Ep. 179: Could undiagnosed autoimmunity affect my fertility? with functional and osteopathic physician, Dr. Mary Davis

What if your menstrual cycle is sending you signals about your overall health? Dr. Mary Davis joins us to talk about how undiagnosed autoimmune issues can impact our periods, fertility, and overall women’s health (not just our overall health and wellness)! As a functional medicine and osteopathic physician, she often works with complex, chronic illness. She believes it’s important to focus on preconception health and address ongoing issues like inflammation and Hashimoto’s disease (a common autoimmune disorder) with holistic care. She offers a unique opinion and I’m grateful she took the time to join us to share her view! 

NOTE: This episode is appropriate for all audiences.

Guest Bio: Dr. Mary Davis is an osteopathic physician board certified in internal medicine. She is also a certified functional medicine practitioner by the Institute for Functional Medicine.  Her practice, Suma Medicine, focuses on working with patients who suffer from chronic complex illness and those that want to optimize preconception health.

Transcript

Caitlin Estes (00:25)
Welcome back to the Woven Well podcast. Today we're going to talk about the impact of autoimmune issues on women's health. And honestly, I can't wait for it. I feel like in my work as a certified fertility care practitioner, autoimmune issues will come up more often than maybe you'd think. But these diagnoses usually happen during our exploration. know, women have been living with symptoms for years without any knowledge that there is some sort of a diagnosis behind them.

And so I really think that it's important for us to understand what it means to have an autoimmune issue, how they show up within women's health and what our options are for treatment, maybe even before and beyond medication. So I've invited Dr. Mary Davis, an osteopathic physician and functional medicine practitioner to join us. She's certified by the Institute for Functional Medicine and her practice, SUMA Medicine, focuses on working with patients who suffer from chronic

complex illness and those who want to optimize preconception health. Dr. Davis, welcome to the show.

Dr. Mary Davis (01:29)
Thank you so much, Caitlin. I'm really happy to be here.

Caitlin Estes (01:32)
I'm happy to have you too. And I'm so curious, like you work with complex chronic illness and especially when it comes to preconception health, like tell me a little bit about what that work is or maybe how you got into it.

Dr. Mary Davis (01:48)
Well, it's interesting. I started out in emergency medicine and I always felt as if ⁓ I was never really getting to the root cause of disease. mean, emergency medicine really exemplifies acute problems and it was rewarding in many ways, but I also felt this draw to really help patients who are struggling with chronic complex illness and getting to root cause. And I also came across my own challenges with fertility and health and was able to meet those challenges and handle them with the help of actually naturopathic physicians and acupuncture and sort of taking an integrative approach. And then it really inspired me to want to provide this for other people who had the same type of struggles and issues. And one of the other big draws for me is seeing the massive increase we're seeing in autoimmune conditions. It's just really kind of exploded and also

tying into that the increase in childhood developmental disorders that we're seeing. So my draw and my passion is getting parents prior to conception so that we can optimize their health and particularly mom's health so that we can optimize her fertility, but also optimize and wellbeing of her future children. So.

Caitlin Estes (03:11)
And what a way to think about it, that long term perspective. A lot of times women are maybe not as willing to put their own health in a place of priority. But when it comes to their children, they are. And so that's a really helpful perspective of thinking about our future children. And so wanting to invest in our health now on behalf of those children before they're even born or conceived. So that's really beautiful.

Dr. Mary Davis (03:15)
Yeah.

Thank you, it's so critical. Because a lot of times when we work with women who have challenges with fertility, they want to get pregnant today. And I get that. And my drive is to really optimize their health. And because if we have a challenge in our fertility, if we have an autoimmune condition, then there's something amiss, something wrong in the system that needs to be addressed.

Caitlin Estes (04:03)
Maybe you could help our listeners understand a little bit specifically about what autoimmune disease is. I we've heard that term, but not everyone feels really comfortable with it. So how would you define it?

Dr. Mary Davis (04:19)
Well, autoimmunity is probably something that our ancestors didn't really have to handle 100, 200 years ago. It's really something that's increased over the past several decades. And what it is basically is when your body, your immune system mounts an attack on its own healthy tissue. So then, you know, so it can manifest in a myriad of different ways and pretty much every tissue in the body can be affected with an autoimmune type of condition.

Caitlin Estes (04:48)
Yeah, so how could those autoimmune issues show up for us in like our menstrual cycles or fertility or just women's health in general, however you'd like to think about it.

Dr. Mary Davis (04:59)
Wow, well, I mean, it's just so many different ways. It's so interesting. mean, when you're looking at, could be, we do something in functional medicine, maybe your listeners have seen a functional provider before called a medical symptom questionnaire. And it scales from like zero to 200 being the highest number of symptoms. And it can be anywhere from headaches, brain fog, fatigue, hair loss, weight gain, joint pain, muscle pain, gastrointestinal complaints, skin issues, mood even. So you'll just see through the gamut of symptomatology. But what's also interesting is that I will have patients come to my practice who may have really high autoimmune markers, but don't have a lot of symptoms. So it's not always geared, but I pretty much feel today that almost everyone should be at least screened for autoimmunity.

Caitlin Estes (05:48)
Mmm.

Dr. Mary Davis (05:57)
you know, that they if they have antibodies to their self tissue, it may not be that the actual that it's really serious and that it's in other words, there's no evidence of end organ damage, even though we're finding those markers. But at least we're aware there's something amiss in the system and it needs to be addressed. And as far as the menstrual cycle, I mean, you can see a lot of PMS ⁓ and ovulation.

Caitlin Estes (06:15)
Yeah.

Dr. Mary Davis (06:24)
can affect definitely the ovulation, the luteal phase issues, luteal phase defect with the sacrifice of hormone progesterone because of all the inflammation. And then it can go on to impact ⁓ fertilization and implantation and all of those things.

Caitlin Estes (06:42)
Of course, yeah. ⁓ I think that it's so interesting. We talk here a lot about how the body is interconnected. And so you really can't just take the reproductive system out and look at it on its own. You have to think about the whole person and the whole body and the whole system there. And so I love that the first symptoms you gave were symptoms that weren't specifically related to what we think of as, you know, menstrual cycles and reproductive health. They were just overall health symptoms.

But obviously you're saying that those can have an impact on your reproductive health, whether you're trying to conceive or not, they can impact those hormones and the process of having regular healthy cycles. Is that right?

Dr. Mary Davis (07:26)
Yeah. And there's a strong correlation with conditions, say, maybe your listeners have heard of Hashimoto's, probably the most common autoimmune diagnosis I see in my practice, ⁓ which is ⁓ autoimmune thyroid disease, which can definitely impact someone's fertility and their menstrual cycle. But there's a high correlation between a condition like Hashimoto's or autoimmune thyroiditis and endometriosis and polycystic ovarian disease and premature ovarian failure, which can be autoimmune in nature.

So those diseases like endometriosis and PCL aren't considered autoimmune, but they're correlated with autoimmune disease. So by addressing root cause and by addressing autoimmune conditions, you're often also helping address the other conditions that impact fertility.

Caitlin Estes (08:03)
Yeah.

Okay, so if someone came to you and they were diagnosed with an autoimmune issue, whether it's Hashimoto's or something else, what is going to be that functional approach to that diagnosis? You know, would it be pretty much standard what you would get in any sort of Western medicine approach, or is it going to be different because it's functional?

Dr. Mary Davis (08:38)
definitely is gonna be different from my perspective and from a functional root cause perspective. In medicine, we don't have auto immunologists. So patients will get, say they have Hashimoto's or type one diabetes, they'll see an endocrinologist. If they have MS, they'll see a neurologist. If they have ulcerative colitis, they'll see a gastroenterologist.

Caitlin Estes (08:48)
Hmm.

Dr. Mary Davis (09:03)
So, you know, it's like there's nobody for these patients to go to to say, okay, there's something awry in my system. I want to address like why this happened. The conventional treatments, they may just do a wait and see approach where they may, if it's serious enough, they may go on what we call biologics or disease modifying medications if they need to. But from a functional standpoint, I'm always like, well, what's driving this? So I have a really nice mnemonic that I use, fit, F-I-T-T.

So, and we can go into that, but I look at foods, I look at chronic infections, burdens, I look at toxicants, which is a huge driver, and then trauma. So I look at those, like what's driving that underlying cause, and we need to sort of fish this out through history, through exam, through testing, and address those imbalances and those insults.

if for lack of a better word, the drivers of chronic inflammation that are driving this autoimmune process.

Caitlin Estes (10:04)
Wow, is it always or predominantly inflammation that creates the autoimmune reaction?

Dr. Mary Davis (10:10)
Yeah. Yeah.

So people think autoimmunity causes inflammation. No, unresolved inflammation is what's causing the autoimmunity. And then the autoimmune condition itself creates more inflammation. So we got to draw down inflammation in the patient. there's many ways we address that. But we also need to address the root causes, which are numerous.

Caitlin Estes (10:18)
Hmm.

Mm-hmm, absolutely. I really like the specific approach you take because even when you hear well we have to take care of inflammation that feels very broad very General and so it's like where do you even begin but even having the FITT, you know, there's a place to start it can be helpful and now I'm not surprised for you to say food as the first one when we talk about what's causing inflammation because I obviously can

Dr. Mary Davis (10:45)
Mm-hmm. Yeah.

Caitlin Estes (11:01)
But do you find it's a combination of all four of those a lot of times or is it usually like, oh, this one is kind of specific for each client?

Dr. Mary Davis (11:01)
Yeah.

Yeah, that's why it's chronic complex illness. It'd be great if it was just one instant. And occasionally you'll see, know, this patient has a high mercury burden from dental fillings and eating a high tuna fish diet or something. And like, we really got to draw that down. you know, they really, really reactive to gluten and getting gluten out of their system is having a profound impact. But for the most part, what we're seeing is it's multifactorial, many things driving that chronic inflammation.

Caitlin Estes (11:39)
Yeah, I would imagine especially for couples who are trying to conceive, this could play a huge role in their ability to do that and what that looks like, how long it takes, how healthy and easy that process is. What does that look like when you have somebody come in who wants to have some preconception health consultations? What does that work look like with them?

Dr. Mary Davis (12:06)
So I always try to, ⁓ wow, I guess we can go back to the fit and the monic because I'm always looking at what can we do to optimize their nutrition, right? We can take out the inflammatory foods ⁓ and we may have to test for that to see if there's specific foods that they're reactive to.

Oftentimes we can get into the weeds on this one, but I'm always, very much about, and I don't know if your podcast has ever talked about the mitochondria and the importance of that in reproductive health. Well, that's what you know. Baby gets all of his mitochondria from mom, all of it. So we got to, and all diseases, 90, 95 % of all diseases are mitochondrial, including fertility, infertility and autoimmunity. So without getting in the weeds on mitochondria, I'm doing whatever I can in my mind.

Caitlin Estes (12:38)
A little bit, a little bit, yeah.

Dr. Mary Davis (12:57)
to optimize mitochondrial health in the mom. Cause I know baby's gonna get all of its mitochondria from mom. So I do that by optimizing their nutrition. I want them eating like clean, non-GMO, organic, free of glyphosate, roundup, know, this may sound kind of kooky, but I have them trying to eat seasonal and local and not eat like it's summer all year round. So let's focus getting essential, making sure that.

Caitlin Estes (13:21)
Mm.

Dr. Mary Davis (13:25)
huge, huge, huge part of it is making sure that they have the right nutrients, like essential fatty acids are key to immune health and reproductive health. So I do testing out of Johns Hopkins Kennedy Krieger Institute to determine if they specifically, do you really need fish oil? Like, don't, we need to know specifically to optimize cellular health. So that's a big one, the food. And then we may assess for, you know, chronic infections. So are there dental infections going on from prior root canals or wisdom tooth extraction? Do they have dysbiosis in the gut that needs to be addressed? Do they have, we live in a, I live in an area where there's a lot of Lyme disease. I'd argue that that's impacting fertility definitely impacts the menstrual cycle. So we do testing for Lyme and some of the co-infections. They're very big drivers, Lyme and Bartonella and other co-infections, huge drivers for autoimmunity.

Caitlin Estes (14:09)
Hmm.

Dr. Mary Davis (14:24)
chronic viral infections, success for that. And there's treatments we can do to help mitigate that in people. Another one that's really big is toxicants. I don't know if you've heard of the million marker. There's a million marker.com, which looks at endocrine disruptors in women. ⁓ So doing kind of an assessment of their environment, their home environment.

Caitlin Estes (14:33)
Hmm.

Mm.

Dr. Mary Davis (14:47)
like there's so much that I do to try to optimize the health of the parents, ⁓ toxic heavy metals, things like that. And then looking at a trauma history too. So to see everything there from that standpoint that we need to assess and optimize. I hope that wasn't too much. I'm just trying to give an idea of what I look at.

Caitlin Estes (14:49)
Sure. Mm. Absolutely.

And you're painting really broad strokes because there is so much that you could investigate, but it's not like all of those things are going to come up for every single woman. That's why it's tailored to her and individualized, but I really appreciate, like you said, you work with chronic complex illness and you're trying to get to the root cause of that. So you probably dig a little bit deeper than the average physician does ⁓ for that reason. And so, you know, I imagine there are going to be some listeners are like, my gosh, that sounds like a lot that's getting really nitpicky, really specific. Well, maybe, but also maybe because the women who are in this situation have already gone through the standard Western medicine and have not come back with necessarily what they want or what they need in order to be healthy and be successful with having a really strong menstrual cycle and the potential to conceive there. So this isn't maybe the average situation, but kind of that next level for someone who's struggling with autoimmunity or someone who doesn't just want to start taking medications.
wants to look at is there a way that I can improve it before we have to get to the point of looking at medications. So is there any other advice or guidance that you would offer for women who are trying to figure out if maybe autoimmunity is playing a role in their women's health or if they should address that in a certain way before they try to conceive?

Dr. Mary Davis (16:39)
I think checking in maybe with, you know, a provider like myself, a functional who's going to take a little bit of a deeper look, you know, you can go to your regular provider and have them say, Hey, I just want to, you know, if you're having issues with trying to conceive or, um, having some physical concerns and we're, you know, maybe check something like there's a nice marker called an ANA. It's not foolproof, but at least it's a nice screen to say, you know, do they have a positive ANA that may indicate an autoimmune tendency?

Caitlin Estes (17:10)
Yeah, there's lots of reasons to do those initial screenings for sure to see if that could be something affecting you. Well, thank you so much for being on the show and sharing some of your expertise and experience, Dr. Davis.

Dr. Mary Davis (17:14)
Yeah. I know it's a lot, I could talk forever about it. yeah, yeah, you're quite welcome. It can be very complex, yeah, but it's rewarding work.

Caitlin Estes (17:34)
Absolutely. Well, listeners, we are all about empowering you to understand your health and to get the best care possible.

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