Fertility Forward

Ep 29: Looking Deeper to Solve Autoimmunity and Infertility with Aimee Raupp

July 23, 2020 Rena Gower & Dara Godfrey Episode 29
Fertility Forward
Ep 29: Looking Deeper to Solve Autoimmunity and Infertility with Aimee Raupp
Show Notes Transcript

Today we are excited to welcome Aimee Raupp who is a women’s health and wellness expert and the bestselling author of Body Belief, Yes, You Can Get Pregnant, and Chill Out & Get Healthy. Aimee is a licensed acupuncturist and herbalist who holds a Master of Science degree in Traditional Oriental Medicine from the Pacific College of Oriental Medicine and a Bachelor’s degree in biology from Rutgers University. She has appeared on The View, and has been featured in Glamour, Allure, and Shape, amongst other publications. Our guest has also received a public vote of confidence from prominent figures such as Deepak Chopra, Dr. Christiane Northrup, Arianna Huffington, and Gabby Bernstein, specifically pertaining to the work she does to help women improve their fertility and overall health.

Speaker 1:

[inaudible]

Speaker 2:

Hi everyone. And welcome to fertility forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai hospital in New York city. Our fertility Ford podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients, because knowledge is power and you are your own best advocate. We are so excited to welcome to fertility Amy Brown. She is a women health and wellness expert and best selling author of the book. Yes, you can get pregnant natural ways to improve your fertility now and into your forties and still out and get healthy. A licensed acupuncturist and herbalist in private practice. In New York, she holds a master's science degree in traditional Oriental medicine from the Pacific college of Oriental medicine and a bachelor's degree in biology from Rutgers university. She has appeared on the view has been featured in glamour and read book and has received endorsement from Deepak Chopra, dr. Christiane, Northrup, Arianna Huffington, and Gabby Bernstein for her work and helping thousands of women to improve their vitality, celebrate their beauty and reconnect to the presence of their optimal health. Thank you so much for being on our podcast. We are so happy to welcome you. I am so honored to be here. Thank you so much for having me. Both of you. I've heard so much about you. I was at union square play doing a fertility event, and someone came up to me and said, you have to have Amy on your podcast. She knows everything and anything, personality and wellness related. So thank you for being here. Thank you there. Thank you so much. So let's start from the beginning. How did you get in the, in the space in this wellness space? Did it start with the fertility aspect and it start with something else? So I've been practicing, I've been in clinical practice. It'll be 17 years as an acupuncturist and herbalist, which, which you mentioned before that I was studying biology and chemistry and with plans to become a medical doctor and I've made some changes and I decided to pursue Chinese medicine instead. So acupuncture is one part of Chinese medicine. We focus a lot on lifestyle and diet and mindset. In my early days of practice, I never wanted to specialize. I just wanted to be a general practitioner. And that was very much how I was raised in Chinese medicine. Just focused on optimal wellness and vitality health will thrive on every level. So there's really no, you know, one thing I say a lot, some of my fellow peers, don't love hearing me say this, but there's no such thing as fertility, right? There's just an acupuncturist. You can do a diagnosis, treat you properly. And when your health thrives and your fertility thrive, that's an extension. And so that was always my premise. And so whether that's balancing hormones or regulating the thyroid or helping when they get pregnant, that's how I've always approached it. But then as the years went on, I started to notice that women needed to hear the words, almost that, yes, I am a specialist in hormones and yes, I can help improve your fertility. And, you know, I started writing books about 10 years ago. And so my first one was just more general health for women. And then my second one was very fertility specific called yes, you can get pregnant. And what I always say is what makes me like a fertility quote unquote expert, is that I understand the ins and outs of the Western side of things, right? And so Chinese medicine doesn't necessarily change their approach, whether we're treating Hashimoto's or[inaudible] or endometriosis or diabetes, right. It's just really, you get the right diagnosis, you can treat the patient, the patient should recover. That's just how we treat it. There is no such thing as infertility in Chinese medicine, right? When you can say maybe, Oh, the uterus is cold or their stagnation in the uterus. And so it's all about, again, reviving vitality over the years, it's just become more and more prominent in the wellness world because of the books. And I think also because of just how much I talk about this, this basic premise, that fertility is an extension of health and they are not separate. And I do believe that really helps women and empowers them and makes them feel less if you will defined by their diagnosis and all of those things. So it's really passion, I suppose, that drives me. And I've always been in the wellness space. I've worked at a health food store back in the eighties. When I was in high school, my mom owned a GM, you know, I was always just around health and fitness and it's very much in my blood. I love that. Wonderful. Yeah. It sounds like you really take sort of each patient individually to, you know, to recognize kind of everyone's different and the difference between Eastern and Western and the idea that you combine them together because they both are important. Oh, so important. I mean, I am incredibly grateful for Western medicine and especially the advancements in Western medicine and fertility treatments. Right. I mean, it is allowed so many women, the gift of becoming a mother where that wouldn't have been the case 20 years ago, 15 years ago, sometimes even 10 years ago. Right. You know, but I do think integration is absolutely key. And I do think there's a lot that we can do from, if you will, the alternative side to give women the best chance possible, whether that's conceiving naturally or finally getting that, that genetically normal embryo, we're actually overcoming habitual, miscarriages, right. There's just so many different things that are going on and that can happen. But I do see that too, the integrated approach works well for a lot of women. So patient and I came to you and I said, look, you know, I'm having trouble getting pregnant. I just started, you know, seeing a reproductive endocrinologist, but I want to introduce an integrative approach to my treatment. Where would you start with somebody like that? So I just, I do what I would do with any patient. I do a very detailed intake, a very detailed health history. So we go through every aspect of your life from digestion to sleep, to skin, hair, and nails to your menstrual cycle and your menstrual history, what ovulation looks like your sex drive your energy, everything. We cover all the bases. And from there, I come up with what we would say in Chinese medicine are our Chinese medicine diagnosis. And then I will make recommendations for supplements and diet and lifestyle. From there. Another thing that I, I dig deep with on a lot of my clients does the emotional piece. You know, there's always an emotional counterpart to every single dis-ease or disharmony in the body from a Chinese medicine perspective. And like you guys know going through fertility challenges absolutely sucks. And women are really traumatized by it. And there's a lot of grief. There's a lot of anger. There's a lot of sorrow. And we see that in Chinese medicine as potentially being a block to the ability to then go ahead and conceive or to continue on this journey. And so, you know, there's a lot of unpacking that happens as well. Of course I will do acupuncture when someone comes to see me in the clinic, but I also do a lot of coaching with women all over the world. And obviously I can't do acupuncture virtually. So I'll make sure they're seeing an acupuncturist and maybe on Chinese herbs and, you know, doing some of the physical recommendations, but the diet, the lifestyle, the mindset is, is tremendous. I think in creating this holistic support system, there's plenty of women that don't need to work out their anger or their grief, and they can get pregnant. But I think you're a much better mom and partner and whatever else you choose to be in life when you do works are the emotional pieces. I know Rena and myself, we both have discussed this many times that your mindset is a great story starting point to at all. Sure. And I think you touched upon too spoken about in other podcasts that mental health practitioners, you know, if you don't, there's so much grief and anger and guilt that goes with this process, and if you don't work through it, now it's going to crop up later and it's something you're going to carry with you. So it's really important to work through all that now, while you're going through it and acknowledge it. I think that's a really, when there's so much talk about inflammation, right. You know, and, and we hear about that quality and inflammation impacts that quality. And everybody's talking about taking all these antioxidants and like, I'll say you, Barry's gonna be, you know, the cure all for your eye quality, right. But nobody's talking about the fact that stress and you're very inflammatory as well. And that's something that I talk about in my most recent book and body belief, which is really more towards women dealing with auto-immunity issues. But, you know, I got to that point because what I saw clinically was that patient after patient from a fertility perspective, either had an autoimmune condition that was complicating her fertility, or had an undiagnosed autoimmune condition that was complicated. Her fragility and in Chinese medicine auto-immunity is, I mean the same as Western medicine, right? The body's attacking itself on a cellular level for unknown reasons, but there's also this emotional part where, where are you attacking yourself on that emotional level? And how do we regulate the inflammation and thereby regulate the body so that it becomes more hospitable to a pregnancy, right? Then it becomes more welcoming just from an embryo and all of these things. And so that emotional inflammation is just such a big deal. And we see it, you know, I mean, women hate to hear, you know, the stress component as it relates to their fertility. And I, you know, I understand that and what came first, the chicken or the egg, we're not quite sure, but the truth is, is that your stress, whether it's the thoughts you think every day or the stress of am I going to get pregnant this month? You know, are we going to get it the right timing or IVF cycles canceled because of COVID. I mean, all these things that really impacts the ability like impacts your hormones at every level, and that impacts your ability to get pregnant at a hundred percent does, and the research supports it. So we have, we have to look at that mindset piece. I'm so glad you, you touched upon that in stress and inflammation. You know, something I always tell my patients is infertility causes stress, but stress doesn't cause infertility. But, you know, back in March, when COVID really started in quarantine, I was dealing with probably the most stressful months of my life, just kind of surrounding all of that. And my body started attacking itself. And so I was going with a lot of sort of auto immune issues. And so because of that, I started, I've spent now the last few minutes, really digging really deep into the research on stress and inflammation. And I've learned so much that I'm now able to bring to my practice just because that experience really kind of gendered look into it. And I've learned so much the past I've been studying it. And I believe so much in the time now between stress and inflammation. And so I'm trying to learn now as much as I can so I can help my patients even more how to kind of combat that and that link. Yeah. Well, even if he's thinking about the hypothalamus pituitary adrenal access, right. You know, it's just, if the stress is constantly triggered and those adrenals are constantly responding in cortisol and cortisone, and you're in this constant fight or flight, it is not safe for the body to concede like the body just does not see that as a safe time. And, and so whether that triggers higher FSH, which you very well can, you know, or if it just triggers in and ambulation, which we know the body needs to feel safe to ovulate. Do you know what I mean? So it's, and I don't know about you guys, but all my clients during the last couple of months, I think 90% of them had irregular cycles, 90% of them, myself, like a week late. I was like, what the heck is going on, but it's amazing how our body, how our body reacts and to tune into that and to see, Oh, you know, listen, there's stressors in life that are unavoidable and we can't live in this bubble. And so it is about, I think really accepting the fact that we're not robots and that we are really subject to our environment. So what are the steps we can take to best protect ourselves? And then also being in tune with that thought process that gets triggered and being able to, you know, as my spiritual teacher would say, like talk yourself off the ledge. Right. Being able to say, okay, yes, I'm under some stress right now, but I don't have to internalize it. Like what can I do to help myself manage it? How can I feel more in control? Or how can I surrender control? Right. So talking through yourself through that and really recognize, I think was fertility really recognizing, yeah. I feel really sad and angry because my life didn't turn out the way I thought it was going to, and I didn't expect this, and this is traumatizing, you know, like just even acknowledging the stress will help dissipate. And that will lower that stress response. That's so true. Actually just acknowledging it, saying it out loud.

Speaker 3:

Yeah. That's you, they always, yeah.

Speaker 2:

I say that with my patients, you know, talking about it, it's very important. And, you know, as I said, I've been diving pretty deep into some different studies about, you know, supplements and diet. Amy, what would you, from that perspective, do you have any blanket recommendations you usually say to people in terms of herbs or supplements or dietary advice to help with inflammation? Yeah. I mean, I think blanket is, I find that most effective is, you know, a nutrient dense food based diets. So animal protein, that's really good quality pasture raised wild, caught fish, six to eight servings of really good quality vegetables every day, couple of teaspoons or tablespoons, if you feel like it a fat every day. And that's the basic diet, right? So fat, right. Fat is the number one thing for air quality. And then you want your veggies for the antioxidant powerhouses, and you need the animal protein, you need the Coleen, you need the fats, you need the college and you need the gelatin. You'd need all that to me, a human, you know, you just need that. And so, and then you need to cut out all the crap, you know, but so basically, yeah, the plate should look like a couple ounces of protein, a couple teaspoons, or maybe even tablespoons of fat and then the rest veggies, you know, so minimal grains, minimal processed crap, zero process practice crap. When I'm dealing with girls, girls, women miles home, my girls dealing with endometriosis or habitual miscarriages or, or just something, some kind of unexplained fertility challenge that we cannot seem to figure out. I do see that autoimmune failure. It was actually the best. So we're cutting out. You know, I have it all in my book, body belief, but we're cutting all the way down at work, cutting out night shades for cutting out nuts for cutting out beans and see what is actually triggering the inflammatory process. Cause those women tend to be really sensitive to what I think is the lectins in the foods. And when I remove those, you know, in lots of bone broth, add in bone broth, it's kind of like a gap slash AIP diet that I have in body belief. I really see these radical changes. It's fascinating. Like even doctors I've had many fertility specialists call me up and say, what on earth are you doing with diet? Because this is beyond what we see in any of the books or anything. Like I've never seen her markers go down like this, or I've never seen heal on its own. And you know, that's pretty awesome to witness. So diet plays a tremendous role and I won't even go to supplements until I get them actually eating clean because we only absorb, we only absorb 15% of our supplements anyway, and you're eating gluten and processed dairy or dairy. If you can't digest it. And soy products like what's the point. So my supplements are all food based. It's Cod liver oil, it's liver as an origami, you could eat liver too. And I recommend spirulina. Nature's multivitamin. That's the way I approach it probiotics, but you could eat probiotic foods if you can tolerate them. What else do I recommend? I think that's the big stuff, you know, and I feel pretty high on the dose of the cup of oil, because it's so powerful. Like you need the EPA DHA and you just can't get it from the seeds and the nuts you need that to lower inflammation in the body. I can say, Amy, I think it's great that you are. I don't see this every day. I don't see other practitioners recommending good quality animal protein. I think that's so key. And I think that could be a challenge for a lot of women. I, I, I'm not sure about you, but I see a lot of my patients tend to be more vegan, vegetarian. You know, there's not a blanket statement saying that no one should be vegan or vegetarian, but I do applaud you for trying to push the good quality animal protein. Well, here's the thing, you know, I'm still probably mostly vegetables in my recommendation and Chinese medicine. We prefer cooked over raw, but it is really apparent, you know, and a lot of great research out there, you know, my books for certain, but you know, like deep nutrition by Catherine Shanahan is her name. I think real food for pregnancy Lily Nichols. She's so great. I just did a live with her the other day. She's so smart. Dr. Kallan Thomas Cowan, you know, he's part of the nourishing traditions, Weston, a price organization. It's just, you just can't even, you know, I'm a big proponent of the Dutch and I, you know, I listened to what we need to do to balance hormones and we need the Omega threes. We need Coleen and we need these vitamin a rich foods. And following vegetarian and vegan diet is just really hard even to get all your B vitamins and not to say you do it. But I do think if I can get, I always kind of make this joke. If I can get my vegetarian eggs, to eat said butter at the very least, and maybe do some bras, I can get them to sneak in the liver until we can eating ground beef every day. You know what I mean? You don't have to be doing it. You could do, you could do fish, you could do eggs or even just eggs and butter. And I will get a lot of my girls. They'll take liver on the pill forms, but if I can get them to do that, we can do it. But I also always pose this question, which I think you guys probably would totally relate to and probably pose in your practices as well is just, how was the surfing you like if you're having fertility challenges and you're coming to me for advice question, how, how is that diet you're currently choosing, serving you because it's not currently working. There are women who can get pregnant on these diets. Absolutely. But if you're coming to me for help, you're not one of them, you know? So we need to just make these adjustments. You can go back to your previous lifestyle. I think after you finished breastfeeding or after your fears through your fertile years, you can absolutely go back. You can have vegetarian days, but if you look at the science, it's just very apparent that these Coleen rich, these vitamin a rich, these, these fat rich foods are just imperative for fertility. So there you have it. That's my opinion.

Speaker 4:

Uh, we like to say is Rena. And I like to say,

Speaker 2:

It's just nice to see other people that are aligned with what we've been thinking about all along and suggesting as well. Let's talk a little about auto-immunity because I know your body believes I have been reading it and I find it so interesting. And also your story of how you've got to do research on this and how this became your passion. So I wrote, yes, you can get pregnant about six years ago. And I was already seeing plenty of women trying to get pregnant, but then obviously you write a book about pregnancy. It puts you on the map. So a lot of people complain about trying to get pregnant. A lot of people started coming to see me and, you know, like I said, I coach women all over the world and my practice just expanded pretty quickly. And I get these really, really challenging cases. These are cases that, you know, they've been to four different nutritionists and six different acupuncturists, and they're on their fourth reproductive endocrinologist. And they, you know, and they're still not pregnant. Right. And they're five years into this journey, especially in these habitual miscarriage cases, which, you know, I don't know about you guys, but it just lights me up in this way that I'm like, there's no more miscarriages. Okay. We are stopping this right now immediately. And so that is really what the lights lit, the fire under my butt, where these freaking miscarriages, I was like, I couldn't even cry thinking about it. But as I started to look at these cases, and I think because I have the biology background, right. So I think I can identify it a little differently than perhaps someone who's just doing Chinese medicine. Would, you know, you just, you just start to see it. You can almost see the case where you're like, huh, I think this is an autoimmune case. And so then I send them for certain testing or I send them to look under those rocks and then sure enough, you know, they come back, it's like high, natural killer cells or Hashimoto's or celiac. And it was untreated. It was undiagnosed. Right. Because she probably knew she had hypothyroidism, but no one's ever checked her antibodies. Why would you, it doesn't really matter. And then you dig deeper and you're like, Oh, endometriosis is auto-immune. Well, that's interesting characteristics. That's interesting. Premature ovarian failure. Well, so that's basically the three main reasons for fertility challenges. And they're awful, actually, this is fascinating. So then you just start, you know, and that was, I remember when I was writing, yes, you can't get pregnant. I really did discover it. And yes, you can go pregnant. Like if you, I didn't so outwardly stated, but I have a whole section in the back where I talk about it and I really bring it to light. And I interviewed a couple of doctors for the book and I, there's a guy he's the head of a yellow reproductive medicine doctor, Sue Taylor. And I interviewed him. And I said, where do you think about the fact that all these unexplained infertility challenges are likely autoimmune conditions? And he he'd like chuckled any, you know, he's probably 20 years older than me. And he's like, young lady you've hit the nail on the head. He's like, in fact, he's like, in fact, he's like, we're screening every single patient now that comes to our clinic for celiac and Hashimoto's. And he said, it's appalling the incidents in these women that are dealing with fertility challenges. And then I said, what about the habitual miscarriage was like, absolutely. And so that's really then where then I got into body belief and, you know, I wrote probably for hay house, I've jumped around publishing houses and hay house as my most recent publisher. And they didn't want a very fertility specific book, which is kind of what I wanted to write. So I said, all right, I'll write a general autoimmune book, but it's the one I have a lot of my longer term science go to. And I haven't followed that book. And it's a lot about the mindset piece, because if you don't shift the mindset first, you can't really follow the diet or supplements if I tell you to meditate. Right. And what do you mean? You guys know this, it just doesn't stick as much. If you're not that invested mentally or you don't actually believe this can help you. And so embodied belief, I really drive home this piece of the emotional and the physical inflammation and that we have to address posts and sure there's a diet and there's supplements, of course. And that's what every woman wants to check the boxes, but, you know, and do the diet and do the supplements and maybe do the acupuncture and maybe the casserole packs and the Mayan massage. But looking under the hood at the emotional stuff is really scary and painful and traumatic. And a lot of women are afraid to do it, but until you do that until you really dig deep into these belief systems and start to reshape them and say, Oh, isn't that interesting? And I've actually always hated my body. I've never believed my body could actually do this. Wow. I remember having this thought 20 years ago, long before I started this fertility journey. You know, when you start to see, Oh, well, it's interesting. I actually never believe to my body or whatever it is, or I always thought I'd get sick or I always thought I'd have problems getting pregnant and then start to rework those belief systems. Are you going to adopt a diet and lifestyle? That's not super easy. You know, I'm not going to lie, but what we all recommend, isn't the easiest for, for most especially American women, but it is a game changer, you know? And so you have to address it both sides. What would you say to a patient who get the diagnosis of, you know, an autoimmune disease, Hashimoto's PCOS, et cetera. You know, I find my patients who they find that out and they get really, really scared. And these scary really, really shaped. What would you say to someone I tend to try and look at it as body chalk, right? Your body's talking to you, it's saying the way you're currently doing, isn't doing it. It's not working for me, but there's a lot we can do to manage this. Can we ever cure this? Not necessarily, you know, well, it's, I would antibodies go down short or can you ever eat gluten again? If you have celiac and no, it's just, you've learned something really valuable about your body. And now you're even more motivated to treat it a certain way. I think though, it's really important. Like we've touched upon before to acknowledge that fear and that sadness and the anger, you know, that there's this, uh, you know, one of my girls recently said to me, I got three major diagnoses in a short period of time. You know, she got endometriosis now she motives and I think celiac and it was really good. She started working with me and reading my books and then brought the attention to her doctors. And she got these diagnoses and now it fits the case. You know, she basically can't stay pregnant. Right. So it makes sense. And then now we just have to, you can't manage it. I mean, that's the one thing I'll say is yes, these diseases are scary. I think upwards of what is it, 40%. They say one in one in three women will have an autoimmune condition by the age of 45. I forget the stat for in my book, but it's very, very prominent quadrupled in the last 40 years. And a lot of it's due to the environment and the chemicals in our food and our stress levels. So to understand like, Hey, you're not alone B there's a lot you can do that, can manage this. And see, I think that it's everything is figureoutable. And to me, when I, when I get one of those diagnoses, yes, it's scary. And then I really hold space for that client. But now I know what to do to fix this. Like now I understand, okay, I get this, guess what? Now you're not going to have a miscarriage. You know what I mean? We're going to, we've got this figured out. Now these are the right doctors for you, and this is the right approach for you. And it's going to involve, you know, I mean, if you guys have read is your body baby friendly by dr. Beers. But you know, it's very much about the auto-immune approach to fertility challenges and it does involve steroids and it does Lovenox. And, you know, there's all sorts of things that I am a hundred percent for, if it means that this woman is not going to miscarry again. But I also have seen, I've seen women just do that protocol and not change diet and lifestyle is still miscarriage. If they change diet and lifestyle and do the protocol. Yes. What we get to, we get to bring a baby home. I mean, I've seen both sides, so it's scary. And it probably feels paralyzing, especially when you're already just trying to get pregnant. And now it feels like a whole other thing you have to deal with and this life long sentence in a way. But I also would use it as, you know, what we call in my world as your red flags and in your body's just talking to you. And so now you know how to manage these red flags. You know, you're in a position that a lot of people aren't, there's a lot of people who have no idea that they're dealing with these underlying conditions until it's really too far gone. And I think it's interesting, Amy, that at least these women, by knowing perhaps that there is some auto immune issue, that there is something that they can do. And I think as humans, we often like to have some form of control, especially when we're going through something where we don't have a lot of control. So sometimes having that, those guidelines and that guidance can really help empower women when they're going through something that's really challenging. It's like an answer, right? You know, so many women are like, Oh no, I'm still happy. I know now, you know, now I had to call you the day. Right. And I said, get, you know, get these bloods done before we talk to him. And he's really low on her. TSH is high. Her mom has Hashimoto's. And I was like, these things have to be fixed before you can get pregnant. So call your doctor, get them, you know, like, yes, we can still do this diet and we're still going to do this lifestyle and all these things, but these things have to be addressed. And guess what chances are, you'll be pregnant in four months, you know? Wow. But yeah, I think it's very empowering. I love when we figure it out, you know, it's like the detective work and then we figure that piece out and it's very empowering. I love patient advocacy there and in there also, you know, in that, okay. It's about reading the books, making, you know, coming to your doctor, you know, making a collaborative integrative team. You know, I find a lot of times patients think like, okay, my doctor said this, so that that's it. That's what it is. And I think a lot of it is going out there finding our own information, picking up the phone, making calls. We don't like an answer, you know, knowledge is power and really empowering yourself and not being afraid to ask questions. You know, we know our bodies better than anybody else. Hey, you know, this isn't right into, I love that. You touched upon that also, you know, it sounds like you really do work to empower patients in it. It really is. A lot of times in integrative collaborative approach, I think it has to, you know, it depends, right. There's I did a call the other night and the woman I was on with, she said, you know, we don't, she's also in the same fields. And she said, you know, we don't see the women that get pregnant easily. And then I think that's where really good point. So, you know, there are a lot of women that this works out for her and quite easily, but if it's not happening for you, and this has been a long road, you do need a lot of support. And I don't think the answer lies in one doctor, those women, you know, I always say it's like the basic protocol. If the big fertility clinics works for 70% of their clients and that's great, so they don't have to change anything. And they don't have to look deeper because it works. And, but then there's this other 30%, maybe even 40% of women that it doesn't work for. And they need to find their team and they need to dig deeper and they do need to change their diet. And they do need to look at their genetics and their hormones and their mindset, you know, does it stink that maybe you're one of those women maybe, but I also, I would challenge you to think too, that it's kind of a gift, you know, you're, you're figuring things out that I remember since you guys know dr. Jeffrey Braverman. I mean, he's since passed that I used to work very closely with him and his clinic and he's reproductive immunologist, but he said to me, one day, you know, he said, I look at what you do as the, you know, the long term vitality for these women. And he's like, because I'm going to help them get pregnant and you're going to help them along with me stay pregnant. But what I really care about is that they're around in 20, 30, 40 years to be with their children. And if these women have these autoimmune conditions that are untreated right now, they're going to be really sick in 30 or 40 years. And that's not to scare anybody. That's to say like, this is the knowledge is power. You can change the trajectory of your life and your health. My real goal is to get you to be the best mom. You can be not necessarily, you know, that positive pregnancy test, right. To get you in the best shape possible mentally, physically, and emotionally nutritionally to do this for, for the next, you know, hopefully 40 years, if we're all blessed moms 50 years, that'd be awesome. So to really start to think of it, that way, that it's a much bigger quote, unquote issue than just getting pregnant. I love that. You're saying that because I know you mentioned that right in the beginning, that fertility as an extension of your health, but if anything, you know, their, their goals may be getting pregnant, but at the end of the day, these tools can be helpful long after a pregnancy. Oh my gosh. Well think about breastfeeding recovery or pregnancy again, right? I mean, all of these really important things, immunity, you know, ability, energy overall, complete health and wellness, especially like going back to stress. Yes. People were trying to get pregnant. We experience a lots of extra stress, but stress in general. I mean, this is something that happens long after, before and after enduring and learning some of those tools so important. I love how you do touch upon that as the basis of your body belief. It's fabulous. Thank you. Thank you. Thank you. Thank you. I want to go back to recurrent pregnancy loss. I was just soliciting for those listeners. Amy has an Instagram live feed every, is it every week or every couple of days? Every week. Every week. Yeah, it might one might increase, but I'll just say every week right now. And it's great. You get to see her, her beautiful being discussing various topics. I know the last one that she had just posted was on AMH levels and FSH levels, and also like the topic of recurrent pregnancy loss and the importance of the miscarriage panel. I love that you brought that up and I know that's something that a lot of patients ask for us in terms of do I need to do anything different, different type of protocol? And I know you mentioned something about the empty, empty H T F R gene and the mutation and the idea that some people should potentially go on a methylated folate my question to you. And you know, I'm not sure if you could answer that is, do you think, especially if this is something that a lot of people we're seeing now potentially have this mutation, my thought is, why doesn't everyone go on? I just basically blanket it now. And you know, what's interesting is so it's gotta be 10 years ago. I started, you know, cause it's a Chinese medicine thing. I started recommending liver to all my women trying to get pregnant. You gotta eat the Oregon meat. And then I found dr. Ron's was the one only one time that he made this. Now there's a couple, but grass fed New Zealand, cattle, liver until form. And so, you know, it's been a recommended setting of mine forever. The MTHFR mutation conversation, I think really hit mainstream was maybe call it five years ago. But I swear when I started doing liver with my patients, they just started getting or not having miscarriage come to realize that the MTHFR mutation was, was probably, I was actually treating the MTHFR mutation that didn't know it. But yeah, I agree a hundred percent, most of the time, the supplements that have folic acid in, in any way or filled with a bunch of other crap. It's like, if you want a whole food nutrient dense based to supplement or from a company that actually does really good research and gets really good quality ingredients, no one's touching folic acid because it's synthesize, it's not naturally occurring. And so 100% upwards of 15 to 80%, we don't know, right. We don't have everybody tested, but a lot of people have at least one copy of the MTHFR. And so it's going to eat any that sits on the receptors and it doesn't even like your spinach or your kids. So you can't even actually get the benefit of the good diets is you're taking the supplement or the protein powder or eating the bread. That's fortified with folic acid. So absolutely everybody should be on muscle or just eating food sources of, and then skip the prenatal. But I wouldn't necessarily say skip the prenatal, you know, these days there's a couple out there that I really liked, but you can do it, you know, with liver and spirulina and a really good quality diet too, but it has to be a really good quality diet. So yes, absolutely. The MTHFR plays a huge role. I think learning disabilities, I think in nutrient deficiencies, you know, and definitely in, in miscarriages. And then of course I think a general rule of thumb is no woman should have two miscarriages or more than one miscarriage in a row without a live birth. If you see that that absolutely needs to be a miscarriage panel. That's great. The body's smarter than that nature smarter than that. It won't keep miscarrying. That's just not how it works. You have to look deeper. I mean, I think that's something so many people have questions about, and it's a great tonight now and someone who has knowledge to really help patients spend here that, you know, I know my experience that it's devastating, it's horrible. And to point them to, to help them on their quest to get through that because it's really absolutely devastating. It's so frustrating to not have any answers and a lot of the, well, I just think there's, there's a lot of fertility clinics out there that don't look under those rocks and aren't up on the research and aren't properly serving this population, you know? And so it is a rare population, right? I tend to see a lot of it, but I know it is rare in the, in the general world, but the spiritual miscarriages who really need to be seen a reproductive immunologist, not just reproductive endocrinologist, or at least someone who's willing to look under the rocks with you and be the detective and try to figure out why, rather than just saying no it's ed quality or YouTube or whatever, the general comment, it's not appropriate in my opinion. So what is the best way to get ahold of you for our listeners to definitely go better books and check her out on Instagram, but what is the best way to reach out to you? I think through my website,[inaudible] dot com is probably the best way to find all the things that I can do. Um, you know, I have a lot of great free resources on there and my blogs, we have a beautiful every month, we do a story of hope and someone that I've worked with on what they've done to, to change their health and improve their fertility. We usually only, you know, most of our stories are hoped. So I think there's one or two on miscarriages, but most of the other ones are women who have gotten to take their babies. Tome. There's a lot of inspiration and hope on the website. And then there's also information on the clinics that I am a part of in the Tristate area. And then also the ways that you can work with me virtually from anywhere on my team, that is wonderful. We have so many more to ask. We'll have to have you back again. I think this has been amazing. I'm so happy we can share this with our patients. Thank you so much. Well, thank you both so much. And I really give you guys so much thanks for the work you do as well. We're spreading this information and empowering women on this path because it's not easy and it's really good to have trusted resources. Absolutely. So how we like to end our podcast session is to talk about gratitude, what we're grateful for at this very moment. So Amy, what are you grateful for today? The view from my home city a couple of years ago, and I live in the middle of the woods. Now I'm looking out at these gorgeous trees, my family, I have a bunch of family coming to visit tonight. So I'm really, really grateful for, for this space that I get to entertain them super grateful at this very moment. I am grateful for my morning meditation. I had a lot on my mind the last couple of days over the weekend, and it was just a great way to be in the present moment and be in that space with myself. And it has been a great start to my week because of it. Rena, where do you grateful for, you know, I'm grateful to be back in this space of recording and meeting other like-minded practitioners. We took a little bit of a recording break just to kind of get our ducks in a row and COVID head and I I've missed this so much. You know, the collaboration between Darren myself and having guests on and gems with reality, you know, it feels normal to be recording again. And I just, I love it. So I'm so grateful for this opportunity. So wonderful, Amy, thanks so much again for being on and we hope to have you on again soon. I would love that. Thank you both so much wonderful day. Thank you so much for listening today and always remember practice gratitude, give a little love to someone else and yourself. And remember you are not alone. Find us on Instagram at fertility underscore forward. And if you're looking for more support, visit us@wwwdotrmaandy.com and tune in next week for more fertility forward,

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