Written by Elizabeth Boham, MD
A Functional Medicine Approach to Infertility

A Functional Medicine Approach to Infertility

When having trouble conceiving, it can be really difficult to decide what the best steps towards finding help can be. In Functional Medicine, we look to get to the individual’s underlying root cause of imbalances within their body. When we are able to do this, we can be more successful in our treatment. For many people, infertility can be improved with lifestyle, for example reducing over-exercising, reducing stress, and improving sleep quality. And diet is of course a huge component when it comes to fertility; Functional Medicine providers appreciate this.  

As a Functional Medicine practitioner, I work to evaluate all of the systems in a person’s body when they are dealing with infertility, including a full scope of their hormonal health. This includes thyroid levels, adrenal levels, and sex hormone levels. Many times I find that women need thyroid support, as inadequate thyroid hormone levels can be the cause of their infertility. I like to recommend they include foods that support the thyroid in their diet, like foods rich in iodine (seaweed), selenium (Brazil nuts,  just 1-2 daily) and iron, which all support the thyroid to function properly. It’s important to note that we need to be careful with iodine supplementation—getting too much can negatively impact your thyroid, which is one of the reasons I like to use food first.

I will also test for signs of insulin resistance when I’m investigating hormonal health. You can do this with fasting blood sugar and insulin, sometimes a glucose tolerance test with insulin, and waist-to-hip ratio measurements as well. This is something that can affect both men and women. If there are signs of insulin resistance, it is time to follow a low-glycemic diet, which can have a tremendous impact, though some people need to be more strict than others.

“Low-glycemic” means the foods eaten do not spike blood sugar, they keep it at a lower and more consistent state. Some examples of low-glycemic foods are healthy fats like avocados and nuts, fibrous non-starchy plants like kale and cauliflower, low-sugar fruits like berries, and high-quality protein from meat and fish. Examples of high-glycemic foods are white sugar and refined flours, bread, white rice, and even non-fat sweetened yogurt. Your Functional Medicine provider can help you decide exactly what diet is right for your body and your hormonal needs, but keep those high-glycemic foods to a minimum.

Another common piece of infertility is toxicity, so we will work to support the body’s natural detoxification processes within our Functional Medicine protocol. This is important for helping the body get rid of excess hormones and any toxins that are present. There are many toxins that impact our hormones, like  BPA, phthalates, parabens, and pesticides, just to name a few. It’s important to avoid plastics and be aware of what you’re putting on your body, using around your home, and what ingredients are in your food if you want to completely detoxify your life.

In this step, I always make sure my clients are having regular bowel movements, eating sufficient fiber, drinking enough water, and sweating, in order to fully help the body eliminate toxins. Cruciferous vegetables (broccoli, cauliflower, cabbage, and kale) help support detoxification as well. I also like to make sure we’re seeing the right balance of good bacteria in the gut, since imbalances in the bacteria could hinder detoxification of hormones. Fermented foods, resistant starch, and probiotics can all be useful in balancing the microbiome when imbalances are present.

Lifestyle is an important aspect of improving fertility as well, so we want to work on supporting the normal daily rhythms of life. This means helping the patient get on a good schedule, making sure they are sleeping enough to support the adrenal glands and all hormones. Many people are not getting enough rest, so we can work towards getting 7-9 hours of high-quality sleep to support their adrenals. Acupuncture can be another beneficial lifestyle practice to reduce stress and help patients regain the normal biological balance that helps support conception.

When it comes to lifestyle we often see women who are experiencing infertility due to over exercising and undereating. What it comes down to is balance. A general rule of thumb is if you are getting more tired after exercise or the next day and are not bouncing back after your workout, then you may be working out too intensely or too hard. These days with the proliferation of fitness studios it seems common to workout 6-7 times a week. Is this too much? Well, that depends on the person. This frequency may be ok for some, but make sure to mix it up with different types of exercise and that at least 1-2 of those days are less intense forms of activity, like going for a walk or going to a relaxing or moderate yoga class.

Women need to be careful.  Too much exercise can backfire. If our period stops, then this is a sign that we are exercising too much or not eating enough calories to support our exercise routine. Also, women don’t often continue to lose more weight with more exercise. Many studies have shown that women will stop losing weight at some point with more and more exercise.  This may be a protective mechanism that we have in our body for the purpose of fertility and it also may be because we get more hungry. Exercise is a wonderful stress reliever and great for our health, but too much exercise can hurt our fertility and actually prevent weight loss in some women.

In Functional Medicine we believe all systems in the body are inter-related, which means some seemingly unrelated symptoms could be contributing to problems with conception. A chronic cough, for example, could indicate that there is exposure to an allergen in foods or the environment.  Inflammatory foods have been shown to trigger insulin resistance in some. These are all things we will take into account for our plan of action.

A woman might also have a nutritional deficiency that’s preventing her body from getting pregnant. That makes sense, since we don’t want to be bringing children into a world where there is not enough food, and the body thinks that when we’re lacking in essential nutrients. So, we work with women to get them on the highest nutrient-dense diet possible.

Many women think they are healthy, but because of some junk food sneaking in, or restrictions to help maintain weight, or because of our low-quality food supply, some women have nutritional deficiencies that are quietly harming their fertility. Screening for Celiac disease and other autoimmune conditions such as autoimmune thyroiditis, can also provide us with valuable information, as these can cause malabsorption, inflammation, and nutrient deficiencies that can make the body unable to support a new life.

The good news is that in finding out these root causes we’re often able to reverse frustrating symptoms and regain fertility. If you’ve been struggling with infertility and you’re not sure where to start, I highly recommend finding a Functional Medicine practitioner to help you understand the root cause of your problem.

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