Joining us today is Sonia Savage, a clinical nutritionist specialising in fertility, hormones, autoimmunity, gut health, and children's wellness.
Today's episode discusses fertility, folate, and autoimmune disorders. But in particular, Sonia discusses
About Sonia
Sonia has worked with Carolyn Ledowsky (founder of MTHFR Support) for the past 6 years, she also works part-time in her own practice Balanced Life Nutritional Therapy. Six years with MTHFR has given Sonia a specialised knowledge in the area of genetics and epigenetics and she has a keen interest in fertility, auto-immunity, gut health and children’s wellness. Sonia works with clients all over the world.
Having grown up just outside Tamworth, Sonia has a down-to-earth approach and appreciates that regional clients don’t always have access to the same range of food, supplements and healthcare services as city folk. She strives to support her clients wherever they are and whatever budget they are on.
Sonia had an early career in recruitment which she also thoroughly enjoyed, She owned her own boutique agency for 10 years before following her passion to help others on their wellness journey. Instead of career goals, she now discusses all manner of personal questions with her clients. Both jobs require mutual trust and asking lots of questions!
Sonia is based in the Northern Beaches and holds an Advanced Diploma in Nutritional Medicine from Nature Care College and a Bachelor of Health Science - Complementary Medicine (with Distinctions) from Charles Sturt.
Connect with Sonia
www.balancedlifenutrition.com.au
Shownotes and references available on your local Designs for Health website
www.designsforhealth.com.au
Register as a Designs for Health Practitioner and discover quality practitioner-only supplements at www.designsforhealth.com.au
Follow us on Socials
Instagram: Designsforhealthaus
Facebook: Designsforhealthaus
DISCLAIMER: The Information provided in the Wellness by Designs podcast is for educational purposes only; the information presented is not intended to be used as medical advice; Please seek the advice of a qualified healthcare professional if what you have heard here today raises questions or concerns relating to your health
Joining us today is Sonia Savage, a clinical nutritionist specialising in fertility, hormones, autoimmunity, gut health, and children's wellness.
Today's episode discusses fertility, folate, and autoimmune disorders. But in particular, Sonia discusses
About Sonia
Sonia has worked with Carolyn Ledowsky (founder of MTHFR Support) for the past 6 years, she also works part-time in her own practice Balanced Life Nutritional Therapy. Six years with MTHFR has given Sonia a specialised knowledge in the area of genetics and epigenetics and she has a keen interest in fertility, auto-immunity, gut health and children’s wellness. Sonia works with clients all over the world.
Having grown up just outside Tamworth, Sonia has a down-to-earth approach and appreciates that regional clients don’t always have access to the same range of food, supplements and healthcare services as city folk. She strives to support her clients wherever they are and whatever budget they are on.
Sonia had an early career in recruitment which she also thoroughly enjoyed, She owned her own boutique agency for 10 years before following her passion to help others on their wellness journey. Instead of career goals, she now discusses all manner of personal questions with her clients. Both jobs require mutual trust and asking lots of questions!
Sonia is based in the Northern Beaches and holds an Advanced Diploma in Nutritional Medicine from Nature Care College and a Bachelor of Health Science - Complementary Medicine (with Distinctions) from Charles Sturt.
Connect with Sonia
www.balancedlifenutrition.com.au
Shownotes and references available on your local Designs for Health website
www.designsforhealth.com.au
Register as a Designs for Health Practitioner and discover quality practitioner-only supplements at www.designsforhealth.com.au
Follow us on Socials
Instagram: Designsforhealthaus
Facebook: Designsforhealthaus
DISCLAIMER: The Information provided in the Wellness by Designs podcast is for educational purposes only; the information presented is not intended to be used as medical advice; Please seek the advice of a qualified healthcare professional if what you have heard here today raises questions or concerns relating to your health
Music. This is Wellness by Designs, and I'm your host, andrew Whitfield Cook. Joining us today is Sonja Savage, a clinical nutritionist, and today we're going to be talking about fertility, folate and autoimmune disorders. Welcome to Wellness by Designs, sonja. How are you?
Speaker 2:Thanks, andrew, really pleased to be here. Thanks for having me.
Speaker 1:It's great to have you on the show Now. Firstly, let's just dive straight in. Tell us about what you love to treat in clinic.
Speaker 2:Yeah, thank you. So I work between two clinics, so Balanced Life, nutrition and MTH Fast Support, so I have a fairly broad range of clients that I really enjoy working with, but I guess my main areas are fertility, autoimmune, gut health and probably children's wellness. I guess would be the main areas that I work within.
Speaker 1:Gotcha, and do you see children at both clinics or do you tend to see them in your Balanced Self?
Speaker 2:Yeah, I do see them between both, but I tend to do probably more at MTHFR simply because I work with their parents through fertility and then I tend to work with the children, but probably it's probably evenly split, but I would say probably a little bit more of the children's wellness at MTHFR.
Speaker 1:Gotcha. And what about autoimmune disease? Do you see both at both clinics?
Speaker 2:Yeah, I see both at both clinics and it is. I was sort of looking at that this week and I would say in a normal week I would say probably 40%. 40 to 50% of the people I see would have some sort of autoimmune process. So it's quite a lot when I sat down and actually had a look at it.
Speaker 1:Yeah, and what about the type of disorders that you see? Like you know, the flavour of the month thing is Hashimoto's, but there's so many others. What about Graves? What about, you know, type of diabetes, for instance?
Speaker 2:Yeah, I had a 14-year-old yesterday who is showing positive autoantibodies for Graves, which is, you know, quite young. I would say thyroid probably is the main component there, in that sort of 40% to 50% range. But I also have a couple of two clients actually I'm working with at the moment for fertility, with ulcerative colitis. So it is quite broad. But I would say, you know, thyroid, type 1 diabetes I don't have a lot of type 1 diabetes clients, but I have a couple of teenagers and then I have a couple that I'm working with for fertility, and then there's the other, you know, celiac. You know I would classify that as autoimmune and also, as I just mentioned, ulcerative colitis, crohn's, that type of thing.
Speaker 1:Yeah, and what about the arthropathies? I stumbled over that word Arthropathies. Do you see things like, for instance, juvenile idiopathic arthritis? Do you see rheumatoid arthritis?
Speaker 2:Yeah, I haven't actually seen a lot in clinic, fortunately, I guess, rheumatoid arthritis. I tend to have clients coming to me who have a family history of rheumatoid arthritis and then getting the achy knees and the you know, and people trying to get in front of it more so than coming after the diagnosis, which is fabulous, Like so parents might have had it, and then they'll be bringing teenagers to me to sort of say, okay, you know, please explain best diet so that they can try to potentially head it off at the pass as they get older. So I don't have an actively actually worked with a lot of people with rheumatoid arthritis but certainly, you know, trying to steer, steer sort of younger teenagers usually away from that direction.
Speaker 1:And when you're dealing forgive me for cutting you off, sorry and when you're dealing with these parents who have autoimmune disorders and then you're dealing with their fertility issues, how much time do you have to spend on just reassuring them about you know genetics and what their child is in for and things like that? Do you spend a lot of time counselling them?
Speaker 2:Yeah, and also not to. I guess, really, like it's important for the kids to not go through life thinking, well, that's what's going to happen, like I guess you know. And actually at the weekend I had two teenagers that I see and both parents are doctors, so so very well informed, and the female parent does have Hashimoto, so she's really mindful of testing the kids and making sure. But right now there's no, nothing going on for those boys. And but you know, wisely, the teenagers are 14 and 16, and they're working on explaining an anti-inflammatory diet. Their mum always says they actually listen when it's me, they don't listen when it's her, which is normal teenage response. But you know, working with from that angle to try to say this doesn't necessarily have to be your path Diet, you know, really, really can make a huge difference keeping stress down, keeping the toxins down and just, I guess, reassuring everyone that you know it doesn't have and one autoimmune disease doesn't have to morph into another, which we we understand, you know can be, unfortunately, what happens.
Speaker 2:They like to travel in pairs, so I guess a win is trying to, you know, steer the next one off at the pass.
Speaker 1:Yeah, yeah, we're jumping around a bit because I was thinking in my mind about following this through chronologically, but it's important things you're mentioning, so let's jump to that. Teenage is you mentioned stress, a very stressful period of many people's lives. So how do you? I mean, let's frame this up better. I'm getting the feeling that these kids are very well informed and I've actually spoken to kids with neuro atypical disorders and I can't believe how poised they are, how knowledgeable they are and how settled they are with their condition, how they're treating it. I was blown away. Is that what you find most people are? Is that like a subset?
Speaker 2:Well, I think the people that you know come and see integrated practitioners are generally fairly, you know, well informed and that means the kids are well informed and they can chat very openly about what's going on, whether it be at school, whether it be to me, whether it be and I just love that because I don't. I think this is a fairly new generate. You know, this next generation coming through can do that. Like you know, I'll have kids that'll say you know, sonia, it's really, you know, going to the toilet's really hurting again. Or you know, they're just, they're not embarrassed about it, like I just think that's great and probably coming from parents, coming from potentially, you know, what they read in the media, but I agree. And then there's the kids, who you know just, and potentially parents, who just have been eating the wrong thing or feeling terrible.
Speaker 2:But it's such a simple change Like teenagers and kids turn around way faster than than sort of us older people do, like you can make a change and within two weeks they're like I feel completely different and it's just marvelous because they, they really see the difference. And I love that in clinic, having the teenagers say you know, sonia, I'm actually getting to bed on time because you told me I should be off my screens. I'm doing it. And now I've taken up soccer. Or now, you know, I've spoken to my parents about you know I really want to do that subject at school or I just yeah, it's really rewarding, but I do. Going back to your question, I totally agree. The people that are certainly coming to me at MTHFR. I learn from them every day Like they are amazingly well educated group of people and I take something away from every console that I have. They'll teach me something Like it's. It's amazing, I love it, yeah.
Speaker 1:Well, you know what? That's actually the sign of a good practitioner. Oh, thank you To you, yeah.
Speaker 2:And I'm sure with other people I'll go to your mind what was that? I'm going to share that with my other clients. And then I'll say a client told me and I I find that just a fabulous way to spread good information. Yeah.
Speaker 1:Yeah, absolutely. I have to ask about these kids with. You know the changes that they feel pretty quickly. And then you've got temptations, you've got birthday parties, you've got peer pressure, you've got the rejection syndrome that people have. You know we see it very commonly with type one diabetes. So do you find that, because of their knowledge, they know how to pull themselves out, or do they come back and go? I fell off the wagon again.
Speaker 2:I think it depends on which autoimmune process we're looking at. So obviously there's not much wriggle room at all. We're celiac, like that's a line in the sand. There's no. You know, when you go to someone's party you've got to take your own food, you know so. And then there's sort of sensitivities that you know you can use more. The 80, 20 year old, and you know I always say what you do every day matters more than what you do once in a while. So you know we try to work out what is acceptable so that they feel part of the peer group and so forth, and I do chat to them, okay. So if you're going to this takeaway place that you like, the better choice is this Like I try to arm them with some information.
Speaker 2:Type one diabetes these days, fortunately, most of my clients would be using the, the intravenous monitor, so that you know it's in like is it cool to introduce it through the stomach? I'm not sure if that's correct, but you know the 24 hour glucose monitor, so it's adjusting insulin. These days it's not like the old days. So my clients who are teenagers that wear those still gosh. The parents do a lot of leg work there. So you know they do often give their kids some freedom, as they should, but I think there's a lot of responsibility till they sort of get to that, you know, 18, 19 year old, so there is some wriggle room with that. And then there's others that I would say you know, guys, for you to feel better like we've got to, absolutely, you know, hold the line with this. But I think they feel so much better and if you explain it to them of why we're doing it, then I think they get it and they might fall off a bit, but they'll come back pretty fast is my experience.
Speaker 1:Yeah, I was very impressed by this young gentleman I met who newly diagnosed type one diabetic and I was amazed a teenage and I was amazed at the confidence and the almost nonchalance and he wasn't denying it, he was accepting of it, but he was just like it is what it is and he was so adult about it I was taken aback I was going. Where was I at that age? Where was my wife?
Speaker 2:Thank goodness that we yeah, no, it was amazing, so mature and I guess you know it's just fabulous now that that is available. You know it was really expensive when it first came in and now it's. You know there's more funding for it and you know so more people can have one of those fantastic devices so they're not pricking their finger and checking their you know their glucose insulin tests all the time, like I just think it's fabulous for having more of a normal life. Yeah.
Speaker 1:So let's go further into diet, about, you know, starting people with changes and when people have been molded into eating the wrong foods habitually, particularly over a long period of time, and I guess this is more evident in the older set. But you know, you get family members that they eat at the dinner table. They've always eaten white food. The white bread's always on the table. La, la, la. How easily do you find it's able to change the life of one patient when the family don't have that same condition?
Speaker 2:I think when we're talking about fertility you get buy-in like you don't get it at any other stage. Like it's amazing what people do when we're talking about the fertility journey and it just impresses me how much people will change and stick with things. You know, and I do work with sort of more mature patients. You know I've got sort of 70, 75-year-old, 179-year-old patient and generally speaking their diet is pretty good. Like you know, they're sort of still making a lot of their own food. They have a little garden in the backyard, so I think it's probably more that sort of. You know, 40 to 50 range. I think by 50 people are starting to go oh, I'm not feeling so good so I better change things. So it's probably like I guess you'd say 25 to you know 45,. Let's say, make a bit broader wear some changes, not so much. I think. Yeah, family's got a lot to do with it.
Speaker 2:But I think people get time poor. They get tricked into thinking oh, you know, you can just buy everything in a packet. You look at the freezer and the chiller now in Woolies, like you know, put your food in a plastic container and put it in the microwave. It takes three minutes. You get a nice, you know, serving of endocrine disrupting toxins. With your plastic you get food that probably has no nutrition in it. But you know the health star rating, the. You know the marketing like it fools people into thinking that they are actually eating well. So I think it's definitely making that move. People are pretty well educated these days, I think, but it's trying to sort of go. Well, here's some things that you can do within 10 minutes that don't require you know. So I try to say, yeah, you're busy, you've got three kids, you're working, but let's get rid of, as you say, let's get rid of the beige food and I want, you know, four different colors on your plate. I want a minimum of three cups of veggie day and I try not to look.
Speaker 2:There's certain clients that I'd work with quite specifically, you know, for different conditions, especially bowel conditions, but in general I'm always just saying, you know, mediterranean style diet, lots of veggies and good fat, good quality protein. You know, not too many grains and if it's a autoimmune process, we're trying to bring down to go into a successful pregnancy. I'm really strict. So I'm like no grains, no gluten, minimal dairy.
Speaker 2:And you know I was just looking at one of my clients before who'd been trying for six years when she came to me and she'd started trying at 28, so wasn't, you know, not aged, didn't have much to do with it. She'd been told the only way they're going to get pregnant is via IVF. And we got her thyroid autoantibodies down from 618 to 56 with diet Like. So it became, you know, and she's.
Speaker 2:I'm now working with her for her second baby and you know that was something that everyone the doctors are sort of saying you'll never get it down. She did everything she had to do. We had to look at her partner and so forth, but I was just I love seeing things like that because it's there, like it shows she changed her diet, the autoimmune markers came down. There's no question, it's there in black and white for anyone to see. So you see things like that. And my client with ulcerative colitis she's unfortunately pregnant at the moment after many years, and her gastrointrologist said the same thing after the diet we've had her on, it's the best she's looked. You know that was a two months ago appointment with him and now, fortunately, she's early days pregnant. So I have to see diet being so important and it sort of depends on what we're trying to achieve on how hard I'll go with. This is what we need to do. There's no wriggle room, or? Yeah, look, you know, this is where we're at. There's a bit of wriggle room.
Speaker 1:So yeah, that's right. And you know, depending on the severity of the condition and how it's affecting the patient, it's really interesting how I'll get sometimes get people who say, you know, can I still have you know how much? I don't want to give up that sort of vernacular. And I say to them well, for those who want much, much is expected. You know, it depends how far you want to go healthy. If you want a little shift, go as you were going, but if you want, if you need to get better, you need to change. And if you're not willing to change, there's some issue here. You know that you need to think about your mindset, sort of thing I was gonna say. Isn't it interesting about this narrative that we're being fed now and that's these insidious, persistent chemicals that have never been seen on earth? 40 odds, thousand is there more? And now we've got this they're forever chemicals. Ah, they're like best friends forever, forever chemicals. So it's this real interesting change in Somnolence. You know, just don't worry about it, they're forever, it's okay, yeah.
Speaker 2:Yeah, one bite at a time. I always send them to Tabitha's book. Please go and read the book and see what that's going to.
Speaker 1:What is it? One bite at a time eat. Eat the life you you love, or something.
Speaker 2:Yes, I think that's right. It's very good book. Yeah, you know.
Speaker 1:Macintosh and Sarah Lance, everyone got to put that yeah and what I love about what she says is that you know we can't all afford. We can't all afford. Certainly in this Economic situation we're going through, we can't all afford the lovely natural, organic foods. That's fine, but she talks about getting the organic buck, your organic one. So there's something what's gonna give you most bang for buck by changing to organic or clean, you know, or something, some change in your grocery list. That's right, really.
Speaker 2:That's right.
Speaker 1:And it's a brilliant.
Speaker 2:Yeah, it makes sense.
Speaker 2:Yeah we've got to try to get the best food chain you can afford, and that might be, you know, just going to the farmers markets. It might not be organic, but it only left the soil two days ago, whereas, you know, woolies, it might have left the soil six months ago and tripped across the world or done anything and it starts to lose, you know. It starts to lose nutrients the minutes out of the ground. So it makes sense that if you want some nutrients, you've got to get something that wasn't, you know, in cold storage for six months.
Speaker 1:It just makes no sense if you can, and we're not just blaming Woolies all, all, all supermarkets, no, that's right, that's right and you know we.
Speaker 2:Well, it's not available to everyone farmers markets. If you live in the country area you know that doesn't happen like it does in the bigger cities.
Speaker 1:I totally get it and I've said it before, this is probably the the one of the very few good things that come out of covert, about Growing people growing some of their own foods, even if it's a herb garden, something that they can put on their table, that they can nurture and see grow and, you know, watch it. I think it's really important for kids to do that as well.
Speaker 2:So, important.
Speaker 1:Um, now, the next thing we have to talk about is and it sort of goes hand in hand with diet and coming to see a naturopath and somebody who'll care and listen and take some active sort of participation in their, in their Condition management, and that is stress management. So how much do you, how much weight do you, put on stress? You know, particularly in auto.
Speaker 2:Yeah, I think it's almost at the top. Like I think your diet is a really great. You know it helps you get through a lot of stress. But I think you know, and we know in the methylation world, stress Throws out methylation, no matter what supplements you're having. So I think you know, and stress, you can't avoid it. So we can't all go and live, you know, in a retreat situation.
Speaker 2:But I think it's part of your responsibility To your health to try to manage your stress and that might be just by Breathing, yoga, walking the dog, gardening, painting, whatever it is.
Speaker 2:But I think we have to identify. You've got to learn how to switch your parasympathetic nervous system on, because I think it's right up there. You can do, you know, especially around that. You know with females and males, but around that sort of 38 to 45, like if you're gonna get something going on with your thyroid that you haven't had before, that's when it starts and there's a lot Juggling at that time and you know people might still be doing, you know, a lot of high intensity running or sport. They've got a job, they've got three, two or three children, like I think stress, even if you're eating the best diet is, it just brings you know, it unravels things. So I think that that's right up there. Like I think diet and stress and sleep are probably the three Main pillars of what you can do to really make a difference to your health. But I think it's it's important yeah.
Speaker 1:Yeah, you were talking about the Premade meals in a plastic container which we conveniently microwave and heat them up and release them into the food. What other sort of toxicants are important in looking for assessing in your patients with regards? To both fertility and autoimmune.
Speaker 2:Yeah, sure, so it depends on who comes to see me, but obviously if the partner is a landscape gardener, you know, or a tradie or a farmer, you know I'm starting to look at you know different sorts of chemicals, whether it be fertilizer or heavy metals. The patient that I mentioned to you before that we got her thyroid or antibodies down, we worked out her partner had a huge copper problem and we balanced that with zinc. But I would probably start with looking at you know zinc and copper because it's fairly easy, straightforward to do in in bloods. If I have to get more into detox, I mean mercury, obviously if they've been eating a lot of fish, it depends on the timeframe. I always ask for everyone to give me three to four months before they try again.
Speaker 2:It sort of depends on you know where we're at with that, but just generally trying to get like as many of the chemicals out of your house as we can start with. So, you know, trying to swap to a natural deodorant, getting rid of the body products, the makeup for the husband, making sure he's not out the back spraying with Roundup, you know of a weekend If he is, he needs to wear his gloves and his mask and things like that. So I think, as far as fertility goes, there's a lot of chemicals that can cause problems. It sort of depends on what sort of timeframe we have to check. You know, mercury in particular, that was that fantastic quick silver tri-test that was available in the store a few years ago and that's not you know. So it's tricky. It's tricky to test and then treat it all.
Speaker 2:But I would just start. I would start to support detoxification and try to get rid of the chemicals that we know they're being kind of, you know, dealing with day to day. So you know the hair, the flu or your carbons and things from the spray. You know the men with the spray deodorants trying to get them to use one that you know will actually work. So I just start there and then support detox. So look at methylation, look at B12, look at folate, look at potentially a small amount of NAC or a small amount of glutathione, resveratrol, just antioxidants leading up to when they start to try. So there can be, and I guess, if they've come to me and there's really you know there's a lot of miscarriages and you know we might have to get into that way more before, before we start trying, which might mean more testing.
Speaker 1:Yeah, Gotcha and you know, we commonly consider detox to involve supplement. But what about things like infrared saunas and dry brushing and hydration and you know all of that sort of thing and I'm going to be and I don't mean this in a creepy way, but it might very well come across that but with males, what about things like, you know, increasing ejaculation while they're not trying, while they're clearing crap out of their body to get rid of toxicants? Is that something? Is that a thing or am I just off?
Speaker 2:Yeah, I don't know about that, Andrew. I'll have to research that one and come back to you.
Speaker 1:I've never researched, I just thought about getting things out. There's a quick way.
Speaker 2:Yeah, I don't know Definitely the infrared saunas. You know I'm always I should take shares in City Cave because I'm forever saying go and get the trial at City Cave. Some of my clients who come to me that are quite unwell, you know, with mold, illness and things, I just have to. You know I wouldn't send them in for 45 minutes on a straight off the bat but I think that's great and I sort of talked to them about going in there with their essential oils, you know, on a little piece of cotton wool or something to you know to really don't. You know, don't get on your phone, use that time, bring this nervous system down, inhale some lavender or you know, and I think that that's definitely a great way to go.
Speaker 2:Epsom salt bars are a great way to go. Body brushing is a great way to go and, as you said, most importantly, drinking enough, you know, filtered water to wash out everything that you know people sometimes just aren't drinking enough water. It can be as simple as that. So, definitely those detox. And then, looking at, you know, liver enzymes are they up? Have they been up? Has there been a lot of pharmaceuticals? Is there a lot of pharmaceuticals that are, you know, the clients taking those sorts of things, but certainly antioxidant support pre, you know, during the preparation, the prep period for both parties, like it's a 50-50 deal, so for the males and the females really important.
Speaker 1:And is that where you start to maybe, if required, you know add in some adaptogenic herbs for their stress. Like, do you? Look at that really early, or do you look at that later on if they need it?
Speaker 2:Yeah, so so I'm not a I'm not a herbalist, so I'm just new clinical nutrition. But definitely some of the yeah, no, that's okay, some are obviously working at MTH far I would share client like I'd get help with that if needed. But I definitely would look at. You know, from my toolbox I'd be looking at. You know, magnesium, potentially even more than that if necessary. You know things like 5-HTP, potentially semi, if you know we really need to look at calming things down, and then adaptogenic herbs would definitely be something that we may look at.
Speaker 2:And certainly when it comes to the thyroid, we have a fabulous preconception autoimmune mix that the girls make up under sort of instruction from Carolyn Lodowski. She would say right, who are you working with? This is what we need and we would make that up on clinic. And I think that was one of the big reasons we were really able to get those thyroid antibodies down with diet. So that was you know, that was part of that and that was I wrote them down. If you'd like to know where I wrote them down. In case you asked me what was in the mandu, do you want me to yell it out?
Speaker 1:So as long as we don't mention product names. That's all.
Speaker 2:Oh no, no, Hemidesmas, romania, ginko and Feverfew. So that is what we would use as an autoimmune pre-conception mix to bring. That helps bring down those autoimmune markers and works really well yeah.
Speaker 1:Yeah, beautiful. And what about you know red flags that you have to look for with regards to say, I mean, I'm guilty of this too heroic dosing, for instance, with methylation nutrients. What do you look for? Do you tend to question patients about? Have you noticed this or you know? Do you wait? For them to say hey, listen, I went off on that.
Speaker 2:Yeah and I didn't do well. So definitely the first point of call would be B12. So look, if B12 is low and you put in methylfolate, doesn't matter what your genetics are that might not go well at all for the patient. And then, obviously, just because of the nature of the MTHR clinic anyway, I often have genetics not all the genetics, but I often have MTHR and these days I often have compt as well, which helps me make the decision on methylfolate. So that kind of that's a little red flag to me to say, oh, we're going to have to go carefully If they've got a lot going on with their gut methylfolate, like candida and things that can make the reaction not so great either.
Speaker 2:So I'd look at B12 first and you can also do a little niacin trial. So using niacin sometimes I'll just start with that and say, if I don't have any genetics particularly, I might say just take 250 milligrams of niacin three or four times a day for two days and tell me how you feel. And if they tell me that makes them feel much better, I'd go really slowly with methylfolate because that tells me there's a block somewhere, like that tells me, because it made them feel better. It could not go well if I hit them with a huge amount of methylfolate.
Speaker 1:You said niacin, we need to be careful about which form. So you've got the nicotinic acid form, which is the flushing form, and then you've got the niacin or nicotine amide form, which doesn't flush. Which ones are you talking about?
Speaker 2:That's right. I would go and look. The nicotinic acid isn't necessarily going, but like people will think they're having a heart attack, like if they get the flush and they don't know it's not readily available.
Speaker 2:So that's not a good start. It's not readily available retail in Australia though. So unless they've bought it off iHerb or something like, they're usually not going to have get hold of that. And I always sort of put it in my notes to say if you've bought it off iHerb, do not do 250 milligrams of nicotinic acid, because it's too high, and you're going to think something terrible has happened. So I normally just sort of say if you're getting it retail-y, you're going to be fine, but just double check, you're not using nicotinic acid, because then 50 milligrams would be more than enough.
Speaker 2:So I'd normally say just use a brand look, there's lots of brands that you can get retail or practitioner and then just try that. And sometimes that if they say I felt so much better when I'm introducing methylfolate, because if we're going down the fertility route we've got to get it in somewhere, or we might have to use phylinic acid if we can't get there. But sometimes they can tolerate it perfectly well if they keep having some nicin at the same time. So sometimes you can balance it that way. But then I'll have clients who just never can get there, like, for whatever reason, homozygous comp, genes or just you know, just feel terrible on it and then we just kind of try to work it in as best we can, getting the dose up based on what they need with phylinic acid?
Speaker 1:And do you find greater issues in those people, in the coffee drinkers, for instance, or those people that might be taking, you know, let's say, dye, indole or methane, for instance, which they sort of compete to go out the the cocked?
Speaker 2:Yeah, and I think it sort of depends then on how anxious the person is presenting in front of you. If you've got full genes, you can have a look at their CYP genes. That like look at, you know how they're, they feel, you know moving through their caffeine and things like that. But if they present and they're really anxious and you think you know there could be histamine, there could be lots of things going on. If it's fertility, once again, they will generally try to do whatever they can to get there. So generally people will go that's fine, I'll give up coffee, I'll do what it takes. So that's always. It's a. I mean I love working with fertility patients. The journey, the email you get from the hospital to say, look, who's here, fantastic. So you know they probably hate me for taking coffee off them. But not everyone has to. You know, go zero coffee. But some people will like if you're getting someone with anxiety and they can't handle you know, certain supplements, you kind of got to go or I think we've got to, we've got to take it out.
Speaker 1:So yeah, gotcha. And so methylation block and hormones. Can we discuss that for a tick?
Speaker 2:Sure. So methylfolate or any form of folate is really important for hormones. So hence, when people are on the pill long term, that depletes folate. So if someone's coming to you being on the pill for 10 years you know, really not tolerant maybe, has tried not tolerating folate, you've got to try to work it in, you know, to the system to obviously get the result that you need. So yeah, a couple of things.
Speaker 2:For methylation block, firstly, you would look at gut, which we spoke about can be something tricky, like oxalate. So if you can get an organic acids test, sometimes that tells you a little bit more about where to start with the block. So has there been mold exposure in the past which has pushed oxalates up? Are they just more predisposed to oxalates, which is blocking pathways? Is there yeast in the gut that can block methylation and block the B12 is really important to utilize folate. So if B12 is low in the cell on the organic acids might look perfectly fine in the bloods, but they've got these B12 type deficiency symptoms.
Speaker 2:And then you look at the oats and you know the methamelonic acid is isn't what it should be. So then you can in our world, if you have the genetics, you can look at TCN2, you can look at MTR, mtrr and go. You don't uptake B12 very well. Let's do subcontaneous injections to get that up whilst we work on what we need to, and then we'll try the methylfolate. So blocks can come in all shapes and sizes, but they would be the main ones that I would try to unpick at the beginning.
Speaker 1:You know. This is the thing about methylation is that it's not just this simple pathway. Even you know the diagram. It's not just cog. There's so much more that goes into it. I have to ask this there's a lot. We are simply are scratching. We're not even digging into the tip of the iceberg. We're just scratching at the surface. Where can we learn more? Have you got courses or anything like that that practitioners can learn from?
Speaker 2:Yeah, sure. So at MTHFR, obviously, carolyn Ladowski runs courses for practitioners, so there's a lot in there. It's not only methylation, it's genetics and things as well. For myself from Balanced Life, I don't have too much to offer, unfortunately, but the MTHFR support website, it has just a lot of general information. But then there's also access for clients. So there's a patient's portal which has recorded podcasts and lots of information, and then there's the practitioner portal as well. So there's, there is a lot of information. There's years of information in there. Obviously, ben Lynch, seeking health he does a lot of great stuff on methylation as well and he has a lot of free. His Facebook page has got so much information on it. So I think, as far as methylation goes and genetics like that, you know Carolyn and Banner, you know there's lots of other people that do great stuff, but just what comes to mind would be for resources. Both of those would be really good.
Speaker 1:As I said, and this one thing I'll disagree with you on, sonya, you said I haven't got too much to give. It's plainly obvious from how you're talking about your patients and how they respond to you when they've had a barbie and things, and how it affects you and the learning that you get from patients. Indeed, I think it's out of shot on the bookcase here, but it's the Oxford clinical medicine to yellow. This is a doctor's handbook and one of the important things that says in the very early chapters is to learn from your patients and in the busy times that we have, people forget to take a moment and just learn from the people under their care, which you do. So that's the sign of a great practice on there. So well done.
Speaker 2:Thank you, I really appreciate it. Yeah, thanks.
Speaker 1:Great to have you on the show and thank you everyone for being here today. Remember you can get all the show notes and the other podcasts on the Designs for Health website. I'm Andrew Whitfield Cook and this is Wellness by Designs.