Category Archives: Hormones

All hormones, all the time.

Seed Cycling For Fibroids

Seed cycling is a gentle way to balance hormones, but with fibroids many women hesitate to start. Uterine fibroids, or leiomyomas, affect millions of women, causing heavy bleeding and often pain. They are space-occupying lesions that can interfere with fertility, with urination, with digestion and also cause severe pain and pressure in the pelvis. Seed cycling could be a gentle way to limit fibroid growth and manage symptoms. They are a serious condition and it is important to work closely with your physician when considering any new protocol, including this one.

What Is Seed Cycling or Seed Rotation?

Seed cycling, also called seed rotation, is a nutritional method of regulating women’s hormones. It works by using two different combinations of seeds for the two phases of a woman’s menstrual cycle. If you are unfamiliar with the basics of the menstrual cycle or of seed cycling, there is a helpful article here. Typically, 1 Tablespoon of flax seeds and 1 Tablespoon of pumpkin seeds are taken for the first half of the cycle (from day one of bleeding to ovulation, or the first 14 days) which is the follicular phase. 1 tablespoon of pumpkin seeds and 1 Tablespoon of sesame seeds are taken for the second half of the cycle (from ovulation, or day 15 to the end,) which is the luteal phase. The basic protocol, however, isn’t appropriate for women with estrogen dominance so severe that it has led to fibroids. Seed cycling for fibroids should be a different protocol.

Seed Cycling for hormone balance adds seeds into your diet following the rhythm of your body or the moon. Seed cycling and pregnancy are a natural fit. Seed cycling for fibroids is a slightly altered protocol.
Seed Cycling for hormone balance adds seeds into your diet following the rhythm of your body or the moon. Seed cycling and pregnancy are a natural fit, and the seeds should be altered in the case of uterine fibroids.

Days 1 – 14; The Follicular Phase

The first fourteen days of a woman’s cycle are dominated by the effects of estrogen. Estrogen is the strongest known contributor to the growth of uterine fibroids, and so it is important to modulate this time of the month. Flax seeds work in two ways to REDUCE the effects of estrogen on the body. In one aspect, the lignan from flax seeds is a phytoestrogen, meaning a plant-based estrogen which mimics 2-alpha-hydroxyestrone. This type of estrogen is biologically far less active than other estrogens (it is often compared to the biologically overactive 16-alpha-hydroxyestrone in research).  Here is a great research article that goes into far more detail about this process. Also, the fiber in flax seeds acts as a natural detoxifier, helping your body to trap and eliminate estrogens from the gut (humans tend to reabsorb estrogens from the gut so that they are never fully eliminated).  Here’s more on fiber. Here’s more about estrogen dominance and the reabsorption of estrogens from the gut. The overall effect of the flax seeds is one of lowering estrogen. For a fibroid, lowering your estrogen levels will help to keep growth to a minimum. It probably won’t be strong enough to shrink the fibroid, but it may help slow or prevent growth. Seed cycling for fibroids should use only flax seeds for the first 14 days.

Days 15-28 (ish); The Luteal Phase

This portion of a woman’s cycle is influenced most strongly by progesterone. Progesterone, although it reduces bleeding from fibroids, is known to increase their growth. Here’s an article about the progesterone link. Sesame seeds are used in seed cycling for fibroids in this phase. They are also lignan-rich like flax seeds and have been shown to have strong anti-tumor effects including anti-proliferative effects that might also slow tumor growth. I have never seen research specifically on sesame seeds and hormone levels but this article on lignans is the closest.

Seed Cycling Protocol For Uterine Fibroids

Seed cycling for fibroids should include the flax and sesame seeds in rotation, without the testosterone boosting effects of pumpkin seeds or the progesterone boosting effects of sunflower seeds.

Days 1-14: 1-2 Tbsp ground flax seeds.

Days 15 – 28 (or the end of your cycle): 1-2 Tbsp sesame seeds.

As always, check with your physician to make sure this is appropriate for you before you start anything new. Also, be sure you are monitoring the size of your fibroids to make sure that their growth is actually slowing and that you are not putting yourself in any danger. As always, listen to your body in everything that you do for your health.

Taurine for Gallbladder Sludge and Stones

Taurine is used for many things, but taurine for gallbladder sludge doesn’t get the attention it deserves.  It’s well known for energy, of course, hence every energy drink out there. While increased energy is a *really* great side-effect, anyone with gallbladder sludge can tell you that getting rid of that is pretty good too.

Taurine is great for gallbladder sludge, and also common in energy drinks (not that I'm suggesting energy drinks for your gallbladder - that wouldn't work out). Great photo by Brekingpic on Pixels.
Taurine is great for gallbladder sludge, and also common in energy drinks (not that I’m suggesting energy drinks for your gallbladder – that wouldn’t work out). Great photo by Brekingpic on Pixels.

Why Does Taurine Help With Gallbladder Sludge and Stones?

So, why does Taurine help with gallbladder sludge and also help to decrease gallstone formation? Great question. The substance we generally call “bile” in the gallbladder is actually a conjugated bile salt. Primary bile acids are made in your liver, then conjugated (which means bonded to) either taurine or glycine to become active bile salts. Meaning, without the taurine or glycine, they don’t do anything at all. If you want more detail about this process, there is a great article here. Taurine and glycine are both common in the Standard American Diet, especially from meat and fish sources and also can be made by our bodies if we’re low. So, what is the problem?

Common Factors that Decrease Available Taurine

This is the part that gets us in trouble, because many of the factors that decrease Taurine are ALSO risk factors for developing gallbladder sludge and stones. Are you noticing a pattern here? Here are some common taurine drains:

  • MSG. Dietary MSG requires taurine for metabolism and excretion.
  • High Estrogen. People with high estrogen use so many of their methyl donors trying to deal with estrogen, that there are none left to help their bodies make taurine (especially methionine). High estrogen, you will recall, is also one of the primary risk factors for gallstones and gallbladder sludge.
  • MTHFR Mutation. Sorry MTHFR folks – I feel your pain. MTHFR mutations also mean there are fewer methyl donors, hence lower taurine production and also lower estrogen clearance. Healthy bile is methylation-dependent.
  • Diabetes. There is a link between diabetes and low taurine (and also taurine has been shown to reduce blood sugars).

The Best Way to Supplement Taurine

While energy drinks are fun, these are NOT the best source if you’re trying to prevent gallbladders sludge or stones. See the diabetes thing above? Yeah. Energy drinks typically have a hefty dose of sugar and aren’t going to help your health at all. Food sources of taurine are great in moderation and as part of a healthy diet – meats, dairy products and fish are all high in taurine, but they are also often high in cholesterol, which is best taken in moderation with gallstones or gallbladder sludge. That leaves supplements, which are probably the best option for therapeutic doses of Taurine for gallbladder sludge and stones. Typically suppelements are dosed in 500 or 1000 mg pills and you can take up to 3000 mg daily without harm, even long term. For more information on Taurine or safe dosing, read this.

What Else Should I Be Doing?

While you’re taking your taurine, it’s important to remember to moderate cholesterol in your diet (but not eliminate it – healthy gallbladders need dietary fats to contract and clean themselves out). It’s also incredibly important to remember to get great water intake because, without water, you’re not flushing anything out of anywhere. Also, increase your fiber intake. Fiber not only helps to eliminate fats and bile salts in the intestines but also, helps to pull out estrogens, which decrease taurine. Taurine will help you to be sludge (and pain) free.

MTHFR and Birth Control Pills. Ugh.

Naturally, MTHFR and birth control pills interact – it’s not like this is an easy mutation to live with in other senses, why would it leave our contraceptive options untouched? Complaining aside, I could have saved myself years of miserable experiences with the pill if I had known this.

MTHFR and birth control pills is a bad combination. Photo by Bryancalabro.

MTHFR and birth control pills is a bad combination. Photo by Bryancalabro.

Birth Control Pills Deplete Folate in Your Body

If you’re familiar with MTHFR mutations, then you’ve probably already figured out why this is a no-win situation for us MTHFR gals, but if you’re not then read on. Birth Control Pills are known to deplete folate levels in women and have been known to do so since the ’80s.  This is a problem for all women, but especially those who have compromised folate metabolism in the first place (ahem, that’s us MTHFR folks). This folate depletion is part of the reason for some of the most common side effects of birth control pills – fatigue, mild depression, even acne.  It’s also linked to an increased risk of neural tube defects in babies born to women who have recently stopped using birth control pills.

Due to the risk of neural-tube defects in women who become pregnant after recently stopping birth control pills, a new folate-fortified pill called Beyaz ® has been developed.  In good news, it is supplemented with an active form of folate so if you’re an MTHFR gal and you absolutely must take oral contraceptive pills, this one might be a good option for you.

If you don’t tolerate birth control pills and can’t figure out why, it could be because you have an MTHFR mutation – especially if you have signs of a folate deficiency even though you’re taking your birth control pills WITH a multivitamin or folate supplement.

Birth Control Pills also deplete B12, Magnesium and other nutrients

Not only is folate depleted, but its partner-in-crime B12 is depleted too.  B12 is also highly involved in the methylation cycle, and again this can be an issue for MTHFR folks (especially those with the related MTRR mutation) as well.  Nutrients to watch when taking birth control include:

  • Folate
  • B12
  • Magnesium
  • Vitamin C
  • B2 – Riboflavin
  • B6 – Pyridoxine
  • Zinc
  • Vitamin E
  • Selenium

Of course for MTHFR folks the folate is the biggest factor, but folate always works in tandem with other B vitamins so make sure you’re getting a good B complex supplement if you do choose to take birth control pills.

Birth Control Pills May Also Affect Serotonin Metabolism

In related bad news, Birth control pills may also affect your Serotonin metabolism (which might also be compromised in MTHFR folks because of this.)  This study, published in the Journal of Ayub Medical College, showed that there was a difference in serotonin levels between non-contraceptive users and oral contraceptive users that was statistically significant in pre-analysis but not statistically significant in post-analysis. That means that although there was a difference in the two groups, it wasn’t large enough that we can say with confidence that it wasn’t chance.  There was, however, a significant difference in serotonin levels for those using injectable contraceptives. Injectable contraceptives are a bad idea on so many levels, but let’s add this as another reason not to use them.

What Type of Contraceptive is Best for MTHFR Mutants?

Completely safe relative to MTHFR mutation types (other risks though – do your research!):

  • Condoms, Female Condoms
  • Copper IUD (non-progesterone secreting)
  • Vasectomy or tubal ligation

If you feel you must take hormonal contraception:

  • Use the lowest dose of hormone possible and make sure you’re adding extra supplements to counteract nutritional deficiencies. Consider Beyaz® but remember if you’re an MTHFR mutant you might still need additional active folate, and it doesn’t supplement any of the other nutrients it depletes so you’ll also need those.
  • Avoid using injections, pellets or implants simply because once they’re in you can’t get them out.  That means if your body doesn’t tolerate it you’re stuck with the side effects until the dose wears off.
  • If you’re considering getting pregnant, please stop all oral contraceptives at least a year before you start to try and make sure you work diligently during that year to boost your levels of all of the nutrients that may have been depleted.

 

PCOS infographic. Because it’s awesome.

I love love LOVE infographics. Seriously. So here’s an awesome PCOS infographic, made by yours truly. Please share this with sisters, mothers, daughters, wives and besties.  Women need to know how common PCOS really is and how many women are struggling but don’t know it. Men should know too – maybe she’s actually doing everything she can but still struggling with weight because there’s an actual medical condition.  Maybe she needs a little more support right now. Send it to your guy friends too, because men you can hand down the tendencies for PCOS to your children and there is growing evidence that men can be affected as well. So pass it on my friends! Pass it on.

PCOS infographic from dramyneuzil.com

PCOS made pretty. Pass it on folks – women need to know.

 

Want to share this on your own website?  Please do!

Link it back to me if you can. Here’s the code:

<iframe width="600" height="2406" frameborder="0" scrolling="no" style="overflow-y:hidden;" src="https://magic.piktochart.com/embed/3914122-pcos-from-dramyneuzilcom"></iframe>

OR:

<div class="piktowrapper-embed" pikto-uid="3914122-pcos-from-dramyneuzilcom" style="height: 300px; position: relative;"><div class="embed-loading-overlay" style="width: 100%; height: 100%; position: absolute; text-align: center;"><img width="60px" alt="Loading..." style="margin-top: 100px" src="https://dramyneuzil.com/wp-content/uploads/2017/02/loading-1.gif"/><p style="margin: 0; padding: 0; font-family: Lato, Helvetica, Arial, sans-serif; font-weight: 600; font-size: 16px">Loading...</p></div><div class="pikto-canvas-wrap"><div class="pikto-canvas"></div></div></div><script>(function(d){var js, id="pikto-embed-js", ref=d.getElementsByTagName("script")[0];if (d.getElementById(id)) { return;}js=d.createElement("script"); js.id=id; js.async=true;js.src="https://magic.piktochart.com/assets/embedding/embed.js";ref.parentNode.insertBefore(js, ref);}(document));</script>

 

Get the Most Benefit from Inositol for PCOS

Inositol for PCOS, or polycystic ovary syndrome,  is one of the best known natural remedies for this condition. Things get a little dicey though when you’re trying to choose a type of inositol and find the right protocol to help your body. Let’s review what inositol is, what it does and what is the best form or forms for you to take to help you the most.

What is Inositol?

Inositol is a naturally-occurring nutrient found in many plant-based foods like oranges and cantaloupe. It used to be considered a vitamin (vitamin B8 to be precise), but an essential component to a nutrient having “vitamin” status is the human inability to produce it ourselves.  When it was discovered that inositol can actually be made in the human body from glucose, it was reclassified. The bulk of inositol from foods is called myo-inositol.  There are many other forms that are significant for health, and they do different things but the other one that is important for PCOS is D-chiro-inositol.  In a completely-unrelated-to-health-but-kind-of-fun aside, inositol is also widely used in explosives (!!) and as a substitute for actual cocaine in TV and movies when they need to show someone snorting something up their nose (!!!)

This explosion is probably not caused by inositol, but it's more interesting than a picture of inositol. Inositol for PCOS is the bomb. See what I did there?

This explosion is probably not caused by inositol, but it’s more interesting than a picture of inositol. Inositol for PCOS is the bomb. See what I did there?

Why Would You Take Inositol for PCOS?

One of the main issues that face women with PCOS is the strong tendency towards insulin resistance or even outright diabetes. According to a 2017 study from the Journal Gynecological Endocrinology, Inositol, at a dose of 4 g (or 4,000 mg) per day has been shown to be as effective at sensitizing the body to insulin as the drug Metformin. This means that by taking inositol you are helping your body to utilize sugars more effectively and so it helps you to lose some of the insulin-related weight and even to normalize your menses.  Inositol is also well known in helping with egg quality and so helps to improve fertility. Inositol also improves ovarian function, reduces testosterone and helps to balance the LH/FSH ratios that are so important for normal ovulation. There are many studies showing all of this, but the best I’ve seen to date is this 2016 review from the International Journal of Endocrinology which compares the effects of myo-inositol and D-chiro-inositol for PCOS.  If the label just says “inositol” it’s myo-inositol.

What Does Myo-Inositol do for PCOS?

Myo-inositol is the form that is most commonly naturally occurring and the form that is most commonly suggested for PCOS. Here’s why according to the awesome review from the International Journal of Endocrinology above:

  • 4g per day is as effective as the pharmaceutical drug Metformin 1500 mg per day in improving insulin sensitivity (see the reference above for the research).
  • With improved insulin sensitivity come improved BMI – this means weight loss
  • Menstrual cycle normalizes with 4 g per day dose in about 50% of the women who take it – that is huge because typically women’s hormones are much trickier than that.
  • Helps to reduce LH and improve LH/FSH ratios which is important for creating healthy eggs and also for healthy ovulation.
  • Myo-inositol helps to reduce total and free testosterone, which is important if you don’t want to be the bearded lady (sadly it doesn’t seem to reduce the hair growth that has already happened. That’s what lasers are for.)
  • Helps balance blood lipids by reducing plasma triglycerides and total cholesterol.
  • Improves ovarian function. Woot woot!




What does D-Chiro-Inositol or DCI Do for PCOS?

D-chiro-inositol or DCI is being studied more recently for its effects on insulin-mediated androgen synthesis (this means excessive testosterone production secondary to high blood sugars). Normally we are supposed to convert myo-inositol to DCI, but some people don’t do this very well (and many of those people have PCOS). The suggested dose is 600 mg for women 130 lbs or under, 600 mg twice per day for women who are over 130 pounds.

  • Improves insulin sensitivity through a different pathway than myo-inositol (by using an IPG mediator).
  • Reduces total and free testosterone through the same mechanism myo-inositol does.
  • Helps those women who can’t convert myo-inostiol to DCI
  • Especially helpful for PCOS if you’re overweight. Not as much if you’re the “skinny” type of PCOS
  • DCI is less effective for women with thyroid disease.

What if I Take Both Types of Inositol for PCOS?

Actually, research is showing this is the best course of action in comparison studies. It’s essentially the most effective scenario because the types of inositol complement each other and you don’t have to rely on your body being able to convert anything.  Studies show:

  • The combination of the two inositol for PCOS gets the same or better blood sugar control, far faster (meaningful change in only 12 weeks for the combo).
  • Restores ovulation
  • Reduces fasting insulin and fasting glucose
  • Decreases LH
  • Decreases free testosterone
  • Increases Estradiol
  • Increases Sex Hormone Binding Globulin (which further reduces the negative effects of testosterone).

So, inositol for PCOS?  That’s a big YES.  Given the effects on ovaries and egg quality (as well as sperm quality for the men) it’s becoming commonly used in fertility treatments too, whether you’ve got PCOS or not.

 



The Best Magnesium Supplement for YOU

One thing you’ll notice about supplements is that everyone is pretty convinced that their product is “THE BEST.” It’s a little hard to believe when every product on the shelf makes the same claim. You would think something like magnesium, which is a mineral, would be pretty straightforward but sadly, no. There is no easy answer as to what is the best kind of magnesium, other than to answer what is the best kind of magnesium for you.

What Is Magnesium Anyway?

Magnesium (Mg) is a mineral that is involved in almost every process in your body from muscle relaxation and proper muscle movement to hormone processing. Clinically it is used to treat muscle cramps, restless leg syndrome, high blood pressure, constipation and chronic stress. Magnesium is pretty much everywhere – it’s the fourth most abundant element in the earth as a whole and the ninth in the universe. Magnesium is also highly water-soluble and is the third most common element dissolved in sea water. Generally, the composition of sea water and the composition of our bodies internal mineral balance is reasonably similar (although sea water is significantly higher in sodium) and, as a human, you function best when you have a rich supply of magnesium in your system. Magnesium is key to all of the energy-forming reactions in every cell in your body and there are over 300 enzyme pathways in humans that are dependent on magnesium.

The best magnesium supplement might just be the one you crave the most.  Chocolate

The best magnesium supplement might just be the one you crave the most. Chocolate

Historically magnesium would have been a much larger part of the human diet for a couple of reasons.  Magnesium is the center of the chlorophyll molecule in plants, so any dark green plant is a rich source. The average person in centuries past would have had a higher proportion of greens in their diet than modern folk tend to.  Also, magnesium is often present in spring water but less likely to be in any quantity in filtered city water. Also, sugar consumption effectively “burns” magnesium, using it to process sugar instead of leaving it available for other bodily functions so modern magnesium usage has changed.




How Do I Find The Best Kind of Magnesium For ME?

Magnesium can’t just be by itself as a molecule – it needs to be bound to something else to be stable, so the biggest difference in different magnesium products comes not from the magnesium itself (which is all the same) but from the molecule it’s bonded to.  The most common bonding agents I’ve seen are oxide, citrate, glycinate, sulphate or amino acid chelate. There are two things to look for about the molecule it’s bonded to: size, and function. There is the secondary consideration of absorption.

The size of the molecule matters because most people don’t want to take a tablespoon of something, they usually want to take a reasonably small amount – like maybe the amount that will fit into one or two capsules.  Magnesium itself is a very small molecule, but if it’s bonded to something large and floppy then you get a very small amount of magnesium, mixed in with a pretty large amount of something else.  So magnesium by weight is higher if it’s bonded to an extremely small molecule (like oxygen in Mg oxide) than if it’s bonded to a large molecule like glycine (in Mg glycinate) or an amino acid (in magnesium amino acid chelate). Citrate and sulphate molecules are somewhat in the middle for size.

Or maybe this is the best magnesium food source? Mmmmm... Coffee...

Or maybe this is the best magnesium food source? Mmmmm… Coffee…

The function of the additional molecule is also something to consider. Oxygen is obviously useful to body tissues, as are amino acids, but some amino acids have functions that may enhance one particular effect of the magnesium that you might be looking for clinically. We’ll go over different forms of magnesium individually.

Magnesium Absorption

Absorption is a separate concern. Magnesium itself is reasonably poorly absorbed (35% absorbed in the worst case scenario and 45% absorbed in the best). Generally if you are magnesium-depleted then your body will absorb any magnesium better than it would otherwise.  Calcium and magnesium compete for absorption, so if you take calcium and magnesium together they will both compete with each other (meaning you will absorb less of each). Also high or low protein intake can reduce magnesium absorption, as can phytates from some vegetables. Generally if you’re taking a magnesium supplement it’s best on an empty stomach. Magnesium also absorbs well through the skin (potentially far better than through the digestive tract), so Epsom salt baths (magnesium sulphate) and magnesium lotions, gels or oils (usually magnesium chloride) can be a great way to increase your body stores. Topical forms can be best if you’re using magnesium for it’s muscle relaxation and calming properties.

Orally, magnesium citrate is the best absorbed form (but it’s bonded to a big molecule so there is a smaller amount of magnesium by weight). Mg oxide is the most poorly absorbed form but has the highest Mg per weight, so actually you may get more elemental magnesium out of the same dose of Mg oxide vs. another magnesium, simply because of the size. The other forms of magnesium are somewhere in the middle in terms of absorption.

What Are The Benefits of Different Types of Magnesium?

Magnesium Oxide (The best magnesium supplement all around and highly cost effective)

Magnesium Oxide (MgO) is simply bonded to oxygen, which is obviously also something your body needs so there is nothing unnecessary in the product. The oxygen is useable by your body but will not strongly affect the way you feel taking the Mg. This is the least absorbed form, but also has one of the highest percentages of elemental magnesium per dose so it still may be the  highest delivered dose per mg. This is a great general purpose magnesium if really Mg is all you need, and it’s typically the least expensive form.  It makes a simple muscle relaxer, nerve tonic and laxative if you take a high dose.

Magnesium Citrate (The best magnesium supplement as a laxative)

This is one of the most common forms of Mg on the commercial market. This is Mg bonded to citric acid, which increases the rate of absorption. Citrate is a larger molecule than the simple oxygen of oxide, so there is less magnesium by weight than in the oxide form. This is the most commonly used form in laxative preparations.

Magnesium Glycinate and Magnesium Amino Acid Chelate (The best magnesium supplement for mental relaxation)

In this form, Mg is bonded to the amino acid glycine. Glycine is a large molecule so there is less magnesium by weight, but the glycine itself is a relaxing neurotransmitter and so enhances magnesium’s natural relaxation properties. This could be the best form if you’re using it for mental calm and relaxation. In general because the glycine or amino acids are large, it’s best to take a higher dose or dose more frequently with these products. Magnesium amino acid chelate is usually bonded to a variety of amino acids, which are all larger molecules. In this form there is less magnesium by weight but the individual amino acids could all be beneficial for different things. Every formula is different so if you need both Mg and a particular amino acid, then this could be the way to go.

Magnesium Taurate (The best magnesium for heart health)

This is a less common form, and is typically taken for cardiac conditions and heart function in general. Magnesium helps the heart muscle relax, as well as the blood vessels that feed the heart to open and deliver more blood to the heart tissue itself, which can be helpful in angina – especially exercise-induced angina. Taurine is an amino acid that is known to feed cardiac muscle and enhance the quality of contractions of the heart so if you’re taking Mg for heart function this is probably the best form for you. Again, taurine is a larger molecule so there is a lower Mg by weight and effective dosing might need to be higher or more frequent.

Magnesium Sulphate and Magnesium Chloride (The best magnesium supplement *topically for muscle cramps and restless legs)

These forms are both typically used topically, although there are some oral preparations as well. Mg sulphate is best known as Epsom salts. If you’ve taken this internally you know it tastes horrible and has a very strong laxative effect, but when used in a bath or soak it is extremely relaxing to the muscles and can ease aches and pains. Epsom salts baths can also help to lower high blood pressure and reduce stress levels. Magnesium chloride is more common in the lotion, gel and oil preparations that can be used topically for muscle cramps and relaxation.

Magnesium L-Threonate (The best magnesium for brain health, Alzheimer’s and cognitive decline)

Magnesium L-threonate A newer player on the magnesium front is magnesium threonate, or magnesium L-threonate. This form effectively crosses the blood brain barrier and so has recently been studied for uses such as patients with Alzheimer’s disease and other forms of cognitive decline.  A recent research study published in the medical journal Neuron showed that magnesiumthreonate creates improvement in learning abilities, working memory and both short and long term memory.  Additionally it has the same benefits as any other magnesium including enhancing sleep quality.

Also a notable food source of magnesium, and probably the one  I should mention first, but chocolate.

Also a notable food source of magnesium, and probably the one I should mention first, but chocolate.

The Best Food Sources of Magnesium

In what amounts to the best news of the day, magnesium is present in high quantity in some of our most craved foods, including chocolate (thank the gods) and coffee. The question then, is do we crave these foods so much because they’re great sources of magnesium?  Possibly. Magnesium helps modulate women’s hormones and chocolate and PMS certainly go together so maybe we’re on to something here (or maybe it’s just that chocolate is awesome.) It’s true that fewer of us are blessed with kale cravings – so maybe the magnesium isn’t the point. Other great dietary sources include tea, spices, nuts and, of course, green vegetables with chlorophyll. Good body stores of magnesium will improve your health, mood and general functioning so finding the best kind of magnesium for you is tremendously important.



MTHFR Basics Podcast

This week I had the lovely opportunity to be on Blog Talk Radio with Erin Chamerlik, The Real Food Revivalist- see getbetterwellness.com. Her listeners wanted to know a little bit more about MTHFR mutation.  You can listen to the recording here:

MTHFR Basics Podcast with Dr. Amy Neuzil, ND on The Real Food Revivalist Show

Tune in now to listen to this MTHFR basics podcast.

Tune in now to listen to this MTHFR basics podcast.

Listen for answers to questions like:

  • What is the MTHFR mutation?
  • Is it Common?
  • What are the implications for fertility and mood?
  • What sort of testing is available for MTHFR?
  • How do you start supplementing with 5-LMTHF?
  • Doesn’t this have to do with detoxification too?

 



I hope you enjoy this free podcast and if you have any questions for me please feel free to post them as comments. 🙂



I Have MTHFR A1298C Mutation – What Does That Really Mean?

MTHFR mutations are just starting to be recognized as an issue and so more and more doctors are testing, but what happens if your doctor tells you that you’re homozygous for MTHFR A1298C? They might as well be speaking Greek! So here’s the skinny on what that really means. Also here’s a post about MTHFR mutation basic in general.

MTHFR A1298C Terminology Basics (or as basic as we’re going to get with genetics).

The simplest level of information here is just the plain genetics.  Here are some quick factoids to get us started:

  • MTHFR is the short name for the genes that code for the enzyme that changes folic acid to the active form that your body uses (the long name is methylfolate reductace).
  • 1298 is the marker for one particular MTHFR gene.
  • The official genetics labeling of this gene is Rs1801131. Sigh.
  • You get one copy of this gene from your mother and one from your father, so there are two possible copies that can be either “normal” or “mutant”
  • If you inherited one good copy and one bad copy that’s called “heterozygous A1298C”
  • If you inherited two bad copies (one from each parent) that’s called “homozygous A1298C”
  • A…C stand for the bases that you actually have.  A = adenine C = cytosine.  Bases are essentially the letters that spell out your genetic code.  There are four of them commonly (C, T, A and G).
  • When this gene is “normal”or “wild type” (I love that name) it looks like MTHFR A1298A.
  • Heterozygous mutations (one good copy and one bad) are MTHFR A1298C because there is one normal A and one abnormal C Also occasionally written 1298AC.
  • Homozygous A1298C (two bad copies) can also be written as C1298C (because there are two abnormal copies with C instead of A). Occasionally you’ll also see it written 1298CC

Phew! So the take-away there is MTHFR A1298C means you have at least one bad copy of this gene, and if it’s called homozygous, or C1298C then you have two bad copies.

How Much of a Problem Is This?

The MTHFR A1298C mutation is considered less serious than the C677T mutation because it seems to cause less impairment to actual methylation function than C677T.  That doesn’t in any way mean that it isn’t an issue. This mutation can still be a significant problem If you don’t have a good diet, don’t take supplements or burden your body with a lot of stressors like smoking, alcohol, drugs, sedentary lifestyle or high stress. If you get lots of dark green leafy veggies, legumes and other food sources of natural folate – see this post – then you’re probably already getting good methylfolate. If your diet isn’t up to scratch, then supplementation can be useful and here’s a whole post about that.

Heterozygous MTHFR A1298C is thought to have mostly normal MTHFR activity  and homozygous MTHFR A1298C (C1298C) have about 65% normal activity (so 35% compromise). Normal activity refers to the way your body converts folic acid to 5-L-methyltetrahydrafolate (the active form) so that it can be used. Compromise in this case looks like a folate deficiency.

What Are The Health Risks of MTHFR A1298C Mutation?

According to SNPedia, which compiles research on genetics, A1298C mutants have been shown in at least one research study to have an increased risk for:

  • Midline defects such as:
    • Cleft lip
    • Cleft palate
    • Neural tube defects
    • Facial asymmetries
  • Cancers including:
    • Breast
    • Lung
    • Brain
    • Stomach
    • Head and neck
    • Kidney
  • Cardiac-related issues including:
    • Thrombosis (increased tendency to clot inappropriately)
    • High homocysteine levels (a heart risk)
    • Pre-eclampsia (dangerous high blood pressure in pregnancy)
    • Vascular dementia
  • Fertility issues including:
    • Multiple pregnancy loss
    • Low sperm count
    • Birth defects such as down syndrome
  • Neurological issues including:
    • Migraines
    • Autism
    • Alzheimer’s dementia
  • Mood and psychological issues including:
    • Depression
    • Anxiety
    • Schizophrenia

You’ll notice that this is quite a list, and it can be a little daunting to think about when you’re just learning about this. Most research doesn’t differentiate between the A1298C genetic variance and the C677T genetic variance so the list is the same for both mutations.  We assume the risk is lower with A1298C because the folate metabolism is less strongly impaired, but that might not be correct.

What Do You Do About This?

Compromise with the MTHFR A1298C gene can have severe consequences so it’s important to work on getting good sources of natural folate from foods, which is generally useable by mutants, or 5-MTHF (5-methyltetrahydrofolate) which is already methylated so the genetic compromise doesn’t matter.  As discussed in this article, I feel supplementation should be started slowly because for many mutants who haven’t had active folate very much in their lives it feels really strange when those active forms start showing up.  There can be quite an adjustment reaction  by your body.

Activated folate is used by your body to run enzyme pathways, to aid in some parts of normal metabolism, to help your body detoxify and even to methylate your DNA. The methylation cycle is also a big part of neurotransmitter manufacture, which explains the strong link to depression, anxiety, and mental disorders including addictions and even schizophrenia. If 5-Methylfolate  isn’t there then your body does maintains those functions as best it can, but the things your body can’t do start to pile up. Starting supplementation means your body can start digging in that pile to clear up high priority items.  This is exactly what we want, but if you start with high doses of a supplement then it’s a little like drinking from the firehose.  Kind of out of control and not very pleasant.

A great way to start if you’re unsure, is with a folate-rich diet.  I love this image because it kind of covers what we’re looking for.  Hint – think dark greens and beans. 🙂




Is folate in foods safe in MTHFR mutants? In these foods YES! For MTHFR C677T or MTHFR A1298C mutants. Thanks to exhibithealth.com for the great image.

Is folate in foods safe in MTHFR mutants? In these foods YES! For MTHFR C677T or MTHFR A1298C mutants. Thanks to exhibithealth.com for the great image.

Can Mutants Become “Normal”?

If you’re a mutant (like me) then you’ll always be a mutant, but it doesn’t have to matter. Essentially as long as you’re getting enough of the active form of folate and taking care of yourself for the other consequences of the MTHFR mutation then the mutation doesn’t have to matter.  If you aren’t taking care of yourself, then it matters a lot.

The bottom line is MTHFR A1298C mutations don’t have to mean anything at all as long as you supplement and have a good diet and lifestyle (here’s an article about a folate-rich diet for MTHFR mutants) I always suggest taking a little more care with yourself too.  There are known health risks for things like clotting, fertility and cancers so it makes sense to take some precautions.  Eat your fiber, do your exercises, get your sleep and generally treat yourself with high regard – shouldn’t we all anyway?



Gallbladder Sludge in Pregnancy – What Now?

Go figure that pregnancy with all of it’s rapidly and vastly changing hormones is one of the most common triggers for gallbladder sludge, and it’s also one of the hardest times to do anything about it. Let’s look at why it happens and what you can do about it. If you’re unclear about what the gallbladder does, and what sludge is then read this post first.

Symptoms of Gallbladder Sludge in Pregnancy

Gallbladder can cause a wide range of issues ranging from mild to severe, but any issue is worth discussing with your doctor because untreated disease can lead to complications for the pregnancy. Symptoms include:

  • Itching – on belly, palms and soles or all over. This can happen with or without a rash. If it’s serious, go to your doctor.
  • Right sided digestive pain – at the bottom of your rib cage on the R side or radiating into the R shoulder blade, R shoulder or even L shoulder blade.
  • Gas
  • Bloating
  • Digestive discomfort
  • Diarrhea
  • Constipation

Why is Gallbladder Sludge So Common in Pregnancy?

Gallbladder sludge essentially happens when your gallbladder is overwhelmed by too much cholesterol and not enough bile.  You’ll recall that the bile acts as kind of a “soap” to emulsify fats and make them more water soluble so that they can be both excreted and absorbed in the digestive tract. Just like with dish soap, if there is too much fat or grease and not enough soap you get a sludgy goo that tends to stick to everything and generally get in the way. Hence gallbladder sludge. But why does this happen in pregnancy? Many reasons:

  • Huge hormone shifts – Rapid changes in hormone levels mean that lots of hormones (fat soluble) are being excreted by the liver, and fat soluble toxins are excreted via bile. In fact, below are pictures of a cholesterol molecule and an estrogen molecule – no doubt you’ll notice the similarities (and estrogen along with the other sex hormones is made in your body from cholesterol).

    Estrogen and testosterone (progesterone as well, but it's not pictured) are incredibly similar to cholesterol, which is why gallbladder sludge in pregnancy is such an issue.

    Estrogen and testosterone (progesterone as well, but it’s not pictured) are incredibly similar to cholesterol, which is why gallbladder sludge in pregnancy is such an issue.

  • High Water Use – Pregnancy uses a lot of water – your body is building a human and that’s no small task. It requires that you also create lots of extra blood, extra fluid to protect and support the baby and of course, all the water that goes into the baby.  Not only that but there are thousands of extra metabolic processes happening to make all of this go.  It’s just a big time for water, and so mild to moderate dehydration is incredibly common – especially in early pregnancy before mama’s intake has adjusted sufficiently to cover it all.  Dehydration is also a risk factor for gallbladder sludge just because all bodily fluids, including bile, get a little thicker and sludgier if there is less water to go around.
  • Estrogen – High estrogen is a risk factor for gallbladder sludge, or cholestasis, independent of pregnancy as well (at least it is in animal studies). In fact, the risk factors for gallstones are called the five F’s – Fair, Female, Fat Fertile and Forty. Lovely.
  • Genetics – There are some genetic conditions associated with gallbladder sludge (more specifically with Intrahepatic Cholestasis of Pregnancy, or ICP). So chances are if your mother, aunties, sisters or grandmother had troubles, you may be at greater risk.

Are There Natural Ways to Help Gallbladder Sludge in Pregnancy?

Yes and no. Pregnancy is a risky time to use any natural or medical treatment and many drugs and supplements are off limits because they may cause harm to the baby. If you’re not pregnant, then here’s a whole post about gallbladder sludge and stones. If you are, then here are the things you can do:

  • Diet – Pregnancy is a great time for a healthy diet anyway, so might as well do a healthy gallbladder-friendly diet. This means:
    • No fried foods
    • Lots of fruits
    • Limited red meat, butter, shellfish and eggs
    • LOTS of veggies – especially dark green leafy veg
    • Good lean meat, poultry and fish
    • High fiber foods – aim for 30 – 50 g per day – some examples below
      • Split peas – 16.3 g per cup cooked (split pea soup. Yummy.)
      • Lentils – 15.6 g per cup cooked
      • Black beans – 15 g per cup cooked
      • Artichokes – 10.3 g each and also gently boost liver function
      • Broccoli – 5.3 g per cup boiled
      • Raspberries – the yummiest 8 g per cup ever
      • Bran flakes – 7 g per cup
      • Avocado – 12 g each



  • Water – Bump the water WAY up. Aim for 12 eight ounce cups with 8 eight ounce cups being the absolute minimum. This will suck because pregnancy makes you pee all the time anyway and drinking this much water will have you running to the bathroom constantly. Sorry! It’s better than a gallbladder attack, believe me.
  • Lecithin – Lecithin is safe in both pregnancy and nursing because as it turns out, one of it’s major ingredients, choline, is great for baby. Typically midwives and doctors suggest 1200 mg 3-4 times per day with lots of water, but here’s more information about lecithin and it’s use in gallbladder issues. It’s also great for blocked ducts when you’re nursing and gallbladder sludge even when you’re not preggers.
  • Gentle Exercise Regularly – Exercise is good for everything in the human body, including the gallbladder. For many women this will actually eliminate mild symptoms.
  • Castor Oil – Topical (NOT INTERNAL) castor oil over the right side of your abdomen and back can help your body to deal with some of the sludge in a gentle way. Here’s a whole post on it with more detailed information. And Here’s info on a great lazy method of doing a castor oil pack. This is both anti-inflammatory and also good for the functioning of the liver and gallbladder.
  • Lukewarm Epsom Salts Baths – The magnesium in the Epsom salts will help to relax the bile duct and allow sludge to pass more easily, and the lukewarm bath can help to relieve the itching.

    Doing all of this in 9 months isn't easy! Great picture from free image.com/Jose Torres.

    Doing all of this in 9 months isn’t easy! Gallbladder is one of the places that fallout can happen. Great picture from free image.com/Jose Torres.

What About Not-Natural Ways to Relieve Gallbladder Sludge in Pregnancy?

If you’re having gallbladder attacks on top of the already uncomfortable state of being pregnant, then sometimes you want a faster option. Also severe gallbladder attacks with protracted vomiting, inflammation or infection can be a serious risk to your baby, so there’s that too.

  • Ursodiol – this prescription drug may be suggested by your doctor to help manage symptoms and increase bile flow.
  • Surgery – It is possible to have your gallbladder removed during pregnancy and sometimes it’s necessary. The second trimester is considered the safest time for both mother and baby to undergo this procedure. Depending on your doctor they  may suggest laparoscopic removal or open gallbladder surgery.

Remember pregnancy is a rough time anyway because your body is doing so much, changing so fast and generally working so hard. Be gentle with yourself, talk with your doctor, and don’t judge – sometimes you can use the natural methods for working with gallbladder sludge in pregnancy and sometimes you really do need something more intense, like surgery.



Seed Cycling and Pregnancy Before, During and After.

Seed cycling is a gentle way to re-establish normal hormonal rhythms for women, but many people have questions about what to do around seed cycling and pregnancy.  If you’re unfamiliar with the idea of seed cycling you can read about the basics here and I’ll add a visual how-to before we get started. Here are some thoughts.

Seed Cycling for hormone balance adds seeds into your diet following the rhythm of your body or the moon. Seed cycling and pregnancy are a natural fit.

Seed Cycling for hormone balance adds seeds into your diet following the rhythm of your body or the moon. Seed cycling and pregnancy are a natural fit.


Seed Cycling and Pre-Pregnancy Fertility Boost

Naturally, anything that helps to normalize your cycle will ultimately boost fertility so seed cycling and pregnancy go hand-in-hand.  In preparing for pregnancy your body is trying to create a soft landing space for a fertilized egg, a cushy spot to settle down and take nourishment. That cushy spot is created via the hormones – estrogen to thicken the uterine lining (in the first half of the cycle) and progesterone to ripen that lining and make it ultimately inhabitable for a fertile egg.  Both halves of the woman’s cycle need to be strong for this to occur and seed cycling helps to encourage that balance.  Days 1 (the first day of your period) through day 14 (when you ovulate) are called the follicular phase. They are building uterine lining and also ripening a strong egg. The flax and pumpkin seeds that you take during those days help to bring healthy estrogen levels while blocking conversion to unhelpful androgenic hormones like DHT.

Day 14 and the window around that time (24-48 hours) is your fertile time – the time when you are most likely to conceive.  Strong ovulations need a healthy estrogen spike nurtured by the hormone balance achieved in Days 1-14.

After ovulation through the rest of your cycle is called the luteal phase and is dominated by the hormone progesterone, which is encouraged by the combination of sunflower and sesame seeds. Progesterone is released by the pocket on the ovary out of which that month’s fertile egg came, called the corpus luteum. If the egg is successfully fertilized (meaning you get pregnant) then progesterone levels must stay elevated to help the egg to implant into the uterus and to prevent your body from flushing out the uterine lining (to prevent your next period).

Encouraging good progesterone levels is, in fact, one of the most important factors in keeping viable early pregnancies, especially in older women who are trying to get pregnant or women who have unbalanced hormone pictures that are shifted towards estrogen (like PCOS, endometriosis, and many cases of multiple pregnancy loss). Happily in the implanting days, women who are seed cycling are already encouraging progesterone with the sunflower seed and sesame combination.  But what to do when you find out you are pregnant?  That depends very much on you.

Seed Cycling and Pregnancy

Once women become pregnant seeds in your diet can still be highly supportive, but it helps to have some idea of your hormone balance beforehand, and the “cycle” of menstruating is no longer happening.  In fact, hormonally pregnancy becomes almost a hyper-extension of the luteal phase.

Progesterone in Luteal phase:  1 – 28 ng/ml. Average is 10-15
Progesterone in First Trimester: 9 – 47 ng/ml
Progesterone in Second Trimester: 17 – 146 ng/ml
Progesterone in Third Trimester: 49 – 300 ng.ml

As you can see, progesterone levels are on the rise throughout the entire pregnancy and logically to support that some women take the theory that they should continue the luteal phase seeds – sesame and sunflower.  Others feel that all the seeds provide support and so choose to do steady amounts of all seeds on a consistent basis.

*One good tip to remember* If you’re trying to get pregnant it’s important to continue the luteal-phase seeds (sesame/sunflower) until you actually have a period, just in case you are pregnant that month. This gives the egg the best chance at implantation.

Women who have a history of estrogen dominance,  repeated miscarriages, or are “advanced maternal age”:

For these women, progesterone support can help to keep the pregnancy viable and often prescription progesterone is given.  Seeds can help as well. Women in this category can use all sunflower/sesame through the pregnancy or a 2:1 ratio of sunflower and sesame: flax and pumpkin.  These seeds are not a substitute for prescription progesterone, but they can be safely used in combination with prescription progesterone. I personally feel that all the seeds are supportive and so taking all of them each day during pregnancy gives the biggest nutritional boost. In this case, a good mix would be:

2 tbsp sunflower seeds
2 tbsp sesame seeds
1 tbsp flax seeds
1 tbsp pumpkin seeds

Young women with typically balanced hormones and normal pregnancy history:

Although pregnancy is still a higher progesterone time, women who have healthy balanced hormones should have no problem maintaining the progesterone levels needed. In these cases, equal amounts of all seeds can be used or the ratios can be weighted towards sunflower/sesame if that is your choice. So:

1 – 2 tbsp sunflower seeds
1 – 2 tbsp sesame seeds
1 tbsp flax seeds
1 tbsp pumpkin seeds

This can be continued through the entire pregnancy as well as the early months of nursing (up to about 6 months post-partum). This seems to help many women soften the post-partum emotional changes that can occur because of the huge hormone nose-dive.

Seed Cycling for Post-Pregnancy Restoration of Cycle

After delivery, some women have a hard time with the sharp drop of progesterone that happens along with the normalization of estrogen levels. Continuing the steady doses of seeds suggested in the pregnancy section can help to smooth out some of the rough edges, but there will come a time when your body moves more towards re-establishing its normal rhythm. Some women have a sense of this, whether it’s from changing the nursing habits of their baby to hormonal symptoms like skin changes and some women really don’t feel it happening until they get their first cycle.  If you start to feel changes then I typically suggest re-starting seed cycling then according to the lunar phase. If you don’t particularly feel anything then around 6-9 months or when your baby really starts to be interested in solid foods you can restart (also according to lunar phase).  If your body surprises you with your first period out of the blue, then start seed cycling using day 1 of that cycle as your starting place.

In every phase of pre-, during, and post- pregnancy, make sure that your maternity care team and doctors are aware of your seed cycling routine and that they don’t have any concerns for your particular pregnancy. Seed cycling during pregnancy is generally easy and supportive, but may not be right for you so always check with your doctor.