Inflammation, Infertility and Miscarriage with Dr. Jan Rydfors

Chronic inflammation may be an important and often overlooked piece of the fertility puzzle, particularly when infertility or pregnancy loss remains unexplained.

Dr. Jan Rydfors, Stanford-trained OB-GYN and founder of the Freyja Early Pregnancy Loss Clinic, joins me on Health Youniversity to explore the connection between inflammation, reproductive health, implantation, and early pregnancy.

We talk about some of the factors that can drive chronic inflammation, including insulin resistance, stress, gut health, endometriosis, and adenomyosis, and why addressing these issues before conception may help create a healthier foundation for pregnancy.

This episode may be especially helpful if:

• your labs look normal, yet you're still having difficulty getting or staying pregnant
• you've experienced more than one pregnancy loss without a clear explanation
• you're wondering what insulin resistance, gut health, or endometriosis may have to do with fertility
• you're preparing for IVF or a frozen embryo transfer and want to support your health beforehand
• you want practical steps you can take now to improve your preconception health

We also discuss AMH, progesterone support, reproductive immunology, and some of the emerging ways inflammation may be measured.

Support your fertility journey with the Preconception Plan at Health Youniversity:
https://healthyouniversity.co/programs

Learn more about the Freyja Early Pregnancy Loss Clinic:
https://freyjaclinic.com/

💻 About Susan Fox: https://www.healthyouniversity.co/about

Take your 5-Element Fertility Quiz:  http://yourfertilityquiz.com/

Detox to De-Stress:  View the FREE Masterclass on the importance of detoxification to prepare for a healthy pregnancy:  https://susanfox1.easywebinar.live/gentle-detox

Learn about our program entitled Your Fertile Health: https://www.healthyouniversity.co/programs

Schedule a Fertile Health Assessment: https://www.healthyouniversity.co/your-fertile-health-call

Let us journey with you as you navigate your fertile health. Connect with me:

🎧 iTunes: https://podcasts.apple.com/us/podcast/health-youniversity-with-dr-susan-fox/id1592763186 

🔊 Spotify: https://open.spotify.com/show/08U9QJf...

📸 Instagram: @dr.susan.fox

💗 Facebook: ...

Transcript

Copy Transcript Copied

SPEAKER_03 1:25

Hello and welcome to today's episode of Health University, where we talk all things fertility, pregnancy and postpartum, and perimenopause. And today we're going to be focusing on fertility and in particular focusing on the discomfort of having recurrent pregnancy loss or struggling with infertility. You don't know what's going on. There may be autoimmune as part of your picture. And we have the good fortune of having Dr. Jan Ridfords who's going to make us smarter on all of this today. He received his medical degree in specialization in specialization training from Stanford University Medical Center, where he is an adjunct clinical assistant professor. He has extensive experience in the work up and treatment of unexplained fertility, and that is always a painful diagnosis to receive because what do you do with it? And unexplained miscarriages, and has founded the Freya Early Pregnancy Loss Clinic in Redwood City, California. He is the initial creator and current co-author of the popular handbook in obstetrics, gynecology, and infertility, now in its sixth edition, my goodness, and the main handbook used by the majority of OB gynes in training in the U.S. He is co-founder of a company called Bonafia, an AI company that is using retinal imaging and AI interpretation to evaluate and reduce chronic systemic inflammation. It's using this technology for endometriosis detection, preterm birth risk detection, IVF success prediction, and miscarriage risk prediction. So welcome, Dr. Ridfords.

SPEAKER_00 3:16

Likewise, likewise, likewise.

SPEAKER_03 3:18

Incredible success. Did I miss anything in the intro in the cover?

SPEAKER_00 3:23

That's fine. That's fine.

SPEAKER_03 3:24

Okay. Well, we we we talked a little bit off camera about how difficult it is to get a diagnosis and to more importantly treat a person who is struggling with either unexplained infertility or recurrent pregnancy loss miscarriages. So let's just take it from the top. I'm gonna have you give me a little bit of the origin story of Freya and then your your your your your treatments, your protocols, um, what people might need to know.

SPEAKER_00 3:53

Yeah, so I mean I've been practicing for nearly, oh excuse me, my my juice is running out. Apologize. Apologize if you just claim it quickly. Um I've been practicing for uh close to 50, 40 years now. Yeah, 40 years. And uh I've always had a special interest with infertility. Um, and so that's been a very big part of my practice, trying to help people get pregnant. And I was always, you know, so dismayed by the fact that a lot of people were not getting pregnant despite the fact that they've gone through the whole standard, you know, workout, which includes a semen test, making sure the tubes are open, the uterus is open, the hormones are okay. And also, likewise, people who um are having miscarriage for no great reasons. And um it's only about I would say 20 years ago that I really started going more deeply into this. And about 10, 15 years ago, um I started getting more into integrated medicine because Western medicine is not, it doesn't answer questions very well. I mean, Western medicine is based upon treating people, it doesn't look at root causes for problems. And so I was just, you know, shocked. I've I've I've uh lived in South America, in Africa, and I remember when I lived there when I was younger, people had 10, 15 kids, you know, and so did we historically. And so, because of evolution, we should be the perfect breeding machines. So, what's going on? There's something going on, and um I was trying to figure that out, and we've learned a lot over the years, but basically, uh, in my opinion, the main reason we're having these issues is that we have too much inflammation, which is when your immune system is revved up. And why is that causing issues? Well, it makes sense if you look at things historically, because historically, when we were inflamed, we were really sick. You know, we did we had severe infections, we had battle wounds, we had severe skin issues. And so it made sense then that your body, when it interpreted it, when it sort of sensed inflammation in your body, that it would think that you are not able to provide the resources of uh making a baby grow. And all of you who've been pregnant or seen people who have gotten pregnant and been through a nine-month pregnancy, it really drains you. I mean, you you can relate to this a lot. Uh, in Chinese traditional medicine, they really uh think of you being completely depleted, and there's a big program that they do. My wife has been in acupuncturist for close to 20 years, so I know a little bit more than the doctor about that. Um, so it makes sense that that whenever it's sensed inflammation in your body, it would right away conclude this is not a good time. Let's pull the plug, uh, let's prevent you from getting pregnant. And the way inflammation does that is by affecting the egg quality, the sperm quality. But also, if you do happen to get pregnant, it will very rapidly make you have a miscarriage. Not only that, it does not even give up then, even later on, it turns out that inflammation is actually the main reason, in my opinion, why people have something called an incompetent cervix. That's when the cervix starts opening up early. Often people lose their babies in the second trimester in preterm labor as well. So your body doesn't give up, it keeps on um uh affecting things. And uh, since it's so concerned about the fact that you may not have enough nutrition, it will also often affect your placenta. So it doesn't uh it's not as strong, and so you end up having a smaller baby. All of those things, in my opinion, are due to inflammation.

SPEAKER_03 7:37

And where are we getting this chronic inflammation from?

SPEAKER_00 7:41

Well, that's the thing. That's where Western medicine basically has no clues. Um and there's a big field in medicine called uh reproductive immunology, where what they do is that they just treat you. So people who have a lot of inflammation, they will just give them a lot of really strong medications consisting of immunosuppressant therapy. Immunosuppressant, thank you. Like prednisone, they use IVIG, they use um um, you know, tachylimus, uh, even progesterone that a lot of people use. The reason it works is because it's anti-inflammatory. So progesterone is also a mild and also baby aspirin. Those are all anti-inflammatory, they're not as strong as the the big ones, but but they're there. And so for me, I just felt, and I do use some of them, but I I felt, you know, maybe we should do a little bit more than that. Maybe we should try to figure out where it's coming from. And if we can figure out, you know, just go upstream and figure out the root causes, and if we can do something about that, then that will dramatically reduce inflammation in the first place. So a lot of people can do that, and so they don't need any of these things.

SPEAKER_03 8:49

And what so and what would you say are sort of like the five top reasons that you that you see across the board why people are struggling with inflammation and or autoimmune?

SPEAKER_00 9:01

Okay. So for me, the way I look at it, I think there are three biggies. One of them is insulin resistance, you know, which is very common in East Asians, South Asians, northern Europeans, like myself. I have it, I know that. Extremely common genetic, and that at an older age causes high blood pressure diabetes. Okay, a lot of people are don't understand why it causes high blood pressure, but it turns out that most people have hypertension, it's because they have an insulin problem. They have high insulin, which is the result of insulin resistance. And the way it works is that insulin will go to your kidney, hold on to more salt, more sodium, more liquid, so you have more, you're you have a larger volume of blood, and at the same time, it causes a vasoconstriction. So you have a pipe that's really full with water, you're constricting it, blood pressure goes up. And at a younger age, what it does is that it um it tends to affect your ovaries so that your ovaries produce more testosterone. And testosterone is a poison, so it does affect your eggs in a negative way. It doesn't change your chromosomes, but it affects the protein surrounding the DNA, which we call the epigenetics.

SPEAKER_03 10:13

Can I interrupt for just one second? Because we do know that there is a certain level of testosterone in the ovary that is effective. It is that this in the presence of insulin resistance, the testosterone is elevated at the point where then it becomes poisonous. Exactly.

SPEAKER_00 10:29

Exactly. And you can tell if you have too much testosterone because it will make you ovulate later. So, you know, as we go typically when you're younger, your ovulation is maybe 28 to 30 days. But as you get older, you tend to ovulate sooner and sooner. But and and there are a lot of charts on the internet. But if you are ovulating later, then um you should, meaning that your cycles are longer because the time uh between the ovulation and your menstruation is pretty much fixed all throughout your your life.

SPEAKER_03 10:58

Well, it should be, right? I mean, that's the other thing. So so the the important thing, excuse me for interrupting, is to know your ovulation. Don't presume you're ovulating two weeks prior to your to your um menstruation because you may be having a late ovulation and a short luteal phase, which is part of the you know the yes, yes, yes.

SPEAKER_00 11:19

And um, and so another thing it does too is that if your testosterone really goes high, then you start um and excuse me, another you you stop ovulating. Yes, okay, and finally the testosterone will make many of the small follicles, the small cysts that contain the egg, it makes them grow much faster. So you tend to get ovaries which have a lot of follicles, and we call that PCO, polycystic ovaries.

SPEAKER_03 11:46

And so now we call it PMO. Yes, you're right, which is a more appropriate definition because it is a metabolic disorder that is causing, i.e., insulin that is causing these follicles to mature erratically and then perhaps not ovulate anyone. And so then they're hanging around these unruptured follicles, totally shooting off hormones that are disrupting the next cycle from from coming through. Exactly.

SPEAKER_00 12:14

No, no, that's the thing. I mean, we a lot of people still use the terms, the old terms PCO, PCOS, which is when you have the ovaries looking like that, and on top of that, you either have extra hair or you're not ovulating. And they think that's a separate disease, but it's not, it's just the consequences of having too much insulin. Uh, and the reason why insulin issue is a problem is that insulin not only does it push glucose into all of your cells, you know, the glucose that you produce when you break down, you know, not only carbs by proteins and fat, uh, but it also pushes fat into your fat cells. And that's where the problem comes up. So it turns out that when you have high insulin, you just are putting on weight more than other people. And insulin issues get worse with age. So that's why a lot of people are thin when they're younger, but as they get older, they start having more and more issues putting on weight easier. And it's not the subcutaneous fat, it's more the visceral fat, you know, the fat that you have inside the belly fat.

SPEAKER_03 13:09

Um, a lot of people If I may, you can you can use me if I'm right, uh, or or I've made this up. That visceral fat in and of itself is inflammatory tissue. So you're doubling or or sometimes quadrupling the problem.

SPEAKER_00 13:24

For sure. So that's the problem, is that we were never fat, you know, historically. You know, we've been around for two million years. If we had a time machine, we went back, we would be shocked how emaciated we look like, because there was never enough food in most cases, and we were just walking, walking, walking. So we were super, super thin. And so our fat cells, you know, are used to being really small. But then you over the last two generations, now we have excessive food, we're not walking as much. For the first time in two million years, our fat cells, our visceral fat cells are forced to get really, really big. I mean, they're big, they're humongous, like they're like hundred to a thousand times bigger than what they should be. And they hate that, so they start dying off. And that's the problem. When you have high insulin, you are you're baking your visceral fat cells too big, they die off. And somebody has to clean up dead tissue. We have dead tissue all the time, you know, when our cells are, you know, sort of changing, getting new arguments, natural replicating. We have you know, surgeries, we have infections which kill off things. Somebody has to clean it up, and and the our cells that do that are actually immune cells. So our immune cells have two functions. Not only do they kill viruses, bacteria, and cancer cells, but they're also little vacuum cleaners. So you get an accumulation of immune cells on your fat cells, you know, very much like bees in a beehive, but you have millions of them. That's inflammation. So anytime you have a concentration of immune cells doing something, that is inflammation.

SPEAKER_03 14:50

Can I just repeat that because I think that this is an important understanding for folks? So, in the presence of insulin resistance and in the presence, therefore, of elevated testosterone, there is more inflammation. The inflammation is visceral inflammation, which in and of itself is inflammatory, which requires a heightened response from the immune system to try to clean it, clean up an IL-7, so to speak.

SPEAKER_00 15:16

Exactly. And let me just switch and give the other side of the story. What actually happens in the uterus when you get pregnant? Well, when you get pregnant, you know, if you have an embryo that sticks to the surface of the of the cavity, right? And it needs food, so it forms roots, just like a plant does. Those roots are the early placenta. And this is really the the the main problem is that the embryo genetically is 50-50, mom and dad. But the placenta, the DNA of the mom is inactivated. So the only active DNA in the placenta is dad. So the placenta looks like dad. All the proteins on the surface of the cells that are generated from the DNA look foreign. And so as it's growing down further and further into the utron wall where the immune cells, you would eventually expect an attack because immune cells attack things which are strange and which are air quote, other, which are other with other, right? So in many ways, you can think of it that there's the percent is like um a transplanted organ that has been that's growing inside of you. But it doesn't happen. This is the magic of pregnancy, is that at the same time the embryo, realizing that it may be attacked, sends uh immune signals to put the immune cells in the uterus asleep. Okay, so that's the magic of pregnancy. Your embryo, your pregnancy typically is putting all the immune cells in the uterus asleep, so there's no attack, despite the fact that it should happen because it looks so strange. And this is and it doesn't affect anything around your the rest of your body, all your other immune cells are really awake and very active. Okay, and that sleep persists until nine months. Then they're allowed to wake up for the first time, and then the immune cells see this huge placenta that looks like a foreign liver and start attacking it, and that's labor. So labor is an immune reawakening event.

SPEAKER_03 17:12

That's very interesting.

SPEAKER_00 17:14

Very interesting, huh? But they have to sleep, and this is how inflammation will cause a miscarriage or very early pregnancy loss, is that all your immune cells are one family, they talk to each other. And so if you have a lot of revved up immune cells, we just talked about one of the biggest, the insulin resistance, where the fat cells get so big they get they die and then they have to be cleaned up by the immune cells. Those chemicals, those immune chemicals from that inflammation will wake up the immune cells in your uterus. So even if your your your pregnancy is trying to keep them asleep, they get awakened. And if they're awake, they will attack. That's how how inflammation causes miscarriages. Okay.

SPEAKER_03 17:57

When I when I so there are often oftentimes, you know, miscarriages are at the eight to ten week time frame, that being a first trimester. I mean, regrettably, tragically, it's it's also can be later in a pregnancy, but it's pretty common when there's recurrent pregnancy loss for it to be that time frame. Can you explain why? Or or is it simply that that immune that you know high hyperactive immune system never got a chance to calm down before conception?

SPEAKER_00 18:24

Yes. Okay. So there's two reasons why people have miscarriages. And one of them is genetic. That's when there's a chromosomal problem, and that's often based upon, you know, the older you are, the more common you have genetic issues in the eggs when they get fertilized, you know.

SPEAKER_03 18:39

But that's explained. That we're, you know, if there's if someone tests the fetal tissue, it's explained.

SPEAKER_00 18:44

But it's the unexplained that's 50% is inflammation, is due to this process.

SPEAKER_01 18:50

Okay.

SPEAKER_00 18:50

So your embryo, so essentially, if your inflammation is not that bad, your embryo is trying so hard to put the immune cells asleep so that it still wins that battle. So they're still sort of sleeping. They may be attacking the placenta a little bit, but not enough to kill it off. And we see that clinically. So when I see people early in pregnancy, when I do ultrasounds, I will often see that the embryo is not growing quite as much as it should, or I see that the heartbeat is not as fast as it should. And then I know that there's a partial immune thing going on. Okay.

SPEAKER_03 19:24

And the interesting thing is that I'm I'm sorry, I'm I'm so fascinated. I forgive me that I keep interrupting, but in that case, if you're seeing that the heart rate is not what you would hope, is there intervention at that stage? Ah, good, let's go.

SPEAKER_00 19:40

So that's why I see people. So typically when I see people who have infertility that's unexplained, or if they have multiple unexplained miscarriages, and many of them I see from IVF clinics where they put in these beautiful genetically normal embryos, and they just you know don't stick or they they miscarriage after a few weeks. I try to figure out why um it's happening and try to mitigate that. And we we bit we started that that conversation already. We'll go back to it. But the second thing that I do is that after I've done everything I can, then I test to see where they're at. You know, there's certain immune labs that we can do which are very specific. We have to send people to Chicago for that.

SPEAKER_03 20:20

Oh wow. So you can't do the a blood draw here and then ship it to Chicago?

SPEAKER_00 20:26

No, you can. You can. That's what we're doing.

SPEAKER_03 20:27

I see.

SPEAKER_00 20:28

We draw them here. Got it.

SPEAKER_03 20:30

I was thinking, my goodness, that's that's arduous to have to get on a plane to Chicago. Oh, no, no, no. The lab is in Chicago, but the but the blood draw happens on premises at your clinic. Gotcha. Exactly.

SPEAKER_00 20:39

Or you can go to um other clinics. You you can do a lot of draw places you can get it done. And then based upon that, I will often give some immune medicines uh based upon what's left over, what inflammation is left over, because many times you cannot completely get get rid of everything. But I end up giving much less than what I had to, if I would have had to, if I hadn't looked into the root causes. So in other words, people are starting at a much lower inflammation to start with. But anyway, when I see signs that there's an immune process happening where it may eventually, you know, um really unfortunately say this, kill the embryo, then I can give things and I tend to give people some strong immune meds, and that usually works.

SPEAKER_03 21:24

And is this prescription medication or is this supplement medication?

SPEAKER_00 21:27

Unfortunately, it's prescription. Prescription.

SPEAKER_03 21:29

It's prescription.

SPEAKER_00 21:30

I use a lot of anti-inflammatory uh supplements as you do.

SPEAKER_03 21:33

Right.

SPEAKER_00 21:33

And we can share, talk about what we do differently or the same. Uh, but I tend to give people, you know, one thing I I I give a lot is is prednisone, which is a very ubiquitous anti-inflammatory medication. The nice thing with it is that it doesn't cross the placenta. There's a theoretical risk of increasing the risk of cleft lips by about one in a thousand, but even that is disputed. So the risk is minimal, minimal, and it works really, really great. I would say 80-90% of cases when I see an early sign, I can save it.

SPEAKER_03 22:05

Okay. And uh of course, when I think of you know prednisone, I also think of things like low-dose naltrexone. Is are they just too different? Do they work?

SPEAKER_00 22:16

They're they're not as strong. I'm not sure.

SPEAKER_03 22:17

So you need a certain level of immunosuppressant. You need something very fast to put the fire out.

SPEAKER_00 22:23

Unfortunately, you need to, yeah. So even if you give people, you know, high dose fish oil, which is a very good anti inflammatory agent. You can't really, we don't use turmeric very much in pregnancy. We do a lot before.

SPEAKER_03 22:34

Uh SPMs are use as well, uh, which are these um um specialized pro-resolving derived from fish oil. Exactly. Yes, that are that have been clinically shown to really be very effective in reducing very early onset inflammation so that you're not going into that uh uh cytokine, you know, uh uh sort of hyper reaction where where inflammation is causing more inflammation.

SPEAKER_00 22:59

Totally, totally.

SPEAKER_03 22:59

Yeah, yeah.

SPEAKER_00 23:00

Um so so people have miscarriages later on due to immune reasons is because inflammation is not that that bad, but eventually it it it's able to it it does it it affects the pregnancy.

SPEAKER_03 23:12

Something flips that switch.

SPEAKER_00 23:13

That's it. And typically when you get to about nine weeks, which is to transition between the embryo, embryo and um and the fetus, um, then the pregnancy. Hormones have reached the level where they themselves will calm down the immune system. That's why it's really unusual to have a miscarriage after that. It's really rare, you know, for immune reasons. Now, the interesting thing is that uh when you're pregnant nowadays, often we do something called NIPT. We do a blood test on the mom, and in there we can find fetal DNA. Okay, so we do that in.

SPEAKER_03 23:46

What does NIPT stand for?

SPEAKER_00 23:48

It's okay. Uh non-invasive um uh is it platelet? Something parental testing or I see. Okay, well we'll look it up.

SPEAKER_03 24:00

I just we have curious minds here, so I'll make sure we look it up.

SPEAKER_00 24:04

No, no, you're you you're good. I I I I I know it, but I just I'm just forgetting. But it's a way to tell what's going on with the baby, essentially. You know, we we do this nowadays instead of doing amnials, we used to do them in everybody or at least recommended it to everybody who's over 35. And it turns out you can actually we do it around nine weeks. Okay, that's the earliest we can do it. But in research setting, that technology can be done actually really, really early, after like a you've been pregnant like a week or or so. And it turns out that in those really early miscarriages, you know, sometimes the so-called bicemical ones, yes, where you you just get a positive pregnancy test and then everything just stops. Um the 90% of them are due to inflammation. So, yes, a lot of miscarriages happen later, but the ones that are mostly due to inflammation are the really early ones. And in fact, many of us believe that a lot of people are getting pregnant much more frequently than they think, but they're having miscarriages so early that they don't even get a positive chemical uh pregnancy test. That's all inflammation.

unknown 25:10

That's all.

SPEAKER_03 25:11

What I'm hearing you say is intervention can occur anywhere. I mean, you don't it you don't have to do this intervention, although it would be ideal to do it before conception, because then you've got a healthier egg, you've got healthier sperm, creating the healthier embryo that's going to be better prepared, as well as the body being less inflamed and ready to fight against the other. But it but it the intervention can also happen anywhere during the nine months of pregnancy. Is that correct?

SPEAKER_00 25:40

Exactly, exactly. You know, I was mentioning to you too as well that the inflammation causes issues even after you pass that stage. You won't get a misketch, but you can have an incompetent cervix or preter birth. And progesterone, which is an anti-inflammatory thing, has been used for a long time successfully to prevent those things. But most optetricians are not interested in immunology, so they don't make that connection. But you and I do.

SPEAKER_02 26:03

Right.

SPEAKER_00 26:04

That's the reason it works, is really because it's anti-inflammatory.

SPEAKER_03 26:07

Right.

SPEAKER_00 26:07

It keeps the cells asleep.

SPEAKER_03 26:09

We if to to dial back to the beginning, um, we talked about insulin as being one of the main triggers. What's triggering insulin and what are the other main triggers that people need to be aware of?

SPEAKER_00 26:22

Okay, so the insulin issue it gets worse with age. You need to have the genetic predisposition, but it also gets worse as you put on weight. So if you can lose weight, you know, either and and really the GLPs have have changed, have dramatically helped this because unfortunately we're not eating well, we're not exercising enough. And it's hard after you get to a certain point, it it, you know, for some reason as you put on weight, it gets easier and easier to put on even more and more weight, which is so frustrating for so many people. So GLPs are really good. Um, we use a lot of um myositol, which is a supplement, which is very effective in reducing insulin. We use alpha liporic acid, which is also effective. We also use berberin, but we have to stop that when you're pregnant.

SPEAKER_02 27:04

Correct.

SPEAKER_00 27:05

Uh and we use a lot of metformin. So some people who feel that they want something a little bit stronger, it's a prescription medication. But that you can also use in pregnancy. So we use a lot of that.

SPEAKER_03 27:16

But that is the that is the prescription that is given when someone has uh uh diabetes. There's they're showing some diet, you know, some of them.

SPEAKER_00 27:24

Exactly, which is the the last stage of that. But you can use it even in the earlier stages, even if you have high blood pressure, or if you have just you know very long cycles or not ovulating, metforming works really well because you're dealing with the same thing. It's all an insulin problem, you're reducing it.

SPEAKER_03 27:39

Got it.

SPEAKER_00 27:40

So the second biggie is stress. So it's really interesting. 15 years ago, they actually did a study in a college setting. They they talked to all these freshmen and said, Hey, we'll give you 100 bucks if you if you want to be a part of a study. And of course, everybody wanted to do it. And they subjected them to the worst stress possible for an 18-year-old. You know what that is, Susan?

SPEAKER_03 28:00

I'm gonna say uh uh contraception or or lower.

SPEAKER_00 28:06

No, that that that too. In this case, it's they felt it was public speaking.

SPEAKER_03 28:12

Ah, okay.

SPEAKER_00 28:13

I can relate to that.

SPEAKER_03 28:14

I don't like speaking in front of people, especially when I was young.

SPEAKER_00 28:17

Oh my god. So what they did is that they put them in front of a room, told them to talk about something that they really didn't know much about, and in front of a hundred hundreds of people, and 10 minutes after they started, a nurse came in who's part of the study and drew blood from them. They were mostly on the floor, so she had to like kneel down. She took the blood to the laboratory and looked, uh, rem sort of uh looked at the immune cells, was able to sort of separate them, and looked at an enzyme in them that's sort of responsible for inflammation, which is called NF kappa B. It had gone up 300%.

SPEAKER_03 28:51

Wow.

SPEAKER_00 28:52

In 10 minutes. Wow. And it stayed high for one hour. And most people are stressed out. It's not just one time during the day, it happens again and again and again.

SPEAKER_03 29:01

So those every red light, every next Zoom call, all of the things. So they're and our bodies are behaving as though it's yet another saber-toothed tiger. So exactly. That's very interesting.

SPEAKER_00 29:13

That costs life, and that's why well-meaning friends will tell their friend friends who are having problems to get pregnant. Why don't you go on a vacation? It actually works. If you get pregnant on vacation, you have much less chance of having a miscarriage because the inflammation is lower, it doesn't awaken those dormant immune cells in your uterus.

SPEAKER_03 29:32

Got it. So so if I were to tell tell the story and tell me if I'm wrong, that that stress, that second leg of the of the triggers, if you will, is is actually releasing cortisol, which is then releasing insulin. So does it still come back to you know the this the cortisol insulin complex or is it a different mechanism?

SPEAKER_00 29:53

It's actually epinephrine in this case. I mean cortisol is important too, but epinephrine is is is the one that's that's that that's affecting things. In this one, it's complicated, but that's sort of what they were focusing on. Yeah. The third biggie, uh, in my opinion, the three, I mean, people have different opinions, but my my feeling is that it's poor gut health, leaky gut, huge, huge problem.

SPEAKER_03 30:16

Oh, that's inflammation. Oh, right.

SPEAKER_00 30:18

It causes inflammation, yeah. I mean, you know, you you deal with that too. We have you know 50 trillion or so uh bacteria, which we call the microbiome. And now you can do DNA testing on the stool to actually see what you have. And if you compare them with certain you know, hunter gatherers like the Hadsa in Tanzania, the Yano Mammies who are in um the Amazon jungle, ours is very different. We don't have more or less, but we just have much less variety. And and and the reason ours is not healthy, obviously, we eat much less fiber, maybe 10% of what we should. We eat much less polyphenols, which are these things that you know are what which give colors to vegetables and fruits and berries and green tea and coffee and chocolate. Those are the two main sources of food for the microbiome. So if you eat if you eat plenty of fiber, plenty of polyphenols, your microbiome will do really well. But if they're not healthy, and on top of that, of course, we take antibiotics, we have glyphosate, which is a weed killer that's that's used a lot in agriculture that stays around forever.

SPEAKER_03 31:20

We're consuming microplastics at microplastics, I mean you name it. It's just please connect with us for a fertility assessment call at the link below. We'd love to learn a bit about you and share our resources. And make sure you subscribe to our YouTube channel so that you never miss an episode.

SPEAKER_00 31:38

And so our microbiome is not healthy, and they're responsible for producing chemicals like butyrate, which is really the food for the intestinal wall. So if they don't get enough, they get very, very weak, they thin out, you get holes between them. And then many of these bacteria and their products and um, you know, parts of them go right through. They can actually slide right through, get into your body, and your body doesn't want to see them, and that's leaky gut. And that's basically an infection. So, you know, we do have 60-70 percent of our immune system residing around our intestines, so they just start attacking that, and this is a 24-7 kind of thing. So that's a low-grade chronic inflammation.

SPEAKER_03 32:21

And as I would tell the story, and and it may not be the whole story, that is the very scenario that is a setup for autoimmune, because the immune system is looking to tag these molecules or particulate so that it can be prepared to kill them again. But when it is our own tissue, our gut tissue, our joint tissue, our thyroid tissue, if it if the proteins look like that, then we're we're creating the onset of autoimmune.

SPEAKER_00 32:49

Totally. Exactly. No, it's it's it's so true. You need leaky gut, and sometimes if you have a genetic presupposition, it makes it even more common. You get, it's basically as getting as if you're getting vaccinated to something. You get antibodies, and then they float around looking for that initial you know, cause that they can't find it, but they can find something that looks like it. It's just as you mentioned, the thyroid is a biggie, the skin is a biggie, like psoriasis, joints, you know. Um, but it you there's about a hundred plus uh autoimmune diseases now.

SPEAKER_03 33:21

So most of them do you have a sort of a secret weapon, if you will, of for testing? Because of course, you know, the standard blood test is looking for uh elevated antibodies at a certain level before they say, yep, that looks like Hashimoto's or yep, that looks like rain nodes or whatever. But of course, before a body reaches that threshold, the autoimmunity is act is active.

SPEAKER_00 33:45

Right, exactly. And it's very possible that many of us, most of us, probably have a low grade autoimmunity and it just hasn't come out, so it's not clinical. Sometimes it's really even hard to measure the antibodies. And the the interesting thing is that if you do a blood test, when what they tell you is normal is what they find in the population. So if if a lot of people already have low-grade autoimmunity, they're going to say that that's within the normal range, but it's not. And in fact, if you look at lab results historically, that normal level has gone up in everything. You know.

SPEAKER_03 34:20

Interesting.

SPEAKER_00 34:20

Um, like liver four.

SPEAKER_03 34:21

What I think I'm hearing you say then is let's all of us presume we've got some level of insidious, perhaps, you know, perhaps not yet on the labs, autoimmunity taking place or just ready to take place. So we do the things to remove those insults and calm the immune system. And a lot of that in in my work is, you know, sort of diet and nutrition, supplementation, lifestyle, proper sleep, proper movement, all of that kind of thing.

SPEAKER_00 34:50

Totally, totally, totally. Yeah, no, and I exactly. I mean, you know, since you know, like when we get the COVID vaccine, we always have to get a booster. So if we're able to heal the gut, there'll be less of these sort of less uh of these proteins that are keeping these antibodies going and they just sort of fade away. So you can actually in many ways improve it by by improving your your gut health. And and as you said, it's it's prebiotics. So I'm I'm a I've sort of moved much more from probiotics, I still use them, to prebiotics. I really push fiber in the polyphenols. And you can go to the internet and get a list of of you know foods that contain Yes.

SPEAKER_03 35:27

And then again, that way you're actually eating healthier food. You're not taking a handful of supplements while you take your highly processed pasta or bagel or whatever is providing no nutrition. So you're really restoring your health with nutrition.

SPEAKER_00 35:43

Exactly. You can restore it. So going back to your your question, there's some tests that I occasionally do. It's made by a kind of company called Cyrex. It's a blood test, and they look at three different proteins that are associated with leaky gut. So you can, if you feel you have leaky gut, and it's hard to detect because most people don't have symptoms, but some do. And one of the big ones is really constipation, in my opinion, and bloating. Those are probably the two the two biggies. Um, and so that's gonna help. Uh so you can do that if you want to document it. But I think everybody has a certain degree of leaky gut. None of us have healthy microbiomes. So eating more fiber, more polyphenols, taking probiotics uh is a good idea. Um, I typically give three different types of probiotics. I mean, the typical one is the one that you find in, you know, kimchi and all the fermented stuff, which is the lactobacillus bifidobacterium class. But you also, in my opinion, need also spore-based ones and also uh the bulardi, which is a fungus which acts as um, and and I so I I often I use all three three of them. We have most data on the first type, the lactobacillus one, but I I feel it's good to do all the other ones. But I have shifted in the sense that I I think that the prebiotics are probably more important than the probiotics. Your body has an amazing ability to heal itself, you just you just have to feed it well, and that's challenging. So um I was gonna say, yeah, so and also to help to heal things well, you can also you probably use them too. There's certain things that you can use, uh glutamine, you can use uh zinc, you can use uh carnosin. I mean, a lot a lot of things that you can use to help to heal as well. Um, I'm a big believer in the elimination diet. I think for something it's a really good way to reset things. You just basically, and you can look it up. You do all of this you can do yourself. You know, you just basically cut down a lot of different things and you stick with that and you slowly uh bring food back. But sometimes it's good to work with somebody, you know, like a provider like yourself or a nutritionist or even a functional uh person.

SPEAKER_03 37:50

And I would agree with you that that because I find that a lot of times patients are eating well, but they're eating the same thing over and over. So they're not getting the variety that's going to actually contribute to either healing particular tissues or restoring a microbiome that is, you know, out of balance. And I usually try, I I try to get a like a 28-day reset. You know, that's like just because we we can all do something for four weeks if the if our motivation is that we want to not just a positive pregnancy test, but a healthy babe in arms after after nine months. So um, and and and then I provide a little meal guide with it to just give the variety some suggestions. It's not, it's not, you know, it's not a workbook, it's just a guide. Because once again, when we're used to having we're eating healthfully, but we're having a salad every afternoon and broccoli every evening with maybe some chicken on on both days. That's not going to always give you what you need for your polyphenols, for instance.

SPEAKER_00 38:46

No, no, you need variety. And if you look at those traditional, you know, groups that we talked about, they they really change their diet because they're living outdoors, so there's always change and things like that. Yeah, so that's that's super, super important. So um, so those are the three biggies, and then there's like six or seven minor ones. Um, and that's lack of sleep causes definitely inflammation.

SPEAKER_03 39:08

I would argue that that's not minor. Yeah, it's because it's going to have an effect on the three major soil.

SPEAKER_00 39:14

Oh, for sure.

SPEAKER_03 39:15

Yeah.

SPEAKER_00 39:16

Um I I low magnesium, you know. I mean, our soil is depleted because we've been using petroleum-based fertilizers since the Second World War. So we some some soil has 30% less minerals, so our vegetables are depleted, were depleted. None of them are good, many of them are cofactors, but the one that is the worst for our purpose is really magnesium because low magnesium causes inflammation. Uh low zinc does too. When it's not as common to have low zinc, maybe 50% have good normal levels. Uh low omega-3, the DHAEPA is huge, you know, because all civilizations, you know, started around water. If you look at even, you know, historically, you know, the Indus culture, the Babylonian culture, you know, the Mesopotamian, the Nile. We all read that when we were younger in history books. It all started around water. And so we ate a lot of fish, a lot of lot of water products. And now we don't. And um, that's really the main source of um omega-3s.

SPEAKER_03 40:19

And I guess I would say that but again, by the time someone is is thinking about fertility or pregnancy or and or having you know recurrent loss, yeah, decades of not having eaten fish, or then that that that how shall I say that that environment is already established. So even if if you say, okay, I'm gonna have salmon three times a week because I'm trying to conceive, it may not be enough. I think you need to eat at this stage, yes.

SPEAKER_00 40:46

So you can do a blood test to look and see how you're doing. And and the one that I like is called the omega index, and that looks at the percentage of omega-3s in your cell membranes.

SPEAKER_03 40:57

And uh threes are the good ones, folks. The threes are the ones we're doing.

SPEAKER_00 41:00

Three good, yeah. The the C-rolls, we we can talk about that for for hours as omega-6s. They're but they're not so good for you. But they've looked at how much you need, it's probably 2,000 of omega-3s. So it's more than a thousand. A lot of people just take a thousand. I I tend to sort of put give people two two thousand and along with SPMs. Yeah. So I do that. Um, so what else?

SPEAKER_03 41:23

Um that's interesting because I I tend to stop SPMs at pregnancy only because the the data, you know, the research isn't there. So I I I get a little bit, a little bit leery. But of course, then but I'm and I'm really on the omegas throughout, and I'll go higher dose if they've been on SPMs prior, because I want to make sure they've got the you know, at least the level of protective support, protective uh nutrients there. Um, and then I will say, you know, if you if you notice that you're starting to bruise easily um because of the blood-thinning potential, then you know, we'll we'll look to we'll either test again and we'll look to back off. But you continue with the SPMs through pregnancy.

SPEAKER_00 42:02

I do, at least through the first trimester where inflammation has a biggest you know issue. But I do continue with the two grams of fish oil all throughout you know, and of course, if they can if they're vegetarian, I I would tell them to do algae oil. Yeah, I mean, all fish oil is originally made by algae that are than eated by krill eaten by the fish. Yeah.

SPEAKER_01 42:21

Exactly.

SPEAKER_00 42:22

So but it's more expensive. Uh the krill, the um the omegas are slightly different. They're like, I think they're esters, so you don't get as much um aftertaste or burping. So so if you re if that really, if that really bothers you, have krill or something.

SPEAKER_03 42:36

But in your ore, if you or if you have um a problem with digesting fish oil, then then yes, there are other options.

SPEAKER_00 42:45

Other options, yeah, unfortunately. And so whenever you have all of those things going on, we talked about the three big E's, the six, seven minor ones, it gives you like a uh underlying level of inflammation. And this it brings you to something that I feel really is extremely common and is really many people the main source of inflammation, and that's endometriosis and adenomiosis. So just to go over that very quickly, um, it turns out that you know, whenever you go through your cycle, you create a lining of the uterus so that the early ember can stick, you know, can grow into it, like you know. And if you don't get uh pregnant, it comes out with blood. That's what you see during As your menstruation. As your menstruation. But what people don't know, most cases, I didn't know this either, is that you have two other openings besides your cervix, you have your fallopin tubes. So all women will menstruate also partially through the fallopin tubes, and that ends up inside your body. So maybe 10% of what you see, that amount ends up inside of you every month.

SPEAKER_03 43:49

And if I may, I I had the good fortune of having the her at her ANOVA and her resolve team here, the blood test for endometriosis. And they really made a very good point that I also want to add here because we're covering endo, is that while all women will have some retrograde menstruation, not all women have endometrios endometriosis, the inflammatory condition. So now I'm gonna let you continue.

SPEAKER_00 44:12

Yes, yes, and and and yeah. So every month somebody has to clean that up. And who does that? Well, it's our little vacuum cleaners, it's our immune cells. So our immune cells clean up that retrograde menstruation every month, and that goes on for a long time. But as your background inflammation goes up because your insulin resistance goes up as you get older, your stress gets more, your your gut, you know, not sleeping well, blah, blah, blah. That uses up a lot of immune cells. And our body feels that that's priority number one. So basically, triage is it pulls them away from doing that cleaning up activity. And if if your cleaners are not there, and I think anybody who listens to this who works in an office can just imagine if the cleaners go on strike for a month, what happens? I mean, the wastebaskets will just overflow and that it's a mess. That's exactly what happens. You get an overflow of endometrial cells. Many of these endometrial cells end up actually going inside the utrine wall.

SPEAKER_03 45:11

Andiosis.

SPEAKER_00 45:12

It will it will lead to a neomyiosis. But anyway, this continues until you you reach a critical point where you have so many excessive cells that your body, like, wait a moment, this is something, there's something wrong. This is an invader again. Disinfection and then it it goes to attack mode. It sends a huge army of immune cells continuously to attack all of this. And they say create peroxide to kill everything. Proxide is like a it's not I I I tend to use the word acid because it sort of uh acts a little bit like that, but it just basically burns off everything and you get scarring and you get a huge amount of inflammation. You get like a red level inflammation inside your body. And inflammation, as you know, in many cases, you can relate to this, makes your nerve endings more sensitive. You know, that's why you get a sore throat when because you're inflamed when you have a sore throat, or you sprain your ankle. You know, many people have had sprain their ankles. It's inflammation that fixes that. That's why it's so painful, you can hardly walk on it.

SPEAKER_03 46:09

Or you're all of a sudden really reactive to your acupuncture treatment.

SPEAKER_00 46:16

Exactly. Uh let's see. Um, and the second thing that it does is that it makes liquid uh build up. And you, you know, you get like a swollen sore throat, you get a swollen um, you know, ankle when you have uh sprain your ankle. But that's also when we do an ultrasound, that's one of the things we look at to see if somebody has endometriosis. Because 50% have no symptoms. That's the crazy thing about endo. You look it up in the internet, it says you should have really painful periods, you should uh you should have um pain when you have relations, but no, 50% have no symptoms.

SPEAKER_03 46:53

They refer to that as silent endo. Silent endo, it's infinite. But it's not so silent when you're trying to conceive.

SPEAKER_00 46:59

That's that's it, because all of your eggs are on the surface of your ovaries, so they're very sensitive to that infl inflammation, that that that peroxide. And it basically just burns off the surface and you lose a lot of those follicles, which is so basically you lose a lot of your eggs. And we have a good way to measure how many eggs you have left over because they produce a chemical or hormone called AMH. And so your AMH is low. So whenever I see somebody and I have their AMH level, I know before I even see them if they have endo or not, because it's nothing that makes your AMH go down except endo. There's there are a few rare conditions, you know, when you're your mosaic turners, meaning that some of your cells have one X chromosome missing, you know. Um, or you have something called fragile X, is a genetic thing that that some people have. Those are the two other things that can cause that, but those are rare.

SPEAKER_03 47:57

So if you have a low AMH, I want to highlight this again, if I if I may, because I think that there are just some points that I don't want them to just go go by in conversation. If you have a lab report showing low AMH, and it is it is an indication, according to Dr. Ridford, and I would agree that there's inflammation taking place and it's likely endometriosis, because that is occurring in the same region of your body as the as the follicles that are trying to send off these, you know, the signals from the granulosa cells.

SPEAKER_00 48:30

Totally. And I've seen so many people over the people over the years now, and it's almost always true. Almost always true. So I would say there's like a 95 plus percent chance that if you have a low AMH, you have endo. And if you have endo, you're very, very inflamed. So going back to the model that we talked about, how the inflammation wakes up the immune cells that should be sleeping, it wakes them up. And the level of inflammation you get from that is higher than the inflammation you get from all these other things we talked about. But you need that as a precursor. That's why some all women have retrograde menstruation, but they do not get this problem because their immune cells are still there to clean, clean up. The cleaning crew is still there. They're only moved away when you have inflammation already.

SPEAKER_03 49:15

Okay, so therefore, if you reduce inflammation, you can increase your AMH levels.

SPEAKER_00 49:21

Yes and no. It does the the ovaries bounce back a little bit, but they will not come back to the same degree.

SPEAKER_03 49:29

Right. They're not going to go back to when you were, you know, 25 years old. Right.

SPEAKER_00 49:33

You've already lost a lot. Yes. Yes. Okay. But but you can you can definitely stop the process. And it it uh it's AMH, if you have low AMH, meaning you have less uh eggs, doesn't mean that the quality is affected. It's not necessarily.

SPEAKER_03 49:48

I mean, there's not that it's there's not a causation, there's a correlation between low AMH and lower quality um egg reserve. Um but that but but the low AMH does not equal poor quality egg. And the our job then, therefore, is to improve our whole health, which will reduce inflammation, which will which will improve the quality, because our eggs are simply a mirror image of what our whole body's going through.

SPEAKER_00 50:17

Totally. Now, so it's not endo itself that causes the problem, it's the inflammation you get from that. Gotcha. And you know, there are many ways we can reduce inflammation, you know, as we talked about. But also, you know, if you take fish oil, um and we talked about how inflammation from endometriosis causes pain. There's a lot of good studies looking at the pain goes down when you take fish oil, and basically that just means that the inflammation from the endo goes down. So many people with inflammation is not that that bad from the endo, you can probably just by making changes in your lifestyle, taking anti-inflammatory supplements, bring it down to a level where it doesn't wake up the immune cells. So if you have so in my practice, the the I see so much endo, there's so much silent endo that especially around here, because people are so stressed out, they're not, you know, they have insulin resistance. I see a lot of people, the engineers who, you know, from South Asia, East Asia, Northern Europeans. And um, so, but I tell them, let's try first to do whatever we can to reduce inflammation by doing all these things, you know, eating better, losing weight, trying to reduce your stress, take more prebiotics, probiotics, eat better food, sleep better, exercise more, you know, take your magnesium, take more fish oil. And often that's enough. Yeah, that's enough. And I would definitely ask your doctor who you're seeing that as soon as you get pregnant, start progesterone because it's anti-inflammatory. You don't have to do this really strong stuff that I summoned.

SPEAKER_03 51:50

IBF centers, yeah. I mean, they're they're they have they have a an obligation, if you will, an onus to have a dosage that is going to guarantee that uterine lining stays intact for a certain period of time. But but but I'm hearing you say that even if if you're not showing low progesterone, taking some extra progesterone in that luteal phase in in early pregnancy as an anti-inflammation, especially if you know you've got inflammation, if you've got autoimmune or other or insulin, you know, signs of insulin resistance, for sure. This is a bit of an assurance policy.

SPEAKER_00 52:21

So that's the thing, is that when you have in when you have inflammation, you actually want to give people higher doses of progesterone than what they normally would be having because it's so anti-inflammatory. And if you give it vaginally, you get a five-fold concentration effect. And they did studies at USC about I think 30 years ago, where they looked at women who were going to have a hysterectomy and they gave them vaginal versus oral progesterone. And then they examined the uterus and they saw a five-fold uh accumulation, concentration effect if you do vaginally. And oral progesterone, by the way, makes you sleepy, so it's harder to take. But we we tend to give it just vaginally for that reason. It's not the most comfortable, it leaks out, but it works well. So, but uh unfortunately, some people will need to have their endometriosis treated. Yes, and you know, because the anti-inflammatory supplements that you are just not enough. And and the treatment for that sometimes you can just take birth control pills for a certain amount of time. Yeah, you know, birth control pills will suppress it. Sometimes you need stronger medicines. There's certain things that you know put your ovaries to sleep and like lupron or elyssay. Um and then finally, some people need surgery.

SPEAKER_03 53:35

Yeah, yeah, yeah.

SPEAKER_00 53:36

Some people need surgery. If nothing works, then surgery is is a way to go. Um there's there's new ways to detect endometriosis. Uh, one of them is something called a receptiva test, which is endometrial biopsy that looks for certain you know proteins. There's something called BCl6 that's higher when you are have endometriosis. It misses some, however. But but you know, but I think if let's say you have problems getting pregnant or staying pregnant, and um you have painful periods and they're getting worse with time, then you should really think about that you may have endometriosis, and it may be good to get that treated with you know hormones or even surgery. Most people do you know medical treatment. Right.

SPEAKER_03 54:25

I think that's actually that tends to be the first course anymore, whereas it used to be that it was straight into laparoscopy. I think now they tend to do suppression therapy with either luPont or ELISA, especially because, again, the people who are who are listening to this conversation, and I'm just noticing the time, are gonna have to wrap it up a little bit early because I want to be mindful of your time and the video.

SPEAKER_00 54:45

Oh no, no worries, no worries.

SPEAKER_03 54:47

Um, but uh there is a new blood test called Her Resolve from a company called Her ANOVA that that actually picks up these um like microscopic RNA proteins, and it's it's a it's a yes, no. Right now they don't have a degree, they can't do stages, but I but I actually offer it in my office, and of course, one needs to be a patient of record in my office. It's like it's not a lab, um, but but with an appointment, we'll do the blood draw. And and the her ANOVA lab will say will come back so often saying positive for endo when either the the either the symptoms were there or sometimes the symptoms weren't. But that before that person goes back to a second frozen embryo transfer, we want to make sure we're addressing this.

SPEAKER_00 55:32

Totally, totally. Yeah, so especially if you've had um an embryo transfer where they put in a beautiful embryo and you end up having a miscarriage where it didn't stick, you probably are too inflamed. Your body's actually the one that's prevent doesn't want you to get pregnant because it doesn't think you're gonna be able to handle it.

SPEAKER_03 55:48

Right.

SPEAKER_00 55:49

Right. Um, it doesn't realize that the old causes of inflammation are not there anymore. You know, it still is thinking from that old perspective. Now we have all these modern things that we talked about that are causing inflammation, not as bad at all. They're like low grade chronic day in, day out. So our body mistakenly thinks that this inflammation we have now is the old kind. And so it will therefore not want you to get pregnant. And and the big, big one, the big, big elephant in the room is endo or adeno, which is basically endometriosis inside the utron wall. And so you can do a lot about all these other things that we talked about, the insulin resistance, you can do something about the gut health, the stress, supplement all these things, get more sleep, more exercise. And often that's enough, you see. Often that's enough. I see a lot of people have these issues, and they and we try that first, you know.

SPEAKER_03 56:41

I agree.

SPEAKER_00 56:42

But if it doesn't, then you should really look at the endo because people, it's hard to diagnose, very hard to diagnose. Yeah, and that's why I I I started this company.

SPEAKER_03 56:54

Yes, I wanted I wanted to ask back to back to Freya. Thank you, Freya. Oh, and to Bonafia, but Freya, the clinic, um are are are you able to see people outside the state of California or do they need to come in and have a you know an in-person visit with you?

SPEAKER_00 57:13

So legally we need to have established care with them. So legally, we we they should come to our clinic. And I do have people who come from from other places around the country, just they come in for the day. I I see them because it's a long visit. We look at all these different things. It's an hour and a half visit often. We do an ultrasound, we look for endo, and then we can we come up with a plan. We can prescribe things if when they go back to a different state.

SPEAKER_03 57:37

Uh, but unfortunately, the first visit they need to establish care. Yes, it's a legal requirement.

SPEAKER_00 57:43

Yes, it's a legal requirement.

SPEAKER_03 57:44

I mean, some people slip through, but you know, I wanted I wanted to make sure that that got stated because I'm sure there are a lot of listeners, viewers saying, Oh gosh, I'd like to I'd like to check that out. So by all means check out Freya and you know, plan if you're out of the st outside the state of California that you'll need to well, even that you'll need to come in for an in-person visit for your first appointment. Now, real briefly, because again, we've we've gone we've gone over the opera market this year. No, no, no. Let's talk about Bonafia because it's because it relates to inflammation. And this is this is your company that measures inflammation through the retina. Yes. Taking a f a photograph of your eye and determining at from the retina whether or not there's inflammation. So tell us.

SPEAKER_00 58:26

So just very quickly, because we don't have that much time, I know. But basically, inflammation, as you all understand now, is really what makes your body think that you're not well. And it's going to prevent you from getting pregnant, staying pregnant. Okay. Or having, if you've had problems, pregnancy issues later on, like incompetent service, preterm birth birth, you're too inflamed. The problem is we don't have any good tests to detect inflammation. We have something called CRP, we have sed rate, we have different things like that, but they miss a lot. They're not that good. They really, really don't, don't, they're not great tests. They miss a lot of stuff. And so it turns out that the back of your eye, the retina, which where you have all these blood vessels and small nerves, they are very rapidly multiplying. They're very metabolically active. And they're the most sensitive part of your body that detects inflammation. Interesting. So they're the earliest because even CRP is something called an acute phase reactant. It's something that your liver produces when it senses inflammation. So it's like an indirect test. If you look at the retina, it it right away, within hours, actually minutes, will start changing. It's we've known this for a long time, but it's very hard to do. And so I teamed up with this person who is part of Stanford. He's a biology AI expert, and he looked at 70,000 retinas and correlated it with their medical history. And he was able to create this AI where basically you take a picture of the eye of the retina, the AI within minutes will tell you how inflamed you are. And it will tell you, therefore, you need to do something. And we are have actually done a pilot study looking at endometriosis. So people had the study before they had surgery, and we feel we have something, and we're starting now a big study with a very active endometriosis person to see if we can. So this will be another thing besides the the test that you're using, because it's so easy. It takes like literally one minute.

SPEAKER_03 1:00:28

And it's and does the test, does the test tell you degree of inflammation? You know, you're mildly inflamed to severely inflamed.

SPEAKER_01 1:00:38

It does.

SPEAKER_03 1:00:38

And does it tell you potential location of the inflammation? Although inflammation is a systemic issue, so I might have just answered my own question.

SPEAKER_00 1:00:46

Yes and no. Yes and no. I think we we see it as a as a systemic thing, but it turns out that inflammation has different levels, different types. So you have neuroinflammation, which is really what causes depression. I mean, 30% of depression is due to inflammation, anxiety, a lot of anxiety is due to inflammation. That's why when inflammation goes down, if you take fish oil, you feel better, for example. Uh, but it also causes MS, you know, the Alzheimer's is an inflammatory thing, a lot of it. Uh, you can also have large vessel inflammation, which is what causes atherosclerosis. You can have small vessel, you can have metabolic, which is related to the insulin resistance we talked about. Uh, you can also have the chronic low grade on top of that. So there's really five different types. But if you look at certain combinations, you see that with endo for some reason. And so we're we're testing that, and then you can you know about that. And again, you don't necessarily have to treat it. If you reduce the inflammation, you will not have the consequences of that. And and you can take a lot of these supplements, do behavior changes, but it tells you about that. And then bona fea can be repeated to see if you're making progress.

SPEAKER_03 1:01:50

And it's just simply a snapshot of your eye, so that you don't there's no blood draw needed or anything like that. But once again, that would need to be sort of in office so that they because it's a particular camera that you're using, you're not using it's a special camera.

SPEAKER_00 1:02:05

So we offer that a Freya, it's walk-in, you can come. Um, we charge $99. If you get a report, it tells you also what to do when you get the result. Yeah, yeah.

SPEAKER_03 1:02:14

And I think what I would like to just I would like to say is you know, you say if you treat the inflammation, you may not have to treat the the disease, but I I guess I would just argue that by treating the inflammation, you are treating the disease. You may not eradicate the disease the way a laparoscopy cutting out the tissue would might do, because frankly, it often doesn't do the full job, but you are you are taking care of the problem that the endo is creating and therefore taking care of the problem that is then either unexplained infertility or recurrent pregnancy loss.

SPEAKER_00 1:02:47

No, totally. And um, and the good thing is when you get pregnant, pregnancy itself will suppress endometrosis dramatically. That's why so many people struggle to get pregnant the first time, they have to do IVF, and then they get pregnant on their own. And it's just because the inflammation is down, because the big, big elephant in the room that's causing the inflammation is endo, and that's suppressed. Yeah. I just want to say too, I'm um for the last seven years, I've been writing a book on everything that I'm talking about, and hopefully it'll be published early next year, is for people to learn all about this and how they themselves, without having to see a doctor, can actually improve their inflammation to the point where they can get pregnant.

SPEAKER_03 1:03:27

That's beautiful. What a what a gift, what a legacy. And where can people find an opportunity to pre-order? I presume on the Freya site?

SPEAKER_00 1:03:35

We're not there yet.

SPEAKER_03 1:03:36

We're not there yet.

SPEAKER_00 1:03:37

Okay, so so I finished the book and I need to find a publisher, but I really want people who um who are struggling because so many people are struggling, they're not getting pregnant, they don't know what's going on with their bodies. A lot of doctors are really good doctors, but they're just not focused in this. They will just tell you, you know, go on vacation or try to relax. And a lot of people are having miscarriage after miscarriage after miscarriage, and the doctors are not able, they they just don't understand inflammation. And many doctors don't have this integrative background that I have, uh, so they don't understand the root causes and so on and so on. And so this goes over really a way for you with without having to see a doctor, how you you so you so that you understand that inflammation is really the culprit, and how you can reduce it just by doing right, just becoming so my takeaway is you know, if if you've suffered pregnancy loss, my my sympathies, our sympathies, and or if you have unexplained infertility and you want to be getting pregnant sooner rather than later, and most people do by the time they're listening to something like this, then I would say you know, get to the Freya clinic or come to you know our my clinic or or online course.

SPEAKER_03 1:04:52

But if you if you want to just have something ready to you know share with your college student, um, you know, uh get ready to purchase the book when it comes out next year.

SPEAKER_00 1:05:04

No, I have to say that, you know, especially I again, since my wife is is an acupuncturist, um, I know more than more people, and I'm just very impressed. And the reason she did that actually is that we had problems getting pregnant if she got pregnant with acupuncture and herbs. So I do think that acupuncture and herbs, and especially if you have you know a little bit more integrated training or a lot of integrated training, uh, that's a very good place to first go because they understand this whole thing about the inflammation and getting that down. Yes. And in acupuncture does also a lot of other things that I don't know.

SPEAKER_03 1:05:35

Acupuncture does a lot of other things, and thank you for saying that because yeah, for sure. It's not every acupuncturist is going to be a fertility specialist. Exactly. So I we don't want you to waste your time by by saying, okay, I'll go find an acupuncturist, because if that person does not know some of the fundamentals about fertility or fertility struggles, then then that's precious time that you that you might be.

SPEAKER_00 1:05:57

It's so true. It's so true. So you need to do a little bit more than just the traditional Chinese medicine. So the good thing in the in the Bay Area, we have some of the best providers in this area and in home.

SPEAKER_03 1:06:10

And nationally and internationally, uh, and I'll put this in the show notes as well. We have the acupuncture and TCM Board of Reproductive Medicine, where people have self-tested a pretty rigorous test, kind of akin to our state boards, to that demonstrate a working knowledge of fertility in the IVF process and how we can then translate it, if you will, and interpret it so that we can support using Chinese medicine and acupuncture. But yeah, but but do do make sure that that you either go to the to the show notes and click on the aborm.org link to find someone near you. Yeah. Dr. Bridford, this has been a phenomenal conversation. While we wrap up, if there's anything that you're like, oh shoot, I really wanted to just add this, then I give you.

SPEAKER_00 1:06:56

I I I think I just want to make people understand who are having problems, uh, getting pregnant and staying pregnant, is that it doesn't make sense. People have been getting pregnant forever, huge families. So if you're having problems, there's something going on. And I just want to emphasize that that something going on is your body. Your body's actually doing it to yourself. And the reason it's doing that is because you have too much inflammation. It's really inflammation that's behind all of this. We're all inflamed, much more than usual. Because of the way we live. But that's really the problem. And so it's good to really look, talk to somebody like Susan or other people, or even somebody like myself, about how to reduce that. You do that, you're fine. Then you'll get pregnant. You'll stay pregnant. That's the thing.

SPEAKER_03 1:07:43

It's and you'll have a healthy baby again.

SPEAKER_00 1:07:45

And you'll have a healthy baby. And oh, yeah, just one last thing I want to say too is that you know, autism has gone through the roof. I mean, just to give you a personal example, when I went to medical school um in the my god, 70s, I never saw an autistic baby or child. Never. It was it was like then one in several thousand. Now in Palo Alto, it's one in ten.

SPEAKER_03 1:08:07

Oh goodness.

SPEAKER_00 1:08:08

It's one in ten. Now, yes, they've expanded the the definition of autism. We talk, we talk about spectrum. And it, you know, we brought in client um Asperger's and things like that, that some people have that we know. Um, but um it's uh but still it's gone through the roof. And I really do think it's due to inflammation during pregnancy because we know that inflammation will go to the baby's brain, the baby's brain is still changing, it's really inflammation, and I see that personally. So I see my some my patients who are really inflamed, they're the ones more likely to have kids who have that. And I should say one last thing is that there's actually some interesting work done at UC Davis by a researcher called Vander Waters, and she actually was able to find certain antibodies. I mean, we talked about antibodies in leaky gut, that if you have them, you have a hundred percent chance, hundred, of having a child with severe autism.

SPEAKER_03 1:09:05

Oh goodness.

SPEAKER_00 1:09:06

And they actually have a company that that just that's actually offering a test for that. It's called Mara Bio, M-A-R-A Bio. I'm gonna get that into the show notes as well because I So I think uh if let's say you've had an autistic, unfortunately, a child who turned eventually got autism, or your friends or family members and they're thinking of getting pregnant again, you may want to um tell them about this test. It just came out. And um, it just came out. And um it, if you do have it, what do you do? Well, I think what they're trying to find ways to actually treat those antibodies, but that's going to take a few years. But for now, you can probably do like like do what Susan and I have been talking about, really reduce your inflammation, really heal your gut so that you don't get that persistent influx of microbiome particles that are basically feeding this.

SPEAKER_03 1:10:06

Wow, that that's such an important piece of information. I I so glad we spent a little extra time so we could close out on that note. That's really, really key. So I again thank you so very much for the conduct, Dr. Rickers. Viewers, listeners, I thank you for your time as well. We know it could be spent anywhere. And we ask that you share this podcast with at least five, because one in five are struggling with infertility. And this is such a fundamental conversation that gives agency back to the person to do what he or she can because male factor is 50% of the cause to reduce inflammation and therefore mitigate or just completely heal from all of the um diagnoses that contribute to infertility. So, on that note, we thank you for your time. We look forward to at uh seeing you at the next episode of Health University. Bye for now.

SPEAKER_00 1:11:02

Yeah, thank you. Bye bye.