The fertility cure
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Transcript of The fertility cure
The Fertility CureDR. PATRICK GARRETT, DC, B.SCI, DCCN, DABFM, FAAFM
CONCIERGE NATURAL HEALTHCARE104 EAST BROADWAY316-212-5429 CELL
Dr. Patrick Garrett
Who is Dr. Garrett?
Dr. Patrick GarrettChiropractic College / Medical School12 Years of Functional Lifestyle Practice Specializing in reversing acute & chronic conditions naturallyPatients / clients all over the country & worldClinical focus on reversing diabetes, asthma, allergies, eczema, psoriasis, migraines and epigenetic food therapy.
Physician
Postgraduate Educator300 Hour / 2 Year Diplomate Functional Medicine / Clinical Nutrition Program in Denver, Colorado
National Speaker Internal DisordersFunctional MedicineApplied Nutrition & Clinical ChemistryClinical NutritionFunctional Approaches to Reversing Diseases
National Speaker
Lifestyle Medicine ProgramCeliac DiseaseLifestyle Medicine – Metabolic Syndrome & NutritionLifestyle Medicine – Stress ManagementLifestyle Medicine – Weight ManagementLifestyle Medicine – Prescribing ExerciseLifestyle Medicine – OsteoporosisLifestyle Medicine – The Biology of Normal Sleep & Consequences of Insufficient SleepInfertility & Endocrinology & More
Postdoctoral Education
Lifestyle Medicine ProgramLifestyle Practices for Weight Management & Health PromotionModels of Behavior ModificationThe Pressure System Model of Lifestyle Counseling in Primary CareRationale for Lifestyle & Weight Management CounselingWeight Bias in Clinical Settings: Improving Health Care Delivery for Obese Patients
Postdoctoral Education
Diplomate of the American Board of Functional Medicine
Board Certified in Integrative Medicine
Diplomate of the American College of Clinical Nutrition
Senior Fellow of the American Academy of Functional Medicine
Diplomates & Certifications
Harvard Medical School Postgraduate Association– Member
American Academy of Integrative Medicine – Member
Physicians Committee on Responsible Medicine - Member
American Board of Functional Medicine - Past President
American Academy of Functional Medicine - Chairman of the Board of Directors
Green Med Info – Board Member
Bloodid - Medical Director
National Clean Eating Challenge – Medical Director
Leadership / Membership
What we will cover
Normal PhysiologyH-P-A-G Hypothalmus Pituitary Adrenal GonadsHormones Structures Ovary UterusMenstraul Cycle
Reactive Physiology Functional Hypothalamic Amenorrhea– Amenorrhea of the athlete– Ameorrhea of eating disorders– Functional Pituitary Amenorrhea– Hyperprolactemia
Ovarian Amenorrhea– Autoimmune Origin of Premature Ovarian Failure– Iatrogenic Origin of Premature Ovarian Failure– Resistant Ovary Syndrome
Annovulation – PCOS
• Insulinemia induced PCOS– Obesity– Adrenal Insufficiency– Thyroid Disorders
Defining Normal Physiology
The Female HPG AXIS
Cycle of Fertility
Cycle of Fertility
Cycle of Fertility
Hormones of the Female HPG Axis Gonadotropin-Releasing Hormone (GnRH):
Produced in hypothalamus Secretion pulses stimulate the pituitary
Short pulses = LH Long pulses = FSH
Follicle-Stimulating Hormone (FSH): Produced in pituitary Causes follicle to mature in ovary After follicle is mature it produces its own FSH
Lutenizing Hormone (LH): Produced in pituitary Triggers ovulation
A peak in LH levels coincides with ovulation
Testosterone Hormone (TH): Stimulates folicle Sexual arousal
Hormones of the Female HPG Axis
Estrogen: Primarily produced in ovaries Secondarily produced in adrenal glands, liver, breasts, and FAT Present throughout the cycle in varying levels Follicle estrogen stimulates the hypothalus to stimulate the pituitary to increase LH
Progesterone: Produced in the copus luteum in the ovaries, adrenal glands and placenta Progesterone is often stored in fat cells Luteal progesterone signals for the uterus to prepare for a possible implantation and supresses LH production by pituitary
through negative feedback Increases thermic changes in body temperature
Human Chorionic Gonadotropin (HCG): HCG is produced if the fertilized egg successfully implants in the uterine wall. It prevents the corpus luteum from degenerating so that progesterone and estrogen levels will remain high HCG is the hormone detected by home pregnancy tests
Gonadotropins, Hormones, and the Ovarian and Uterine Cycles
Gonadotropins, Hormones, and the Ovarian and Uterine Cycles
The Uterine Cycle
Figure 27.22c, d
Thermogenic Changes
Mucus Method
Reactive Physiology
Can I get pregnant?
Ovulation versus Menstration:
1. Is the patient having a normal menstrual cycle?
2. Is the patient ovulating?
When things aren’t working.
Female Only
Issues
Start with Amenorrhea
Reactive Physiology
Functional Hypothalamic Amenorrhea Functional Pituitary Amenorrhea
Amenorrhea of the athleteAmenorrhea of eating disordersHyperprolactemia
Ovarian AmenorrheaAutoimmune Origin of Premature Ovarian FailureIatrogenic Origin of Premature Ovarian FailureResistant Ovary Syndrome
Amenorrhea
2 Forms
Primary amenorrhea is the complete absence of menstruation by age 16 in a female with secondary sex characteristics.
Secondary amenorrhea is the cessation of a woman’s menstrual cycle for more than three (3) months.
Once amenorrhea is detected, the etiology must be determined.
Primary Hypothalamic Amenorrhea
Hypogonadotropic hypogonadism
Primary Hypothalamic amenorrhea Low gonadotropin-releasing hormone (GnRH) levels
Cranial radiation Central nervous system tumor
Sellar cyst, craniopharyngioma, meningioma, or other adenoma) Hypothalamic / pituitary destruction
Due to radiation, infarction, or infiltration due to lymphoma or hemochromatosis
Sheehan syndrome Postpartum hypopituitarism (Severe low blood pressure)
Secondary Hypothalamic Amenorrhea
Hypogonadotropic hypogonadism
Secondary Hypothalamic amenorrhea Low gonadotropin-releasing hormone (GnRH) levels
Chronic illness Diabetes Thyroid disease (T3Free / TSH,T3, T4, rT3) Inflammatory bowel disease (IBS) Chronic renal insufficiency (LOW eGFR) Depression / severe psychosocial stressors (Per Patient Report) Chronic liver disease (AST / ALT) Immunodeficiency (WBC) Anorexia nervosa or bulimia nervosa (Per Patient Report)
Chronic excessive exercise Chronic excessive weight loss Chronic malnutrition (SAD DIET)
Secondary Hypothalamic Amenorrhea
The plan for restoration of fertility due to secondary hypothalamic amenorrhea is:
1. Identify likely cause(s)2. Reverse the primary cause3. Revaluate success
Amenorrhea of Hyperprolactemia
Amenorrhea of Hyperprolactemia
Restoring physiology Reverse the cause Vitex / Chasteberry
Autoimmune Origin of Premature Ovarian Failure
Typical causes of POI Genetic disorders (think methylation problems) Tuberculosis of the genital tract Smoking Radiation and/or chemotherapy Ovarian failure following hysterectomy Prolonged GnRH (Gonadatrophin Releasing Hormone) therapy Enzyme defects Resistant ovary Induction of multiple ovulation in infertility
And Autoimmune diseases
Autoimmune Origin of Premature Ovarian Failure
Restoration Physiology Reverse endocrine auto-immune
Reducing estrogen / xeno-estrogen Improving Th1/Th2/Th17 ratios Improving nutrition Boosting immune system Immunomodulators Chemical toxicity Parasites Food sensitivities Etc…
Finish with Anovulation
Reactive Physiology
Annovulation PCOS
Insulinemia induced PCOSObesityAdrenal InsufficiencyThyroid Disorders
PCOS Induced Anovulation
Poly Cystic Ovarian Syndrome High levels of androgens Missed or irregular
periods Many small cysts (fluid-
filled sacs) in their ovaries
PCOS
Typical PCOS patients: Infertility (PCOS is the most common cause of female infertility) Infrequent, absent, and/or irregular menstrual periods Hirsutism (increased hair growth on the face, chest, stomach, back, thumbs, or toes) Cysts on the ovaries Acne, oily skin, or dandruff Weight gain or obesity Male-pattern baldness or thinning hair Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black Skin tags Pelvic pain Anxiety or depression Sleep apnea
Adrenal Androgens- Hirsutism
What causes PCOS?
PCOS
Restorative Therapy Low glycemic nutrient dense diet Exercise / purposeful movement
Mediterranean diet + active lifestyle No gimmick healthy weight program that is sustainable and healthy
Clinical Considerations
Restoration Therapy Many people oscillate between phases and exhibit both
fertile and infertility Tailor the treatment to the individual. Goal of treatment is to restore the proper and harmonious
functioning of the endocrine system through diet, exercise, lifestyle modification and nutrients.
You can retest after symptoms start to level. Gonads are not independent organs, look for all
imbalances including thyroid, immune, nervous system, endocrine disruptors, etc…
Lifestyle Approach
Start with nutrition (Food) No gluten No gluten free No dairy No processed sugars
Veggies, fruits, nuts, seeds, berries Whole naturally gf grains Lots of greens Drink ½ body weight in ounces of water
Lifestyle Approach
Cleaning products
ALL CLEANING PRODUCTS ARE TOXIC
Natural cleaning products, vinegar (1 part vinegar to 4 parts water in a spray bottle), add lemon oil for scent and thymol oil for antiseptic properties.
Lotions
ALL LOTIONS ARE PRETTY TOXIC, baby oil, petroleum, mineral oil, etc…
Natural lotions or make your own (1 part aloe, 1 part glycerin, 1 part olive oil, 1 tsp honey), or just straight olive oil or coconut oil
Cosmetics NEARLY ALL MAKE IS TOXIC
Natural make up from the health food store that doesn't contain harmful chemicals. Larenim at Food for Thought is a good start.
Lifestyle Approach
Eating for your hormonesRaise natural progesterone levels
Alfalfa Anise Apples CarrotsCherries Dates Fennel Green BeansGarlic HopsLicorice ParsleyPeas Pomegranates Sweet PotatoesPotato Pumpkin Pumpkin seedsRed beans Rice SageSesame
Lifestyle Approach
Eating for your hormonesRaise natural thyroid levels
Selenium rich foods 2 Brazil nuts a day, button mushrooms, shiitake mushrooms, wild caught fatty fish,
grass fed liver Iodine rich foods
Kelp (Highest by a long shot), wakame, nori, wild caught fatty fish
Lifestyle Approach
Eating for your hormonesRaise magnesium levels
Green drinks Kale, Swiss Chard (highest by far) Pumpkin Seeds Halibut Dense greens - Collard, Turnip, & Mustard
Greens Blackstrap Molasses Green Beans Sea Vegetables
Lifestyle Medicine
Ensure healthy weight Purposeful movement Cardio >110 beats per minute Not too much or too little
Lifestyle Medicine
Prevent Hormone Exhaustion Sleep Relaxation response
Lifestyle Medicine
Prevent Hormone Disruption Endocrine disruption Meds Industrial chemicals Synthetic hormones Herbicides Pesticides Fungicides Personal care products Heavy metals Smoking
Estrogenic – hormone disruptors
XENOESTROGENS Pthalates -Fragrance -Parfum -Plastic #3 Styrene Styrofoam Parabens Bisphenol A -Plastic #7 PVC
Polybrominated biphenyls -(PBDE) DEHP Benzophenone 4-Methylbenzylidene Heptachlor Lidane Fenthion Fertilizers / pesticides Propyl Gallate
Restoration Therapy
Herbal therapy
Vitex / Chaste tree berry (Vitex agnus-castus) – (MY FAVORITE) Chaste tree berry. Regulating hormonal balance, promotes ovulation, improves timing of the menstrual cycle.
Shatavari root (Asparagus racemosus) - Promotes regular menstrual cycles by aiding in regulation of estrogen levels.
Tribulus (Tribulus terrestris) - May normalize ovulation when used prior to ovulation. Increase in serum FSH and estradiol in women. Increase in sex hormone production.
White Peony (Paeonia officinalis) - Helps build the blood and increase circulation to the reproductive organs. Overall this herb has excellent hormone balancing support.
Restoration TherapyHerbal therapy
Black Cohosh (Cimicifuga racemosa) - Aids in tone, regular function and shedding of the uterine lining
Dong Quai root (Angelica sinensis) - Increases circulation to the uterus, tones and strengthens the uterus
Maca root (Lepidium meyenii): Promotes hormonal balance
Motherwort (Leonurus cardiaca) - Very effective at reducing uterine muscle spasm, cramping and improving uterine tone. Mildly stimulate the uterus
Mugwort (Artemisia vulgaris) - Used traditionally world wide to encourage menstruation in women with amenorrhea.
Parsley (Petroselinum crispum) - Has been used as an emmenagogue to bring on menstruation. Rich source of vitamin C.
Restoration Therapy
Emmenagogues
Special herbs which stimulate blood flow in the pelvic area and uterus some stimulate menstruation Used for oligomenorrhea Examples
Mugwort, chamomile, ginger, parsley
Shouldn’t use when pregnant
Closing thoughts
Where do we go from here? You are not broken Know how the physiology works. Know what interferes with that physiology. Identify & eliminate those interferences. Eat for the hormones. Let the body get back to work.
Closing thoughts
When in doubt feed the body and remove emotional and chemical interferences and the body will start working.
Success with lifestyle change
Relax, it is just a lifestyle
Change your diet Change your stress Track your symptoms Adjust as needed
QUESTIONS?
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