Fertility is the New Holy Grail

Resolve to know more about the underling factors affecting conception and alternative family possibilities. * This article was originally written for the February 2015 Digital Issue of Essential Living Maine*

I had two stepmothers who were infertile for various reasons, and have an adopted baby brother. Several of my close friends and family member have used IVF to conceive, and I have my eggs cryopreserved. A few of my good friends have fostered and adopted, and others have intentionally chosen childfree lives. As lesbian and gay marriage has normalized, and divorce rates have climbed, more and more alternative families are being created using sperm banks, surrogates, egg donors, known sperm donors and more. The quest for fertility is all around us, and has been for the past 30 years in ever-increasing numbers.

The Internet has an enormous amount of information available on this topic, as the World Wide Web offers an enormous cross cultural support network for women trying to conceive (#TTC.) Infertility is usually a silent disease without any visible disability associated; however, it draws deeply on the mind/body and soul in underground ways that cannot be explained to those who do not have to undergo its trails and tribulations. Thus, the web is a great way to connect, share information, and do research while maintaining public anonymity.

220px-Sangreal-1Integrative Medicine is key to enhancing fertility. Integrative Medicine combines the best of modern medicine (reproductive technology) with time-honored complementary and alternative medicines (botanical therapies, clinical nutrition, homeopathy, acupuncture, and stress management support.) The quest to get pregnant (and stay pregnant!) has been a calling of doctors and midwives since the beginning of time and across all cultures.

After ten years of fertility specialization, here are my Top Ten Integrative Medicine Fertility Fundamentals to know about when mapping your journey:

  1. First, while on oral contraceptive pills, rings, or IUD’s and for at least 6 months coming off them, it is important to supplement with a good quality multivitamin that contains at least 10-20mg of all of the B vitamins, magnesium, vitamin C, and 800mg folic acid. These are depleted by synthetic estrogens, and a deficiency can cause long term fertility issues down the road.
  1. If you have a family hx of miscarriage, have had a miscarriage yourself, or have any anemia or high homocysteine on lab work, you may want to test for a genetic defect called MTHFR that leads to a folic acid absorption issue. http://www.apothecarybydesign.com/blog/archives/332
  1. DHEA is a fat-soluble antioxidant and hormone precursor produced by the adrenal glands. DHEA is also a key player in egg health, showing improved embryo quality and higher live birth rates than controls. Studies have used 75 mg of DHEA daily. 1 DHEA supplementation also evidenced higher rates of spontaneous pregnancies in long-term poor responders to IVF in another study using 25 mg three times per day. 2 DHEA supplementation slows the aging process by preventing lipid oxidation while improving energy and metabolism.
  1. CoQ10 is imperative to egg health. Egg division from 46 to 23 chromosomes requires effective mitochondrial function. 3. It has been suggested that mitochondrial DNA defects that effect metabolic capacity may be a cause of failure in egg maturation, fertilization, or early embryonic development. 4. Aged eggs have decreased mitochondrial energy which can result in deficient energy to divide properly resulting in Downs’s syndrome and other genetic anomalies. All women over 30 who are still considering pregnancy should be on 100mg of ubiquinol daily to maintain efficient mitochondrial activity.
  1. Test your hormones early, and keep testing every few years for an objective measurement of fertility reserves. Follicle Stimulating Hormone (FSH) levels must be tested on day 3 of the menstrual cycle with Anti Mullerian Levels (AMH) levels before beginning fertility protocols. FSH reflects the relationship between the ovaries and pituitary and higher levels indicate perimenopause and poor ovarian function. Therefore, levels of FSH under 10 are best. AMH is also called the “egg timer” as it gives an accurate level of the follicular reserves of the ovaries. AMH levels do not fluctuate throughout a cycle and can be tested at any time. Serum AMH levels decline throughout ones reproductive life cycle, and are undetectable after menopause; therefore, higher levels are more desirable.
  1. Don’t wait too long to consider IVF. If you have been #TTC for more than 9 months and have not become pregnant with regular, timed inseminations, IUI’s or intercourse, make appointments with a fertility clinic and an Integrative fertility specialist. Having a Plan B will decrease stress, and it takes time to consider the financial and medical burdens associated with reproductive technology. However, it is worth it to have that baby in your arms! If IVF is needed, committing to the process earlier in your fertility journey can increase your chances for that #BFP (Big Fat Positive) on your first attempt.
  1. Don’t forget the men! At least 30% of infertility is male factor. Too often one half of the couple is doing everything possible (yoga, clean eating, no caffeine, no alcohol, meditation, support group, acupuncture, etc) while the other half is the root cause of the issue. Getting a sperm analysis is one of the first steps in a fertility evaluation, and can bypass months of angst from non-conception.
  1. Sperm need fertility enhancing supplements too! Omega 3 fats, 15 mg zinc, and stress busting herbs like Maca or Ashwaganda will improve sperm health, tonify libido and boost fertility.
  1. Have your thyroid hormones including TSH, Free T3 and Free T4 and your progesterone levels tested. Low thyroid function leads to low progesterone, which leads to frequent miscarriage in a classic vicious cycle. Some Endocrinologists and Family Docs may have conservative opinions on these levels and may use outdated reference ranges or be unwilling to test for Free T3. Consulting an Integrative Medicine Doc, Naturopathic Doctor or anti-aging Hormone Doctor may give you more information about optimizing your hormone levels rather than operating at a subclinical deficiency.
  1. Consider alternatives to the traditional nuclear family. There are many beautiful babies who want safe, stable, loving homes and need fostering and adoption. I know three amazing families of beautiful fostered babies! There are also women able and willing to carry babies to create families that are not their own. While a biological birth is what we are taught to dream for, this is not the answer for some. Infertility is tragic and real for people who have always assumed they would be able to birth when they are ready. Allow your self to grieve as a couple, but do not close the door on other options even if they seem inconceivable at first.

On another note, childfree living also has many blessings. Our culture is slowly shifting away from the definition of having a (nuclear) family as the ultimate success. Childfree living allows for a more relaxed and abundant lifestyle with more freedom, ability to travel, and heightened romance for a couple. We are an overpopulated planet, and I know from my life, having an auntie that is invested and involved in my life is incredibly valuable. Here are many ways to be a part of a family, and each version needs to be recognized as equally valuable and important!

I could keep typing another ten set of treatments supports, and probably another ten after that,  I am so passionate about fertility! However, as I said earlier the Internet is a rich resource. Some other articles I have written on the topic include:

I wish each of you success on your Holy Grail of Fertility. May your journey connect you to your own Divine nature as you experience one of the great, uncontrollable mysteries of life: Conception!

References

  1. Addition of Dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study. Hum Reprod.  2010; 25(10): 2496-500Accessed September 13 2013
  1. Leonidas mamas, Eudoxia Mamas. Dehydroepiandrosterone supplementation in assisted reproduction: rationale and results. Current Opinion in Obstetrics and Gynecology 2009, 21:306-308.
  1. David Meldrum, MD. Aging gonads, glands, and gametes: immutable or partially reversible changes? Fertility and Sterility 2013; 99:1-4.
  1. The use of mitochondrial nutrients to improve the outcome of infertility treatment in older patients. Fertility and Sterility 2010; 93:272-5.

To book an appointment:

http://www.agemanagementcenter.com/contact-amc/  or call 207-774-1356

Clinical Practice:

www.agemanagementcenter.com

www.facebook.com/AgeManagementCenter

For more information about Infertility see:

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Advanced Maternal Age

IMG_0560I did not think I would be single and 41. I was pretty sure at 25, 27, 33, even 35 that kids were unconditionally on the horizon. I was not concerned that I would have kids later – after all I didn’t even graduate from medical school until I was 27. Then, I broke up with my long term love at 35. A quick trip to the fertility clinic at that time told me I was still good to go, and gave me info on my options.

I have been a lesbian for most of my adult life,  so assisted reproduction was  a necessary part of the planning. I  had considerable time to collect information on the legalities of sperm donors vs sperm bank options, and to become familiar with the insemination options that both gay and straight couples use in the quest for pregnancy. As a fertility specialist, I have supported many people through natural conception, IUI, and IVF. Now, well, lets say it could happen accidentally as I have switched teams. But, at my “advanced maternal age” natural conception is quite unlikely. So, after a second trip to the fertility clinic to confirm my continued fertile-ability, I am 3 days away from cryopreserving my eggs.

What this means, is I am doing the first half of an IVF cycle, and then instead of fertilizing  and transferring them, the eggs are put on ice for a later date. I am choosing to suspend the eggs instead of pre-made embryos, because  as referenced above, I am not in a relationship ready for babies. Its a logical choice for a single woman who is reaching the end of the #fertile years. It is also exciting to foil time, and have the possibility of a young family in the next few years. The miracles of modern medicine :)

Fortunately,  I decided around 33 to become an expert in #enhancingfertility and Assisted Reproductive Technology (ART) as an Integrative Medicine doctor. I studied  TCM/ acupuncture and fertility support from 2005-2011, and switched my focus to botanicals, endocrine function and anti-aging medicines in 2012. Read my published article about Integrative Medical support for the follicular phase of #IVF here.

I have quietly been preparing for this date in case I did not end up with a kid on my hip during my rather tumultuous 30’s. I will gracefully accept a child-free lifestyle if that is what is meant to be, as it has a freedom I value and I have wonderful children in my life. I may also choose to foster and adopt locally in Maine. The point of this cryopreservation is not only to end up with a child,  it is to preserve my choice to work towards conceiving within the next few years.

IMG_0672For those in the know, I am on day 8 of a stimulation cycle. I took 450 IU of Gonal-F for the first 6 days, and have ramped down to 300 for the next 2 days. I started 0.25 mg Cetrotide yesterday and will be continuing that for the next few days. Then, the trigger shot and retrieval Tues or Wed. My response is good and side effects minimal, which I am very grateful for. It really does pay to prepare for an event like this even years ahead. (PS. I had 21 eggs collected! 12 mature and 8 immature)

Here are my Top 5 steps for Fertility Preservation in Women over 35

1. CoQ10 preserves the quality of the eggs mitochondria  – essential for replication and good “egg energy” aka ATP for cell division. 100-400 mg daily prevention, 400 mg twice daily during a stimulation cycle.  ( The use of mitochondrial nutrients to improve the outcome of infertility treatment in older patients. Fertility and Sterility 2010; 93:272-5. )

2. DHEA is a lipid antioxidant and youth-reviving hormone precursor. I suggest 10 mg daily for prevention,  25 mg daily 6 weeks before stimulation cycle. Up to 75mg daily is evidenced to improve egg and embryo quality and enhance spontaneous conception. (Addition of Dehydroepiandrosterone (DHEA) for poor-responder patients before and during IVF treatment improves the pregnancy rate: a randomized prospective study. Hum Reprod.  2010; 25(10): 2496-500 Accessed September 13 2013)

3. This is your individualized medicine step – what do you need to tonify your specific reproductive patterns and enhance the chances of conception?

4. Fertility Massage is key for addressing muscular and ligament stress lodged deep in the pelvis that could mechanically impair the ability to maintain pregnancy. Concomitant castor oil packs clear debris from the ovaries and fallopian tubes, flushing lymphatic channels for a more balanced local immune response. The self massage/ hands on aspect maintains a connection between the cerebral, medicalized experience of ART and the physical sensations of the lower belly while reducing emotional stress. http://natural-fertility-info.com/fertility-massage.

5. Optimize your nutritional status with: extra leafy greens on a regular basis; superfoods especially in smoothies;daily  fresh vegetables; and choosing clean meat and dairy whenever possible. Reduce or eliminate sugar during high intensity hormone treatments including birth control pills.

It is the grit of everyday living that builds the pearl of one’s career. In the process of enhancing my own fertility, I have learned as much from the patients I have treated and supported as they learned from me. This primal biological drive has helped me to become a much better doctor in this field as I experience the nuances of treatment myself. I look forward to continuing to support all patients seeking conception, especially those of us above 35 that have lived full complicated lives and have had to balance the biological desire to have children with the real-life tensions of sex, gender, career, finance, and relationship.

 

 

 

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Using Herbal Medicine in Pregnancy

pregnancy-tonic-tea-220x231There are always questions about which herbs are safe to use in pregnancy. There is considerable historical and clinical information on the use botanical medicine for enhancing fertility, treating common conditions of pregnancy, and supporting postpartum care and lactation. The modern push for evidence-based studies to confirm safety of use is hindered by the ethical issue of conducting clinical trials during pregnancy. Therefore, there are very few if any double blind placebo controlled studies to reference for this population. For this reason, most online and allopathic resources will list herbs as “not safe in pregnancy” even if they have been safely used for centuries as part of maternal medicine. Furthermore, the World Health Organization label requirements for botanical medicines includes information on the use during pregnancy and lactation. As there is insufficient evidence-based studies on botanicals in pregnancy, almost all products will say Not Safe in Pregnancy or Lactation. This is good in some ways, because it protects the fetus from harmful herbal constituents accidentally taken by an unsuspecting parent. On the other hand, it limits many people from accessing safe and effective supportive herbal therapies during this unique time of life.

As a general rule of thumb, almost all herbs are best avoided during the first 12 weeks of pregnancy unless specifically prescribed by an expert in this field. Ginger is one exception to this, as it has significant clinical evidence to reduce nausea of pregnancy. Still, even ginger can be too stimulating and is best taken in moderation. *Dosage for hyperemesis gravidum could be 5-10 drops of a ginger glycerite tincture as needed, up to 70 drops daily. Ginger tea or  chrystallized ginger can be used 2-4 times a day, and ginger candies up to 10 daily. Roobios is another herb that is a safe tea in early pregnancy. This is a traditional pregnancy medicine in Africa, and a very common tea base. Nettles are also very gentle and provide a mineral-rich tonic for the newly pregnant mom. Nettle is a lovely tea base to use throughout pregnancy and lactation for hydration and nourishment. As every person’s body is different, it is sometimes best to stick with what your body knew pre-pregnancy rather than trying new things in these sensitive weeks to avoid unexpected allergic reactions or other physical repercussions.

There are some herbs which must be completely avoided throughout pregnancy as these are known to be harmful in some way. For a complete list see:  http://thewrightdoctor.com/womens-health-2/herbs-not-safe-in-pregnancy/

Herbs with strong alkaloids (identified by a bitter taste) are to be avoided. These often have a strong action on the body, whether digestive or cardiac. There are many gentle herbs and nutritional supports which are safer digestive tonics for pregnancy. Laxative herbs exert their effects through muscular contractions and can stimulate uterine contractions as well. Most herbs with strong hormonal activity are to be avoided completely , as are all anti-parasitic formulas. Certain herbs that are to be avoided in pregnancy can be prescribed by experts in this field in the last few weeks of pregnancy to prepare the uterus for labour.  These are only to be used under the guidance of an experienced midwife or prescribing professional with obstetric training in botanical therapies.

There are many herbs which help pregnant women connect to their body and the environment in a grounding, tonifying way that are safe and effective. Some women will make their own creations from local plants, and others will buy them. When purchasing plant remedies, it is important to buy from reliable brands. Gaia, Apollo herbs, Herb Pharm, Vitanica, Wise Woman and Avena Botanicals are all ethical and responsible manufacturers of high quality herbals. If you are concerned about whether or not a product is safe for you, simply do not use it! Or, find a local Naturopathic Dr, Midwife, or Herbalist to guide you in your pregnancy care.

These are some herbs which are safe to take. * Alfalfa is very high in chlorophyll and rich in minerals and vitamins. This is a great greens powder in smoothies. Burdock can be used in small doses of 20 drops 1-2 times a day after the first trimester. Burdock supports women with blood sugar difficulties or constipation later in a pregnancy. Dandelion greens are a great tonic for women pregnant in the spring. They are robust in vitamins and strengthen the urinary system. Dandelion root can also be used in small amounts like burdock, for sour stomach, nausea and itchy skin. Oatstraw is a soothing tea or tincture which calms an overstimulated nervous system. This is a must have for pregnant moms with other small children! Up to four cups of Oatstraw tea daily is safe or use in tincture form 40-60 drops in water 2-3 times a day.

Rose hips are safe throughout pregnancy. These have abundant vitamin C to support collagen production in skin and help maintain vascular wall integrity.  They have a sour zip, and make a yummy tea with nettle and honey. Saint Johnswort herb is a safe and gentle mood support during pregnancy as well as a safe option to treat herpes outbreaks both topically and internally. It should not be used with other medications, but is a reliable ally for women during this time of life. Red raspberry leaf is very well known as a late pregnancy tonic. This silvery-green leaf strengthens the uterine muscle without stimulating contractions, preparing the body for the adventure of labour. It is rich in iron to support the increased blood volume in later pregnancy. It is best drank as a tea 1-3 cups per day for the third trimester. Finally, Valerian is a safe sleep support. It is best to use the smallest dose needed for therapeutic value, so start with 1 cup tea before bed or 10-30 drops of tincture and increase as needed.

Pregnancy is a time of life when so much is unknown, and so much can go wrong – there is so much responsibility for both parents and care providers. For this reason much of modern medicine has erred strongly on the side of caution when it comes to using herbal medicines in pregnancy. This caution is compounded by the high cost that many IVF assisted pregnancies carry. Every move becomes highly medicalized, and simple acts like a cup of herbal tea are forgotten as effective therapeutics. The bottom line when it comes to using herbs in pregnancy is: if it makes you nervous, dont do it. You cannot rely on the internet, on your OB,  or on labels to tell you what is safe to take during this time of life. However, there are some very reliable books on using herbs in pregnancy, and many Herbalists, Naturopathic Doctors and Midwives have expertise in this area. Enjoy!

http://apps.who.int/medicinedocs/en/d/Jh2945e/9.5.html

http://www.ahpa.org/default.aspx?tabid=70

*ABC Clinical Guide to Herbs. M. Blumenthal p. 174

*The Natural Pregnancy Book. Aviva Jill Romm

*Herbal Childbearing Year. Susun Weed p. 19, 51

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#TTC Obsession – Confessions

Getting pregnant is scary and exciting. The process of wanting to conceive and then waiting to find out…. not priceless. I am intimately aware of this as a Naturopathic Doctor with a focus on In/Fertility. I have also been privately preparing for this moment of my late 30’s when I am ready to conceive.  I have treated and supported many women through this process already. And here I am, alone with my OPK stick in the bathroom, discerning the workings of a secret universe. CONCEPTION.

I am amused at my complete immersion in the consuming nature of trying to predict my own ovulation. I cannot believe how often I think of the subject. I am constantly turning the information over in my mind. I read fertility forums online to gather information; I delve into friends’ personal experiences. Medicine looks so different when one is the patient! Suddenly there are a thousand things I do not know… Ovulation Predictor Kits are only the beginning.

And, in the obsession of pregnancy, it becomes everywhere. Books and television remind me that women have been torturing themselves about the ability to get pregnant forever! First, it was conceiving a boy, and whether or not the First Son would be born.  With rampant infertility, the collective obsession has turned to the BFP and away from gender preference.

We want to be able to control this event with every ounce of heart and mind. We are so used to be able to create what we need, if we only put enough effort into the act! It is maddening to have to develop techniques like trust and patience to achieve our highest goal…. and yet that is what it comes down to in the end. Do we hold the ultimate responsibility of whether or not life occurs in our very body?  It is appears to be the hugest responsibility, and yet it is one we cannot. create. on. our. own.  As my friend said yesterday, “We are accomplished and often privileged women! Powerful creations, and yet…” we cannot read what should be the simplest signs of all from our flesh. Are we ovulating today? Are we pregnant? It’s a huge pressure.

For same sex couples and single folks, there is the additional stress of genetic material to procure. The art of conception (often) looks very different for lesbian and gay couples. Not only will the inseminations need to be precisely timed, but the acquisition of said tools of conception must also be arranged. The cost of becoming pregnant begins with the very first try, an additional ingredient in the pressure-cooker of preparation. (In a call-out to women with biologically male partners, I do understand that when women hit the fertility clinics, we are all in the same machine.  The sex or gender of our partner becomes much less relevant although issues of accessibility to and cost of genetic material remains an additional stress.) It’s a wonder any of us become pregnant at all! But we do, in every increasing numbers.

The minute details, test results, and potential scenarios become an endless gerbil wheel of anxiety. It is important to step back from your own fertility and restore some normalcy to your daily routine. I was wound up over the timing of what was only a pre-cycle. Imagine how physically stressed out I could be for the real thing! One of my friends advised me after her first birth – make it fun. Try to relax around it. And she laughed knowing how hard that would be. I suggest distracting yourself as much as possible from thinking the same old anxious thoughts.  HOW? Listen to music that makes you sing. Watch a movie that engages you. Make time for friends or family who you like talking to and who are interesting. Write in a journal so you can get the thoughts out of your head and onto paper. The less time that is spent obsessing about the timing or prediction of said events will be in your best interest overall!

There is no conclusion to the story. The (new brand of) OPK kits wait for next cycle in my bathroom cupboard. I am going to pray for myself, light candles of hope, and continue to make the daily small offerings I do towards pregnancy – high quality prenatal vitamins, DHA essential fats, green tea, and other things appropriate for my personal care. My sweetheart and I also have a plan B, and C in place to rely on. When I get in the hamster mind of prediction anxiety again, please remind me of this post. Stress inhibits Ovulation!

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Spring Wellness Shopping List

Spring! Winter skin comes out from under the covers, and the winter blues start to melt away…. Here are a few simple things you can do to feel and look your best!

Shopping List

£ Nettle Tea

£ Dry Skin Brush

£ Weleda Cellulite Birch Oil (or other good quality body oil.)

£ Flax Seeds

£ Sheep Yogurt

Instructions:

The key to Spring Wellness is getting the lymphatics moving and improving detoxification systems. The lymphatic channels run just underneath the skin, and are the highways of the immune system. Rough and bumpy skin is often from congested lymphatics – toxins literally surface to the skin when they cannot be eliminated properly. Nettle tea is an excellent and very safe lymphatic tonic that can used by everyone – for children, in pregnancy and breastfeeding, with multiple medications, and beyond!

Dry skin brushing is a physical medicine that sloughs off dry skin and stimulates lymphatic channel movement. It creats a youthful vibrant skin surface and helps to eliminate toxins released by the Nettle tea! Dry skin brush before every bath or shower. How? Using a specially designed brush, start at your feet and gently sweep upwards in big circles. Repeat from the wrists to the shoulders and across the chest.

Continuing topical care, nourish your skin with a rich organic oil when you are just out of the bath or shower. This improves dehydration and provides your cell membranes with the rich lipids it needs for optimal elasticity. Don’t towel off your extremities, instead just dry your trunk, face and hair. Generously apply your body oil, massaging your muscles and rubbing it in. Then, take a minute and lie back down wrapped in your towel to let the oils sink in. If you don’t have the time to rest, just wait a few extra moments before you get dressed (to let the oils sink in.) Weleda Birch Cellulite Oil is my favorite for Spring as it stimulates the dermal layers under the skin to continue detoxifying, and has no synthetic perfumes or chemicals that add to your body’s toxic burden.

Internally, adding 2 tbsp of ground flax seeds daily will have great health benefits. First, they are good source of fiber – this  will gently help your bowels to eliminate more effectively, without any laxative effect. Flax seeds also contain lignans, which support estrogen detoxification, which can help men and women taking any hormonal therapies. If you aren’t taking any hormones, lignans still help your body find its best state of hormone balance. And finally, flax seeds are a tasty source of vegetarian omega 3 oils.

I like taking my flax seeds in organic sheep yogurt, with fresh or frozen fruit and maple syrup. This makes a great snack! Its also an easy and yummy breakfast. The reason for using sheep rather than cow yogurt is threefold. First, Variety is the Spice of Life. Most of us eat a fair amount of cow dairy, so diversifying the food spectrum is good for the digestive health. Secondly, our body is made to absorb the small protein molecules in sheep and goat (and human) milks, not the large protein molecules from a cow. This is why many people with dairy intolerance can still have goat (and sheep) products.  Third, sheep yogurt is creamy and tasty! It doesn’t have the “farmy” flavor that many goat products have, so it is more like organic cow dairy in taste and texture. Yum.

Simple changes for simple wellness. Its not the drastic cleanses and restrictions that really make a difference to health in the long run. It’s the simple daily choices that add up to big results. Gently sweeping out the old and inviting in the new and fresh cells by stimulating lymphatics and nourishing the skin will have you feeling radiant.  For any questions or concerns about your personal health and health care, please contact me at http://thewrightdoctor.com/contact-information/

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Nutrition to Strengthen Liver Yin

     Modern culture is Yang obsessed. We go-go-go, we seek sun, we burn the candle at both ends, we exercise vigorously, and we love stimulants. It is a rare bird that has enough quiet, meditative alone time, in a dim or dark environment. This is the Yin state – nourishing, moistening, dark, and quiet – Yin builds what Yang wears down.

Every organ of the body has a Yin and a Yang aspect. Some organs (Spleen, Liver, Heart, and Lung for example) are naturally more Yin in Nature. Other organs (Stomach, Gall Bladder, Small Intestine and Large Intestine for example) are more Yang in nature. These “natures” were determined by the functions each organ enact as well as more energetic attributes. Supporting the natural state of each organ will optimize health, and promote healthy functioning.

      Much is said about detoxifying the Liver, and reducing its Yang (brought on by alcohol, drugs and stimulants) but what happens when you actually have deficient Liver Yin that needs to be nourished?  Stripping an already deficient organ will create further disharmony that will eventually manifest as pathology.

      A diagnosis of Liver Yin deficiency means that this aspect of the Liver organ network is compromised. The Liver not only detoxifies, it has many other (building) jobs including cholesterol metabolism, vitamin storage, bile production, and blood reservoir. Blood is a Yin substance (all fluids are yin) and many B12 and iron anemias can be diagnosed early on as a Liver Yin deficiency by a trained Acupuncturist. Thin brittle nails, anemia, sallow skin, easy bruising, hair loss, blurred vision, tinnitus, dizziness, infertility  and some tremors  are all associated with a Liver Yin deficiency diagnosis.

Nutrition is one of the best ways to support and recover Liver Yin. A diet that is nutrient rich and nourishing is essential, as is sitting down to relax while you eat and chewing thoroughly to savor flavors. The diet should also include plenty of fluids, especially in the form of soups. Meals consist of 40% easily digested complex carbohydrates like whole grains and starchy root vegetables. Another 40% of the diet is cooked vegetables. Proteins comprise 10-20% of the diet, with a focus on high quality organic or grass fed sources. Healthy fats fill the other remaining 5-10%.

Below is a list of recommended foods to nourish Liver Yin. Do not limit your nutritional intake to only these foods. Instead follow the guidelines above of the optimum ratios of carbohydrates, vegetables and proteins, and add the recommended foods from the list below within your meals. Where ever possible choose organically grown foods to avoid genetically modified ingredients.

Foods to Nourish Liver Yin Deficiency

 Zucchini, squash, potatoes, sweet potatoes, string beans, beets,

Mushrooms including wood ears & tremella,

Tomatoes, spinach, carrots, parsley,

Molasses

Apples, banana, mulberries, mango, coconut, peaches, lychee fruit, melons,

Grapes, raisins, cherries, plums

Olive oil, flaxseed oil, almond oil

Vegemite, kelp, spirulina, wheatgrass

 Oats, rice, millet, barley

Adzuki beans, black beans, mung beans

Organic cow, goat and sheep yogurt

Tempeh, tofu, miso

Nuts & seeds, black sesame seeds (great as a condiment!)

Eggs

Pork, chicken, Chinese black boned chicken, duck

Mackerel, sardines, oysters, mussels, clams

Cuttlefish, squid, perch, eel

Foods to Restrict or Avoid

Chilies, cinnamon, garlic, ginger, onions, shallots, leeks, basil, cloves, wasabi

Coffee, black tea

Vinegar, pickles

Lamb, shrimp, veal

Citrus fruits

Cigarettes, alcohol

Recreational stimulants

Activities that build whole-body Yin nourishment are also encouraged while working specifically on Liver Yin. Rest more. Read. Spend some quiet, alone contemplative time in a cool, dark room with a candle lit (taking a bath is a nice way to do this.) Exercises like Tai Chi and Yoga are more Yin building than Yang in nature. Drink warm water and lemon. Get extra sleep. Breathe.

References:

Clinical Handbook Of Internal Medicine, Vol. 2. MacLean & Lyttleton. University of Western Sydney: Australia. 2002.

Chinese Dietary Therapy. Liu, J. Churchill Livingston: Edinburgh. 1995.

The Healing Cuisine of China. Zhao & Ellis. Healing Arts Press: Vermont. 1998.

An interesting theoretical write up: http://www.indiadivine.org/audarya/ayurveda-health-wellbeing/997986-liver-yin-deficiency-patterns-derived-patterns.html

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Nutrition and Lifestyle Support for First Trimester

Pregnancy Nutrition for First Trimester

More than half of all women suffer from nausea and vomiting during their pregnancy.  No one knows what causes “morning sickness” but it has been linked to higher hormone levels, changes in blood sugar, and stress.  Nausea and Vomiting usually begin around the 6th week of pregnancy. It usually stops at about the 12th week, although it can continue throughout pregnancy for 20% of women. L During these weeks,  allow yourself to change your activity level and adjust your schedule to help yourself cope with the physical symptoms. Your body is doing some incredible chemistry creating a tiny new being!

Here are tips for keeping the nausea at a minimum.

Lifestyle

  • Eat a few crackers before you get out of bed and rest for 15 more minutes.
  • Keep small snacks in little jars and containers in your purse, your desk, your car, and your kitchen.
  • Eat every 1.5 -2 hours in little bits. You may feel nausea if you eat, but you will feel even worse if you don’t eat!
  • Try not to skip meals
  • Eat slowly, and do not lie down right after eating
  • Ask friends and family for help with errands and housework!
  • Take naps – Nausea is worse when you are tired.
  • Get fresh air daily
  • Avoid hot and stuffy rooms
  • Taking a prenatal multivitamin in capsule form that can be split up throughout the day with meals can make it easier to take your vitamins. If there are days you cant stomach it, don’t worry.
  • Take your folic acid daily even when you don’t take your prenatal.
  • Acupressure “sea sickness” wristbands are helpful for some women.

Food Choices

  • Choose easily digested foods – baked potatoes, mashed yams, homemade gravy, stewed fruits, watery fruits, crackers, etc
  • Avoid cooking spicy or greasy foods at home
  • If you are craving greasy foods, have a few plain potato or rice chips
  • Hot women – put grapes in the freezer to snack on
  • Cold women – drink ginger teas, eat candied ginger
  • EmergenC packets also contain electrolytes and can help rehydrate if you have been vomiting.  Drink 1-2 per day as needed.
  • Soups, porridges, and stews provide healthy  liquids and nutrients.
Food Ideas To Relieve nausea
Ø    Salty Ø    Chips, Spelt Pretzels, Tamari Almonds
Ø    Tart / Sweet Ø    Pickles, Organic Lemonade, Kombucha
Ø    Earthy Ø    Brown Rice, Mushroom Soup, Almond Butter
Ø    Crunchy Ø    Celery Sticks, Apple Slices, Nuts
Ø    Bland Ø    Mashed Potatoes, Broths
Ø    Soft Ø    Bread, Rice Noodles
Ø    Sweet Ø    Homemade Muffins, Cereal with Honey
Ø    Fruity Ø    100% Juice Popsicles, Watermelon
Ø    Liquid Ø    Juice, Seltzer, Ginger Ale
Ø    Dry Ø    Rice Crackers, Saltines, Rice Cakes

Beverages

  • Dehydration will make you feel worse!
  • Plain water can make some women feel worse. Try drinking lemon water, or lemon water with a little maple syrup.
  • Drink in small sips.
  • Avoid drinking before, during and after meals.

Smells can be very nauseating for a pregnant woman. A good tip is keeping a piece of fresh lemon peel or ginger root on a hankie, and sniff it when feeling nausea. Don’t use synthetic scents as these often make it worse.

What if you can’t keep anything down?

Hyperemesis Gravidarum affects 1% of pregnant women per year. Lack of food, fluids and nutrients can be harmful to mom and baby. Severe cases of dehydration require IV fluids and nutrient supplementation from a hospital. Seek medical attention if you have frequent vomiting and infrequent urination or dark yellow urine. Early diagnosis and treatment is best, so don’t try and “be brave!”

Acupuncture, B6, ginger capsules, and homeopathy can treat mild to moderate cases of nausea and vomiting. Use 50 mg of B6 twice daily with food. Severe Nausea may need a prescription medication called Diclectan.

Summary: Congratulations on being pregnant! For this first trimester 3 keys are:

1.     Rest Rest Rest Rest

2.     Eat frequent small amounts – every 2 hours is a must! Remember, eating might not help but Not eating will make you feel worse

3.     Follow your body’s cravings, trying to stick to wholesome home cooked versions of the more junky cravings. And. Don’t forget to sip lots of water!

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