The Dr. Hyman Show - From Inflammation to Conception: Solving the Fertility Puzzle

Episode Date: March 31, 2025

Fertility challenges are increasingly linked to lifestyle and environmental factors that go far beyond reproductive organs. Emerging science reveals that metabolic health, inflammation, diet, and expo...sure to environmental toxins all play a profound role in hormonal balance, egg and sperm quality, and even early embryo development. Key drivers of dysfunction—such as ultra-processed food, insulin resistance, gut imbalances, and mitochondrial damage—are rarely addressed in conventional fertility care, despite their deep impact. Paying attention to these overlooked root causes offers not only a powerful path to improving fertility but also the foundation for lifelong health in both parents and their future children. In this episode, I discuss, along with Kelly LeVeque, what we can do to improve our fertility, which ultimately impacts the future health of our children. Kelly LeVeque is a holistic nutritionist, celebrity health coach, the best-selling author of Body Love and Body Love Every Day, and most importantly, mom of three little boys. Kelly LeVeque is passionate about the science of human nutrition and is always guided by a practical and optimistic approach to wellness. Kelly helps clients improve their health, achieve goals, and develop sustainable habits to live a healthy and balanced life. Kelly is a regular contributor to numerous health, wellness, and lifestyle publications. This episode is brought to you by BIOptimizers. Head to bioptimizers.com/hyman and use code HYMAN10 to save 10%. Full-length episodes can be found here: Fertility in Crisis: Exploring the Toxic Threats to Fertility and the Rise in Infertility The Fertility Crisis: Why it’s Happening and How to Fix it Boost Fertility Naturally: Top Foods to Eat

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Starting point is 00:00:00 Coming up on this episode of the Dr. Hyman show. 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 or eating a lot of sardines can have all these benefits. Are you feeling stressed, sluggish, or struggling with sleep?
Starting point is 00:00:31 You might be low on magnesium and trust me, it's a bigger deal than you think. Most magnesium supplements miss the mark, but magnesium breakthrough by bioptimizers gives you all seven essential forms in one capsule. Your body gets the full benefits, better energy, stress relief, and deep restorative sleep. I take it every night and it's a total game changer. Try it now with an exclusive discount. Go to bioptimizers.com slash Hymen and use code HYMAN10.
Starting point is 00:00:54 Your body will thank you. Before we jump into today's episode, I'd like to note that while I wish I could help everyone via my personal practice, there is simply not enough time for me to do this at scale. That's why I've been busy building several passion projects to help you. If you're looking for data about your biology, check out Function Health for real-time lab insights.
Starting point is 00:01:12 And if you are in need of deepening your knowledge around your health journey, check out my membership community, the Hymen Hive. And if you're looking for curated and trusted supplements and health products for your health journey, visit my website at drhymen.com for a summary of my favorite and thoroughly tested products. 93.2% of Americans have some level of metabolic dysfunction, meaning they were on somewhere in the spectrum from insulin resistance to pre-diabetes to type 2 diabetes. And this is the thing that screws up both men and women's fertility.
Starting point is 00:01:41 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.
Starting point is 00:02:03 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. The spiking sugar leads to high insulin levels, that leads to insulin resistance and then we get blood sugar and hormonal balances 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
Starting point is 00:02:34 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, so clotting, heavy bleeding, a 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
Starting point is 00:03:09 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 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
Starting point is 00:03:32 dysfunction and it also because of low testosterone affects sperm quality. 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. They get higher body fat, they lose the hair in 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
Starting point is 00:04:04 endometriosis, more PCOS, worse 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, 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.
Starting point is 00:04:31 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. 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,
Starting point is 00:05:00 at least the leaky gut. Also our C of environmental toxins is not good for our hormones, the C 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 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.
Starting point is 00:05:30 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
Starting point is 00:05:56 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 mitochondria and mitochondria. Those are your testicles and that is necessary producing testosterone. So you can see the whole hormone production cycle requires energy and we do a lot of things
Starting point is 00:06:26 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
Starting point is 00:06:54 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 is problems in your the right environment for having a healthy baby. So what is the 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 influences.
Starting point is 00:07:15 This influences inflammation and causes inflammation throughout the body, including 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.
Starting point is 00:07:33 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. 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-gluturonidase, a little technical here but I'll explain it.
Starting point is 00:08:02 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,
Starting point is 00:08:19 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.
Starting point is 00:08:44 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 can be
Starting point is 00:09:16 problematic obviously. Birth control pills, antidepressants, antipsychotics, obviously anabolic steroids. If you're taking testosterone as a guide it's gonna 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
Starting point is 00:09:38 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. 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,
Starting point is 00:10:08 stress, autoimmunity. You know, 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 gonna be happening to the plants that they're growing in there.
Starting point is 00:10:32 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 gonna be healthy or whether the baby's gonna be healthy? 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 and nutrient status to toxin levels, looking at
Starting point is 00:10:55 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?
Starting point is 00:11:11 Does she have weight gain, acne? Is she on the pill? What's going on that we need to address that can help to regulate hormones better? So 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 at the first sign of hormonal balance, there's painful periods, PMS, heavy bleeding,
Starting point is 00:11:34 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't actually help us support our natural cycle. There's a lot of side effects with these digestive issues that causes yeast overgrowth in the gut and bounces in the microbiome.
Starting point is 00:11:50 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
Starting point is 00:12:06 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.
Starting point is 00:12:21 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,
Starting point is 00:12:34 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 gonna be tested by your doctor when you go in for your fertility checkup or your pregnancy 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
Starting point is 00:12:56 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 it came out in 2014. It's still on Netflix about childhood obesity.
Starting point is 00:13:23 She told me this 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 this 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 her 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
Starting point is 00:13:55 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 you know 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 the publicity tour for the movie, she had this beautiful 10-month-old baby and we're hanging out before 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
Starting point is 00:14:34 science. Men also need to worry about folate because folate is 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. Deficiencies in vitamin D have also been associated with PCOS and get this guys, erectile dysfunction.
Starting point is 00:14:58 Now low levels, less than 40, I would say the lab says less than 30, but less than 40 is really probably what's considered low, maybe in 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?
Starting point is 00:15:31 B12 is another important one. It's required for the development of your nervous system, for DNA synthesis, for cell division, cell tissue formation, 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 methamalonic acid, what we check with function health panel. And if you had high levels of homocysteine, as high rates of miscarriage, as I mentioned in this recent story I told you, it increases the risk of birth defects, we call it neural tube defects like spina bifida in the baby
Starting point is 00:16:02 and also affects a sperm motility and concentration and prevents DNA damage. And B12 also has amazing benefits. It increases sperm motility, it increases the concentration of sperms, you have more sperm and it prevents the 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.
Starting point is 00:16:26 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 is 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
Starting point is 00:16:47 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
Starting point is 00:17:03 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,
Starting point is 00:17:21 sperm count, sperm motility, the amount of semen you make, your testosterone levels, and even the rates of in vitro fertilization. Just taking fish oil, and eating a lot of sardines can have all these benefits. For women, also important, it helps egg quality and the 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 the uterine blood flow, helps the embryo implant, helps pregnancy rates. Again, just from eating sardines or taking omega-3s.
Starting point is 00:17:48 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
Starting point is 00:18:04 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.
Starting point is 00:18:37 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 quality. All these nutrients play a role in reproductive health. What about zinc? Zinc is really important for ovulation of 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.
Starting point is 00:19:08 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 regulates hormones necessary for fertility. In men, it's important for sperm motility and sperm health.
Starting point is 00:19:24 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 multivitamin selenium, we're 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 wanna check estradiol,
Starting point is 00:19:38 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.
Starting point is 00:20:00 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
Starting point is 00:20:22 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 and it makes you have 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,
Starting point is 00:20:47 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 and 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 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.
Starting point is 00:21:14 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. about 18 to 23 days of your cycle and that'll give you a sense of where you're at. Did you know that over 75% of people are deficient in magnesium? That's a problem because magnesium is essential for over 600 functions in your body including energy production, stress regulation and deep sleep. But here's the catch, not all magnesium is created equal. Most supplements only contain one or two forms, but magnesium breakthrough by Biooptimizers
Starting point is 00:21:46 gives you all seven essential forms in one capsule. So your body gets exactly what it needs, where it needs it. I take magnesium breakthrough every night and I've noticed a huge difference in my sleep, stress, and muscle recovery. It's a game changer. Right now, Biooptimizers is offering my listeners a special discount.
Starting point is 00:22:02 Just go to biooptimizers.com slash Hymen and use code HYMEN10 at checkout. Don't wait, your body will thank you. There was actually a recent published study out of Mount Sinai that looked at over a thousand women and it researched blood levels of PUFAs between 2015 and 2017 and they found up to a 40% decrease in fertility. That can be overwhelming because you hear the word endocrine disrupting chemicals, forever chemicals, they're omnipresent, they're in everything from your non-stick cookware, waterproof clothing, the Lycra, food packaging,
Starting point is 00:22:34 the lining inside your coffee cup, coatings on your carpet, upholstery, you're like, wait, my whole life is covered in this stuff. But what I always like to give is a promise of hope. And that is when we look at urine excretions of PUFAs, if someone removes these endocrine disrupting chemicals, they can see the decrease of the urine excretion of PUFAs by half within a few days or a week.
Starting point is 00:22:58 So we have so much power in our ability to make decisions around these forever chemicals that cause oxidative stress to our body and our ability to make decisions around these forever chemicals that cause oxidative stress to our body and our future, the DNA that we'd be passing down for future children. So when it comes to these types of chemicals, there are so many things you can do from using, storing your food in glass, swapping out nonstick cookware, even just taking a stainless steel coffee mug to your coffee shop or sitting down and having it in, instead of in a to-go mug, in a to-go cup,
Starting point is 00:23:29 have it at the coffee shop, avoiding those plastic water bottles. A lot of these like Pufas, these are made to make things resistant to water, oil and grease, whereas phthalates make plastic malleable. Free things you can do, open your windows, take your shoes off at your door.
Starting point is 00:23:47 All of these are gonna lower a lot of those forever chemicals that are making their way into our house. It is critical in those three months or four months prior to conception to really think about, well, where would I be coming in contact with these things the most? And how do I lower my exposure to them? Because we do have so much power in
Starting point is 00:24:06 the decisions we're making every single day. That's true. It's what we're eating. It's what we're eating from, the containers, right? It's our household cleaning products and it's our body care products. And those things we have control of. I don't know if you know this, but I'm on the board of the Environmental Working Group. There you go, skin deep. Yeah, skin deep. And you go to ewg.org and they have guides on body care products, household cleaning
Starting point is 00:24:32 products, what foods, vegetables, fruits, animal products, how to reduce your exposure from every potential source of environmental chemicals. And so you can't be perfect, but it's something you can actually have a fair bit of impact in. Like you say, if you reduce these, consciously you see a drop in the urine levels very quickly. Now, Kelly, most of fertility doctors focus on women, but the truth is it takes two. And even though men are 50% of the equation, they're not really often considered. Even 25% of the men in infertility couples are not even evaluated as part of dealing with infertility.
Starting point is 00:25:11 So, what are your thoughts for how men need to think about fertility too? And how they need to think about improving their likelihood of conceiving a baby with their partner? Yeah, well, men are 50% of the equation and how their lifestyle factors, how they're taking care of themselves, their nutrient status, their health
Starting point is 00:25:32 is going to have an epigenetic effect on the DNA that they're passing down. And so it's critically important that they take care of themselves, especially during that spermato genesis period, which is around 74 days on average to produce sperm. And so for men, fertility does drop and it drops about 52% in their early to mid thirties.
Starting point is 00:25:55 And so just like women, they're experiencing a drop in fertility around the same amount of time. And what we've seen in studies over and over and over again is that introducing antioxidants into the diet. These are, you know, leafy greens, things that are going to provide vitamin C, you know, your wild fish, your lean pasture raised meats, all the things you talk about, even when you think about your book, Forever Young, a lot of those steps-
Starting point is 00:26:22 Young forever, young forever. That was Bob Dylan. That was Bob Dylan. Well, Bob Dylan. Yeah. When you think about all of the ways that we are protecting our own health, we're protecting our, men are protecting their sperm's health. And so when we look at it, we can see that vitamin C, vitamin E, L-carnitine, zinc, all of these nutrients are critical in producing sperm. And when we look at sperm, we're looking at quantity, we're looking at morphology, we're looking at DNA, and their lifestyle is impacting it. We look at the research and we can find that men
Starting point is 00:26:56 who walk over 4,000 steps a day versus those who have less than 4,000 steps a day have an increase in their testosterone levels. But what's so interesting is a thousand000 steps a day have an increase in their testosterone levels. But what's so interesting is a thousand more steps a day on top of that 4,000 increases testosterone, seven nanograms per milliliter. And when you look at that, that's pretty powerful. Like getting out there and getting active
Starting point is 00:27:17 increases the quality of your sperm that you're passing on to your children. And testosterone does that, which is so great because we have power to make these healthy choices, to increase the nutrients and antioxidants on our plate, to move our bodies, to sleep, to decrease stress. You know, I think we forget that stress doesn't just come in the form of endocrine disrupting chemicals and in the form of our lifestyle choices or undiagnosed issues, it's coming psychologically too. And sleep and activity really combat that. And it is just equally
Starting point is 00:27:54 as important for the man and the woman to get active and get healthy together prior to conception. And it definitely actually helps. But watching sports may not because one study actually showed that if your team won, your testosterone level went up. But if your team lost in the sports game, your testosterone level went down. So better exercise. Now, one of the things that's important is sperm quality. And I think people think, oh, men don't really have a time clock, right? They don't have a biological clock, but they
Starting point is 00:28:36 do. And men can conceive, I think the oldest man ever to conceive was 96, which I think is pretty impressive. But it's not the same as men get older in terms of the quality of the sperm, their fertility rates, or the consequences for their offspring. I mean, I think we see more autism rates with older fathers. So can you tell us more about men's sperm health
Starting point is 00:28:58 and why we see this decline and what do we know about how to address it? Yeah, well, one study looked at like the genetic changes in sperm health from young men to older men. And what we see is you are gonna see the DNA involved there. He's gonna have an increased risk of autism, Alzheimer's, type two diabetes, even heart disease. And when those genes are implicated
Starting point is 00:29:23 based on the man's lifestyle choices, they're actually passing that down to their children. And if they end up having a baby girl, they're actually passing those genetic changes down to their grandchildren. And so what we really want to do for men is to increase the antioxidant status. When we look at men who increase their antioxidant status by taking things like L-carnitine, vitamin C, zinc, all of those nutrients of concern that I talked about, even CoQ10. CoQ10 is shown to improve sperm concentration,
Starting point is 00:29:53 quality, motility, and morphology. And when you pair that with B12, it actually improves DNA, lowers the rate of DNA damage, which is also really impressive because we have this control. We can add NAC to our diet. We can look at all vitamin D status in the same way women will prior to pregnancy. It's equally as important. And I think this research is building and building. And that's why you see companies like WeNatal, which I know, you know, both
Starting point is 00:30:18 of us love very much, coming out with a prenatal for men because we can protect sperm quality, we can protect the morphology and we can increase the chances that someone gets pregnant and actually men on antioxidants, they have a four times higher rate of getting their wife pregnant and a five times higher rate of that woman having a live birth when they're taking antioxidants prior to conception. Your gut microbiome plays a huge role in hormone regulation and fertility. Now researchers are discovering there's a lot of roles for gut microbes and optimal gut health and how it contributes to obesity, to PCOS, to hormone imbalances and lots more.
Starting point is 00:30:58 So it's important to tend your inner garden and I always talk about that, but it's really important to learn how to take care of your inner garden. You need gut supporting foods, things like fermented foods that have probiotics in them. There are other things that are great in there like fiber and great probiotics. Prebiotic foods are important like fruits and veggies and you get eight to 12 servings of non-starchy fruits and veggies. Certain gluten-free whole grains can be helpful. Cruciferous vegetables also really important for the gut health because cruciferous vegetables
Starting point is 00:31:29 like broccoli, collards, kale, Brussels sprouts, collard greens, they help to regulate excess estrogen in the body. They help with estrogen dominance, which is something that happens commonly as women enter their later reproductive life where they get higher estrogen than progesterone, either relative or absolute. That can help lower beta-glucuronidase, which is a really important compound that's produced by certain bacteria in your gut that can actually lead to higher estrogen levels and more problems with cancer and fertility. There's a lot of really important things to consider.
Starting point is 00:32:01 Also, there's another class of foods that are great for your gut, which is the garlic family, garlic, onions, leeks, shallots, they're anti-inflammatory. Certain gluten-free cold grains can add fiber like amaranth, teff, buckwheat, I like Himalayan tartar buckwheat. I like my Himalayan tartar buckwheat sprouted powder, which is great. I put it in my smoothie. Wild rice is great, all those tect technically not a grain. Black rice, quinoa, all they're fine. Fermented probiotic-rich foods are great. Sauerkraut, goat or sheep yogurt, kefir, kimchi, natto, tempeh, miso, all these are great for helping your gut health.
Starting point is 00:32:35 So you really need to learn how to take care of your inner garden. And you might even need to take probiotic supplements. Now, if you have a messed up gut, it's important to work with somebody on this. If you have leaky gut or irritable bowel, you want to work with a good functional medicine practitioner to fix it. And you need to learn how to do that with the 5R program, which is avoiding minimizing the foods that create problems using pre-improbotics and gut repair tools.
Starting point is 00:32:59 All right. So once you've dialed in your nutrition and you're focusing on eating specific foods to support your hormones, your reproductive health, your sperm and egg health, it's really important to clean up your diet, not just add the good stuff, but take out the bad stuff, and reduce your intake of more problematic foods that cause insulin resistance, oxidative stress, and inflammation, which definitely reduce fertility
Starting point is 00:33:21 and cause impaired fertility. And what are those foods? No surprise if you're listening to me, right? Ultra-processed foods, basically foods that contain ingredients that you wouldn't have in your kitchen and that are made in factories and are deconstructed science projects. You do not want to eat those,
Starting point is 00:33:37 even though they may look like food, they're not actually food by definition. Refined grains, refined flours, added sugars, all bad. Now potato chips, crackers, pretzels, candy, microwave popcorn, muffins, donuts, sandwich, bread. I mean, it's not even really bread. Cookies, flavored yogurts, puddings. These foods, why are they bad?
Starting point is 00:33:59 Well, they contribute to the epidemic of metabolic dysfunction, which affects 93% of the population and is somewhere on the trajectory of insulin resistance. They lead to oxidative stress. They reduce the chance of fertility. They increase PCOS. They cause sexual dysfunction, erectile dysfunction, and poor blood flow.
Starting point is 00:34:17 Yep, that's true guys. That's what happens when you eat junk. And it contains a lot of forever chemicals, these endocrine disrupting chemicals that you don't want to be having in your body like BPA and others. You want to get rid of all those. Those are very much significant endocrine disruptors. We call this whole class of chemicals endocrine disruptors because they disrupt your hormone system.
Starting point is 00:34:40 They also contain a lot of bad stuff, chemical additives, artificial sweeteners, emulsifiers, thickeners that all contribute to inflammation through damaging the gut lining leading to a le'i gut. They also often contain low quality fats like trans fats and inflammatory oils like soybean oils, sunflower, canola, vegetable seed oils, GMO, corn, soy, all that crap. Sugar sweetened beverages, definitely a no-no
Starting point is 00:35:01 because that'll drive in some resistance including sodas, diet soda, although artificial sweeteners work definitely a no-no because that'll drive in some resistance, including sodas, diet soda, although artificial sweeteners work in a different way. Fruit juice, green juices, unless they're truly green juices, because a lot of them are just jacked with pineapple juice and sugary fruit stuff, which is just as bad. Of course, there may be more antioxidants
Starting point is 00:35:17 and other good stuff in there, but it's a lot of bad stuff. Obviously don't have soft drinks, lemonade, iced teas that are sweetened, alcohol, sports drinks, meal replacement drinks, protein drinks like Boost, Fairlife, Core, Protein Power, SlimFest are all garbage. There are good plant proteins out there, there are good animal protein products out there,
Starting point is 00:35:36 but just be careful. And also be careful with the plant milks. They can be flavored, sweetened, they can have emulsifiers, thickeners, they can be some good ones, but make sure they're just simple ingredients like almonds, water, salt for example. Energy drinks, definitely do not have those.
Starting point is 00:35:48 Those are full of colors, dyes, artificial sweeteners, flavored coffees. I mean, you go to Starbucks, you're getting tons of sugar, probably as much sugar as a can of Coke or sometimes more depending on what you're getting. Fruit juices, creamers that are weird creamers, just stay away from all that. Also, you wanna stay away from conventional dairy.
Starting point is 00:36:06 Dairy is a hugely hormonally disruptive food unless you're eating sheep or goat cheese, which is less, most conventional dairy has antibiotics, hormones, pesticides, a lot of hormone disrupting compounds in them. And it's one of the things for women who have menstrual issues or hormonal issues, I very strongly recommend they avoid.
Starting point is 00:36:24 Kefi can be fine, but be careful of too much. It can wear out your adrenal glands. Alcohol, definitely not a good thing. For fertility, it affects your, obviously, liver and your ability to regulate hormones through your liver. It can cause a dysregulation of estrogen, testosterone, and many other hormones. And alcohol consumption in men can lead
Starting point is 00:36:43 to lower testosterone levels and higher estrogen levels which can cause all sorts of issues like lower libido, fertility issues, you can increase breast size in men, it can cause loss of hair in the body, it's just not a good thing. So what are the practical dietary adjustments for enhancing fertility? Let's go through them a little bit one by one here. What are the practical tips for creating a diet that's incorporating fertility boosting foods into your everyday meals? Build your meals around protein and veggies and fiber,
Starting point is 00:37:15 which makes you feel full and less likely to overeat. Try food stacking. Start the day with protein and fat for breakfast. You can have a savory breakfast. You're gonna have a protein shake. That's really fine to do. I mean, I don't know why we've sort of, in America, gotten to a place where we think sugar
Starting point is 00:37:32 for breakfast is a good idea, but it's the worst possible thing that's ever happened to us. So what can you have for breakfast? What does that mean? Well, eggs are great. They're rich in vitamin D, B12, and protein. They're great for hormone balance. You can have an omelet with spinach, tomatoes,
Starting point is 00:37:44 added folate, vitamin C. You can have an omelet with spinach, tomatoes, added folate, vitamin C. You can have poached or hard boiled eggs. I like, for example, shishuka, which I buy the kind of jarred version, and I put the eggs in there and put in the oven and cooked in like 10, 15 minutes, pretty quick. Don't eat those quick cooking oats, get rid of those. If you're gonna eat oats, only have steel cut oats,
Starting point is 00:38:01 but you wanna add protein and fat. So flax seeds, chia seeds, almonds, nuts. You can also put in some butter in there, grass-fed butter or some other kind of oil like flax oil. You wanna get protein, fat and fiber in there. Chia seed puddings, a great breakfast. Coconut yogurt, very smoothy with protein powder. I like that one, it's my favorite.
Starting point is 00:38:20 What about snacks? Well, I don't really snack that much, but if you're hungry, nuts and seeds are great. A handful of almonds, walnuts, pumpkin seeds are great snacks that have zinc, selenium, lots of good fats. Meat sticks are great. I like the Maui Nui, Paleo Valley, they're great. Raw veggies and homemade hummus is an option. Low glycemic fruit is fine. Berries, apples, cherries, citrus fruits. What about lunch and dinner? Well, salads are great. You're, you know, you can put a base of leafy greens like arugula or just dark leafy greens, mixed greens.
Starting point is 00:38:51 You can use spinach or kale to increase folate intake. You can add avocado for healthy fats, sprinkle some sunflower seeds for vitamin E. And I basically use olive oil. So you get a fat salad with nuts and protein and fat. And you can even add a can of sardines or salmon on there. It's also great. You can include fatty fish like salmon mackerel. I get some canned salmon or mackerel. I love that with my salad. That helps boost your omega-3s. It helps firm quality and your reproductive health. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman.
Starting point is 00:39:26 Please reach out, I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to The Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on The Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center,
Starting point is 00:39:46 my work at Cleveland Clinic, and Function Health where I am Chief Medical Officer. This podcast represents my opinions and my guests opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness
Starting point is 00:40:18 Center at UltraWellnessCenter.com and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening. What if I told you that you could change your life in just 10 days, that you could reset your metabolism, break free from food addiction and feel better than you have in years? You'd probably be skeptical.
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