The Dr. Hyman Show - Fertility in Crisis: Exploring the Toxic Threats to Fertility and the Rise in Infertility

Episode Date: April 26, 2024

View the Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal Infertility is a significant challenge for many couples, with statistics now showing that one in six couples face difficulties conceiving. What was previously perceived primarily as a woman's issue is now recognized as a shared concern between partners. In today’s episode, we'll explore the factors in our modern environment contributing to this growing problem. In this episode, we’ll explore what’s driving this infertility epidemic and a step-by-step Functional Medicine protocol for correcting hormonal imbalances and elevating overall health through targeted dietary choices, lifestyle changes, and the strategic use of supplements. Tune in for a comprehensive approach to addressing infertility from the inside out. In this episode, I discuss: The fertility crisis (4:03) Top drivers of the global decline in fertility (7:01) How sugar can cause hormonal imbalances (7:36) Chronic inflammation and trouble conceiving (9:46) The role of the gut microbiome (12:50) Conventional Medicine fails to get to the root cause of infertility (17:12) The Functional Medicine approach to infertility (19:33) The importance of testing and correcting nutrient deficiencies (20:21) Hormones to test and why (26:59) Step-by-step protocol to support fertility (34:32) Choosing the right prenatal supplement (44:59) This episode is brought to you by AG1, Momentous, and Cymbiotika. Get your daily serving of vitamins, minerals, adaptogens, and more with AG1. Head to DrinkAG1.com/Hyman and get a year’s worth of D3 and 5 Travel Packs for FREE with your first order. Head over to LiveMomentous.com/Mark for 20% off creatine, collagen, and all of their best-in-class products. Upgrade your supplement routine with Cymbiotika. Get 20% off with free shipping on all orders. Head to Cymbiotika.com and use code HYMAN.

Coming up on this episode of The Doctor's Pharmacy. Why has there been declining female fertility? So the very seed of a new life is being damaged by your diet, and we're going to talk about that. What's causing this global decline in fertility? Let's get into it. Hey everyone, it's Dr. Mark here. When you're overtired, it's super easy to start defaulting to caffeine

to get you through the day. But that just masks the symptoms of why you're tired, and it can make things worse in the long run. So if you regularly lean on caffeine, I got a better solution for you. AG1. AG1 is a science-driven formula of ingredients that supports your body's foundational needs, which means you'll be able to reduce your caffeine intake while feeling less tired throughout the day. I drink AG1 every day and ever since I started, I've consistently felt better and had more energy. I just add a scoop to my water in the morning and I feel the effects all day long. We have an exciting new offer for my listeners.

Right now, AG1 is offering my audience a full year supply of their Vitamin D3 K2 Liquid Formula free with your first purchase. They're also going to give you five free travel packs as well. Just go to drinkag1.com forward slash hymen to get your free supply for a year of vitamin D3 and K2 and five free travel packs with your first purchase. Again, that's drinkag1.com forward slash hymen. Now a good diet is foundational to living a long healthy life, but because our food just isn't as nutritious as it once was, most of us have to supplement to get all the vitamins and minerals we need. Unfortunately, finding a high quality, no filler supplement used to be a real challenge, but not anymore. That's why I chose Momentous. Their supplements are developed in collaboration with leading experts like Andrew Huberman and Andy Galpin, and are used by 90% of the teams in the NFL, as well as

nearly 200 pro and college locker rooms. They're also committed to rigorous third-party testing and independent certification, which means the ingredients on the label are in the product and that's it. With no fillers or additives and with Momentous, what you see is what you get. I take Momentous Collagen and Creatine daily, two supplements that work together to repair and power my body.

Momentous Collagen is a clinically researched formula that delivers 15 grams of collagen in support of type one, two, and three collagen in the body. Momentous Creatine uses creatine monohydrate, the gold standard in creatine supplementation. So if you're like me and you want to take supplements that are made by and used by the best in the world, go to libmomentous.com forward slash mark for 20% off creatine, collagen, and all their best in class products. That's libmomentous.com, L-I-B-E-M-O-M-E-N-T-O-U-S.com, full-size mark for 20% off.

Welcome to The Doctor's Pharmacy. I'm Dr. Mark Hyman, and welcome to another episode of Health Bytes, where we take a deeper bite into juicy topics. And today, we're diving into the problem of infertility. Now, chances are you or somebody you know has dealt with or knows somebody who's dealt with fertility issues. In fact, one in six couples worldwide experience infertility. What was once rare in humans is now very common.

And so what's happened to create such an uphill battle for couples? And why have we become so increasingly reliant on expensive and invasive treatments such as in vitro fertilization? Well, the answer, my friends, lies in our modern day food system, our toxic environment, and our westernized lifestyle. From our ultra processed diet to our sedentary lifestyle, to nutrient deficiencies, to too much stress and overload of toxic chemicals, an explosion of chronic disease, and lots more, we live in an environment that's rife with challenges, making conception more difficult than ever before. In today's episode, we're diving into what's driving this epidemic of infertility and how we can use the power of functional medicine to take a proactive approach using diet and lifestyle

that will often work without the need for expensive and emotionally exhausting infertility treatments. Now, for some couples, that may be necessary, but for many, they can be avoided. We're going to talk about the role of diet and treating the root causes of infertility for both men and women. And yes, you guys carry 50% of the weight. I work with many women and couples and help them conceive without the need for fertility specialists using the foundational principles of health optimization that form the basis of functional medicine.

So let's dive in. Why does this matter? Well, we're facing an epidemic of inflammation. It's driving hormone imbalances and infertility. Infertility is hitting record lows. Couples are struggling to conceive today. One in six couples, as I mentioned, is infertile. That's 17.5% of the global adult population.

12% of women between the ages of 15 and 14 struggle with infertility, affecting over 7 million American women. One in four women will experience some miscarriage or pregnancy loss. And the global decline in fertility rates to just above replacement levels is kind of scary, meaning we're not replacing the population. And this is in part driven by socioeconomic factors, women working and other factors. But I think it's in large part due to long-term consequences that are driven by inflammation and hormone imbalances that result from poor diet, our imbalanced

lifestyle, from endocrine disrupting chemicals, and from chronic disease. And we're going to get into all that today and what to do about it, why it's causing a problem, what the science shows. And by the way, friends, all of the references, all the science I'm talking about in today's episode is in the show notes. So you want to dive in deep, you want to look at the science yourself, go ahead. Why has there been declining female fertility? Well, there's a number of reasons. A diet is a big factor. And one of the big dietary factors that's driving infertility, something called PCOS or polycystic ovarian syndrome. And this

is a condition that's not really an ovarian problem. It's related to insulin resistance or prediabetes. And when women get insulin resistance because of our high starch and sugar diet, it leads to a whole host of problems. And the primary factor that is going on in people with PCOS is anovulation, meaning you have a cycle, but you don't ovulate. So when you don't ovulate, you can't get pregnant and that causes infertility. And this affects 8 to 13% of women of reproductive age. It's not something most of them know they have. Up to 70% of women are not diagnosed. And it's mostly a dietary problem. Now, there's some other factors for sure. There's endocrine

disrupting chemicals, but it's primarily a dietary problem that's caused by insulin resistance from our high starch and sugar diet. Another big factor that's on the rise is something called endometriosis, another cause of infertility. It affects roughly 10% of women, about 190 million women globally of reproductive age. It's a lot of women and girls. And it's an inflammatory disorder that actually some are now considering to be autoimmune. And we'll talk about what to do about that. Not only women are affected, but we're also seeing declining male fertility. Women tend to get all the blame for trouble conceiving, but it's not true. Men contribute to 50% of conception rates, miscarriages, and infertility cases.

So sperm count is a problem. It's been declining at an accelerating rate, about 2.64% a year. And that's more than doubled since the 1970s. A man today has nearly 60% less sperm than his grandfather had. Think about that. Current projections suggest that sperm counts, if we see the current rates, which I don't think will go to zero, but that sperm counts could reach zero by 2045 if nothing is done to improve the status of men's health. So that's a scary thought. What's causing this global decline in fertility? Let's get into it. First and foremost,

it's our diet. It's our poor diet and the metabolic dysfunction that's driving this infertility epidemic. 93.2% of Americans have some level of metabolic dysfunction, meaning they were on somewhere in the spectrum from insulin resistance to prediabetes to type two diabetes. And this is the thing that screws up both men and women's fertility. Now, sex hormones are regulated by our diet. You may not have known that, but sex hormones are directly regulated by what you eat. And pretty much everything is regulated by what you eat if you don't know by now listening to me. Ultra processed foods and sugar and starch are causing massive shifts in our sex hormones. And that's driving the infertility crisis. Our SAD

diet or standard American diet is 60% or more from ultra processed foods. The average American consumes anywhere you look at it from 113 to 150 pounds of sugar and about the same amount of flour every year per person. That's almost a pound a day of sugar and flour per person. And that is not something we're used to eating. That's a pharmacologic dose of sugar that's causing dramatic hormonal shifts in our biology. Spiking sugar leads to high insulin levels. That leads to insulin resistance. And then we get blood sugar and hormone imbalances as a result. So what happens?

What is the biology here for women? Let's talk about it. It's a little bit different for men and women. When women have high sugar and starch, it drives the insulin. That leads to increased androgen production. Androgens are testosterone. That leads to free testosterone being increased. And that will lead to all sorts of problems like PCOS, for example, which causes irregular, painful, heavy periods,

or clotting, heavy bleeding, weight gain, hair loss on your head, hair growth on your face, acne, lack of ovulation, as we mentioned. And so this is really not a fun problem to have for women, but it's often solvable by addressing the root causes of diet and lifestyle. Endometriosis is another factor we talked about that can be driven, but not necessarily by the high sugar diet. Although there's some evidence that this is an autoimmune disease, which can be caused by leaky gut and other drivers of inflammation caused by our diet. Now, what happens with men when they have too much starch and sugar? Well, they get insulin resistance and that leads to the opposite,

leads to low testosterone levels in men. That leads to damage to their blood vessels because of the insulin resistance that causes inflammation and blood vessels are needed to have good erection so they get erectile dysfunction. And it also, because of low testosterone, affects sperm quality. And what's even worse, when they gain body fat as a result of insulin resistance they make more estrogen because there's an enzyme in your fat tissue called aromatase that converts testosterone to estrogen so that's really bad as you get higher body fat they lose the hair on their bodies and they have low sex drive low sex function low fertility low sperm count and the list goes on so when you have this higher body

fat you get all these problems and that leads to more inflammation. And then more inflammation for men and women leads to more infertility, more endometriosis, more PCOS. Whereas pregnancy outcomes, even if you're using IVF or advanced fertility treatments, ovulation problems, as I mentioned, you get poor quality of eggs and sperm. So the very seed of a new life is being damaged by your diet. And we're going to talk about that. This can also lead to miscarriages or inflammation can lead to that and also birth defects. So all around our toxic diet, lifestyle and environmental toxins are driving so much of these problems. As I mentioned, inflammation is a big driver in fertility. So what's causing inflammation? Of course, inflammation, as you know, listening to me forever, driving almost

every known chronic disease, heart disease, diabetes, cancer, dementia, autoimmune diseases, the list goes on, depression. And it's not just driving those things, it's driving fertility issues, right? So it's our processed sad diet, it's excess sugar, it's the insulin resistance that results, the blood sugar imbalances, the chronic diseases that result, type 2 diabetes, obesity, and damage to our gut microbiome. We're going to talk about how the gut microbiome plays a big role in hormones and fertility, at least a leaky gut. Also, our sea of environmental toxins is not good for our hormones. The sea of industrial chemicals and pollutants, sometimes latent infections can cause inflammation, but those are the main causes. And then we also see damage to our mitochondria because anything that causes inflammation will affect our energy production.

And energy production is essential for every factor of life, including healthy sperm and eggs. So we need healthy mitochondria to have healthy sperm and eggs. It's our energy factories. It's involved in ATP production. And ATP is the energy. It's the gas. So sperm have to swim, right? Eggs have to grow mature.

That takes energy. And we lose energy. And that leads to more fertility issues. After fertilization, if you're lucky enough to have a fertilized embryo, then the embryo has mitochondria from the mother and that's good. If you don't have healthy mitochondria from our diet and from toxins and so forth, we can't have proper embryonic development. We can't have proper cell division and differentiation, which is necessary for the developing fetus to grow into a healthy baby. Also, sex hormone synthesis takes place in the mitochondria.

So poor mitochondrial function is connected to hormone balance. The estrogen and progesterone are produced in special cells inside the ovaries. And these cells require mitochondria functioning at a good level to do this. Testosterone is also produced in cells called the lytic cells, which contain a lot of mitochondria. Those are your testicles. And that is necessary for producing testosterone. So you can see the whole hormone production cycle requires energy, and we do a lot of things that cause mitochondrial dysfunction. Again,

our poor diet, it's all the same stuff, right? It's not like different things causing different problems. It's all the same stuff. It's our diet, nutrition, lack of exercise, insulin resistance, inflammation from all the causes, oxidative stress, chronic diseases, environmental toxins, all these things, aging, will affect the quality of sperm and egg. Microbiome, another big factor in causing infertility. Again, these things are not addressed. Think about it. Who's addressing mitochondria? Who's addressing inflammation? Who's addressing the issues around microbiome when it comes to fertility? These are not things you're going to hear about when you go to your fertility specialist, but they're critically important in providing the right

environment for having a healthy baby. So what does problems in your microbiome cause? Dysbiosis, that's imbalances in the flora, that's bad bugs. Symbiosis is good bug, good balance, right? Dysbiosis is bad, bad influences. And this influences inflammation and causes inflammation throughout the body, including your reproductive organs. It can cause even other things like obesity. Even having bad bugs in your gut can make you gain weight. And this negatively impacts the microbiome. It causes ovarian inflammation.

It affects the gene expression in your eggs. It causes poor egg quality. The dysbiosis also affects estrogen levels. One of the things we see, and this is really important, is that your gut microbiome plays a role in regulating estrogen levels. One of the things we see, and this is really important, is that your gut microbiome plays a role in regulating estrogen levels. And often when you have high estrogen levels, it causes something called estrogen imbalance or estrogen dominance, where you have too much estrogen, not enough progesterone. And that is often found in PCOS. And when you have certain bad bugs in your gut that produce an enzyme called beta-glucuronidase,

a little technical here, but I'll explain it. What happens is that enzyme takes the estrogen that you excrete from your liver that's already packaged and ready to be pooped out and unpacks it. That enzyme cleaves the estrogen from its basically carrier molecule. Then estrogen becomes free in your gut and you reabsorb it into the body, into the intestinal circulation. And then it goes into your body, creating higher levels of estrogen, leading to more estrogen dominance and hormone imbalances. And then other problems like estrogen related cancers, breast cancer, ovarian cancer, uterine cancer, endometriosis,

worsens PMS, worsens pregnancy complications. When you look at the data, actually probiotics can be very helpful in improving pregnancy outcomes and even IVF outcomes. So giving probiotics when you're getting your fertility treatments can be a good thing. It also affects not only women, but men too. So having bad bugs in your gut affects your testosterone levels. Antibiotics and hormonal contraceptions will affect the gut microbiome. So a lot of things will mess up your gut microbiome. Taking the pill, antibiotics, stress, certain acid blocking drugs, which you take all the time. Obviously alcohol and other things are not good for fertility too.

Obviously you should probably not smoke. You shouldn't have too much pot. All those things are bad for you. Certain medications can be problematic, obviously. Birth control pills, antidepressants, antipsychotics, obviously anabolic steroids. If you're taking testosterone as a guy, it's going to decrease your sperm production.

Calcium channel blockers, because we need various pathways in our biochemistry to make things work. So these are blood pressure pills, but they can affect sperm motility. Antibiotics can interfere with menstrual cycles. All this stuff is just to say that there's a lot of factors that we have control over that affect our fertility that are not being addressed,

from inflammation to metabolic health to mitochondrial function to dysbiosis to the medications we're taking, and all those things can be addressed. Hey, everyone, it's Dr. Mark. Now, modern foods aren't nearly as nutrient-dense as they used to be, so we all need a little help from supplements if we want to function and feel our best. But supplements can also be tricky. Some use low quality ingredients that are difficult for the

body to absorb and others add cheap fillers and additives. And that's why I love Symbiotica. Cutting edge formulas they have like liposomal glutathione and liposomal vitamin C use liposomal technology, making them the most bioavailable and optimal for absorption. If you're unfamiliar, liposomes are fatty membranes, like little bubbles, that encapsulate nutrients and prevent them from being broken down in your digestive system and increasing their bioavailability or the percentage of the active ingredient actually absorbed into your body. Not only do they formulate their supplements for higher absorption, but Symbiotica is also extremely transparent about how and where they source their ingredients.

So you know you're getting high quality products that are safe, effective without any seed oils, preservatives, toxins, or artificial additives. It also means they taste great. Flavors like citrus vanilla made from organic vanilla extract and organic orange peel oil. I also love they come in convenient packets so I never have to worry about missing doses or packing big bottles when I'm traveling. Right now, you can try them for 20% off with free shipping on all orders. Just go to symbiotica.com and use the code Hyman. That's symbiotica, C-Y-M-B-I-O-T-I-K-A.com

and use the code Hyman for 20% off plus free shipping. And now, let's get back to this week's episode of The Doctor's Pharmacy. So let's talk a little bit more about where conventional medicine just misses the mark. No pun intended. Why does it miss the mark? Well, it doesn't get to the root causes of the hormone imbalances and other factors that cause this decline in fertility. It doesn't address diet, inflammation, mitochondrial health, dysbiosis, environmental toxins, stress, autoimmunity. You know, and they give you like, you know, general advice. Okay, lose weight, eat more veggies.

It's not quite personalized. It doesn't really measure what needs to be measured to understand what's going on in your biology. You know, you look at farmers, they're testing the soil. They want to know what nutrients are in there, what the levels of nitrogen, potassium, phosphorus. They're so deep in understanding soil health as a way to predict what's going to be happening to the plants that they're growing in there. How do we not test for what's going on in a woman or a man to find out whether or not the sperm and egg are going to be healthy or whether the baby's going to be healthy, right?

They don't check inflammation levels. They don't check nutrient levels. They don't check toxin levels. So we really need to do proper testing for fertility, looking at all sorts of things from metabolic health to hormonal health, the nutrient status, the toxin levels, looking at something called AMH, which we'll talk about for women, which measures the quality of their eggs. So we kind of have to look for what's really going on and not just ignore the symptoms, right? We need to look at how is a woman doing? Does she have hormonal imbalance clues, right? Does she have painful periods?

Does she have PMS? Does she have weight gain, acne? Is she on the pill? You know, what's going on that we need to address that can help to regulate hormones better? So, you know, when women have hormonal issues, they don't really address in conventional medicine the root causes. They just kind of treat you with hormones, right? They give you the birth control pill. So the first sign of hormonal balance is there's painful periods, PMS, heavy bleeding, clotting, acne, PCOS,

boom, you get the pill. That does not get to the root cause. It doesn't address how we regulate our hormones. It doesn't actually help us support our natural cycle. There's a lot of side effects with these digestive issues. It causes yeast overgrowth in the gut. It bounces in the microbiome. It depletes nutrient levels that you need for pregnancy, like folate, B12, B6, and vitamin B2, as well as vitamin C and E and magnesium, selenium, and zinc. All of these are necessary for fertility. Traditional approaches kind of fail in my view. And I've worked with so many women and so many couples and helped them have healthy babies simply by addressing these phenomena. What is

the functional medicine approach then? What do I do? What is the functional medicine approach? It's really important to address overall health, right? Not just looking at hormones. You need a deep dive on your biomarkers. And this is really what we do at Function Health. function health this is why i co-founded the company function health which is a way for you to get access to all this data about yourself to get over 110 biomarkers including all the things we're talking about today for less than 500 bucks it's a membership model we have a big waiting list but you can jump the line if you go to functionhealth.com forward slash mark and you can sign up and get a lot of these diagnostic tests and most of these things are not going to be tested by your doctor when you go in for your fertility checkup or your pre-pregnancy exam, or they're not going to look at the man. And it's

really important to do a deep dive and correct these things. And this is what I do all day long in my practice, and it's why I see such good results. So first you need to test for nutrient deficiencies. The most important is folate. It's critical for egg quality, for implantation of the egg in the womb. Deficiencies can lead to increased levels of something called homocysteine, which is a marker of folate insufficiency, as well as B12, B6. Again, something not tested typically. I'm just going to share a quick story with you about a woman who I was working on a film with.

She was the director of this film called Fed Up. It was, I think, came out in 2014. It's still on Netflix about childhood obesity. She told me the story where she had miscarriage after miscarriage after miscarriage and even had babies that were born with anencephaly, which means no brain. Terrible condition. And she told me the story that she read this article I wrote about methylation and about the importance of checking homocysteine and B vitamins and the genes that regulate this, something called MTHFR. And so she went to a doctor and she made him test for this. And she found very high levels of homocysteine. She made him test the gene called MTHFR, which we know affects about 35% of people that have this

variation in this gene that can cause this problem. And we know that these problems of deficiency in folate lead to all sorts of bad pregnancy outcomes, including infertility and miscarriages. So she said to the doctor, well, this is what I want. And she got the test and sure enough, she was positive. And he said, okay, just take a prenatal vitamin folate. Dr. Hyman says, I need to take methylfolate because I read in this article and I want to take the right kind. So she took the right kind. And when I saw her during the publicity tour for the movie, she had this beautiful 10-month-old baby and we're hanging out and people are going on TV and stuff. And I was like, wow, this is a miracle story,

but it's not a miracle. It's just using good science. Men also need to worry about folate because folate's important for sperm, DNA, and integrity. So low levels can also lead to decreased sperm counts and motility issues. So sperm aren't great swimmers. Vitamin D, also important. It influences the production of estrogen and progesterone in women and also sperm quality in testosterone in men. And deficiencies in vitamin D have also been associated with PCOS and, get this guys, erectile dysfunction. Now, low levels, less than 40, I would say, you know, the lab says less than 30, but less than 40 is really probably what's considered low, maybe even 45. But low levels of less than 40 in published data show there was an increased risk of infertility if

your level was under 40. And this is probably accounting for 80% of the population who are not taking vitamin D supplements. And we test this as part of your function health panel. Super important. Vitamin D supplementation in infertile women, in another study, significantly increased clinical pregnancy rate outcomes and pregnancy outcomes. So just taking a simple vitamin D makes a huge difference. What about B12? B12 is another important one. It's required for the development of your nervous system, for DNA synthesis, for cell

division, cell tissue, formation of new red blood cells. And if you don't have adequate levels of B12, it can affect ovulation. It can cause trouble with implantation of the embryo. And you can check your homocysteine levels as well, and also called methylmalonic acid, what we check with function health panel. And if you had high levels of homocysteine, it has high rates of miscarriage, as I mentioned in this recent story I told you, at increased risk of birth defects, we call neural tube defects like spina bifida in the baby and also affects sperm motility and concentration and prevents DNA damage. And B12 also has amazing benefits. It increases sperm motility. It increases the concentration of sperm. So you have more sperm and it prevents DNA damage in the sperm

so you have healthier sperm. Homocysteine, an important thing to check in your blood, really important. As I mentioned, it can increase the risk of preeclampsia by threefold. This is a high blood pressure condition in pregnancy. It's very dangerous. And the best way to test for B6, B12, and folate is to measure your homocysteine level. What about iron? Iron, another important nutrient, really important because you get a lot of blood loss during menstrual cycles and the deficiencies of iron are so common. It affects so many women. We saw so many people in our function health cohort that are iron deficient. This leads to problems with ovulation and ovulatory cycles where you don't ovulate, you can get anemia, you can have

trouble with fetal development and making red blood cells. And get this, 35% of women, less than 50 are iron deficient. Over a third of women trying to get pregnant are iron deficient and listen to all the bad things it does. The next thing that's important to test and measure and it's important to understand is omega-3 fatty acids. Now, there's a lot of reasons for that, but if you have omega-3s at adequate levels,

it lowers inflammation, it lowers reproductive system inflammation, and it supports hormone function. Now, if you're a guy and you have omega-3s in your diet or from supplements, it affects sperm quality, sperm count, sperm motility, the amount of semen you make, your testosterone levels, and even the rates of in vitro fertilization.

So just taking fish oil and eating a lot of sardines can have all these benefits. For women, also important, it helps egg quality and in vitro health, which is the lining of your uterus, critical for implantation and maintaining an early pregnancy so you don't have a miscarriage. It helps uterine blood flow, helps the embryo implant, helps pregnancy rates. Again, just from eating sardines or taking omega-3s. And two-thirds of adults are not meeting the dietary guideline requirements of two servings of fatty fish per week or 250 milligrams of EPA and DHA per day. This is from British Medical Journal Open. That's two-thirds who are not meeting the dietary guidelines. But the dietary guidelines are the minimum amount of something

you need to not get a deficiency disease. So 90% plus, I'm sure are low in this. And we know this from other data. Another important nutrient, magnesium. Again, all these things we test for and your typical prenatal visit or your fertility visit will not be checking these things. Magnesium is critical because it balances estrogen and progesterone. It helps a lot with menstrual cycles and cramps, helps a healthy uterine lining. It helps with DNA synthesis and repair, helps with healthy egg production. And of course, it's the relaxation mineral because it makes everything in your body relax. So I call it the stress reduction mineral. And for stress adversely affects fertility, magnesium helps with blood sugar control and

insulin sensitivity, PCOS, really important. It's also essential for sperm production, development of healthy sperm. And magnesium is really important because it's linked to sperm motility and qualities. All these nutrients play a role in reproductive health. What about zinc? Zinc is really important for ovulation in women and menstrual cycle. And if you don't have enough zinc, it can affect all these processes affecting fertility. For men, it's even more important. It's important for sperm quality and sperm deficiency can lead to low sperm count and low testosterone levels. So that's not good. Selenium, another important mineral. Again, something we test for in function health. We can look at all these things. We can see what's going on. And selenium is important for thyroid

function, which it regulates hormones necessary for fertility. In men, it's important for sperm motility and sperm health. And if you don't have enough selenium, it can impair these functions. And many soils are depleted in selenium. If we're not taking a multivitamin, selenium are often low. And again, it's something we can test for. So it's important not just to check for nutrient levels, but also your hormone levels. So women, obviously, you want to check estradiol, which is the main female hormone. Regulates the menstrual cycle. it prepares you to lining for pregnancy.

And if you're having abnormal levels, it can kind of give you a clue that there's problems with the ovaries, with your menstrual cycle, fertility. Often infertility can be explained by what we call estrogen dominance. Estrogen dominance means you have too much estrogen, either relative or absolute in relation to progesterone. And you get a lot of symptoms from that. Heavy bleeding, breast tenderness, fluid retention, premenstrual migraines, PMS, blood clotting, fibroids. I mean, it's kind of a mess and it's not normal.

And there's a lot of causes for it. Our high sugar starch diet, alcohol, environmental toxins, change in our microbiome, all things that we can treat. For men who are actually having high estrogen levels, which they can because they're eating a lot of sugar, starch, and alcohol, all that will increase men's estrogen levels. That will affect their fertility. So if you have high levels, it can disrupt the balance of testosterone. It affects sperm production. It makes you have low sex drive and erectile dysfunction and infertility and weight gain. So it's just bad news. As I mentioned, the fat tissue is a site that has this enzyme called aromatase and it converts testosterone to estrogen. And that can lead to all sorts of problems with men, like I mentioned, like loss of body hair, libido, all the things we talked about. And it's really driven by

a high sugar, high starch, ultra processed food diet. Another important hormone to check is progesterone. It's really important for women. This is called progesterone for a reason. It's the progestational hormone. And it prepares the uterine lining for an egg and it supports early pregnancy. So you need to have adequate progesterone. And often women don't have this, particularly in their later reproductive years. And if you have low levels after ovulation, it can affect your ability to maintain a pregnancy or to conceive. So it's really important. And you want to look at the estrogen progesterone ratio. You want to test it at the right time of the cycle, usually about 18 to 23 days of your cycle. And that'll give you a sense of where you're at. And there's a lot of

things you can do to regulate that. We're going to talk about all those things, how to treat these, because it's one thing to know about it. It's another thing, what do you do about it? And we're going to get into what to do. So stay with me. I know this is long. You can skip to the end if you want, but I'm giving you the science behind this because I want you to understand how this is so important for us to understand as a way of addressing our infertility crisis. And it's the stuff that's being missed by traditional medicine and that you're not getting when you go to your typical gynecologist or OB or fertility specialist. Now, what about testosterone? Another important hormone. It affects women's sex drive, particularly around the time of ovulation, which is women get testosterone too, by the way. If you

have high levels, too much, it can be bad, right? PCOS, it can lead to this hyperandrogenism, facial hair, loss of hair on the head and so forth, acne, all androgenic symptoms, metabolic dysfunction from the PCOS, insulin resistance, type 2 diabetes, so really important. For men, obviously testosterone is really important. It's critical for male fertility, for sperm production, for functioning of your penis, for maintaining an erection. It influences the production of something called nitric oxide, which is really important. It's a chemical that helps relax blood vessels and particularly the penis. Viagra actually works by that mechanism. So you're kind of probably familiar with it. It improves blood flow and it's really critical for achieving and maintaining an erection. If you have low levels, it can lead to low libido, poor sperm quality, and erectile dysfunction. So all this is really important.

Men need testosterone at the adequate levels, and sometimes they need a replacement. We look at other hormones too, like LH, which is the luteinizing hormone. These come from the brain. Pituitary, they trigger ovulation. They cause the release of the egg from the ovary. And if you're imbalanced with this, it can affect ovulation. The ratio of LH and FSH, which is the follicle stimulating hormone, super important because if you have a high LH to FSH ratio, it's probably a clue you have PCOS, which you really need to deal with. These are not just female hormones, okay? Although they have female sounding names, like luteinizing hormones named after the corpus luteum cyst on the ovary and the follicle stimulating hormones named after the follicles that release the cyst on the ovary, and the follicle-stimulating hormone is named after the follicles that release the egg on the ovary, but men have them too. LH really is

important because it stimulates testosterone production in the male, and you can have abnormal levels, and that can affect sperm count. Follicle-stimulating hormone, also important regulating menstrual cycle and the growth of the eggs in the ovary, so it stimulates the egg growth. Abnormal levels of FSH can indicate issues with low ovarian reserve or function and affect the chance of conception. For men, FSH improves spermatogenesis. So LH increases testosterone. FSH increases the production of sperm. High levels can be a problem because it may mean that your testicles aren't working, so you need to make high levels by trying to make it more. Whereas low levels can often signal other issues, maybe a pituitary problem. So you can really tell what's going on with the men too from these hormones.

Prolactin, another hormone, it's related to fertility. It could be from a benign tumor in the pituitary gland, but often needs to be addressed. Another hormone we look at is DHEA, which is an androgenic hormone, a precursor of testosterone and also estrogen. It's typically elevated in PCOS and it can be a factor also indicating stress response. Now, sex hormone binding globulin, really important to look at as well.

And that's something that carries the hormones around in your blood and lets them go when they need to be active. So like the reservoir, that's a normal thing. But if you have high levels of inflammation, it can actually cause high level of sex hormone binding globulin, meaning you don't have enough free hormone around to do the job. Another important hormone for women to check is something called anti-malarian hormone or AMH. And that indicates your ovarian reserve, meaning your egg quantity. So if you're low, it means you don't have a lot of egg reserve,

and that's an issue. And knowing that helps assess fertility potential, how you respond to fertility treatment. So all that's really important. What other hormones do we need to know? Well, it's a lot of things we need to know if we're going to fix the body and get it in balance. Because the body is a system. We can't just treat one thing. We have to treat everything to get it back in balance and optimize your health and hormones. Thyroid plays a big role in fertility. And if you have low fertility, it could be a factor and it's common. And then we've had women get pregnant just by giving them thyroid replacement,

which optimizes their health. So you wanna check all the thyroid hormones, not just the main one your traditional doctor checks, which is TSH, but you wanna check free T4, free T3, thyroid antibodies, all of it. If you have low thyroid function, it affects menstrual cycles, it can cause delayed menstruation,

it can cause anovulatory cycles, it makes menstrual cycles. It can cause delayed menstruation. It can cause anovulatory cycles. It makes your ovaries malfunction. It affects embryo development. So it's really important. It affects the ability to implant a baby. Thyroid disorders can be really a problem and they can lead to menstrual issues, fertility issues, and they can disrupt egg production, the release of eggs from the ovaries. It can increase risk of miscarriage. And as I mentioned, developmental issues. So it's really important for women to check this. And it has to be done before you get pregnant. You want to make sure all this is looked at. Men also, it's important to look at thyroid as well because it affects their sperm quality, their motility, their

morphology, meaning the shape, do they have two heads, your sex function, your drive, all that. The next big thing we need to look at is your metabolic health. And this again is looking at one of the key factors in infertility, which is insulin resistance, blood sugar dysregulation, belly fat, all these things I've been talking about forever. It's important to check that with a fasting glucose, fasting insulin, which by the way, again, is not going to be on your regular panel, but we include it on the function health panel, your A1C, which is the average blood sugar. You want to look at cholesterol profiles because that gives you a clue about your metabolic health. We use something called lipoprotein fractionation.

Again, it's less than 1% of all cholesterol tests, but it's on the function panel. That gives a sense of whether or not you're insulin resistant. Cortisol, looking at stress hormones, inflammation markers like CRP. We look for environmental toxins like heavy metals, lead, mercury, and so forth. So now we've covered what causes infertility. We talked about some of the most important diagnostic tests you need to do to figure out what's going on in your body and what

to fix. But now let's talk about what to do to increase your chances of conception and having a healthy baby. And it's stuff that we all have control over, right? We're going to start with our diet and lifestyle. So what should we be eating? Basically the same thing as we eat for everything else. It's not like there's one diet to prevent diabetes and another to prevent cancer and another for preventing dementia and another for infertility. I mean, it's basically the same stuff, right? It's eating whole real food, focused on nutrient density, have high quality protein, like grass-fed beef, lamb, or venison, full of nutrients like zinc, selenium, all the things we talked about, iron, CoQ10, beef liver, that's good too if you like it, wild-caught fish but small fish

like the smash fish, salmon, anchovies, mackerel, herring, and they all include great nutrients like omega-3s, vitamin E and selenium, which we talked about, shellfish like clams and oysters are great, B12, zinc sources, pasteurized eggs and egg yolks with B12, folate, choline, poultry, all great. Bone broth is great, collagen, glutamine, glycine, folate, choline, poultry, all great. Bone broth is great. Collagen, glutamine, glycine, amino acids, really important. Grass-fed yogurt, if you can get it from sheep or goat, that's better. Lots of vegetables, lots of fruits and vegetables, some whole grains, legumes. If you're really insulin resistant, you should be careful with the grains, but many people can do

well with them. Lots of antioxidants in your diet, right? You want to have all the colorful polyphenols, all the antioxidants from all the colorful fruits and vegetables. And the studies showed that antioxidants can actually increase male fertility fourfold, and they can increase the chance of a successful pregnancy by up to five times. Think about that. Just having high levels of antioxidants in your diet can increase the chance of a successful pregnancy by 500%. If you're going to eat food that has a lot of these pytochemicals, that's good, but make sure you have organic when possible. You can use the EWG guide to help optimize your intake for the dirty dozen and clean 15 fruits and veggies. You also want to have lots of good

fats in your diet, olive oil, avocados, nuts and seeds, lots of veggies. I mentioned green vegetables are really important. The spinach, kale, they have a lot of folate. Asparagus is great as well as vitamin C. Dark chocolate can be okay. Lots of iron, magnesium, some polyphenols. You also want to really work on your microbiome. We've talked a lot about that on the podcast, but just to reiterate, we need a lot of gut microbiome support, lots of fiber, prebiotic, probiotic foods, and polyphenols.

And you also want to eat a lot of the broccoli family vegetables. They have really beneficial effects on hormones. They prevent estrogen dominance. Things like collards, kale, Brussels sprouts, broccoli. something called the glucuric acid which lowers beta-glucaninase so all that's really great supports something called the astrobalone which is the metabolism of your estrogen again we talked about the probiotic foods the fermented foods sauerkraut kefir kimchi natto tempeh miso nuts and seeds also also great. They're really good for fertility.

They have lots of healthy fats, lots of fiber, lots of vitamins and minerals. It was an interesting study. In 2020, a study found that men who ate basically about two handfuls of nuts, about two servings a day of mixed nuts without changing any aspect of their processed diet for just 14 weeks, they had beneficial effects on their DNA methylation, on sperm count, on size, the motility, the viability of their sperm. That's pretty darn cool just from two handfuls of nuts. So eat your nuts. They're also a great source of vitamin E, which is really important for protecting the sperm membrane against oxidative stress. Again,

whole grains and beans are great if you can tolerate them with lots of fiber that help the microbiome. I prefer gluten-free grains like black rice, wild rice, teff, amaranth, buckwheat, quinoa, millet, various beans are going to be helpful. Herbs and spices are great for you. Lots of phytochemicals in those. Balancing your blood sugar, another critical aspect of your diet. Having protein, fat, and veggies is the best way to do that. Lots of fiber at every meal, obviously getting off the ultra processed foods, starch, sugar, all the liquid sugar are really bad for you. Soda is really bad. Exercise, you know, go for a walk after eating. You know, I had a nice big dinner last night. We went for like a half an hour walk after dinner. Really helps sequester all the sugar in your muscles, prevents it from getting stored. Make

sure you do resistance training, get more muscle. It helps boost glucose absorption and insulin sensitivity. Again, we're trying to make you insulin sensitive because that's going to help fertility. Really big deal. And who knows, maybe you even want to try a glucose monitor to see how you're doing because that's a big factor for fertility. You can try Levels. Go to levels.link forward slash, I think Hyman or Mark or something. Check it out. I will put in the show notes. You can try out the glucose monitor. Get off all the inflammatory foods, all the beverages that are bad for you, right? Ultra processed food, high fructose corn syrup, sugar sweetened beverages, refined grains and flours, all the toxins that, you know, eat organic when you can, get rid of glyphosate, trans fats, get rid of all the low quality fats in your diet, the refined oils. Gluten is typically bad for most

people in inflammatory, corn, processed soy, all that stuff. Conventional dairy, just get rid of it. Caffeine can be okay. You want to make sure you're not doing it while you're pregnant, particularly coffee, green tea, black tea. It can also wear out your adrenals. Alcohol, definitely a no-no if you want to get pregnant and get rid of all the environmental chemicals you can from your life. I read a book years ago by Theo Colburn.

It's called Our Stolen Future. And it was really a shocking book because it outlined the impact of these endocrine disrupting chemicals from petrochemicals, plastics, BPA, phthalates, dioxin, pesticides. The name goes on and on. These things are just everywhere. There's 80, 100,000 of these things around and they're just, they're awful. But what we're learning now is that they have huge endocrine disrupting effects. They have huge effects on fertility. They're causing hermaphrodism in animals. They're affecting egg quality and shells and birds. They're creating all sorts of issues in the animal population and also in the human population. I'm not going to get into too

much detail on all these. We've talked a lot about them before. We'll have it all in the show notes, but I'm just going to list a few of the important ones. BPA is one of the worst ones. It's used in the production of plastics, epoxy resins. It's one of the worst endocrine disrupting chemicals, and it makes a bad scene for men and women trying to get pregnant. It inhibits sperm motility, it do his ATP, it binds to estrogen receptors, affects all kinds of epigenetic effects, lifelong transgenerational impacts on your baby on the baby's baby it's just bad it really damages all of the things we want to protect like female reproductive organs affects follicle loss inhibits the embryos from implanting and impairs reproductive cycle so how do you get rid of all this stuff right you've got to just be smart you got to get rid of the plastics in your

life as best as possible don't use plastic containers. Don't buy stuff in plastic. Don't drink stuff in plastic. You know, use glass, use metal. Don't heat anything, obviously, in a food or drink in a plastic container. You know, all that's really important. So, you know, there was a new study that was looking at liter water bottles from plastic water, and they had 240,000 detectable plastic fragments, 100 times more than previous estimates, which is crazy. This is from the Proceedings of the National Academy of Science, a major medical journal. Get rid of all the BPA-lined coffee cups, all the canned foods you're eating,

unless they're BPA-free cans. Skip the receipt. Most have BPA coating. Avoid plastic bags, plastic tea bags. It's just in everything. It's in plastic. Personal care products, fragrances, deodorizers, lotions, everything. Basically, you want to get rid of all this stuff. And I'm making this up for you. Just go to ewg.org and they have a great database called Skin Deep Database. They have a household cleaning product database. They have a food database.

So this is all deeply researched information about what's in the products you're using and how to find products that are not having an issue. PFAS, those forever chemicals, really a problem. They've found a 5% to 10% reduction in the probability of conception for every quartile increase of exposure, for every 25% increase in exposure, you have a 10% reduction in fertility. And so it's just bad news. It's in tap water, filter your water, get the right cookware. We're going to guide you on how to do this all. Get rid of heavy metals, large fish, and filter your water, glyphosate, pesticides, eat organic. So all these things we got to pay attention to, and we're going to have them all in the show notes. I don't want to go too deep into it here, but it's all there, and the data's all there, and how to protect yourself is

all there as well. Other things that might help with improving your fertility. Fasting can be helpful. So that can help with blood sugar control, help with insulin sensitivity, can help activate autophagy. When you calorie restrict, it can rebalance the microbiome, helpful in estrogen detoxification. It can help with weight loss, inflammation, can help all kinds of things.

For men and women though, fasting is not the same. Intermittent fasting is essentially or time-restricted eating. It's basically shortening the window of time you eat to allow your body to rest and digest. And I don't really want you to restrict calories on it, but you sometimes eat less, right? Because you're having less time to eat during the day. And the best form is really a 12 to 14-hour fast. So 12 hours overnight, you eat dinner at six, you can

eat breakfast at six, right? If you eat dinner at six, you want to have a 14-hour fast, you can eat breakfast at eight. It's not that hard, but just give your body a little break from eating and that'll help a lot. Also, it's really important that you're really paying attention to the effects of fasting on fertility and so forth and not get over enthusiastic about it because you want to make sure you're not doing this throughout the cycle if you're a woman. And just basically just 12 hours is enough overnight. And I'd kind of leave it at that for both men and women. Men can probably do a little bit longer. There are other things you really want to do as well, obviously,

besides this exercise, really important. It really improves testosterone levels in men. It helps balance hormones, balance blood sugar, balance insulin, increases blood flow. Sweating also is great as another tool for optimizing your health. If you want to do it preconception, obviously, you don't want to do it during, I think. But basically, it's sweating, really important. That gets rid of heavy metals, some of these forever chemicals. Your man, you don't want

to avoid excess heat from a sauna and hot bath because that can affect sperm count. If you're basically looking at inactivity and sedentary lifestyle, it leads to trouble conceiving. Make sure you exercise, do strength training, do cardio, and also I encourage you to manage your stress, right? Because stress can really disrupt reproductive hormones and lead to fertility issues. And particularly when you look at stress levels during each phase of the menstrual cycle, women who were reporting being more stressed than other women during that auditory window, right? If you're stressed when you're trying to get pregnant, you're 45% less likely to conceive. So what can you do? Mindfulness, meditation, movement, yoga, nature, bathing, breathing, gratitude, breath work, whatever

works for you, but you've got to practice self-care. Sleep also really, really important. Getting quality sleep, having regular circadian rhythms really, really helps. And I have a sleep masterclass we'll link to the guidelines on how to optimize your sleeper in our show notes. But you don't want to have a set bedtime. You don't want to be on screens before. You don't want to eat before bed two or three hours. You want to avoid snacks high in sugar and carbs anyway. Get at least seven to eight hours a night. Get sunlight in the morning. Basic stuff. Now, what about supplements? Supplements are really important before you're trying to conceive, not just when you get pregnant.

So your prenatal vitamins should start at least three to six months before conception. You want the right prenatal vitamin with the right nutrients, the right type of nutrients. For example, not regular folate, not folic acid, but you want five methylfolate. And 40% of the population, about a third to a little more, has this mutation or variation in this gene called MTHFR that impairs the body's ability to utilize synthetic folic acid, which is found in prenatal vitamins. So you can take this prenatal vitamin, but up 35 to 40% of you can't actually turn into something your body needs to regulate your hormones. So you want methylated B vitamins like methylcobalamin, lots of omega-3s from clean sources, Probiotic, really important to help your microbiome.

Vitamin D3, we mentioned all the reasons why. Iron, so you're not iron deficient. And for men, you also want it as well, right? You want hormone-supporting nutrients for men. Men also need to take prenatal vitamins. Surprise. You need to have a number of different things that can be very helpful. For example, a full-spectrum multivitamin, vitamin D, omega-3s, folate, B12, antioxidants, zinc, CoQ10 is better

for men's sperm production, N-acetylcysteine boosts glutathione, but also helps sperm quality, sperm volume, motility, viscosity in infertile men. Carnitine can be helpful as well, and maca, which also improves sperm parameters. That's an herb. And these are found in really good quality prenatal vitamins, but you need to find the right ones. A brand I love is called WeNatal. We as in his and her, right? So there's men and women's prenatal vitamins.

That's why it's called WeNatal. We'll put a link in the show notes and check them out. As you've come to see, fertility is a huge crisis in our society. We're seeing declining birth rates, fertility rates. Many couples struggle to have babies. The science is pretty clear about why we're seeing this. Traditional medicine doesn't do a good job

of sorting through the root causes, which we've talked about, anything that drives inflammation, our processed diet, our environmental toxins, our microbiome, our mitochondrial dysfunction. And there's simple ways to reduce your exposure to things that are causing imbalance by changing your diet,

by reducing your toxin exposure, by taking the right nutrients, making sure you get the right testing to see what's going on for you because you want to know what's going on inside your body. You want to look under the hood and you're not getting those tests from your traditional checkup. You can go to functionhealth.com forward slash mark to skip the wait list and get all these diagnostic tests for both the men and the women to see what's really going on. You can use those insights to help optimize your health and hopefully have a healthy, happy baby. Thanks for listening today.

If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts. And follow me on all social media channels at DrMarkHyman. And we'll see you next time on The Doctor's Pharmacy.

I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes, and lots more. And now you can have access to all of this information by signing up for my free Mark's Picks newsletter at drhyman.com forward slash Mark's Picks. I promise I'll only email you once a week on Fridays and I'll never share your email address or send you anything else besides my recommendations. These are the things that have helped me on my health journey and I'll never share your email address or send you anything else besides my recommendations. These are the things that have helped me on my health journey, and I hope they'll help you too. Again, that's drhyman.com forward slash Mark's Picks. Thank you again, and we'll see you next time on The Doctor's Pharmacy. This podcast is separate from my clinical practice at the Ultra Wellness Center

and my work at Cleveland Clinic and Function Health, where I'm the chief medical officer. This podcast represents my opinions and my guests' opinions, and neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. Now, if you're looking for your help in your journey, seek out a qualified medical practitioner. You can come see us at the Ultra Wellness Center

in Lenox, Massachusetts. Just go to ultrawellnesscenter.com. If you're looking for a functional medicine practitioner near you, you can visit ifm.org and search find a practitioner database. It's important that you have someone in your corner who is trained, who's a licensed healthcare practitioner and can help you make changes,

especially when it comes to your health. Keeping this podcast free is part of my mission to bring practical ways of improving health to the general public. In keeping with that theme, I'd like to express gratitude to the sponsors that made today's podcast possible.