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Monthly Archives

October 2017

This is What Infertility Looked Like 30 Years Ago

By | Fertility | No Comments

This is what infertility looked like 30 years ago, told through the eyes of an “infertile” couple’s daughter (that’s me!)

In honour of Canadian Infertility Awareness week, I sat down with my parents and asked them what infertility looked like over thirty years ago. You see: I am the very happy ending of a ten-year struggle with infertility. Just as you’ll one day share your journey with your baby to be, my parents shared their overwhelming journey with me. They never would have imagined that their daughter would be telling their fertility story, yet here I am sharing it with you!

Their Story

Thirty years ago the fertility world looked a little bit different than it does today. My parents were never offered IVF, but they did undergo a handful of memorable IUIs. In order to get a semen sample for the IUI, my dad was instructed to use the public washroom across the street and have my mom store the sample in in her bra until her appointment. Bra storage isn’t exactly standard care these days. With a different fertility specialist, my mom underwent a laparoscopy to diagnose endometriosis and the doctor forgot to chart his findings and couldn’t remember the results! Needless to say, my parents went through many fertility doctors and refused to settle for one they didn’t connect with. But forget about doctors, my mom said she was so desperate for answers that she sought the help of an astrologist and a psychic and “if there was a Martian trained in infertility” she would have gone to see him too!

Sacrifice

My parents taught me that infertility is paved by sacrifice. They donated their bodies to be poked and prodded and followed a diet that my dad loathingly refers to as “cardboard and vegetables”. My mom said she once found a receipt for a secret chocolate bar in my dad’s grocery bag and completely broke down, refusing to speak to him for days!

There were really awful and devastating moments. My mom vividly recalls being invited to a baby shower where every single woman who attended was pregnant (all too common for women struggling with infertility). My mom said she cried a lot through all of these awful moments, but that it was really important to her that her friends and family know what she was going through. She wrote personalized letters (remember this was the 80s!) to the people in her life so they could better understand her journey and her ever so deserving tears.

Holding Onto Hope

Throughout my parents’ 6 year struggle with infertility, they never gave up hope. They would buy baby clothing and baby books wherever they went because they knew they would be parents, even if it were through adoption. In fact, the public adoption agencies in Ontario were closed thirty years ago so my mom resorted to some very unconventional methods. She wrote letters to high schools (she’s a teacher) explaining her story and asking if there were pregnant teens giving up their children for adoption! She recalls a news story where a couple had twins but only wanted one of the twins, and she somehow found the couple’s contact information and called them directly to tell them she would take one of the babies! I mean, YIKES, the police would be knocking on her door if she had tried any of this nowadays! She was one determined parent.

And Then There Was Me

Of course there’s a silver lining to this story, and that’s me… and did I mention I have two biological brothers too!?! It wasn’t until they saw a naturopathic doctor (and yes, all of their friends thought they were crazy) that they finally got pregnant. It may not be a surprise to you that I was then raised with naturopathic medicine and here I am as a naturopathic graduate with an immense passion and dedication to fertility. I haven’t personally experienced infertility, so when I first started my naturopathic internship I was determined to build a set of resources to help people like my parents.

After spending some time talking to my parents, I asked them to share some coping strategies that made their journey just a little more bearable. Here’s what they had to say:

  1. Tell people what you are going through
    My mom constantly felt guilty for crying when she was “supposed to feel happy” for her pregnant friends. Instead of burying her feelings, she wrote letters (this was 30 years ago when texting wasn’t available) to her friends explaining what she was going through and how it was affecting her life.
  2. Remove negative people from you life
    My parents were not willing to hold space for people in their lives that were not going to support them. When they were getting approved for adoption, they needed letters of recommendation from their friends. One of their friends said she was “too busy to write it”, that friend is obviously no longer in their lives.
  3. Find support beyond your partner
    Even 30 years ago they saw a fertility counselor, both on their own and together. Nowadays there are many amazing online resources and support groups too!
  4. Try not to put your whole life on pause
    Try new things, find some new hobbies, travel the world. It was important to my parents that they have something in their lives besides fertility appointments. They tried every class possible at the local community centre: pottery, basket weaving, calligraphy, soccer, hockey, you name it.
  5. Acknowledge your strength
    My parents certainly acknowledged their sadness after every failed cycle, but they stayed positive and told themselves they would “just try again in two weeks”.
  6. Hold on to hope and be who you are
    Infertility does not make sense and my parents were damned sure they were never going to give up on parenthood…even if my mom had to call every single news station looking for a baby to adopt!

Evidently, a lot has changed in the past thirty years, fertility technology in particular! But the emotional toll infertility takes on a person remains all too much the same. Ask for support whenever you can, and don’t give up until you feel it’s right for you. Who knows, maybe one day you’ll have a daughter who will share your fertility story.

To learn about the fertility services I offer click HERE. To learn about my healthy conception program click HERE

Confessions of a Tap Water Drinker: How To Combat Environmental Estrogens Without Losing Your Mind

By | Women's health | No Comments

I drink tap water and it is one of the major sources of xenoestrogens in our environment. I don’t have one of those fancy reverse osmosis water filtration systems, but I do have a water pitcher filter that I surely don’t replace often enough. But you know what? I’m doing the best I can, and so are you!

There are so many things you can do to reduce your chemical load and you don’t have to turn your life upside down to do them. I’m here to tell you that even small changes make a BIG difference when they all add up.

Xenoestrogens

Maybe I’ve gotten ahead of myself and you’ve never heard of these “xenoestrogens” I’m talking about? Xenoestrogens are chemicals we encounter daily that behave like estrogen in our bodies; they interfere with the functions of our hormones.  They’re in our water, our pesticides, our shampoo, our coffee cups, our cans/plastics and the list goes on. Well, they’re seemingly inescapable.

The bad news: When there are more xenoestrogens in our environment, we end up with more estrogen in our bodies.  These xenoestrogens are unfortunately much stronger than the natural estrogens our bodies produce, so you may experience symptoms of excess estrogen, like: breast tenderness, irregular menstrual bleeding, ovarian cysts, fibroids, PCOS, endometriosis, PMS, headaches, excess fat tissue, low libido, etc all due to environmental exposure. Xenoestrogens affect men and women.

The good news: Thankfully, our bodies are brilliant machines that have the amazing ability to remove the majority of these toxic estrogens through liver detoxification and elimination. It is only when we are over-exposed, and our bodies are over-exerted, that we start to feel the symptoms because our elimination pathways just can’t keep up with the chemical load.

There’s more good news.  The purpose of this blog is to teach you how to reduce your load of xenoestrogens so that your body is better equipped at getting rid of them.

Here’s what you can do:

 

  1. Enjoy foods and drinks that help your body eliminate harmful estrogens, you’re already eating anyways!

The following foods/drinks decrease the binding effects of xenoestrogens in the body:

  •      Almonds
  •      Walnuts
  •      Ground flax
  •      Sunflower seeds
  •      Sesame seeds
  •      Non-GMO, organic soy
  •      Green tea
  •      Hibiscus tea
  •      Alfalfa sprouts

The following foods/drinks increase the elimination of xenoestrogens from the body:

  •      Broccoli
  •      Cauliflower
  •      Brussels sprouts
  •      Cabbage
  •      Collard greens
  •      Arugula
  •      Bok Choy
  •      Kale
  •      Turnips
  1. Know the common sources of xenoestrogens and make small changes to avoid them

  •      Xenoestrogens can be found in a wide variety of household products: cosmetics, cleaning products, body products, cookware etc.The next time you you run out of laundry detergent buy a natural one instead, and skip the unnecessary dryer sheets full of chemicals.
  •      Skin Deep is a site where you can search cosmetics and determine whether they have hazardous chemicals, without having to read a single label!
  •      Avoid plastics as much as possible: use glass containers, use a reusable water bottle, do not heat plastics in the microwave or dishwasher, bring a travel coffee mug to work.
  •      The “dirty dozen” is a list of the top 12 produce with the most pesticides. You do not need to buy everything organic, in fact buying organic in only these 12 foods reduces your pesticide exposure by 60-90%.
  •     Avoid tap water when you can- reverse osmosis water has the fewest toxic compounds (although it is not great for the environment).

Other tips for healthy elimination of estrogens:

  •      Opt for high fiber foods, including: complex carbs, fruits, veggies
  •      Drink at least 2L of water daily to support elimination
  •      Limit alcohol intake to 1-2 glasses of red wine a week for optimal liver function
  •      Get outside in the sun and exercise: vitamin D and sweating both contribute to lower estrogen levels

Even if you only choose to make one tiny change after reading this blog, you’re still better off than you were before. I do the best I can but I don’t treat it like a full time job! I use natural cosmetics, body products, and tampons. I try to use glass containers and avoid heating plastic, but I do love coffee shops and my faithful dishwasher!

Book an appointment with Dr. Sumner HERE. Learn about her healthy hormone program HERE

References

Wozniak, M., & Murias, M. (2008). Xenoestrogens: endocrine disrupting compounds. Ginekologia polska79(11), 785-790.

Paterni, I., Granchi, C., & Minutolo, F. (2015). Risks and Benefits Related to Alimentary Exposure to Xenoestrogens. Critical reviews in food science and nutrition, (just-accepted), 00-00.

Arya, G., Tadayon, S., Sadighian, J., Jones, J., de Mutsert, K., Huff, T. B., & Foster, G. D. (2017). Pharmaceutical chemicals, steroids and xenoestrogens in water, sediments and fish from the tidal freshwater Potomac River (Virginia, USA). Journal of Environmental Science and Health, Part A, 1-11.

Michałowicz, J. (2014). Bisphenol A–sources, toxicity and biotransformation. Environmental toxicology and pharmacology37(2), 738-758.

The Top 10 Hormones Worth Testing in Blood Work & The EXACT Results You Want to See

By | Women's health | No Comments

You know the drill when it comes to hormonal blood work; it’s a lot of poking and prodding on multiple days of your menstrual cycle. In my experience, my patients have had all the right testing done (mostly), but no one has taken the time to sit down with them and explain what the results truly mean.

 

The biggest pitfall of serum (blood) hormone testing is that the reference ranges are MASSIVE. Which means it is highly unlikely that your results will be deemed “abnormal” even though you know something is wrong. So that’s what this blog is for; I’m going to break it all down for you and discuss what the results mean and the REAL range you’re looking for. Note: the following reference ranges are for women and are Canadian units.

 

1) Estradiol

What it is: Estradiol, along with LH and FSH, stimulate follicle (egg) maturation. It’s also responsible for female sex characteristics, thickening of the endometrial lining, and bone protection. Estrogen can also be converted from fat, in both males and females, by an enzyme called aromatase.

What it means: Low estradiol is present in peri-menopause and menopause. Elevated estrogen is present in early premature ovarian insufficiency (followed by low levels), and in estrogen dominant conditions like: PMS, endometriosis, PCOS, and obesity.

Reference Range:

Follicular 77-921 pmol/L

Luteal 77-1145 pmol/L

The “real” range: The width of the above ranges is ridiculous! Estradiol should be tested on day 3 and should be lower than 200 pmol/L and higher than 80 pmol/L. A level higher than this is a sign that the body is trying too hard to stimulate egg development, and the ovaries are not responding. In this case, you will likely see elevated FSH too.

 

2) FSH (follicle-stimulating hormone)

What it is: The name says it all. FSH is in charge of the development and maturation of follicles.

What it means: High levels are diagnostic of menopause, ranging from 27-133 IU/L. When your body is pumping out more FSH than normal, it’s a sign that the ovaries are not responding (just like estrogen). Low levels of FSH are typically present in PCOS.

Reference Range:

Follicular 3-8 IU/L

Mid-cycle 3-22 IU/L

Luteal 1.5-5.5 IU/L

The “real” range: Higher than 8 IU/L on day 3 (that’s the 3rd day of your period) is too high and the value is only going up from there. 6 IU/L is as good as it gets on day 3.

 

3) LH (Luteinizing hormone)

What it is: Ah, the hormone everyone knows and loves! The LH surge triggers ovulation and is measured by urine strips. LH also contributes to the maturation of eggs. You may not know that estrogen surges right before LH, which can also be used to detect ovulation.

What it means: On day 3, an LH to FSH ratio greater than 2:1 is indicative of PCOS. LH is elevated in PCOS for so many reasons I’ll need to dedicate another blog to it. Elevated LH also stimulates elevated testosterone production, and in turn estrogen production. Contrary to what you may think, high LH actually inhibits ovulation instead of stimulating it.

Reference Range:

Follicular 2-12 IU/L

Mid-cycle 8-90 IU/L

Luteal 1-14 IU/L

The “real” range: LH should be almost equivalent to FSH on day 3. 6-8 IU/L is ideal.

 

 

4) Progesterone

What it is: Most of the body’s progesterone is produced by the outer coating of the egg, called the corpus luteum. After you ovulate, progesterone levels increase to maintain the endometrial lining and prepare for embryo implantation. Progesterone also stimulates the production of a thick mucous that covers the cervix so no sperm can enter the uterus (FYI this is the basis of hormonal birth control).

What it means: A low level of mid-luteal progesterone indicates anovulation and luteal phase defect (short luteal phase) and predicts implantation failure/ early miscarriage.

Reference Range:

Luteal 4-50 nmol/L

The “real” range: On day 21 the minimum value is 10 nmol/L to have ovulated and 20 nmol/L to carry a pregnancy. Day 21 is arbitrary if you don’t ovulate on day 14. Progesterone is best-tested 7 days after you ovulate.

 

5) Prolactin

What it is: The main function of prolactin is to stimulate breast milk production. However, elevation can also occur due to the following: benign pituitary tumor, periods of high stress, hypothyroidism, PCOS, and certain medications.

What it means: Elevated prolactin inhibits the release of GnRH, which then inhibits the release of LH and FSH. Without LH and FSH, follicles will not develop.

Reference Range:

5-30 ug/L

The “real” range: Prolactin levels as high as 50 ug/L can inhibit ovulation, but small increases by a few points are relatively harmless. One-time elevation should be followed by repeat testing. As mentioned, stress is a major influence on this hormone.

 

6) DHEA

What it is: A precursor hormone to both estrogen and testosterone.

What it means: DHEA is often evaluated in PCOS, as elevations in this hormone increase androgen levels. It may be prescribed to improve ovarian reserve (but not without fun side-effects).

Reference Range: <9.8 umol/L

 

7) Androstenodione

What it is: Produced from DHEA, this hormone is the precursor to testosterone.

What it means: Elevated androstenedione is found in PCOS and adrenal hyperplasia. Both conditions inhibit ovulation. It may be elevated in isolation, or with testosterone.

Reference Range:

Follicular 1.2-8.7 nmol/L

Luteal 1.1-8.2 nmol/L

 

8) Testosterone

What it is: You know this hormone for its role as the primary male sex hormone, but it’s important for women too! In the ovaries, testosterone is produced by the stromal cells and converted to estrogen. It participates in follicle growth and development, not to mention male and female libido.

What it means: Too much is present in PCOS which is far from ideal, but too little can inhibit ovulation and egg development.

Reference Range:

Total testosterone 0.3- 1.8 nmol/L (some labs up to 4 nmol/L)

The “real” range: Testosterone is extremely tricky to test accurately. Free testosterone is a better measurement than total and the reference ranges (depending on the lab) have huge variability. In order to test free testosterone you need to test total testosterone and sex hormone binding globulin.

 

9) AMH (Anti-Mullerian Hormone)

What it is: It’s a hormone that can depict the female egg reserve because it is secreted by the eggs in the ovaries. The more eggs you have, the higher the value will be. Not surprisingly, AMH decreases with age. This is the only hormone test we have for predicting ovarian reserve.

What it means: A lower value for your age means you have a lower number of eggs than the average female. A much higher value for your age is indicative of PCOS, as the cystic ovaries in PCOS secrete excess AMH.

Reference Range: The numbers are averages based on age:

< 33 = 2.1 ng/mL

33-37 = 1.7 ng/mL

38-40 = 1.1 ng/mL

> 41 = 0.5 ng/mL

The “real” range: At any age, a value > 3.15 – 4.45 ng/mL warrants further testing for PCOS. A value of 6.8-10 ng/mL is diagnostic.

 

10) TSH (thyroid stimulating hormone) & Antibodies (anti-TPO, anti-TG, anti-TSH)

What it is: TSH is released by the anterior pituitary, which then stimulates the release of thyroid hormones (T3, T4) from the thyroid gland. TSH above the reference range with symptoms present is diagnostic of hypothyroidism, and below is hyperthyroidism. TPO and TG antibodies cause the thyroid condition known as Hashimoto’s, anti-TSH is more commonly present in Graves’.

What it means: Deficient thyroid function affects egg quality, embryo quality, and implantation rates. Combine that with thyroid antibodies, and there’s an increased risk of miscarriage.

Reference Range:

TSH 0.32-4.0 mIU/L

Antibodies should all be negative

The “real” range: TSH should be < 2.5 to prevent miscarriage. A full thyroid lab panel (with individual thyroid hormones) is certainly necessary in cases of recurrent miscarriage.

Book an appointment with Dr. Sumner HERE to request & review lab work. Learn about her hormone balancing program HERE

References

Zadehmodarres S, Heidar Z, Razzaghi Z, Ebrahimi L, Soltanzadeh K, Abed F. Anti-mullerian hormon level and polycystic ovarian syndrome diagnosis. Iranian Journal of Reproductive Medicine. 2015;13(4):227-230.

Wiweko B, Maidarti M, Priangga MD, et al. Anti-mullerian hormone as a diagnostic and prognostic tool for PCOS patients. Journal of Assisted Reproduction and Genetics. 2014;31(10):1311-1316. doi:10.1007/s10815-014-0300-6.

http://tests.lifelabs.com/Laboratory_Test_Information/Search.aspx

Huhtinen K, Desai R, Ståhle M, et al. Endometrial and Endometriotic Concentrations of Estrone and Estradiol Are Determined by Local Metabolism Rather than Circulating Levels. The Journal of Clinical Endocrinology and Metabolism. 2012;97(11):4228-4235. doi:10.1210/jc.2012-1154.

Kumar P, Sait SF. Luteinizing hormone and its dilemma in ovulation induction. Journal of Human Reproductive Sciences. 2011;4(1):2-7. doi:10.4103/0974-1208.82351.

Can coenzyme Q10 supplementation make your eggs act a little bit younger?!

By | Supplements | No Comments

It’s an unfortunate fact of life: every single day we get a tiny bit older. I truly believe that you’re only as old as you feel, and just because you’ve hit your 35th birthday doesn’t mean you don’t look and feel 25! Unfortunately our eggs, or oocytes, don’t agree with the theory that feeling young at heart makes us look young at heart. As women, we are born with an unchangeable number of eggs. Over time the quality of these eggs naturally declines, regardless of how we feel about it, but it’s not all downhill from there! Although we can’t change the number of eggs we have, we may be able to change the quality of those eggs and quality is more important than quantity, right?! And while we’re on the topic, we can influence the quality and quantity of sperm too!

How can we influence egg quality?

Even though we’re stuck with a certain number of eggs, we can influence the quality of our eggs because they are arrested in a stage of cell division called meiosis I. This means they are not mature and they have not completed cell division. It’s the maturation process that we can influence! Female eggs remain in the early stage of cell division until a woman reaches puberty. Once a woman has a menstrual cycle, a few of these eggs mature each cycle and compete for ovulation and move into the next stage of cell division. This cell division is responsible for dividing DNA and ultimately influencing the end quality of the egg.

Where does CoQ10 come in?

If you attended grade 8 science class then you’ve probably heard of the mitochondria being the “powerhouse” of the cell. In order for the oocytes to divide efficiently, they need lots of energy from their mitochondria and coenzyme Q10 is an antioxidant that is essential for providing this energy. Our eggs cannot function without CoQ10, which is why our body naturally makes a certain amount. However, as we get older we produce less CoQ10 and we end up with eggs that aren’t great at dividing and have poorer development.

This lack of mitochondrial energy translates into: difficulty ovulating, trouble conceiving, and in the case of IVF- issues with making an embryo that survives to day 5 to be transferred. Poor quality eggs put you at greater risk of miscarriage due to aneuploidy, a term that refers to an abnormal number of chromosomes in the embryo. Poor egg and sperm quality are major causes of infertility. This can all sound very overwhelming, but CoQ10 plays a role in improving the quality of both eggs and sperm!

The possibilities of CoQ10 for egg development:

  • Decreases the rate of aneuploidy (abnormal chromosome numbers)
  • Boosts mitochondrial function and cell division
  • Increases energy, or ATP, production in the egg
  • Stimulates more eggs to develop in combination with IVF
  • Prevents DNA oxidation, causing damage
  • Induces ovulation in combination with clomid in cases of clomid-resistant women with PCOS
  • Significantly improves endometrial thickness, serum estrogen, and serum progesterone in clomid-resistant women with PCOS
  • Significantly improves clinical pregnancy rates in clomid-resistant women with PCOS
  • Greater concentrations of CoQ10 are associated with higher grade embryos in IVF and better embryo development

The possibilities of CoQ10 for sperm development:

  • Decreases the rate of aneuploidy (abnormal chromosome numbers)
  • Increases energy, or ATP, production in the sperm
  • Prevents DNA oxidation, causing damage (decreases DNA fragmentation)
  • Increases sperm concentration
  • Increases mitochondrial function and sperm motility
  • Decreases abnormal sperm morphology

Wow that’s a lot! Are you hooked on CoQ10? Here’s what you need to know to incorporate it into your life:

If you’ve been to the health food store lately you’ve likely seen the innumerous number of brands and forms of CoQ10. There are two forms of CoQ10 that are important to know: ubiquinone and ubiquinol. They both exist in our cells; in fact our mitochondria depend on the interconversion between the two forms. According to current research, ubiquinol is slightly more readily absorbed in the gut compared to ubiquinone. However, even more important than the form of CoQ10 is the method it is delivered. Since CoQ10 is a fat-soluble substance, it needs to be compounded in a fat-soluble material. This can be tricky to figure out based on a label alone, so it’s best to trust your neighbourhood naturopathic doctor in prescribing the best option for you. You should also refer to a naturopathic doctor to determine the optimal dose to suit your unique needs. Dosing can range from 200-800mg depending on your requirements, but there’s also a maximum amount of CoQ10 your body can absorb at one time.

The take home message:

CoQ10 has the potential to significantly improve egg and sperm quality due to age related decline. It takes both an egg and sperm about 3 months to mature, so if you’re considering CoQ10 supplementation you and your partner should begin at least 3 months prior to conception. May you always be ageless, including your eggs!

 

Book an appointment with Dr. Sumner HERE. Learn about her fertility services HERE

  References:

Ben‐Meir, A., Burstein, E., Borrego‐Alvarez, A., Chong, J., Wong, E., Yavorska, T., … & Alexis, J. (2015). Coenzyme Q10 restores oocyte mitochondrial function and fertility during reproductive aging. Aging Cell, 14(5), 887-895.

El Refaeey, A., Selem, A., & Badawy, A. (2014). Combined coenzyme Q10 and clomiphene citrate for ovulation induction in clomiphene-citrate-resistant polycystic ovary syndrome. Reproductive biomedicine online, 29(1), 119-124.

Barakat, A., Shegokar, R., Dittgen, M., & Müller, R. H. (2013). Coenzyme Q10 oral bioavailability: effect of formulation type. Journal of Pharmaceutical Investigation, 43(6), 431-451.

Turi, A., Giannubilo, S. R., Brugè, F., Principi, F., Battistoni, S., Santoni, F., … & Tiano, L. (2012). Coenzyme Q10 content in follicular fluid and its relationship with oocyte fertilization and embryo grading. Archives of gynecology and obstetrics, 285(4), 1173-1176.

Bentov, Y., Hannam, T., Jurisicova, A., Esfandiari, N., & Casper, R. F. (2014). Coenzyme Q10 supplementation and oocyte aneuploidy in women undergoing IVF-ICSI treatment. Clinical medicine insights. Reproductive health, 8, 31.

Failla, M. L., Chitchumroonchokchai, C., & Aoki, F. (2014). Increased bioavailability of ubiquinol compared to that of ubiquinone is due to more efficient micellarization during digestion and greater GSH-dependent uptake and basolateral secretion by Caco-2 cells. Journal of agricultural and food chemistry, 62(29), 7174-7182.

Calogero, A. E., Condorelli, R. A., Russo, G. I., & Vignera, S. L. (2017). Conservative Nonhormonal Options for the Treatment of Male Infertility: Antibiotics, Anti-Inflammatory Drugs, and Antioxidants. BioMed Research International, 2017.

 

 

What I Take for Endometriosis

By | Women's health | No Comments

Endometriosis (or “endo” for short)

It’s a female condition in which uterine tissue grows outside of the uterus. If you have this condition then you know it’s a real b!@*% and that’s the understatement of the century. The growth of uterine tissue on the ovaries, fallopian tubes, rectum, bladder, intestines, diaphragm….you name it….causes constant, excruciating pain. This is not your typical “period cramping”, this unrelenting and incurable pain has made headlines by the likes of fearless warriors Lena Dunham and Halsey (to name a few).

The tricky thing about endo is that there’s no known cause. It’s chalked up to be an autoimmune phenomenon, oh and yes there’s a genetic link (my mom was diagnosed in her early 20s). I care about endo because it’s one of the leading causes of female infertility, and have I mentioned enough that it hurts like hell every single day?!

Conventional Treatment

So what are your treatment options? Well, there’s laparoscopic surgery, suppressive hormones, hospital stays, and a crap-load of painkillers (I’ll take the full cocktail, thank you for asking). Then there’s the integration of naturopathic medicine.

Naturopathic Treatment

Naturopathic medicine is NOT just about replacing pharmaceuticals with “natural” pills. The naturopathic approach to treating endometriosis looks at lifestyle and dietary changes. There is a significant amount of research on the avoidance of caffeine and gluten (I know, I’m Italian!), daily exercise, maintenance of detoxification pathways, and limiting exposure to endogenous estrogens. But sometimes you do need a few evidence-based supplements to take the edge off, so let me finally get to the punch line and tell you what I use to help manage my endo.

NAC

Patients treated with NAC show a statistically significant reduction in the growth of endometriomas compared to placebo, leading to cancellation of surgery

EGCG (and other antioxidants like pycnogenol)

It significantly inhibits endometrial cell proliferation, and reduces symptoms by 33% compared to drugs like lupron

Omega-3: EPA & DHA

Potent anti-inflammatory and antiangeogenic (stops the formation of new blood vessels supplying the endometriomas)

Herbs for decreasing flow:

capsella bursa-pastens & rubus idaeus

Herbs for reducing pain and spasms:

piscidia piscipula, viburnum opulus, dioscorea villosa

 

Check out my program on endometriosis HERE

Acupuncture & My Heart: A Personal Story

By | acupuncture | 2 Comments

PSVT

12 years ago I started experiencing abnormal heart palpitations. After a few years of misdiagnoses, I was told I had paroxysmal supraventricular tachycardia (PSVT for short). PSVT is just a fancy term for having a really, really fast heart rate due to extra electrical fibers in the heart interfering with the normal electrical circuit.

PSVT is not uncommon and not harmful. It wasn’t going to kill me, but man was it annoying! It got in the way of me doing seemingly everyday things, like sitting on the couch, dancing at weddings, going in saunas, tripping up the stairs (which I do often), and even studying. But it was a part of me and I was used to it and I dealt with it fine for 11 years. Until one day it annoyed my parents more than it annoyed me. It was getting worse as I got older.

Cardiology

So to please Sue & Randy, I met with two different cardiologists who both said the same thing- the only cure was cardiac ablation (burning the heart tissue that might be causing the abnormal rhythm). It was the only option so I made an appointment for the ablation 3 months into the future. But I was worried, I was worried that the ablation wouldn’t solve the problem and I’d just be left with a scarred heart.

Acupuncture

I decided I would book a different appointment while I was waiting. I sought the help of my friend and fellow ND, Ayla Andrus, and asked her to give me her best shot because I had 3 months to avoid surgery. She came up with an evidence-based approach for acupuncture (that means there’s published research!)

Success

Now here’s the point: After THREE acupuncture treatments, I had no more episodes. I went from having multiple episodes a month/week for 11 years to NONE at all. Needless to say I cancelled the surgery and I haven’t had a PSVT episode for EIGHT MONTHS. Every now and then when I’m really stressed I get a little episode, but I could not be happier with my treatment.

It’s not about “believing” in acupuncture. Acupuncture is not a belief system; it’s not alternative medicine, it’s JUST medicine. Medicine is the treatment and prevention of disease- and that’s exactly what acupuncture can do

Book an appointment with me and try acupuncture out for yourself! Right HERE

My 8 Simple & Essential Tips for Living A Positive Life

By | Food for thought | No Comments
  1. Spend the first minute of the day on gratitude

    As soon as you wake up; reflect on something in your life you are grateful for as a way of starting the day with balance and perspective. Come back to this gratitude reflection when you are overwhelmed to remind you of what matters most.

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  2. Drink one glass of water as soon as you get out of bed

    Water will fire up your digestive system and metabolism and get your bowels flowing. It also gets you in the habit of drinking more water throughout the day.

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  3. Finish your showers with 15-30 seconds of cold water

    Cold water at the end of a shower can improve immune function and circulation, while also energizing the body and mind.

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  4. Practice intermittent fasting

    Eating should take place in an 8-hour window, with the remaining 16 hours of the day fasting. For example, if you finish eating at 8pm you should not eat your next meal until 12pm the following day. This fasting technique can help you burn fat, lower insulin levels, reduce inflammation, and alleviate cellular stress on your body. It’s a very simple strategy to see fantastic metabolic outcomes. You may have water, black tea, and black coffee while fasting.

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  5. Treat yourself daily

    Self-care is the most important thing you can offer yourself. Self-care is any activity that makes you feel sweet (but doesn’t include food!) Activities like: exercising, bubble baths, reading, music, napping, drinking tea, surrounding yourself with people you love etc.

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  6. Make your bedroom an electronic free space

    When electronics are in your room you are more likely to use them right before going to bed. The blue light they emit interferes with melatonin production and prevents sleep initiation ad maintenance.

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  7. Commit to a bedtime routine

    It is ideal to go to sleep at night and wake up in the morning at the same time everyday. This routine is critical for your adrenal function and will help you cope with physical and mental stress.

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  8. Spend the last minute of the day on calmness

    Meditation, breathing exercises, body scans, and yoga poses are all ways of encouraging your body and mind to find closure for the day and prepare for restful sleep. Meditation is an opportunity for you to clear the day’s events away and make space for the next. Take a few moments to bring calmness to the mind before trying to sleep.

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Book an appointment with Dr. Sumner HERE and revitalize your life

The Top 5 Benefits of Soy for Women

By | Diet | No Comments

I’ve been wondering for years why everyone seems to hate soy. As a part-time job during naturopathic medical school I used to sample health foods at various grocery stores and customers were so avid that they avoid soy. When I asked them why, they said, “Soy causes cancer”. This is a common misconception about soy. In fact, there’s evidence that soy consumption decreases the risk of many cancers such as endometrial, ovarian, gastrointestinal, breast, and prostate. If that’s not enough, I personally grew up on soy and I’ve turned out okay…so far! In a world full of fast food, microwavable meals, and plastic everything – is an innocent bean really the enemy? Since I’m passionate about female hormones, I hit the books and researched the effects of soy on estrogen and progesterone levels. I hope you’ll be pleased to read what I’ve discovered, and accept that soy isn’t so scary after all!

The components of soy: what’s in a bean?

  • Protein– soy contains the complete spectrum of essential amino acids, which is why it is a staple in a vegetarian diet.
  • Isoflavones– these are the constituents that act like estrogen and are the reason why it’s common to get confused about soy. Another term for isoflavone is phytoestrogen. Isoflavones/phytoestrogens can exert weak estrogenic effects in our bodies. This means they can bind to estrogen receptors in the body and prevent strong/harmful estrogens from binding. This is a good thing! It does not promote cancer, it protects us.
  • Beta-sitosterols– these are constituents that have been proven to lower cholesterol. Soy is recommended by Health Canada as part of a cholesterol lowering diet.
  • Vitamins & Minerals– soy is high in fiber, iron, folate, and B-vitamins. If you’re concerned about the bioavailability of nutrients in beans, opt for sprouted beans.
  • “Fermentability”– I may have made up this word, but I’m using it to explain all of the wonderful foods that have been created by fermenting soy, like: tempeh, miso, and natto! Fermented foods are amazing for gut health, lowering inflammation, and benefiting mood.

 

The Top 5 Benefits of Soy for Women

 

  1. Soy isoflavones bind to estrogen receptors and promote the urinary excretion of estrogen in estrogen dependent conditions like endometriosis and fibroids. With increased amounts of soy consumption, severity of endometriosis can decline and women can experience fewer symptoms.
  2. In menopausal women with low estrogen levels, soy consumption can improve serum estradiol levels and reduce hot flashes and symptoms of declining estrogen.
  3. In women undergoing IVF, those with higher soy consumption had increased fertilization rates. Women who consumed soy, compared to women who did not, had a 6% greater chance of fertilization.
  4. Not only can soy improve fertilization, but also pregnancy and live birth rates. In women who consume soy, there’s an 11-13% greater chance of pregnancy and birth rate compared to women who don’t eat soy.
  5. Soy increases a protein called sex-hormone-binding-globulin (SHBG). This protein binds estrogen and testosterone in the blood. If these hormones are bound then they are inactive, a greater ratio of bound hormone to free hormone can lower symptoms of androgen excess, like: acne, hair loss, and male pattern hair growth, as well as estrogen excess, like: breast tenderness, painful periods, and heavy periods.

 

What about men consuming soy? Here’s where it gets less obvious

There is a lot of conflicting research on the effects of soy consumption in men. For example, one human study showed that soy consumption lowers sperm concentration, and another showed that soy has no effect on any semen parameters. Soy has the potential to decrease testosterone levels in men who already have hypogonadism (low testosterone). It may exert estrogenic effects in men but the research is varied. However, it is undisputed that soy has great cardiovascular benefits and can lower cholesterol levels. It may also present a preventive role against prostate cancer and benign prostatic hypertrophy (BPH). If you’re male and you’re not trying to conceive, the benefits of soy likely outweigh the potential risks. It is ideal for man to eat a variety of plant and animal sources of protein; soy can be included in this daily diet.

 

The Bottom Line:

  • Opt for non-GMO, organic, and sugar free soy products
  • WOMEN: aim for 7-28mg of isoflavones daily (one cup of soy milk has about 6mg, 3 ounces of tofu has 20mg
  • MEN: when not trying to conceive, aim to consume about 3 servings of soy a week

 

Book an appointment with Dr. Sumner HERE

References:

 

Die, M. D., Bone, K. M., Williams, S. G., & Pirotta, M. V. (2014). Soy and soy isoflavones in prostate cancer: a systematic review and meta‐analysis of randomized controlled trials. BJU international, 113(5b), E119-E130.

Chavarro, J. E., Toth, T. L., Sadio, S. M., & Hauser, R. (2008). Soy food and isoflavone intake in relation to semen quality parameters among men from an infertility clinic. Human reproduction, 23(11), 2584-2590.

Vanegas, J. C., Afeiche, M. C., Gaskins, A. J., Mínguez-Alarcón, L., Williams, P. L., Wright, D. L., … & Chavarro, J. E. (2015). Soy food intake and treatment outcomes of women undergoing assisted reproductive technology. Fertility and sterility, 103(3), 749-755.

Tsuchiya, M., Miura, T., Hanaoka, T., Iwasaki, M., Sasaki, H., Tanaka, T., … & Tsugane, S. (2007). Effect of soy isoflavones on endometriosis: interaction with estrogen receptor 2 gene polymorphism. Epidemiology, 18(3), 402-408.

Saeidnia, S., Manayi, A., Gohari, A. R., & Abdollahi, M. (2014). The Story of Beta-sitosterol-A Review.

Messina, M. (2010). Soybean isoflavone exposure does not have feminizing effects on men: a critical examination of the clinical evidence. Fertility and sterility, 93(7), 2095-2104.

Chen, M., Rao, Y., Zheng, Y., Wei, S., Li, Y., Guo, T., & Yin, P. (2014). Association between soy isoflavone intake and breast cancer risk for pre-and post-menopausal women: a meta-analysis of epidemiological studies. PloS one, 9(2), e89288.

5 Really Simple Strategies to Reduce Period Pain

By | Menstrual health | No Comments

If you experience debilitating menstrual cramps, just as I do, then I’m sure you remember the first time they started and the constant struggle you’ve battled in learning to cope with them. I’ve been trying to take my own pain away since age 12 and it hasn’t looked pretty. It’s been a lot of missed work, sleepless nights, tears of desperation, and a couple of memorable hospital trips.

I have tried so many things I’ve lost count of what I’ve tried. I even have a closet full of half empty supplement bottles to show for it. In my countless efforts to find relief, I’ve found that bringing it back to the basics has helped me cope the most. I’m not going to lie and say that I don’t have pain anymore, but I’ve found these really simple strategies helpful and I wish I had known about them sooner.

5 Simple Strategies that Make a Difference

  1. Go to sleep.

    I know that sounds crazy because the pain can make it impossible to sleep, but what I mean to say is get regular sleep before your period. You know you already want to nap all of the time before your period because of our trusty friend progesterone! Progesterone is the driving hormone in the second half of your cycle (after you ovulate) and it has been shown to promote and maintain sleep. But even better than sleeping before your period, get regular sleep all of the time. Regular sleep means going to sleep and waking up at the same time every day. When you have a predictable circadian rhythm, you produce optimal amounts of melatonin. Melatonin is an antioxidant, analgesic, and anti-inflammatory [1]. Those are all actions you want for your uterus when you have a scalding hot water bottle pressed against your pelvis and there’s no relief in sight.

  2. Say goodbye to caffeine.

    You’ve just spent the night awake in pain and now I’m taking away your coffee? It seems cruel but it helps. Caffeine can be found in pain relieving medications (like midol) but it’s not necessarily your friend when it comes to period cramps. It turns out, period pain may be more common in coffee drinkers than non-coffee drinkers [2]. Think about this, caffeine is a vasoconstrictor (it constricts your blood vessels), which means decreased blood flow to your uterus. Reduced blood flow means reduced oxygen, which means muscle spasms, which means pain. I too love a good cup of joe in the morning, but I’ve found I do better when I give it up a few days before my period and during. You can have it again afterwards of course!

  3. Eat nuts, seeds & chocolate.

    What do they all have in common besides being a delicious trail mix? They decrease prostaglandins, which are fatty acids and hormone copycats that cause uterine contractions, pain, and inflammation [3]. Chocolate wants to heal our pain soooo badly, so let’s just let it! Make it dark chocolate (rich in magnesium) and add some almonds, walnuts, sunflower seeds, sesame seeds, pumpkin seeds, and flax seeds for the ultimate anti-inflammatory snack.

  4. Try castor oil massage.

    Castor oil is a wonderful oil used topically to decrease pain and inflammation. I’m not recommending that you drink it as a laxative! When applied over the uterus, it can increase blood flow and activate your parasympathetic nervous system (your resting and relaxing nerves) to calm uterine spasms and bowel spasms [4]. Use 1-3 tablespoons and massage it over your uterus when you’re in pain. The oil can stain your clothes so wear old pj’s and don’t be shy about the amount you use, it will absorb overnight. You can also rub it on aching joints and tissues, like your breasts and low back.

  5. Take ginger capsules. 

    They can be as effective as Advil. It’s just too simple. I avoided trying it for so long because I just figured I needed something fancy, expensive, and complicated to help my pain. Well, I didn’t. Now the dosing is important, you want to start taking ginger three days before the first day of expected pain. Pain reliving medications always work better before the pain starts; if you wait until it starts then you’re playing catch up. It’s also recommended that you take the ginger during the painful days of your period. The recommended dose in the study I refer to here is 250mg 4x a day [5]. Unlike ibuprofen, it has no liver or gastrointestinal toxicity.

    Super simple tips for preventing, reducing, and coping with period pain. If you’re like me and have spent years miserably trying to alleviate your pain, I hope you’re able to try out these techniques and see how you feel.

    Book an appointment with Dr. Sumner HERE. Learn about her program for endometriosis HERE

    References:

[1] Schwertner, A., Dos Santos, C. C. C., Costa, G. D., Deitos, A., de Souza, A., de Souza, I. C. C., … & Caumo, W. (2013). Efficacy of melatonin in the treatment of endometriosis: a phase II, randomized, double-blind, placebo-controlled trial. PAIN®154(6), 874-881.

[2] Unsal, A., Ayranci, U., Tozun, M., Arslan, G., & Calik, E. (2010). Prevalence of dysmenorrhea and its effect on quality of life among a group of female university students. Upsala journal of medical sciences115(2), 138-145.

[3] Awad, A. B., Toczek, J., & Fink, C. S. (2004). Phytosterols decrease prostaglandin release in cultured P388D 1/MAB macrophages. Prostaglandins, leukotrienes and essential fatty acids70(6), 511-520.

[4] Ozgoli, G., Goli, M., & Moattar, F. (2009). Comparison of effects of ginger, mefenamic acid, and ibuprofen on pain in women with primary dysmenorrhea. The journal of alternative and complementary medicine15(2), 129-132.

[5] Arslan, G. G., & Eşer, İ. (2011). An examination of the effect of castor oil packs on constipation in the elderly. Complementary therapies in clinical practice17(1), 58-62.

5 Ways to Keep Your Testicles (and everything they stand for) in Tip-Top Shape

By | Men's health | No Comments

Although I’m not an owner of testicles, testicular health is of the utmost importance to me and it should be to you too. I’ve learned over time from the men in my life that testicles are the sole representation of manhood.

  • If you have a pair it means you are courageous and strong and everyone else should grow some exactly like yours
  • If you have a pair it means you have a strong opinion on boxers, briefs, and of course the aptly named boxer brief
  • If you have a pair it means you’re the master of secret (or not so secret) adjustments
  • If you have a pair it means you can create life even once you’re over the hill
  • And if you have a pair you protect them like your life depends on it because even though they make you strong they can be oddly fragile

So if you own a pair of balls, or even just one, I want to help you keep them healthy. This blog post is dedicated to the health of your nuts and the future spawn they may contain. Here are five ways to keep your testicles in tip-top shape:

 

  1. Ejaculate often. Very often

    Tell your partner (or yourself) that I said so. If you want genetically healthy sperm, the more you ejaculate the better the sperm DNA will be. Periods of abstinence, even as short as 3 days, increase the amount of DNA in the sperm that is fragmented or broken. The longer the sperm hangs out in the epididymis the more likely it is for the sperm to become damaged. I’m only talking about DNA quality here, if you’re concerned about the quantity of semen you have, you should ejaculate less and save some for later.

  2. Give your scrotum a well-deserved breeze

    Cosmo Kramer wasn’t messing around when he switched from briefs to boxers. Your precious balls maintain a very specific temperature, 35 degrees Celsius to be exact, to manufacture the highest quality semen. You already know that the scrotum moves depending on temperature, you can thank the cremaster muscle for that. When you’re in the pool the scrotum rises closer to the body to maintain its temperature, and we all understand the consequent phenomenon of shrinkage! But it’s not just water that changes scrotal temperature; sitting for long periods of time at a desk, wearing the latest skinny jeans, placing your laptop on your groin, and putting your cell phone in your pocket all compromise your scrotal temperature. There’s only so much hanging your balls can do to escape the heat of these activities before the sperm starting committing suicide- a process known as oxidative stress mediated apoptosis.

  3. Wear protection… when playing sports

    I don’t now how painful it is to be kicked in the groin but judging by the reactions I’ve seen I’m lead to believe that it’s worse than childbirth. You already know that a jockstrap is your friend, but the damage from a testicular injury lasts much longer than the pain you experience. When the vasculature in the testicle is compromised, i.e. when blood vessels are broken, your body can mount an immune response against your sperm and create antibodies that kill it! Frequent genital infections, and a condition known as varicocele, can also lead to the creation of anti-sperm antibodies.

  4. Let your testicles tan

    What I mean to say is, think twice before you load up on sunscreen. Even though your testicles live in a place where the sun don’t shine, applying sunscreen that contains benzophenones to any place on your body can affect the health of your boys. You can still use sunscreen when you’re on a tropical nude beach, just opt for one without benzophenones.

  5. Brush your teeth and sleep well

    Good oral hygiene isn’t just for real men, it’s for everyone. Believe it or not, but healthy testicles start in the mouth. That’s not a pun. Research is noticing associations between periodontal disease and semen quality. After you brush your teeth, you should get a good night’s rest because the hormone melatonin that you produce while sleeping is a powerful antioxidant. Antioxidants are important for testicular cancer prevention, and all cancers for that matter.

    I hope you use these five simple strategies to take care of your testicles AND your manhood. The next time you tell someone to grow a pair, think about how you’re treating your own!

    Book an appointment with Dr. Sumner HERE. Learn about her healthy conception program HERE

 

References:

 

Bozhedomov, V. A., Nikolaeva, M. A., Ushakova, I. V., Lipatova, N. A., Bozhedomova, G. E.,   & Sukhikh, G. T. (2015). Functional deficit of sperm and fertility impairment in men with        antisperm antibodies. Journal of reproductive immunology, 112, 95-101.

Buck Louis GM, Kannan K, Sapra KJ, Maisog J, Sundaram R. Urinary concentrations of             benzophenone-type ultraviolet radiation filters and couples’ fecundity. Am J Epidemiol. 2014 Dec 15;180(12):1168-75.

Klinger A, Hain B, Yaffe H, Schonberger O. Periodontal status of males attending an in vitro         fertilization clinic. J Clin Periodontol. 2011 Jun;38(6):542-6

Moore, C. R., & Quick, W. J. (1924). The scrotum as a temperature regulator for the         testes. American Journal of Physiology–Legacy Content, 68(1), 70-79.

Pons, I., Cercas, R., Villas, C., Braña, C., & Fernández-Shaw, S. (2013). One abstinence day         decreases sperm DNA fragmentation in 90% of selected patients. Journal of assisted r eproduction and genetics, 30(9), 1211-1218.