levels in pregnancy - normal and abnormal
• Hope in the MTHFR and fertility journey.

The infertility journey can be a difficult path and is often an endurance race with sprints mixed in.  This episode is less about mental health expertise, we will defer to therapists, counselors, and mental health professionals for that, and more about starting a conversation around some of the issues we see commonly in our practices.  Four of the big ones that come up are:

• Self worth, self image, masculinity and femininity
• The timed sex problem (because making sex a task-based activity takes a lot of the magic out of it)
• Actual loss
• Not getting the thing you want, only makes you want harder

We'll also talk about the link between the increasing stress of infertility, and stress making it harder to conceive. Additionally, Dr. Amy will mention a couple of homeopathic remedies that are useful in the infertilty space as a support to help you heal.

Dr. Kate and Dr. Amy both encourage you to take mental health as seriously as you do your physical health and we hope this episode can encourage some conversations with friends, loved ones, or mental health professionals.

PCOS is one of the more common causes of female-factor infertility because it creates a situation in which ovulation is unpredictable or not occurring and babies can't be made if no good eggs are released. Dr. Kate and Dr. Amy will talk about

• The diet they typically suggest for PCOS
• Why a PCOS diagnosis is commonly missed
• Inositol for PCOS
• The difference between working with PCOS for clients on a fertility journey vs. clients who are just looking for health
• Supplements used for PCOS.

Last week we talked about how endometriosis affects fertility and pregnancy outcomes. This week, let's dive deeper into what is really going on with endometriosis and why it has such far reaching effects for women. We'll discuss

• Gene SNPs associated with endometriosis
• The link between inflammation and endo
• Endometriosis and oxidative stress
• Treatment goals with endo
• Association between endometriosis and autoimmune disease, depression, migraines, and more.

Endometriosis is one of the leading causes of female factor infertility and it's responsible for incredibly painful menses, heavy bleeding, and often pain with intercourse as well.  This week we'll talk about the links between endometriosis and fertility and next week we'll deep dive into some of the underlying causes, including inflammation and hormone imbalances.

We'll also talk about the value of integrative medicine indulging main stream medical practice with naturopathic care specifically for endometriosis.

Lots of people come to NDs to help them on their fertility journey, but what does an ND actually do?

In short, your ND can support your fertility journey in a lot of ways, no matter where you are in the process. We can

• Balance your hormones and help you with preconception (for both sperm and egg donor) so your baby can have the healthiest start
• Help to get your body ready for Assisted Reproductive Technology like IVF
• Help you to reduce the side effects of Assisted Reproductive Technology and other fertility interventions

An ND that focuses on reproductive health and fertility can help you at any stage of the journey, whether you're in the early days, or you've been through three rounds of IVF and you're considering a surrogate. 

The idea of getting an infertility evaluation is a daunting one, but it gives you such a wealth of valuable information and can help you to steer your treatment in the right direction, for both potential parents, without wasting precious time.

Let's talk about:

• The best doctors to visit for this, and how to get it if you're in an area with limited health resources.
• When to get a complete infertility evaluation
• Why it matters for both partners
• What tests are included in an infertility evaluation for men and women
• How Ovarian Reserve is assessed
• Why the uterus and fallopian tubes might need investigation and how that is done

This week we're talking about a basic tool in every woman's arsenal, it's tracking her period and charting her cycle. Especially on the fertility journey, knowing when you're ovulating and your most fertile window is invaluable, and knowing if you ovulate at roughly the same time every month gives you a great indicator of how things are going in your body right now.  We'll talk about:

• Why to use the Fertility Awareness Method of Cycle charting
• Who this might not be right for
• Why we're not suggesting paper tracking vs. period tracker apps in the US
• How to tell when you're ovulating
• A great resource to learn more.

Folic acid is the standard of care for both prenatal vitamins and high doses for couples struggling with infertility. So let's look at a compelling research study about using 5-LMTHF as an intervention instead of folic acid for couples who have been struggling with infertility for four years and have already failed high-dose (5000 mcg) folic acid. We'll talk about 

• The potential risks of 5000 mcg folic acid in pregnancy
• UMFA and the dangers of unmetabolized folic acid
• A remarkable study that  helped 27/33 couples get pregnant after FOUR YEARS of infertility
• The difference between people who have an MTHFR mutation and people who don't.
• Research that you can take to your care team if you'd prefer to try 5-LMTHF instead of folic acid.

Seed Cycling sounds too simple to work, but it's a lovely nutritive way to get your menstrual cycle back in balance. This technique uses a combination of four seeds, flax seeds, pumpkin seeds, sesame seeds, and sunflower seeds, to balance and regulate hormones. Seed cycling can help to:

• Reduce heavy bleeding
• Reduce cramping
• Decrease frequency and/or severity of hormonal migraines
• Regulate cycle length
• Reduce severity of PMS

There are so many women's hormone symptoms that women have regularly that we think of as a "normal" part of being a woman, but that might give you some good clues about your fertility. This week we'll expand on this topic from last week and go over symptoms like pelvic pain, cramping, PMS, PMDD, fatigue, chronic acne or hormonal acne, lower abdominal bloating, fatigue, hot flashes and night sweats, unexplained weight gain, pain with sex, low sex drive or low libido, infertility or difficulty getting pregnant, sores that won't heal, a sudden change in your period, and spotting.

There are lots of red flags in every day life that might indicate a hormone imbalance or other problem that could have fertility consequences. This week we'll talk about the first ones, including:

• Skipped or missed periods
• Heavy bleeding or flooding
• Scanty bleeding (even though it makes for a nicer period)
• Abnormal hair growth
• Hair loss

Next week, we'll go over more red flags because women's hormones can go crazy in so many ways.

Your annual exam isn't normally the place where you're looking for fertility insights, but if you know where to look there is hidden information in:

• Your annual bloodwork
• Your breast exam
• Your bimanual exam
• Your pap smear

Just because it isn't "about" fertility, doesn't mean this isn't useful.

Last week we talked about basic preconception supplements. This week, we expand on that and add some specifics about:

• Magnesium
• Choline
• Iron and iron infusions
• Preconception supplements for people with PEMT
• Preconception supplements for people with COMT
• Preconception supplements for people with VDR
• Preconception supplements for people with GST or GPX

Lots of people talk about what you need to take while you're pregnant, but what about the supplements that will boost your fertility and give your baby the healthiest foundation before you conceive? This week we'll discuss:

• The three preconception must-haves - one of these will definitely surprise you.
• Supplements for special situations like mothers at risk of preeclampsia, mothers with leg cramping, and more.

Next week we'll talk about modifying your preconception supplement routine based on your gene SNPs.

If you're in the ideal situation of planning things out before you decide to get pregnant, then here are the factors you should work on before you try to conceive.

• What to watch for on your blood work
• The hormone test that isn't a sex hormone (but is important for healthy pregnancy)
• The lifestyle habits that might need to change 
• How often you should be gettin' down

Lots of us have babies without a lot of planning, but if you have the opportunity to plan your family then here is information about:

• Questions to ask your primary care provider
• Well woman exam
• Talking to your dentist
• What to do with your prescriptions
• Some hard conversations you might want to have

Last week, we talked about Estrogen, the primary female sex hormone. This week, let's round out the conversation with a discussion about progesterone, testosterone, the pituitary hormones LH and FSH.

We'll talk about:

• Progesterone and its role in pregnancy
• Testosterone 
• Signs and symptoms of both testosterone excess and deficiency in men and women
• The pituitary hormones FSH And LH and the different roles they play for both women and men
• What is involved in a basic infertility diagnostic work-up for a couple.

We've all heard of estrogen, of course, but how much do you really know about it? Let's talk about why estradiol is called the Marilyn Monroe hormone. Also, the relative value of hormones vs the absolute value - which matters more? Let's talk about high estrogen symptoms, low estrogen symptoms and some of the causes for both.

We already talked about what happens in women's bodies, but what about men? How do men make sperm that will be healthy enough to win the egg race? Let's talk about the four-month process called spermatogenesis. Check the show notes for more about spermatogenesis and MTHFR as well.

To begin to talk about what is abnormal about women's menstrual cycles, we have to first understand what is normal. 

Most doctors and experts tend to talk about the two phases of a menstrual cycle, but to more accurately represent the lived experience of having a menstrual cycle, I think four phases are more accurate. These are:

1. Menstrual
2. Follicular
3. Ovulatory
4. Luteal

Each phase has its own level of energy, physical changes, and of course hormone processes in the body. Each one also tells us a little bit about how you feel in the world at that time of the month. Let's talk about it!

It's really tempting to avoid the diagnosis part of fertility - you can just get a bit healthier and it will all work out, right? Except for when it won't. Listen to Dr. Kate Naumes, ND and Dr. Amy Neuzil, ND talk about the biggest reasons why diagnosis is important if you're working on fertility.  Here's a hint: The problem might not even be with you.

For the first episode of this season on infertility, hormones, and how it all ties in with genetics - let's actually talk about what "infertility" means and why you might have passed some major benchmarks without even knowing it.

Meet Dr. Kate Naumes, ND our fertility expert and see Dr. Amy Neuzil, ND in the video version.

The internet is full of doomsday prophecies about MTHFR and vaccines, but what does the actual science say? In this episode we'll cover:

• Dr. Amy's general views of vaccines
• MTHFR data in the Vaccine Adverse Event Reporting System in the US
• MTHFR and the smallpox vaccine research
• A case report about MTHFR and blood clots after the covid-19 vaccine
• The controversial issue of vaccines and autism risk

This is the last episode of the season. Stay tuned for a Season Three preview in the next few weeks. We will have an exciting new topic, and Dr. Amy will collaborate with a dear friend and colleague, so stay tuned!

Living the MTHFR lifestyle means reducing as much toxic exposure as possible and a lot of that comes through skincare. Today, Dr. Amy is talking with Renee Harris, founder of MadeOn skincare.  You can find Renee's products at hardlotion.com

Tricia Nelson is an emotional eating expert and the author of Heal Your Hunger: 7 Simple Steps to End Emotional Eating.  I am delighted to have the opportunity to talk with her because emotional eating, while it might sound like a departure for me, is a common problem among us MTHFR folks.  

Anyone with MTHFR, COMT fast, or MAO-A fast can be more susceptible than average to emotional eating because emotional eating typically stems from low dopamine or low serotonin. Emotional eating falls within the realm of addictive behaviors and so it can be an MTHFR issue.

If I had to pick one mutation that was AS pivotal as MTHFR is, it would be PEMT. This mutation affects literally EVERY cell in your body - all 37.2 trillion of them. We'll talk about:

• The one well studied polymorphism (and the legions of other ones)
• Signs and symptoms that may point to a PEMT problam
• How to ease the burden on your PEMT
• And why it's important to love your liver.

This week we'll talk about another gene SNP picture that is called MAO-A Fast. Having a fast MAO-A means you break down neurotransmitters faster than average, and since this gene SNP breaks down Serotonin, Melatonin, Norepinephrine, and Epinephrine you can imagine it leads to quite a lot of self-medication, and the easiest way to self-medicate is with Carbs. So we'll talk about:

• What is happening when you reach for the sugary and starchy carbs
• How to get off of the carbohydrate rollercoaster
• What diet is best for you
• Other things you can do to support healthier neurotransmitter levels.

MAO-A is another gene SNP that is different from the others we've talked about because it is actually linked to a sex chromosome. The various SNPs add up to produce a "fast" or "slow" picture. We'll discuss:

• Why we can't tell women's MAO-A picture from a genetic report
• What symptoms to watch for that might indicate you have an MAO-A Slow picture
• How to manage slow MAO-A naturally
• Foods to enhance and avoid for slow MAO-A

Vitamin D doesn't link into the methylation cycle, the folate cycle, or even the BH4 pathway so it seems highly unrelated to MTHFR, but is that true? This week we'll explore:

Why vitamin D seems to do literally everything in the research

The gene SNPs that affect vitamin D

Why folate and vitamin D have relationship status "complicated"

How folate and vitamin D might have influenced skin pigment in evolution

An MTHFR superpower that regards, you guessed it, vitamin D.

Low histamine isn't something that doctors are talking about yet. It hasn't even really made it to the internet, which is usually first to know everything. But I think there might be more to low histamine states than meets the eye, so let's talk about it. We'll cover:

• Emerging research on cancer, cardiac disease, and Alzheimer's disease with low histamine
• Signs and symptoms of low histamine
• The Over-methylator/Black sheep basic state tie-in
• Four natural ways to boost your histamine if it's down.

Histamine and MTHFR are joined together in so many ways. Let's talk about:

• The surprising things other than allergies that histamine influences.
• Risks and symptoms of high histamine
• Seven things you can do to lower your histamine naturally.

I love listener questions because it's always something good!

This week, we talk about:

• Detoxifying Arsenic
• Mercury toxicity with adrenal fatigue and MTHFR
• Amy's quick and dirty about fibromyalgia.

MTHFR is closely tied to heart disease, and nitric oxide (not to be confused with nitrous oxide, or laughing gas) is a big part of the reason why. In this episode we'll talk about:

• How nitric oxide is linked to heart attacks, strokes, alzheimers, sinus health, mouth breathing, and even some birth defects.
• Why humming matters
• How the NOS3 gene affects you and how it interacts with MTHFR
• How you can boost your nitric oxide production - with or without these genes.

Of course B12 is important to methylation and MTHFR, but why is that precisely? Well, spoiler alert - it has something to do with two different genes that are also involved in the methionine pathway - MTR and MTRR. So this week, let's talk about:

• Which gene creates especially difficult to treat issues with homocysteine (especially in combo with MTHFR).
• What to do about MTR and MTRR polymorphisms
• Why I talk about MTHFR so damn much
• How to get on the beta list for a teachable course this summer.

We've talked about glutathione before, but now let's talk about two gene SNPs that really mess with your glutathione functioning. We'll discuss:

• Signs and symptoms of a GST polymorphism
• Signs and symptoms of a GPX polymoprhism
• Which SNP is linked to diabetes and early grey hair
• Which SNP makes walking through the perfume department a nightmare
• What you can do to help your body get stronger and healthier with either of these gene SNPs

We've talked about glutathione before, but let's review before we dive into gene SNPs that affect glutathione. We'll cover:

• The most common fatal overdose globally (that glutathione can help prevent)
• The heavy metal that needs glutathione to be taken out of your brain
• Why glutathione is called the "master antioxidant"
• Natural ways to boost glutathione
• Two surprisingly under researched gene SNPs affecting glutathione production.