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October 2017 - Page 2 of 3 - Dr. Caleigh Sumner ND
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October 2017

The Quick Cheat-Sheet On Body Changes to Expect During Pregnancy

By | Natural Pregnancy Support | No Comments

Healthy body changes are inevitable during pregnancy. A lot goes into making a tiny human, especially when your body is the vessel for that human’s life! The most supportive thing your can do for yourself is to love your changing body, there’s no space for self-judgment when you’re pregnant (quite literally).

Not all changes discussed here will happen for every pregnant woman or every pregnancy you may have, but when you know what to expect there are fewer surprises and so much about pregnancy can be a surprise for a first time mommy. It’s not all bad news! I’m just giving you the honest facts and there’s lots we can do with natural pregnancy support

Weight Gain

There’s no perfect amount of weight gain during pregnancy. Even though some research may recommend that you only need to eat an extra 350 calories a day (that’s about two cookies), I subscribe to the philosophy that you should eat when you’re hungry and stop when you’re full. Opt for healthy, nutritious meals most of the time but it’s okay to give in to your cravings too! If you are considered a “high-risk” pregnancy due to weight, please be mindful of your specific dietary concerns.

What to Expect: First Trimester

  • General fatigue – It’s tiring making a human!
  • Nausea/ vomiting – Potentially due to gradual displacement of gastro-intestinal organs upwards as the uterus enlarges, or the presence of hCG
  • Breast tenderness – Due to estrogen and progesterone developing the breast tissue for milk production
  • Blood pressure – It falls for the first 20 weeks, normalizes in the second trimester, and increases in the third
  • Increased heart rate and respiratory rate – To accommodate increased metabolic processes
  • Nasal congestion – Progesterone can affect the respiratory mucosa and lead to increased respiratory infections and mucus production
  • Sleep – It’s common to sleep more in the first trimester, and less in the third trimester

What to Expect: Second Trimester 

  • Leg cramps – Occur due to calcium stores being taken for fetal skeletal development
  • Reflux/ Heart burn – Due to slower stomach emptying, and progesterone decreasing the esophageal sphincter tone allowing stomach acid to raise into the chest
  • Increased urinary frequency – Due to increased progesterone, displacement of the bladder upward, and the bladder not emptying completely so it feels like you have to go more often!
  • Increased UTIs and yeast infections – Due to more urine collecting in the bladder and attracting bacteria, and estrogen causing vaginal pH changes
  • Increased vaginal discharge – This occurs because there is extra blood flow to the reproductive tract
  • Diarrhea or constipation – Both result from either increased or decreased motility of food in the intestines. The bowels are a little too relaxed under the influence of progesterone during pregnancy
  • Hemorrhoids, varicose veins, vulvar varicosities – More blood volume can cause venous pooling and the enlargement of the uterus can also exert extra pressure
  • Stretch marks – The growing fetus demands more space!
  • Foot growth & hip flexibility – The same hormone, progesterone, that loosens the pelvic ligaments for labour, loosens the ligaments in the feet. Don’t worry they shrink back

What to Expect: Third Trimester

  • “Hives- like” rash – Typically presents on the belly and legs. It is more common when carrying multiples, but the cause is unknown
  • Cholasma – Areas of darker skin on the face stimulated by estrogen and progesterone, which goes away after labour or breastfeeding. Can occur during any trimester  
  • Linea nigra – Vertical line on the belly due to increased melanocytes. Can occur during any trimester

Signs of Labour

  • “Nesting” – Desire to clean/organize weeks to days before labour
  • Dropping of the uterus – 2-3 weeks before labour
  • Loss of mucous plug – Clear, pink, or bloody fluid days to hours before labour
  • Water breaking – Gush or trickle of fluid that signifies cervix dilation
  • False labour “Braxton Hicks” – Contractions that are irregular, they don’t get more frequent or stronger, they stop when talking/ resting/ moving positions, only felt in the abdomen and pelvic region
  • True labour – Regular contractions at 30-90 sec intervals, continuous, increase in frequency and strength, start in lower back and move to abdomen

Self-care is critically important when it comes to pregnancy. Make sure you rest when you need to and find support we you need to. Also make sure you check-in with your doctor or midwife and let them know if you experience unexpected or concerning symptoms.

Book an appointment with Dr. Sumner. Learn about pregnancy nutrition too!

References

Descamps, P., Marret, H., Binelli, C., Chaplot, S., & Gillard, P. (2000). Body changes during pregnancy. Neuro-Chirurgie46(2), 68-75.

Singh, S., & Urooj, A. (2015). Influence of Pre-Pregnancy Weight, Food Habits and Lifestyle on Gestational Diabetes. Current Research in Nutrition and Food Science3(2), 156.

Pomeranz, M. K., & Dellavalle, R. P. (2015). The skin, hair, nails and mucous membranes during pregnancy.

Murkoff, H. (2016). What to expect when you’re expecting. Workman Publishing.

Davis, E. (2004). Heart and hands: a midwife’s guide to pregnancy and birth. Random House Digital, Inc..

The “All You Need To Know” Guide to Hormone Changes During Pregnancy

By | Natural Pregnancy Support | No Comments

You’re pregnant! Now what happens? Whether your journey to pregnancy has been a roller coaster ride, or a pleasant surprise, all women go through similar hormonal changes during pregnancy. The female body is absolutely incredible, resilient, and intuitive when it comes to pregnancy. It knows exactly what to do, even if you’re unsure of what might be happening in your body! Don’t worry; in this post I will guide you through all of the hormonal changes during pregnancy so you know exactly what’s going on. I also offer tons of resources for natural pregnancy support. After all, knowing what is happening in your body can make you feel more empowered and in control during your pregnancy. Let’s see how incredible the body can be!

Fertilization

It starts with an egg breaking free from the ovary during ovulation.

If that egg is fertilized with sperm, the fertilized egg begins differentiating into a group of cells called a trophoblast. This occurs about 6 days after ovulation. It is this trophoblast that produces the pregnancy detection hormone known as human chorionic gonadotropin (hCG). On average, hCG is detectable in your urine 10 days after ovulation/ fertilization.

hCG

When your egg ruptured from the ovary, it left behind its outer coat called the corpus luteum. It is the job of hCG to maintain the corpus luteum so that the corpus luteum can make progesterone and estrogen to support embryonic growth. If your egg is not fertilized and you do not produce hCG, the corpus luteum slowly disintegrates and you will get your period. hCG is present throughout your whole pregnancy but reaches peak levels around week nine to ten, at this point the placenta is able to take over hormone production.

Estrogen

Estriol (E3) is the predominant form of estrogen during pregnancy. Cholesterol from your circulation enters the placenta and is required to make all steroid hormones. The production of estrogen depends on the mother and the fetus. You work together with your baby to make estrogen! Here’s how it happens:

  • Cholesterol enters the placenta and turns into pregnenolone
  • Pregnenolone is converted into DHEA in the adrenal gland and liver of the fetus
  • DHEA crosses back into the mother’s circulation
  • Mommy uses the enzyme aromatase to convert DHEA into estriol

Phew!! Now that’s teamwork!

What does estrogen do?

  • Develops breast tissue
  • Supports the lining of the uterus
  • Increases blood flow to the uterus – and everywhere else which can cause rashes and venous stasis
  • Stimulates fetal organ development
  • Relaxes smooth muscle – causing reflux and constipation
  • Closer to term, it stimulates prostaglandins to promote uterine contractions and helps ripen the cervix with the hormone DHEA

Progesterone

Compared to estrogen, progesterone production is easy! It is made entirely by the placenta. Mommy doesn’t have to do anything. Just like estrogen, progesterone is made from cholesterol. It is first converted to pregnenolone, and then it becomes progesterone.

What does progesterone do?

  • Allows for implantation of embryo – if you’ve gone through IVF you make take a progesterone supplement during your third trimester to ensure embryo stickiness!
  • Suppresses the maternal immune response – this prevents rejection of the fetus and can stabilize immune conditions like multiple sclerosis
  • Maintains the placenta
  • Supports the lining of the uterus
  • Prevents uterine contractions
  • Relaxes smooth muscle – causing reflux and constipation
  • Loosens pelvis ligaments to prepare for labour

Thyroid Hormone

There are two thyroid hormones to take note of during pregnancy. T4 is an inactive, precursor hormone. T3 is your active thyroid hormone, which is derived from T4. Elevated estrogen levels promote elevated T3 and T4 to help with metabolism and regulation of steroid hormones.

 

hPL

Human placental lactogen is secreted by the placenta in order to help mom break down fats and carbohydrates for the baby. Unfortunately, this hormone opposes insulin so it can lead to insulin resistance in mom; this is why you may be screened for gestational diabetes at the end of the second trimester.

Cortisol

Cortisol is your “stress” hormone. As you near 40 weeks of pregnancy, cortisol production from the baby’s adrenal glands increases. This increase makes the uterus more sensitive to contractions; it also increases estrogen in the circulation and decreases progesterone to allow for even more contractions! You may be familiar with Braxton Hicks contractions, which are false contractions that occur from pressure on the uterus, not from elevated estrogen.

Oxytocin

Get ready to push! Oxytocin is made by mommy and is responsible for dilating the cervix and stimulating strong uterine contractions for delivering baby. After delivery, oxytocin is stimulated by the baby suckling on the nipple and promotes milk let down.

Prolactin

Prolactin is the hormone that stimulates your breast tissue to make milk. Estrogen promotes prolactin secretion from mom’s pituitary gland to prepare for lactation, but you will not typically begin lactating until after birth because the high amounts of estrogen and progesterone inhibit prolactin from acting on the breast tissue. After delivery when the hormone levels decrease, prolactin can then promote lactation. When the baby sucks on the nipple, prolactin and oxytocin are secreted to produce milk. Prolactin can be a “natural birth control” if you produce enough of it and breastfeed frequently, this is because prolactin inhibits ovulation.

After Birth

Hormones begin to normalize immediately after the delivery of the placenta, and are back to pre-pregnancy levels by day five post-labour. That’s really quick! It is this spontaneous change in hormones that can lead to low mood in the post-partum period. Being more aware of the influence of these hormones on your body will help you understand what you’re feeling and hopefully help you cope with the symptoms.

Book an appointment with Dr. Sumner. Learn more about pregnancy nutrition too!

References

Kumar, P., & Magon, N. (2012). Hormones in pregnancy. Nigerian medical journal: journal of the Nigeria Medical Association53(4), 179.

Hendrick, V., Altshuler, L. L., & Suri, R. (1998). Hormonal changes in the postpartum and implications for postpartum depression. Psychosomatics39(2), 93-101.

C,L. S., PhD. (2014). Physiology (5th ed.). Wolters Kluwer.

Chakrabarti, S., Morton, J. S., & Davidge, S. T. (2014). Mechanisms of estrogen effects on the endothelium: an overview. Canadian Journal of cardiology30(7), 705-712.

Byrns, M. C. (2014). Regulation of progesterone signaling during pregnancy: implications for the use of progestins for the prevention of preterm birth. The Journal of steroid biochemistry and molecular biology139, 173-181.

Do you become flushed or itchy after eating or drinking…everything? You could have histamine intolerance

By | Food Allergies | No Comments

Histamine 101

Histamine is an organic compound made by your body that’s responsible for initiating immune and inflammatory responses…and about a million other functions that we don’t have time to discuss here.

What do itchiness, watery eyes, stuffy nose, and skin rashes have in common? They’re all provoked by histamine! Some people have allergies and some don’t because of the responsiveness of their histamine production to external influences. Anaphylactic allergies to things like peanuts and shellfish are also triggered by histamine release, but from specific immunoglobulins called IgE antibodies.

However, this isn’t a blog about seasonal allergies or anaphylactic allergies, it’s about not being able to drink wine and eat smoked meats! It’s about getting a skin reaction after eating just about anything. Why does this happen??? It’s called “histamine intolerance”.

Histamine Intolerance

Histamine intolerance results from a lack of degradation of histamine and a build up of histamine from foods that, well, produce histamine. Your body can become intolerant to histamine because there’s just so much of it! Histamine is broken down by two different enzymes in the body: diamine oxidase (DAO) and histamine-N-methyltransferase (HNMT). Reduced activity of either enzyme can cause symptoms of elevated histamine, such as: hives, itching, rash, flushing, headache, diarrhea, heartburn, and asthma. Histamine can be found in foods and it can also be formed by the bacterial fermentation of foods. But, you thought saukerkraut and kombucha were good for you?! Not if you have histamine intolerance. Here’s the kicker: some foods are both histamine producers AND DAO inhibitors! Unfortunately, that’s the case for red wine, which also contains sulfites. Sulfite sensitivity can look exactly like histamine intolerance, and can also be due to a deficiency of degradation enzymes.

So what are these histamine-producing foods already!?

  • Alcohol
  • Pickled or canned foods – like sauerkraut, peppers, pickles
  • Matured cheeses
  • Smoked meat products – salami, ham, sausages, jerky
  • Shellfish
  • Beans and canned legumes– chickpeas, soy beans, peanuts
  • Nuts – walnuts, cashew nuts
  • Chocolate
  • Vinegar
  • Citrus- like tomatoes
  • Dried fruits
  • Artificial colouring- found in candies, desserts, cereals, sodas, juices etc.
  • Preservatives- like sulfites
  • MSG

Other tips for reducing histamine production:

  • Avoid canned foods
  • Aim to eat fresh foods, rather than preserved foods
  • Don’t leave foods out of the fridge for long periods of time, pack your lunches with a cold pack
  • Ensure that your kitchen is always kept clean to minimize bacteria exposure
  • Everyone has their own histamine threshold; you may need to experiment to find yours

How will you know if you have histamine intolerance?

  • You experience any of the symptoms listed in this blog (hives, itching, rash, flushing, headache, diarrhea, heartburn, and asthma) after eating/ drinking the above foods
  • Your symptoms may decrease after taking over the counter anti-histamine medications
  • You are sure you do not have anaphylactic allergies, and other allergies have been ruled out by a doctor

Print off the list of foods and keep it on your fridge. When you eat them, write down your corresponding symptoms and watch for patterns. Remember that your threshold may not be reached until after eating the foods for several servings or several days.

Book an appointment with Dr. Sumner

References:

Maintz, L., & Novak, N. (2007). Histamine and histamine intolerance. The American journal of clinical nutrition, 85(5), 1185-1196.

Jarisch, R. (2011). Histamine intolerance. Aktuelle Dermatologie, 37, 1-8.

Wöhrl, S., Hemmer, W., Focke, M., Rappersberger, K., & Jarisch, R. (2004, September). Histamine intolerance-like symptoms in healthy volunteers after oral provocation with liquid histamine. In Allergy and Asthma Proceedings (Vol. 25, No. 5, pp. 305-311). OceanSide Publications, Inc.

Schwelberger, H. G. (2010). Histamine intolerance: a metabolic disease?. Inflammation research, 59(2), 219-221.

The Ins & Outs of the DUTCH (dried urine test for comprehensive hormones)

By | Hormonal Imbalance, Hormone Testing | No Comments

Over the past 4 years I have committed myself to learning all about dried urine hormone testing (aka DUTCH). I have run countless tests on patients, and myself, and have found it to be the single most useful hormone assessment.

In this blog I break down MY results to give you an example of how the DUTCH can be interpreted.

The purpose of all hormone testing is to give you more information than you already have. If having more information is not going to change the diagnosis, or your doctor’s treatment plan, then lab testing is unnecessary.  If you want to know more about individual hormonal pathways or have symptoms of hormonal imbalance, then hormone testing is for you! Keep in mind that the person is always more important than the numbers; naturopathic doctors always practice individualized medicine.

So what’s the DUTCH test and how is it completed?

DUTCH stands for dried urine test for comprehensive hormones. The test measures steroid hormones excreted in your urine (I will just be talking abut sex hormones in this blog).

In Canada, a naturopathic doctor can requisition this test for you from several different private lab companies. It’s a very simple test to perform. I used Rocky Mountain Analytical:

  • “Collection day” is 6-7 days before your expected menses- e.g. if you have a 28 day cycle you will be collecting urine on days 21-22 of your cycle
  • You’re given 4 sheets of laboratory paper for your samples
  • You are instructed to pee on the paper at 4 different times: once around dinner time, once before bed, once when you wake up, and once 2 hours after waking (I brought my pee paper with me to work, it’s the only way if your collection days don’t land on a weekend!)
  • You will be given specific instructions on how much water to drink as to not dilute the urine
  • You will fill out demographic information and answer questions about your menstrual cycle and corresponding symptoms
  • Then pack up all of the materials and send it to your lab and you’ll have the results within 3 weeks

How does the DUTCH test work?

Sex hormones exist in our bodies in many different forms. Inactive hormones are bound to proteins in the blood; active hormones are free in the blood. Hormone testing via blood measures both free and bound hormones. Urine testing measures free hormones. These free hormones are found in the urine as precursor hormones like estrone and estradiol, or in the form of free metabolites like 2-OH-E1. Estrogens for example, exist in their original forms: estradiol, estrone, and estriol, but they can also interconvert between their original forms or be converted by the liver into metabolites. I will discuss metabolite formation in detail, as it is one of the main “claims to fame” of the DUTCH test!

You may be wondering, well how do our hormones get into our urine?! And the answer is through liver processing!

In order for sex hormones to be excreted, they have to be processed by the liver. The liver is our main organ of detoxification, the goal of the liver is to take your hormones and make them more water-soluble so your body can excrete them in urine (and stool).

There are two phases to liver processing of hormones: aptly named phase 1 and phase 2:

Phase 1 takes your hormones and makes them more potent. It is during this phase that hormone metabolites are made through a process called hydroxylation. These metabolites can exert negative and positive effects in the body.

Phase 2 takes your hormones and tries really hard to get rid of them through a process called conjugation. Think of conjugation as tagging your hormones with a sticker that says “I don’t want this anymore”. Once hormones are conjugated they are ready to be excrete by your body. The hormones that are found in urine are conjugated with a sulfate or glucuronide group (now we’re getting fancy). After you’ve sent you urine samples to the lab, the lab has to break the conjugation bonds in order to measure your hormone levels.

Urine hormone testing measures free hormone levels only, because bound hormones are not metabolically active and thus are not broken down by the liver. Urine hormone testing allows you to get a picture of the active hormones in your body, not the bound and inactive hormones.

Oh but there’s more to hormone excretion- it’s called enterohepatic circulation!

After the liver detoxifies your hormones, the majority are excreted in the urine (and a small amount in the stool). However, pesky hormones can be reabsorbed by the gut before they make it to the urine through a process called enterohepatic recirculation. This is your body’s unfortunate way of storing hormones for later. If you don’t have a high fiber diet and lack healthy gut bacteria you are more prone to this recirculation. We don’t want this to happen, and measuring hormones in dried urine can help you measure this process! I’ll explain how as we go.

Now that we have a better understanding of how the DUTCH test works, I’ll explain the exciting part of INTERPRETING THE RESULTS!

Remember how I mentioned that the DUTCH test measures both “precursor” hormone levels and hormone metabolite levels? This is where interpretation gets interesting!

Here are the top 4 benefits of DUTCH testing:

  1. The DUTCH can demonstrate whether your body is efficient at turning “mother” hormones into “daughter” hormones

For example, androstenedione is a mother hormone that makes testosterone but it also makes androsterone, eticholanolone, and estrone. Elevation in androstenedione can be found in PCOS and can cause symptoms of acne and male pattern hair growth.

This is a photo from my personal DUTCH test. You will see that of the three “daughters” of androstenedione, the lowest daughter is testosterone and the highest daughter is androsterone. This is okay news for me. It shows that my body is converting androstenedione into androsterone instead of testosterone, which is an extremely weak androgen. (I owe this ability to certain enzymes I will save for another blog). This explains why I don’t have symptoms of hyperandrogenism, even though my androstenedione metabolites are extremely high! Sure serum blood tests measure androstenedione and testosterone, but they typically don’t measure androsterone…which turned out to be crucial information for me.

  1. The DUTCH measures estrogen metabolites, and certain metabolites are more harmful than others.

As I mentioned earlier, estrogen has many potential metabolites. The DUTCH test measures three estrogen metabolites: 16-OH-E1, 4-OH-E1, and 2-OH-E1.

2-OH-E1 is considered the healthiest and most protective form of estrogen. 16-OH-E1 and 4-OH-E1 are more potent and harmful and have been indicated in cancer risk. Here is the breakdown of my estrogen metabolites:

My production of 16-OH-E1 is low, which is good, however I’m not making much of the protective 2-OH-E1 estrogen either. Having this information is extremely valuable, because naturopathic medicine has the potential to alter the metabolism of estrogen in a more favourable way and preferentially metabolize estrogen into the protective and healthy 2-OH-E1. Both 2-OH-E1 and 4-OH-E1 can be methylated by an enzyme called COMT, and naturopathic medicine can support the function of specific enzymes! Pretty awesome!

  1. Speaking of methylation, the DUTCH measures the function of the COMT enzyme

    It measures the amount of methylated 2-OH-E1 in your urine. You want this enzyme in tip top shape to prevent DNA damage. Here’s my result: given the small amount of 2-OH-E1 I make, my body is doing a pretty good job with methylation.

  1. Can the DUTCH measure whether or not my body is adequately excreting hormones, and not just reabsorbing them in the gut?

    Remember that the DUTCH test is based on the urinary excretion of hormones, so you may be wondering “what if my body isn’t excreting the hormones properly, does that mean my hormone levels will look deceptively low?!?!” I’ve wondered the same thing!

The three estrogen metabolites all come from a form of estrogen called estrone, except for 16-OH-E1, which is produced from a number of reactions! Below you will find my estrone level. Next to the photo of estrone, are my metabolites. Now look at where all of the green arrows are pointing. My estrone level is midrange, however my metabolites are all low range. The makers of the DUTCH would like to see the arrows of the metabolites all pointing in the same direction as their precursors- meaning they are all in the same range. This is not to say that the metabolites should directly equal their precursors, hormone production is much more complicated than that! Given this information, my results indicate that I have high circulating levels of metabolites and I am not excreting efficiently. I need to prevent recirculation of hormones in my gut.

Holy smokes?!?! I know that’s a lot of information to take in!

The Benefits of DUTCH:

It can easily be performed at home. The interpretation gives us information on metabolic pathways and enzyme function. It also gives as a greater picture of active hormones levels, compared to bound and inactive hormones in serum. It can also provide us with insight on hormone elimination and recirculation. There isn’t another hormone test out there that can do ALL THAT!

Want your results interpreted?

Want to order the DUTCH test? Book an appointment with Dr. Sumner. Already have your results and want them interpreted? There’s an appointment for that too! Book a lab work consultation appointment.

References:

Tsuchiya, Y., Nakajima, M., & Yokoi, T. (2005). Cytochrome P450-mediated metabolism of estrogens and its regulation in human. Cancer letters227(2), 115-124.

  1. Whirl-Carrillo, E.M. McDonagh, J. M. Hebert, L. Gong, K. Sangkuhl, C.F. Thorn, R.B. Altman and T.E. Klein. “Pharmacogenomics Knowledge for Personalized Medicine” Clinical Pharmacology & Therapeutics (2012) 92(4): 414-417.

Im A, Vogel VG, Ahrendt G, et al. Urinary estrogen metabolites in women at high risk for breast cancer. Carcinogenesis. 2009;30(9):1532-1535. doi:10.1093/carcin/bgp139.

Sanderson, J. T. (2006). The steroid hormone biosynthesis pathway as a target for endocrine-disrupting chemicals. Toxicological sciences94(1), 3-21.

Could your yeast infection actually be cytolytic vaginosis?

By | Hormonal Imbalance, Women's Health | No Comments

We all know those tell tale signs, the itchiness, the redness, the agony; the instant you notice them you run to the nearest pharmacy and grab an over the counter pill and cream and go about your day waiting for the discomfit to pass. Then the next infection hits and you’re going through the same thing all over again. We just assume it truly was a yeast infection because the anti-fungal medication sort of works, and well, we really hope it’s not anything else! But, what about when it doesn’t work? What about when you keep getting them over again and no amount of Canesten or Monistat is doing the trick? In these cases the yeast infection you think you have may actually be cytolytic vaginosis.

It sounds scary, cytolytic vaginosis, but it really isn’t! It’s just an overgrowth of the normally occurring, protective bacteria in the vagina called lactobacilli. What’s the difference between this and a yeast infection? A yeast infection (candidiasis) is fungal overgrowth, but cytolytic vaginosis is bacterial overgrowth. Confusingly, the symptoms are exactly the same! When you have too many lactobacilli in the vagina they produce extra lactic acid and hydrogen peroxide, which cause the itchiness, redness, and white curdy discharge that look and feel exactly like a yeast infection! It can be caused by a hormonal imbalance, or a more local concern.

Yeast Infection vs. Cytolytic Vaginosis

  • BOTH present with irritated and itchy vulva and vagina
  • BOTH present with profuse white and thick discharge that has no smell
  • BOTH present with a vulva that is red and swollen
  • BOTH present with a vaginal pH that is less than 4.5 (optimal vaginal pH is 3.8-4.5)
  • ONLY a yeast infection will present with a positive swab for candida, if you have cytolytic vaginosis the candida swab will be negative

Neither a yeast infection nor cytolytic vaginosis are sexually transmitted, meaning you don’t typically “catch” them from your partner, however sex can lead to imbalance in the vaginal and penile flora so both partners (same sex or opposite sex) can develop similar symptoms. Both the penis and vagina depend on steadily controlled, protective flora in order to stay healthy.

Here is a list of some of the factors that affect our flora and predispose us to developing vaginal infections:

  • Oral antibiotics – These can wipe out the healthy bacteria in the vagina
  • Unprotected sex (with a male partner) – Semen is acidic and can irritate the vaginal mucosa.
  • Protected sex (with a male partner) – But on the other hand, latex condoms and condoms with spermicides may irritate the vagina and eradicate good bacteria.
  • Oral sex – Saliva is not the most hygienic of lubricants, but it can also interfere with the pH of the vagina (which should be 3.8-4.5). I wouldn’t ever suggest taking this away from you; just take a little break if you’re prone to infections!
  • Low vitamin D – Vaginas need sunshine too!
  • Vaginal creams – The vagina is self-cleaning, that’s why you have daily discharge, so there’s no need to use any store bought cleaning products.
  • Scented toilet paper and tampons (and wearing daily pads for that matter) – Even though Tampax makes a pumpkin spice tampon it is not our friend!
  • Food sensitivities and too much sugar – Food intolerances affect the gut flora, which often translate to the vaginal flora. Sugar is also a motivating fuel source for pathogens.
  • Not letting the vagina breathe- G-strings and skinny jeans aren’t doing as any favours, but going commando at every opportunity will!

If you’re suffering from the symptoms of a yeast infection but the vaginal swab comes back negative, you should suspect cytolytic vaginosis.

Here’s what to do to get rid of it:

Twice daily baking soda sitz baths. Fill your bathtub (or a large bucket) with a small amount of warm water and add two tablespoons of baking soda per litre of water in the tub. Sit in the bath and read a book for at least 30 minutes. The purpose of this treatment is to decrease the acidity of your vagina and reduce the lactobacilli. You should be feeling better in no time!
Book an appointment with Dr. Sumner

References

Sobel, J. D. (2016). Recurrent vulvovaginal candidiasis. American journal of obstetrics and gynecology214(1), 15-21.

Yang, S., Zhang, Y., Liu, Y., Wang, J., Chen, S., & Li, S. (2016). Clinical Significance and Characteristic Clinical Differences of Cytolytic Vaginosis in Recurrent Vulvovaginitis. Gynecologic and obstetric investigation.

Ahmad, A., & Khan, A. U. (2009). Prevalence of Candida species and potential risk factors for vulvovaginal candidiasis in Aligarh, India. European journal of obstetrics & gynecology and reproductive biology144(1), 68-71.

Suresh, A., Rajesh, A., Bhat, R. M., & Rai, Y. (2009). Cytolytic vaginosis: A review. Indian journal of sexually transmitted diseases30(1), 48.

Why Probiotics Are the Greatest Supplement & 3 Tips For Buying the Best

By | Food Allergies | No Comments

Following up on my blog post titled “Why Supplement Brand Matters”, this post is dedicated to picking the best probiotic supplement

Probiotics are my absolute favourite supplement!

  • If I was stranded on a deserted island and I could only bring one supplement I would bring probiotics (even if protein powder would be a more likely choice for survival….)
  • If I could describe myself using one supplement it would be a probiotic: I can ease your anxiety, I care about your gut, I don’t want you to get sick, and I’m dedicated to helping you go to the bathroom!
  • If I had to pick just one supplement that is the greatest of all, it would be probiotics!

So what is a probiotic?

A probiotic is a live, healthy bacterium. Your body naturally has healthy bacteria that protect you from harm, but your body can also develop bad bacteria that do cause harm. The bacterial habitat in your body is known as the microbiome and when supported it can do wonders for your health!

 

Why do I need probiotics?

Your body is born with lots of good bacteria, but overtime this good bacteria is depleted with antibiotic use, medication, poor diet, inflammation, infection etc. When the good bacteria disappears, there is more space in your gut for bad bacteria to adhere and cause health concerns. The goal of probiotic supplementation is to replenish your body with good, protective bacteria, get rid of the bad bacteria, and take up lots of space so there’s no room for bad bacteria to adhere (picture your gut like a parking garage that needs all the spaces full). You may have also heard that the gut is the “second brain”. A huge component of your nervous system (and immune system) is in your gut, so when bad bacteria starts to populate and affect your digestive health, it also affects your mental and immune health.

Can I get probiotics from my food? What about Jamie Lee Curtis the dancing Activia lady?

There are many foods that have naturally occurring probiotics, like: yogurt, kefir, kombucha, sauerkraut, kimchi….well essentially anything fermented. I’m sure you’ve seen the countless yogurt ads of middle-aged women belly dancing after they’ve eaten their probiotic yogurt and gone to the bathroom! Sure yogurt has probiotics, but it also has lots of sugar. It’s fantastic to include these probiotic foods in your diet, but if you’re looking to up the anti and achieve a greater therapeutic benefit then read further.

Probiotic supplements can be used very effectively for, but not limited to:

  • bloating/ gas
  • digestive pain
  • constipation
  • diarrhea
  • nausea
  • anxiety
  • low mood
  • frequent colds/flus
  • skin concerns
  • vaginal health
  • bladder health
  • kidney health
  • liver detox
  • hormonal imbalance 
  • weight loss
  • …..wow that’s a lot of stuff!

Hopefully I’ve now convinced you that probiotics rule, so how do you pick one? If you read my last blog you know that supplement brand matters, and it’s not any different when it comes to probiotics. So here we go…

3 Tips for Picking the Best Probiotic Supplement

  1. Take a look at the CFUs (colony forming units)

This indicates the number of bacterial units in the supplement. Different areas of your digestive system have different amounts of probiotic bacteria (you already know that there’s lots of bacteria in your gut!). For example, your colon has more good bacteria than your mouth (up to 99 billion more to be exact). This means that in order to improve the health of your colon and replenish the bacteria, you need a higher number of CFUs than replenishing the healthy bacteria in the mouth. Most health concerns come from a depletion of good bacteria in the small intestine and colon, so you need a higher number of CFUs.

Quick tip– the typical maintenance dose of probiotic for general health is 10-20 billion CFU

 

  1. Take a look at the bacterial strain(s)

It’s pretty simple: different strains have different therapeutic uses, because different strains of bacteria are found in different parts of your body. For example, if you experience chronic urinary tract infections, Lactobacillus rhamnosus and Lactobacillus reuteri are the well-researched probiotic strains. For irritable bowel syndrome you may want to consider Lactobacillus plantarum 299v, and for C. difficile Saccharomyces boulardii is commonly used. And the list goes on!

Quick tip– Multi-strain probiotics, as the name suggests, have multiple probiotic strains. More strains = greater likelihood you’ll get the strain you need. Combining probiotic strains also has a synergistic effect, meaning they work together to improve your gut health. Sometimes it’s more effective to have a whole team instead of just one guy.

  1. Take a look for Prebiotics (aka FOS) and Dairy

Okay what? You read it right; there are probiotics and PREbiotics. PREbiotics are the food source used to fuel the PRObiotics. FOS (fructooliosaccharide) is a form of prebiotic that is added to certain probiotic supplements. For some people, like those with irritable bowel syndrome, FOS can cause bloating and digestive upset and should be avoided. Finally, some brands of probiotics grow their bacteria on a dairy medium (because it’s a sugary fuel!), if you’re sensitive to dairy this is important for you to know.

Quick tip– make sure you read labels thoroughly. The first one has FOS, the second is dairy free

So Now What?

If you are experiencing the symptoms I’ve discussed in this post, you want to belly dance after going to the bathroom, or if you’re interested in what probiotics can do for you book an appointment with me

References

Borchert, D., Sheridan, L., Papatsoris, A., Faruquz, Z., Barua, J. M., Junaid, I., … & Buchholz, N. (2008). Prevention and treatment of urinary tract infection with probiotics: Review and research perspective. Indian Journal of Urology24(2), 139.

Simren M, Syrous A, Lindh A, Abrahamsson H. Effects of Lactobacillus plantarum 299V on symptoms and rectal sensitivity in patients with irritable bowel syndrome (IBS)—a randomized double blind controlled trial. Gastroenterology. 2006;130(1):T2043.

Hickson, M. (2011). Probiotics in the prevention of antibiotic-associated diarrhoea and Clostridium difficile infection. Therapeutic advances in gastroenterology, 1756283X11399115.

Foster, J. A., & Neufeld, K. A. M. (2013). Gut–brain axis: how the microbiome influences anxiety and depression. Trends in neurosciences36(5), 305-312.

Million, M., & Raoult, D. (2013). The role of the manipulation of the gut microbiota in obesity. Current infectious disease reports15(1), 25-30.

Anders, H. J., Andersen, K., & Stecher, B. (2013). The intestinal microbiota, a leaky gut, and abnormal immunity in kidney disease. Kidney international83(6), 1010-1016.

Kelly, D., Conway, S., & Aminov, R. (2005). Commensal gut bacteria: mechanisms of immune modulation. Trends in immunology26(6), 326-333.

6 Ways To Know Your Supplement Will Actually Work

By | Fertility Supplements | No Comments

I’ve been in the health products industry for a number of years now, long enough to see the good, the bad, and the ugly (aka the life changing, the mediocre, and the complete waste of money) when it comes to supplement brands. It seems like there are more and more brands producing what seem like identical supplements, which makes it impossible for you to make a decision! The health products industry is not rigorously regulated to protect you as a consumer, which unfortunately leaves it up to you to choose brands that actually work.

This blog post is to help you navigate the supplement jungle and to share with you that all supplement brands are absolutely not equal. If you’re finding your supplements, especially fertility supplements, aren’t working for the reasons you bought them for, then this blog is for you. Please let me be the one to tell you that it’s not you, it’s the brand!

Here is my list of 6 things that ensure a fantastic brand, and an effective supplement:

1. Your supplement brand does not have any unnecessary additives.

There are so many brands that have countless non-medicinal ingredients that no one can pronounce!

Quick tip: if your pill is in a coloured capsule you know harmful ingredients have been added. Here’s an example of a common label that has unhealthy non-medicinal ingredients

2. The ingredients are standardized to the medicinal component.

This means a brand is not just throwing an herb in a capsule, but extracting the medicinal  ingredients from the herb. For example, the first label provides a guaranteed percentage of the medicinal ingredient in ginger: gingerol. The second label just has ginger, with no gingerol.

Quick tip: a percentage next to the herb indicates the medicinal standardization

3. The form of the ingredient is bioavailable to your body.

This means the ingredients are in a recognizable form for your body to absorb. If your body is not able to process the ingredients then you don’t get any benefits and they end up in your urine! Below there are two labels that include forms of folic acid. The first label describes the form of folic acid: L-MTHF (the most readily absorbed form). The second label does not list forms of ingredients at all.

Quick tip: form can be really confusing, your naturopathic doctor is trained to know what is best absorbed by your body

4. Fat-soluble herbs have fat-soluble ingredients

There are certain vitamins and herbs that need to be taken with fat in order to be absorbed. Did you know Vitamin D and Curcumin/Tumeric are examples of these? Curcumin supplements are extremely popular now for inflammation and pain. Every brand makes a curcumin supplement! But only a good brand makes sure it will be absorbed properly.

Quick tip: the terms for “fat soluble” include: glycine, phosphatidylcholine, lecithin, emulsified, liposomal.

5. Ingredients listed have been validated by third party lab testing

This means the product has been tested by an unbiased lab to ensure the ingredients are present in their labeled dosage. Unfortunately, health product companies aren’t forced to test their products at all in Ontario! So when you see a company that uses third party testing you can rest assure they care about your health!

Quick tip: brands that use third party lab testing include: NFH, AOR, Thorne, Cyto-Matrix, Designs for Health, MediHerb and Seroyal.

6. The dose

The dose on the bottle does not actually reflect therapeutic benefit. Depending on your concern, you may need to take less…or significantly more of the ingredient to see benefit. For example, a product may have 30mg of magnesium citrate, but for bowel function, sleep, and muscle pain you would need a much more powerful product.

Quick tip: your naturopathic doctor is an expert in the scientific evidence for effective dosage.

If you find yourself staring at a sea of supplement brands in your medicine cabinet that don’t meet this criteria, or you’re spending hours at the health food store surrounded by walls of brands, I can help you determine the most effective brands for you. If your supplements aren’t working it does not mean natural alternatives don’t work, it means the brand you’re using doesn’t work!

Book an appointment with Dr. Sumner

References:

Radomski, J. L. (1974). Toxicology of food colors. Annual Review of Pharmacology14(1), 127-137.

Kakkar, V., Singh, S., Singla, D., & Kaur, I. P. (2011). Exploring solid lipid nanoparticles to enhance the oral bioavailability of curcumin. Molecular nutrition & food research55(3), 495-503.

Akoglu, B., Schrott, M., Bolouri, H., Jaffari, A., Kutschera, E., Caspary, W. F., & Faust, D. (2008). The folic acid metabolite L-5-methyltetrahydrofolate effectively reduces total serum homocysteine level in orthotopic liver transplant recipients: a double-blind placebo-controlled study. European journal of clinical nutrition62(6), 796-801.

Pills & Periods: Everything You Want to Know in One Blog

By | Hormonal Imbalance, Hormone Testing, Women's Health | No Comments

This blog is to help you navigate the world of periods and birth control, so instead of the debilitating fear we have associated with a little mishap, or a late period….you’ll know exactly what’s going on in your body. Be empowered, knowledgeable, and in control! Periods are annoying, hormonal imbalance sucks, but I can help you navigate the physiology. Buckle in ladies!

In order to explain how birth control works, we first need to start with periods. You may also want to do some hormone testing if you have any concerns about what is happening in your body.

How Periods Work: Intro to Hormones

All you need to know is that all of your reproductive hormones are under the control of gonadotropin releasing hormone (GnRH). GnRH is released by the hypothalamus in the brain. GnRH controls:

  • Follicle stimulating hormone (FSH) – makes those eggs mature
  • Luteinizing hormone (LH) – makes the ovary ovulate the egg
  • And indirectly: Estrogen and Progesterone – does everything else

The 3 Phases

 Follicular Phase & Estrogen (about 14 days)

The follicular phase occurs when your ovaries are working on maturing the “eggs” (aka oocytes or follicles). This happens under the influence of 3 main hormones: estrogen, FSH, and LH. It’s a competition of the fittest. Typically, only one follicle is released by one of your ovaries (you have two of course). When estrogen reaches it’s peak and then falls, you subsequently develop what’s called an “LH surge” this makes one of your ovaries release a follicle and you have officially ovulated! Some girls experience ovulatory pain called mittelschmerz and they can feel which side they ovulated from! Pretty cool eh! When you’re using ovulation strips to plan for pregnancy, it is LH that is detected in the urine. This follicle maturation process takes about 14 days.

While all of this is happening, under the power of the estrogen I mentioned earlier, your uterus is developing a thick lining called the endometrium. We’ll hear more about this later.

Luteal Phase & Progesterone (about another 14 days)

Once you have ovulated, you’re now in the luteal phase. This phase is mostly under the influence of progesterone. The little follicle that was released from the ovary travels into the fallopian tube and waits to be fertilized by a little, mighty sperm. If you’re actively avoiding pregnancy, the follicle is not fertilized and it dies. The follicle only lives for 12-24 hours after ovulation. That’s not very long at all! The mighty sperm however, can live up to 5 days in the uterus waiting for the perfect follicle to fertilize. This means, there’s a chance you can get pregnant 4 days before you ovulate and the day you ovulate. That’s a very narrow window ladies! That is not to say that accidents don’t happen and result in unplanned pregnancies, but I am saying that you DO NOT need to live in fear every day of the month waiting anxiously for your period. If you know your unique body and keep track of when you ovulate then you hold the power!

Now, where was I? When this follicle was released from the ovary it left its fashionable yellow coat behind. This outer coat layer is called the corpus luteum (aka yellow body) and it secretes progesterone! How amazing is that?! Remember that thick lining we were talking about earlier? It is progesterone’s job to make it grow nice and thick so the follicle you released has a comfy spot to live once it has been fertilized. It is also progesterone’s job to keep other sperm away from the uterus after you have ovulated. No tardy sperm allowed! Progesterone blocks late sperm by creating a really thick mucous plug that covers the cervix, which is the opening to the uterus from the vagina.

The corpus luteum, which secretes progesterone, only survives for about 14 days. If the follicle is fertilized, human chorionic gonadotropin (hCG) is created. This is the hormone detected by a pregnancy test. If hCG is present, it tells the corpus luteum to stick around and keep making progesterone to support the endometrial lining. If the follicle is not fertilized, there is no positive feedback to the corpus luteum and it dies. Now there is no more progesterone. It is this progesterone withdrawal that causes bleeding.

Menses (who knows how long this lasts!)

Phew, we made it, what a relief! Now that there’s no progesterone to support the endometrial lining, your body gets rid of the “functional layer” and you have what we loving call a “period”. The length and symptoms of your period depend on ALLLLLL of the hormonal influences in the follicular and luteal phase and vary significantly from girl to girl!

Okay finally the fun stuff: How does birth control work?

The Pill e.g. Alesse

  • These pills are called “combination pills” because they contain 2 hormones: synthetic estrogen and synthetic progestin
  • These synthetic hormones suppress your body’s natural production of FSH and LH so that you do not ovulate. They essentially trick your hypothalamus and GnRH into thinking that your body has already ovulated so that you don’t!
  • Remember how progesterone created a thick mucous preventing sperm from entering the uterus? If you have synthetic progestin in your body at all times you always have this mucus plug, the progestin also changes the endometrial lining so it’s not thick and comfy for a fertilized follicle

The “pill” is 97-99% effective when used correctly

Patches and Rings

  • The Nuva Ring, which is vaginally inserted, and Evra patch, which you put on your skin, both work exactly the same way as an oral contraceptive pill

Hormonal IUD e.g. Mirena

  • The hormonal IUD only contains synthetic progestin. It creates those same mucous changes as the pill and may prevent ovulation.
  • Since it is directly in the uterus, it interferes with the mobility of the follicle and sperm, it produces “hostile” inflammatory prostaglandins, and it affects the enzymes in the endometrium preventing the fertilized follicle from implanting.

The hormonal IUD is 99% effective when used correctly

Copper IUD e.g. Nova-T

  • It is also placed directly in the uterus but does not secrete any hormones at all. It owes its effects to the copper
  • Like the hormonal IUD, it prevents mobility of the follicle and sperm by creating “hostile” inflammatory prostaglandins. It also affects the enzymes in the endometrium preventing the fertilized follicle from implanting.

The copper IUD is 98% effective when used correctly

And there we have it!

Now you have all the knowledge you need to understand what’s going on in your body and I hope this info alleviates the anxiety associated with…..well, not knowing.

Book an appointment with Dr. Sumner

When did the relentless pursuit of stress become admirable? The 3 Things I’ve Learned About Being Stressed

By | Naturopathic Mental Health | No Comments

When did it become popular to strive for sleepless nights and burnt-out days as a badge for being successful? I’ve often questioned if it’s even possible for me to achieve a goal that’s not motivated and driven by stress!

I’ve always struggled with the feeling that if I’m not doing 1000 things that are useful with my time then I’m failing; that I’m better off predicting my future than going to bed at a decent hour; that if I have trouble sleeping it means I didn’t do enough that day and I need to get up and do more. Sometimes I feel like I’m competing with everyone around me to be the busiest… and then it hits me- why am I striving to be busy?!?! I’m starting to think that it’s okay to get some sleep and manage my stress and still be successful. I’m starting to think that I can earn my success and enjoy myself too. I’m slowly coming to terms with my need to be busy to feel like I’m achieving something worthwhile. In this slow and ongoing realization I have stumbled upon three life lessons that I have completely ignored, but I’m done with ignoring them now. I want to share with you the lessons I’m learning and how they’ve changed my outlook immeasurably:

Lesson 1: Cherish the journey

My mom has been telling me to do this for 20 years but I’ve had a lot of trouble hearing it. She even made me a t-shirt with the saying written on the front when I was freaking out about naturopathic medical school! If that’s not obvious ignorance then I don’t know what is. I’m always so focused on the end goal and rushing to get there, that I don’t notice the individual steps I take to achieve the goal. I truly have no recollection of anything that has happened in my life besides the ending of everything! Since I’ve started switching my focus to the journey instead of the conclusion, I’m finding I’m enjoying the process so much more. I’m even starting to appreciate the mistakes I make. Can you believe that? When I wasn’t cherishing the journey, every mistake I made just took me that much further away from the end goal. But now when I cherish the journey, I learn from every mistake I make and somehow it makes the end goal that much better.

Lesson 2: Comparing yourself to others is poisonous

If you’re only focused on big accomplishments and achieving success that other people can see, then you’re still preoccupied by the end goal and not the journey. In a world where our self-worth comes from likes, shares, and views it’s just way too easy to compare yourself to others. I mean you don’t even have to ask if people like you, it’s represented in thumbs! If you take the first lesson to heart and enjoy the ups and downs of your journey, then there’s no comparing yourself to others because your journey is completely unique. It has never been walked before! Next time you feel down about yourself because someone is doing it better than you, remember that no one can do what you’re supposed to do, in the way that you do it, but you!

Lesson 3: Put your mind at ease

Impossible right? I often let my restless thoughts control everything that I do. I have this habit where I twirl my hair incessantly as a way of getting a hold of my thoughts, it never really works but I do it all of the time. Instead of giving in to my nervous thinking, my new lesson is to do whatever it takes to put my mind at ease. When I can’t sleep at night and everything I have to do is racing through my head, instead of letting it force me out of bed I try to breathe. I breathe and I picture a place that makes me feel calm. During the day when I’m feeling so overwhelmed that I don’t know where to begin, instead of re-writing my to-do list a million times I do a few yoga poses and have a cup of tea to put my mind at ease. I can’t get anything done when I’m burnt-out and I’m slowly learning that being burnt-out is not to be admired. Peace of mind is to be admired.

Sometimes I lose focus of the lessons I’ve been trying to learn, but the more I remind myself of them (like writing this blog) the easier they come to me. I still forget to cherish the journey, I still compare myself to people who seemingly have it all together, and I still go to bed way too late but it’s all part of the process and I’m recognizing that every day. I hope this blog can give you the insight to slowly recognize these things too.

Book an appointment with Dr. Sumner

The ONE Tool You Need To Figure Out Your Hormones

By | Hormonal Imbalance, Natural Fertility Support, Women's Health | No Comments

It’s a thermometer! And it only costs $10.00!

This simple and informative technique is called Basal Body Temperature Tracking

Basal Body Temperature  Tracking is the perfect tool for you if you:

  • experience PMS
  • have painful periods or cramping before your period
  • get hormonal acne or headaches or other hormonal imbalance
  • experience mid-cycle spotting or premenstrual spotting
  • you’re trying to conceive and want natural fertility support
  • you’re trying NOT to conceive
  • you have a really long cycle ( > 35 days)
  • you have a really short cycle (< 28 days)
  • you have an irregular cycle (who even knows when your period comes!)
  • you have just come off of birth control
  • you’re still on birth control
  • you’re curious about your body and want to be empowered!

If you haven’t read my blog titled “How Stuff Works: Pills & Periods” you should read it first to get a better understanding of hormone physiology and the menstrual cycle. In extremely simplistic terms, the first half of your cycle- the follicular phase– is dominated by estrogen. Once you have ovulated and are in the second half of your cycle- the luteal phase– it is dominated by progesterone.  What is unique about these 2 hormones is that they have different thermogenic effects, this means they change your body temperature. If you track your body temperature daily you can chart your hormone patterns and figure out what’s going on in your unique body. Not every girl’s cycle is a perfect 28 days with ovulation on day 14!

Here is an example of a BBT chart using an app called Fertility Friend:

  • The lower body temperatures for the first 14 days show that this gal is in the follicular phase of her cycle
  • The red cross denotes ovulation. You will see that ovulation is the last day of low temperature. Once the temperature peaks, she has officially ovulated
  • As you learned in my other blog post, progesterone is secreted from the corpus luteum which is a byproduct of the egg. Progesterone is thermogenic, as you can see from the elevated temperatures. She is in the luteal phase starting day 15
  • On day 26 you can see that her temperatures are falling, this shows that progesterone is also decreasing and the endometrial lining will be shed
  • You may have noticed that the BBT tracking method is a hindsight method. You will not know that you have ovulated until after you have ovulated and you see a temperature peak
  • After tracking a couple of months of your cycle you will see that you always ovulate at the same time in your cycle so you can plan accordingly for future months

Sweet! Now how do I do this?

I highly recommend you download the fertility friend app so that you can easily record your temperature and the app will make you a beautiful chart and show you when you ovulate with a giant red cross.

Here are the rules:

  • Take your temperature as soon as you wake up in the morning, before doing anything else. The goal is to hardly move
  • Take your temperature at the same time every morning, or as close to the same time as possible (within a 30 minute window)
  • Take your temperature after a solid few hours of sleep (minimum 3 hours)
  • If you want to get really fancy you can take your temperature using a special BBT thermometer that has more than 1 decimal place
  • Enter your data on your chart in your Fertility Friend app
  • The rise in temperature is usually about 0.4 degrees Fahrenheit or 0.2 degrees Celsius, but the rise may be as slight as 0.2 degrees Fahrenheit or 0.1 degrees Celsius or even less in some cases. Great variability is possible.
  • More important than the value of the rise, is the overall pattern of the chart. Fertility Friend helps you determine ovulation based on the pattern of the chart and all fertility signs. It’s an awesome app

If you have questions about BBT tracking book an appointment