This post will seek to simplify a seemingly complicated issue that is sadly all too common. Some of the information may not be a surprise and yet some might be astounding.
Infertility is a multi-faceted issue, so this post will only cover the biochemical aspect, not the structural or emotional aspects. (For more on the structural foundations of infertility, check out my facebook page at http://www.facebook.com/pages/Solutions-Integrative-Health-Care/167024840053867)
According to www.americanpregnancy.org there are 6 million women that deal with infertility per year (up from 4.6 million in 1988).
Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) are both secreted by the anterior pituitary gland in the brain. These two hormones work synergistically in reproduction. Estrogen’s affect on the anterior pituitary greatly decreases the release of FSH, which inhibits follicular development and then prevents ovulation.
The major players in the hormone game are the hypothalamus, anterior pituitary, thyroid, and ovary glands. Secondary players are the adrenal glands, pancreas and liver.
The best way to analyze hypothalamus, pituitary and ovarian hormones is through salivary testing, as this gives an indicator of active hormone levels. Blood tests tend to give inactive levels of these. This is the same for the adrenal hormones, cortisol and DHEA. The best way to gauge thyroid function is through blood tests. If your physician is testing your thyroid and just running a TSH, ask him/her to run a full thyroid panel. This would include not just a TSH, but T3 and T4 levels. If they won’t do this, find another doctor that will. Optimal blood levels of TSH are 1.5 to 3. .9 to 5 or generally the lab values and many people in this “gray area” will have no diagnosis.
I have written several articles on thyroid dysfunction, so please check those for more information.
If you have had your hormones tested through your saliva, chances are you already have met a doctor that utilizes natural therapies. If not, most doctors in general are not aware of this type of testing, so the likelihood of your general physician knowing about this type of testing is not high.
The liver is a much overlooked organ when discussing fertility, as ALL hormones are broken down in the liver. If this breakdown is inefficient, imbalances can easily occur. For example, many women use progesterone creams. If this progesterone is not broken down efficiently, the liver then spits it back out as estrogen and thus creates more of an imbalance. Faulty liver function can also affect pancreatic function. If the liver is working sub optimally, the blood levels of glucose will be out of balance; sometimes too high (diabetes) and sometimes too low (hypoglycemia). The low aspect is overlooked as being problematic frequently.
The best way to gauge liver function is also through blood testing. Normal lab values for liver enzymes (AST and ALT) are typically 5 to 50 with some variance on the high level. Now, optimal levels are different; those being from 10 to 30. Clinically, I have noticed that the body functions better when those levels are between 20 and 30.
If these liver enzymes are elevated, it means your liver is starting to become toxic and potentially storing fat. In this case, a good solid bio-detoxification program is essential. Any doctor skilled in natural methods should be able to help you with good quality detox procedures. These liver enzymes are dependant of vitamin B6. If your levels are below 20, that is suggestive of a deficiency of B6. Care must be taken with B6 as too much can inhibit pituitary function. Please see an earlier post about types of B vitamins.
While we are on the subject of liver function, we must discuss (shortly) cholesterol function. Cholesterol is formed in the liver and is the precursor of adrenal and sex hormones. There is mass confusion in society about cholesterol issues, but if your cholesterol levels are too low (yes…too low), your body will not be making these hormones in sufficient amounts. This can inhibit your ability to get pregnant or hold a pregnancy. Anything below 160 for total cholesterol is too low for hormone function. The only way to increase your cholesterol production efficiently is to increase your intake of good quality fats like fish and flax seed oils, black currant seed and evening primrose oils, and coconut oil. Check out an earlier post on cholesterol medications and their side effects.
The most common reason for B6 deficiencies in women today is estrogen dominance. Estrogen dominance has been plaguing our society for decades now. Hormone replacement therapy (HRT) has since been removed from most medical doctor’s treatment regimens for many years now due to the Women’s Health Initiative’s findings of significantly increased risk of coronary heart disease, breast cancer, stroke, and pulmonary embolism. Estrogen dominance can be multi-faceted and has been proven to cause these prior issues. Estrogen is not only produced by the ovaries, but also by the adrenal glands. Much lesser known is that estrogen is also produced by adipose tissue (fat cells), can be absorbed through the use of cosmetics and skin lotions and also through the use of plastic bottles and linings of most cans (xenoestrogens). So, optimizing your insulin levels not only can help you lose weight, but also decrease your estrogen levels. Read labels of all cosmetics and anything you put on your skin; the big print gives and the fine print takes away.
Do not get me wrong, we all need estrogen for our bodies to function properly. There is “good” estrogen and “bad” estrogen and these must be in the proper ratios. One nutrient that works very well with balancing estrogen these ratios is iodine. I have also written much about iodine (blog and facebook) as it relates to thyroid function. Iodine supplementation can also be useful in polycystic ovarian syndrome (PCOS). Most women with PCOS are told that they are not likely to get pregnant. I can tell you first hand, that I have helped several women with this diagnosis. They have gone on to raise beautiful families.
Oral contraceptives have been around since the early 1950’s. With these containing estrogen (sometimes large amounts), it is likely that a woman taking these will be estrogen dominant and hence, deficient in B vitamins, especially B6. Taking the birth control pill (BCP) for even short periods of time can suppress pituitary function and as mentioned earlier, this is crucial for overall hormone balance. Not to mention, crucial for fertility.
Taking the BCP for actual birth control is one thing, but taking it to help rectify some issue with your menstrual cycle, like cramps or heavy bleeding, is not a great idea. Women, your bodies are giving you signs that something is out of balance, don’t ignore it and be careful covering things up. Messing around with Mother Nature can have long lasting effects.
If a woman is taking the BCP and looking to get pregnant, she needs to stop taking it for at least one year prior (optimally two) to allow for her body to balance some of the hormones. Working with a doctor skilled in nutritional therapies as it relates to hormone function can make this transition much easier. Doing this also can minimize the likelihood of miscarriage also (see facebook).
Saliva hormone testing can be done for about $50 to $250 depending on the type of test. Blood chemistry panels can be run to test for all of the above for about $70. Comparing this to In vitro fertilization, which can cost from $10,000 to $20,000 per attempt, you do the math. The big key with these tests is knowing what to do with the information that they provide. Working with nutriceuticals (high quality nutrient companies) can have very profound affects.
Working with women’s hormones can get very complicated as the endocrine system is like a big symphony all playing the same song. Each organ or gland has a separate role to play, but each is vitally important to the whole system working correctly.
Above all, NEVER stop looking for answers to your questions.
I hope this helps those of you looking for natural fertility methods.