Wellness by Designs - Practitioner Podcast
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Wellness by Designs - Practitioner Podcast
Fertility, Folate & Autoimmune Disorders Part II with Sonia Savage
Join us for Part II of our enlightening journey into fertility, folate, and autoimmune disorders with the esteemed clinical nutritionist, Sonia Savage.
Building upon the foundations laid in our previous episode, we delve deeper into the intricacies of methylation and its pivotal role in reproductive health. Together, we unravel the mysteries of optimal preconception care and empower couples embarking on their fertility journey.
Episode Highlights:
- Essential Assessments: Sonia guides us through the crucial blood tests and assessments recommended for both partners at the onset of their fertility exploration.
- Nutritional Compass: Discover the transformative potential of tailored nutrition and supplementation in fueling your fertility voyage. Sonia shares insights on the significance of folate, vitamin B12, and genetic variations, equipping listeners with practical know-how in selecting the right supplements and addressing broader health issues like gut health.
- Managing Pregnancy Symptoms: We navigate the delicate realm of pregnancy symptom management. Learn effective strategies to counteract challenges such as nausea and the role of specific nutrients in facilitating a smoother pregnancy journey.
- Male Subfertility: Delve into the tide of male subfertility and autoimmune disorders with Sonia and explore the profound impact of lifestyle changes on sperm quality and conception. We emphasize the importance of a collaborative approach in the fertility equation, offering guidance to both healthcare professionals and individuals alike.
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 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
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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
This is Wellness by Designs, and I'm your host, andrew Whitfield-Cook. This is Wellness by Designs and I'm your host, andrew Whitfield-Cook. Joining us again today is Sonia Savage, clinical nutritionist, who specialises in methylation issues, fertility and autoimmunity, and today we're doing part two of exactly that topic. Welcome to Wellness by Designs again, sonia. How are you?
Speaker 2:Hi, andrew, good morning. Thanks for having me Pleased to be here.
Speaker 1:Great to have you on Now. Today we're going to be doing a lot of the pointy end, if you like, of methylation, fertility and autoimmune disorders. We're going to be talking about dosages and exactly what you use in clinic to help people. So I guess, to start off with, can you take us through what assessments, blood tests and maybe other tests you do to see if an initial fertility appointment in an initial fertility appointment for both partners?
Speaker 2:Yeah, sure, thanks, andrew. So I guess, as I've chatted about before, I work lucky enough to work in two clinics. I work for MTH Fast Support Australia and then I also work under Balanced Life Nutrition. So sometimes it depends which clinic they sort of see me through, I guess, because at MTHFR often people have sort of been on a long journey to get to us. So what I guess they present with at MTHFR is a lot, so often it's, you know, four, five, six years of trying to conceive. So often that comes with a lot of, you know, blood semen analysis, really good workups At Balanced Life they might be just starting out, so potentially I've sort of got to get, you know, full bloods, you know, a semen analysis, depending on where they're at in the journey.
Speaker 2:Sometimes that's a bit tricky to get off the bat, you know. Unfortunately, you know you sort of getting from clients two to three losses doesn't count as a reason to do. You know, to look at the male sub fertility, which I think is a little bit disappointing, especially if you're the female going through it. But yeah, it's really, and that's the general stance that I'm getting, it's only two miscarriages, usually by three they'll do it, but I find that's a bit disappointing. Is that because of cost? I think so, and through Balanced Life I see a lot of country-based clients. So it could be a bit more of a country versus sort of city thing as well.
Speaker 2:But I do find that especially, you know, one person comes to mind. They were, you know, 10-week, 10 and 11 weeks. You know they're not talking about four weeks and the GP's answer was oh, 10, 10 week, 10 and 11 weeks. You know they're not talking about four weeks. And the GP's answer was oh, yeah, we'll look at, we'll look at your partner if you have another one, which I find is, you know, is pretty traumatic. But yeah, so full bloods is great to see. So you know full blood counts, zinc, vitamin D, sort of biochemistry, love to see iron for both parties generally, and then anything extra on top of that I love. So, you know, any sort of workups or functional tests they may have done elsewhere. Anything I can get my hands on, I love, because that just helps sort of really work out where we go, just helps sort of you really work out where we go. And with MTHFR, often I do have genetics, even if it is just MTHFR to start with, right from the beginning.
Speaker 1:Right, okay, so just going back to the blood tests, do you order those yourself? Do you find that it's just easier to bypass the GP and get them done? You know there's a couple of people that I've used, yeah.
Speaker 2:How do you accomplish that? Sure, and I often ask, sort of request it, before the first consult so we can really get into the nitty-gritty. I mean, there's always a lot to do with diet, but having those bloods really helps you with diet as well, it, but having those bloods really helps you with diet as well. So in the lead up to the consult I'll be recommending a list that the GP may be happy to do, and I don't even, you know, put any pressure on GPs to do things they're not comfortable with. So that might be homocysteine. Zinc is kind of sometimes in, sometimes out's, normally out.
Speaker 2:But I'm encouraging sort of instant scripts. So $20, do one of the general blood panels or the why am I tired all the time blood panels. You can get one of those a year and then I'll just send them a pathology request for the three, maybe the three extra that we need. That might be vitamin D, zinc, maybe homocysteine. So I normally do that before I actually meet with the client and then I've got all that worked up and I know sort of where to go. Sometimes it isn't done, but generally I like to see it, you know, right from the beginning.
Speaker 1:Yeah, okay, and can I ask, do you get any kickback? Like, for instance, if you asked for, say well, you said homocysteine. Are you getting a lot of kickback with this? I think it was. Was it taken off the screening availability?
Speaker 2:Yeah, and it's quite a tricky one Like. Forgive me, I'm not exactly sure about all the ins and outs of how they do it, but I believe it has to be packed onto ice, so it's tricky. So it is a bit more of an expensive test I think. I think to pay for it's about 60 dollars or something you know, rather than just the 25 to 35 um. So, but I'll have some GPs that are very, very happy to to do it.
Speaker 2:But you know I'm cognisant of not. You know that they're working within their lane and if it's not something they're comfortable to do, I'll sort of explain that to the client and minimise the cost for the client to do it as best we can, utilising, you know, what they can under Medicare. But, being realistic, I often say look, you know it's a meal out, let's just get it done. We probably won't have to do it again. You know, just try to get the a really good work up to start with. And homocysteine is a handy one to have, especially going into pregnancy, because if it's too high, like you really, it can have some risks of, you know, affecting um, miscarriage and so forth. So I do, and for the male it can kind of really show where he's at with methylation and you know potentially you know heart health even you know, depending on where he's at. So I do like it if I can get it, yeah.
Speaker 1:Right, even B12, though B12 was taken off the Medicare list of screening tests, I think with vitamin D, so that was way back in gosh 2016,. Something like that.
Speaker 2:Yeah, and that's a definite. I'm sorry I probably put it. It's too early for me. Andrew, I didn't think of B12, but it is sort of the main leading one that I'd go for. So an active B12, if I can get it, so you know, b12 and an active B12 or holotranscobalamin, and also folate, so they would be the leaders of the pack of what you really need, what I would see you need going into it.
Speaker 1:So asking a GP to do those tests? Because you're not screening, you're suspecting. Do you find there's any issues with getting those tests?
Speaker 2:done. Do you just get them done?
Speaker 1:yourself.
Speaker 2:Yeah, no, I find B12 generally the GPs are happy to do it and sometimes happy to do both. So I haven't found as many issues sort of with clients getting B12 through their GP as with the other tests like zinc and vitamin D. I think vitamin D is now what once every three years or something under Medicare?
Speaker 1:Yeah, yeah, yeah. What about other tests, of course, using maybe more expensive, but methylmalonate?
Speaker 2:Do you use any other surrogate?
Speaker 2:markers yeah, love them if I can get my hands on them. And so I I tend to sort of what, rather than just doing methylmalonic acid if it's in the budget, do a full organic acids test, because then you're getting just so much more um, I think methylmalonic acid's about 70 or something just to do on its own, and if you can kind of get the whole organic acids test, that sort of really is helpful. And I think for people who've had, you know, multiple losses or have been trying for you know, five, six, seven years, it just can show us, you know, could it be yeast? Are the oxalates up? What's happening, you know, with nutrition in the cells, I think it's a great one. And then, depending on where the female's at with her cycle and so forth love a Dutch too, I love Dutch, so I'd love to have all of them. But obviously you know it's an expensive process. So you've got to pick and choose. And if the client can only afford bloods and change their diet, I'm happy to work with that as well.
Speaker 1:It's one of those horrible choices. Sometimes they're expensive tests. We're in a tightening economy, but to do, for instance, a cycle of fertility, you then got to look at value versus disappointment and the emotional pain that couples go through. So it's kind of like oh.
Speaker 2:Yes, that's correct, yeah.
Speaker 1:Okay, so let's move on to supplements. What are the main supplements that you use for fertility clients? How do you start them? How do you start them, how do you initiate them, and how long do you recommend that they use these before they start trying, for instance?
Speaker 2:yes. So ideally I'm loving to see people at least four months before they want to start to try to conceive and that often isn't always the case. I get people who you know are two weeks pregnant or they want to start IVF in two weeks or you know. But realistically you know, to get the folate into, you know whether it's for both female and male it's important to do. You know to start that process minimum six weeks out, but ideally longer. And if there's a lot going on, you know, if there's a lot of inflammation, if diet's terrible, if there's autoimmune involved, like probably sometimes, six months is what you need, but you know it depends where they're at. It's often very hard if someone's been trying and actively through the fertility kind of you know up and down journey, to ask them to wait for six months. But you can normally get three months or at least you know two to three months. But that would be ideal. And you know spermiogenesis takes I think it's 70 days. I sort of explain things like that. What you're doing 70 days before is what counts. You can't just start the multivitamin a week before you want to start trying to conceive and it makes a huge difference.
Speaker 2:So as far as supplements go, the first thing I always look at is B12. Poor old B12. Left it off my blood list, but that's where I would start and look into it a bit further. So sometimes you know, b12 might look really good in the blood and if you're lucky to have genetics as well, I might see their TCN2 and I'd be questioning whether the B12 in the blood is actually what you see is what you get. So that could actually mean you know you do an organic acids and the methylmalonic is not good. So you might want to look at some subcutaneous injections, particularly if they're presenting with B12 deficiency type. You know fatigue and you know lots of other things that go with b12. So I guess, starting with b12 and in the sort of methylation side of things I find, then I'd work in the folate and the folate will be dependent on a lot of things. But you know, ideally methylfolate is generally what you'd go for, but once again that can be genetics of why that doesn't work.
Speaker 2:So get the B12 in first, because people will react to methylfolate if they're low in B12. So you've got to get the B12 in first. Even if it's just a week or two, you'd start with B12. And then I'd look at whether that's methyl B12 or hydroxy B12, a few reasons for that whether I think they're going to react. If the homocysteine is really high, then I definitely want methyl. If it's on the lower side I'd probably go hydroxy, then working in the folate, so I'd start really low if I think they're going to react.
Speaker 2:If I've got genetics and they're comp plus plus, I'd be really careful with methylfolate because it's going to increase dopamine and then that could cause anxiety. And by the time they've got to me often they've said I've tried methylfolate and I felt terrible. So I sometimes already know that without even genetics that we have to be careful and that's not always the reason someone's going to react to methylfolate. It could be yeast in the gut, it could be poor detox pathways, so inflammation can affect your ability to utilize methylfolate. So there's a few different reasons. It's not always genetic but I'd put in the B12.
Speaker 2:Then I'd probably get in a prenatal which is probably going to have either phyllinic acid and methyl or just methyl folate um. If they react to that, then I'd be looking at a methyl free prenatal um. So sometimes that can be. You know through that sometimes that there is not, that we're mentioning any names, but there is one that you can kind of get already done, or you might have to compound it. So you might, you know, because there aren't actually many at all on the market that are methyl free. So then that would be using folinic acid but working up the dose and using magnesium to make sure they can actually utilize the folate.
Speaker 2:So I'd get B12 in, I'd get prenatal in and then I'd be correcting things. So looking at vitamin D and this is for both, like a prenatal for the man, b12 for the man this is both sides of the coin here. Looking at, generally, men are okay in iron, but I have a number of clients who are vegan partners, so you know we've got to look at their iron just as, just like we have to look at the female's iron. Then we'd be looking at correcting things. So I really like to know zinc, particularly for the male. So looking at optimising zinc, optimising copper, balancing that out, looking at inflammation markers and working on antioxidant and liver support, like in that three months, looking at reducing inflammation, reducing free radicals. So then you might. The beauty of the prenatal is often there's so much in it that you know you're ticking quite a few boxes, but then looking at things like maybe St Mary's thistle alpha lipoic acid, you know some extra things that are going to help that detox process, which is then going to help, obviously, the quality of the sperm.
Speaker 1:Yeah, sonia, can I just go back a little bit to where we were discussing how people flip, if you you like, and they get bad reactions from taking a methyl supplement. Obviously the 5-mthf are sorry, forgive me, the 5-mthf is the form that's found in vegetables. So do these people react adversely to foods as well, do you find? And then obviously we bring in that whole gut thing. So it's kind of like the naturopathic axiom. You know, we go back to healing the gut.
Speaker 2:Yeah, that's right. So in question, generally, if there's a lot of reactions to food, that's going to be reactions to vegetables, obviously your leafy greens and things which I would see as that wouldn't happen generally because of folate, but it could happen for a number of different reasons, with food sensitivities and things. Potentially low molybdenum and things like that which I would see as something you have to fix before you fall pregnant, because I don't think you should be going through pregnancy vegetables, yeah, I think. Yeah, or you know, digesting and so working it out, because that's usually something else going on. Um, I feel like for some people with mthfr, you know, I guess with the c667t polymorphism, if it's homozygous, I think folic acid in food can be causing some dramas for those people who've got 70% downregulation in your methylation folate pathway and you're eating the standard straightened diet, I think, and you know they probably don't realize how that's coming out, but that's, you know, driving inflammation and so forth. So I'd see that as a problem. I wouldn't see generally people tolerate folate from food really well, but once you're actually getting it in as a supplement, that's when you might. And look, I have got one client, to be honest, who does react to vegetables and she is about to sort of go through IVF. But we've done our best, like we've got her eating, you know, so much more than she was, but it's still not easy for her for lots of reasons. But I think, as far as methylfolate goes, it's usually, as I said, one of those reasons why so genetics, inflammation, poor detox pathways.
Speaker 2:And then I would start, if I feel that's going to happen, would start with niacinamide. So I'd start with a little niacin trial. So before I even gave someone methylfolate, I might say, okay, for two days, every couple of hours, take 250 milligrams of niacinamide and see how you feel. Do you feel less anxious? Do you feel nothing? Do you feel worse? You know and I get a little bit of a handle on from that little trial how they might actually react to the methylfolate. And then I drop dose in, like very slowly. I might, you know, just use a tiny little bit or break open a capsule or something to get them once B12 is in place. But that is sort of how you would also deal with a methyl folate reaction. If you didn't feel great, b3 helps you utilise your methyl groups. So that will generally give you a little indication of how they're going to go, but be really, really helpful for people that have got some sort of a methyl block.
Speaker 1:I actually wonder if this is me wondering, forgive me. I actually wonder if part of the issues that we blame wheat for might be the folic acid in the wheat products, or indeed the glyphosate. But anyway, that's another, that's another podcast. Uh, but I wonder if we might be blaming the food for how the food is made or what's added to that food in preparation for, um, you know, being on the shelf in the supermarket there's a can of worms, andrew, but but.
Speaker 2:I do feel that there could be a lot.
Speaker 1:Way too early in the morning.
Speaker 2:Oh, my goodness, what clients that will report. You know they feel terrible for eating any sort of bread here. Go for a trip around Europe, can eat some bread and feel okay, you know I do, and Australians are. You know I'm, I'm from the country. I totally empathize. It's hard to grow wheat in Australia but it's. You know we're a tough country but it's very highly sprayed. We're adding folic acid to everything. I just you know. And if you're 70% down-regulating your ability to break it down, why wouldn't it affect you somehow? Like, I just feel you know and not everyone has as high MTHFR SNPs as that but I feel that there has to be something to it. And if you really want to be on the pregnancy journey, people are really prepared to probably cut that out, at least whilst they get, you know, get to the result they need.
Speaker 1:But I agree there has to be something in it so I think you just might just have answered my next question, that is, um. Can you, because of the intake of folic acid rather than the natural form, um methylfolate? Um can you up regulate methyl folate so that it basically pushes folic acid out?
Speaker 2:it like yeah basically gets the cogs turning yeah, I believe yes, the answer to that is yes. Ideally you'd minimize it or cut it out at the same time. For this you know very reason of, because usually with fertility, people are very invested to do whatever it takes. So I think you know very reason of, because usually with fertility, people are very invested to do whatever it takes. So I think you know, if you got a little bit of sourdough couple of times a week good quality fermented probably some has folic acid, some doesn't I think you know that might not be, as you know, a bigger deal, but it sort of depends on your genetics, would be my answer to that.
Speaker 1:Yeah, yeah aha aha, thank you. Salient point, okay. So moving further into, you know we've been discussing when things go wrong. What about, say, um uh, nausea in early pregnancy, for instance?
Speaker 2:what do we do?
Speaker 1:here when people have already been on their supplements, and then things go wrong yes, and it's.
Speaker 2:It is tricky. So, um, first thing would be obviously to try to just keep in the minimum of what you can manage and hopefully we've had some good time to get in some really good nutrients before that and hopefully, fingers crossed, it doesn't last more than you know, that sort of 14 week mark and some people it does. But I always think you know, if we've had time to prep, we've got some good nutrients in. We we should be able to, you know, drop a few things out for the poor female going through the nausea. But putting putting the supplements in the fridge can sometimes work, but you might have to drop back to doing you know what you can in liquid form and drop dosing it.
Speaker 2:You might have to open the capsule and put it into a smoothie and I would generally just pick out the basics of what we need and I would see that as B12, ideally a prenatal, but you know at least B12 and some folate to keep that in and anything else on top of that is a is sort of a win, and then just trying to do as much as we can through food, so working out whether that's smoothies, if that's all they can manage, if it needs to be dry things, maybe making some seed crackers or you know some good things like that that are still really nutritious and working really closely with whatever we can get in and also potentially looking at what else can we do there to minimise the nausea.
Speaker 2:So potentially some liver support. So, st Mary's Thistle, you know, to deal with the hormones, maybe some extra B6 can work. Sometimes some ginger or ginger chews can work. So we try all of that sort of thing, but there has to be a little bit of wiggle room in that sort of 12 to 14 weeks. Some people fly through it, but not everyone.
Speaker 1:I've got a question which I've never investigated and I'm just again wondering if there may be some tie into methylation, the super sensitivity that women many women get, I've got to say, during pregnancy. You know they can get sensitive to, for instance, raw meat or tea and coffee, where they get a metallic taste in their mouth, but they get super sensitive to foods Raw chicken is there, but also supplements, so for instance the B3, because it's based on tryptophan. There's that real. What do you say? It's a B vitamin smell, it's like a yeasty smell, if you like. But do you find that women with methylation issues tend to have a preponderance for this increased sensitivity? Or is it just pregnancy?
Speaker 2:Look, it's an interesting question and I'm sure I think methylation if it's not and not all of us with MTH fast SNPs aren't methylating properly, but we've done some work to get there but I absolutely think it would have to have an effect because it really does downregulate your hormones and your detoxification if you're not methylating properly. So I think in general it would have to have some effect. And I don't I've never sort of thought about it about who, because most people, I see, I guess, do have an mth of arsenic.
Speaker 2:So I'm a bit of a I guess I'm probably not a level playing field here, but by a sample yeah, exactly, but through life.
Speaker 2:I think that is so. That is so know, whether it's alcohol, whether it's, you know, hormones, I think if you're not methylating properly and you could still be not methylating properly and have no MTH fastnip if you're really depleted in B vitamins, like that's still going to affect anyone's ability to handle and to handle. You know that sort of detox process, so I'm sure there'd be something to it. Not an exact answer, but I would think yes, because methylation, the end result is detox, you know, of hormones or detoxification in general yeah.
Speaker 1:And you were also mentioning earlier how some patients, when they start a methyl supplement, they feel terrible. Take us through how that looks. What do they feel? What do they report?
Speaker 2:yeah, and look, it can be quite quite an adverse reaction. So it could be. It generally is going to be. Look, as I said it, it's that sort of group genetics, inflammation, poor detox pathways so it could be huge anxiety, it could be, headaches it could be, and they'd be the main two. I would say like it can definitely affect mood adversely. And you know, I'll never forget, I was a fairly new practitioner and one of the practitioners had a client call to say she'd actually had suicidal thoughts taking methylfolate. I haven't come across that again, thankfully, but it stuck with me. It stuck with me. That was probably in my first couple of months um consulting. So you know that's what, that you can be quite extreme. So you do have to be careful, like you don't just sort of say to someone go and get you know five, five, you know grams of folate, you know methyl folate, and go because it just isn't right.
Speaker 1:Yeah you know what that also may be an example of something actually working. Um, I'll I'll segue back to this. I've known about a patient who previous history of suicidal thoughts, quite severe depression, multiple medications, but in this instance he started a new medication for anxiety and prior to that he was anxious about having suicidal ideations again. The drug worked. The drug was successful. It took away his anxiety. So therefore he merely had his suicidal ideation without any anxiety associated with it. In other words, he was now going to suicide. So the drug effect was successful. The outcome for the patient was not. Now, thankfully, this patient was saved. But it's just interesting how we can get a disconnect with what we, what we want and what the patient needs that's exactly right and methylfolate does work.
Speaker 2:You can see the first couple of cycles after you've got it in the cycle might be a bit different and it might not be great the first one, but you it. You can see it's starting to affect and you know they've brought out for a very short time the antidepressant. That was just methylfolate, which I think it was 12 um, 12 milligrams I think it was um, and it worked for a lot of people. So you know really high dose. So for some people methylfolate is fabulous. It's just not fabulous for everyone to start with and often you can get someone to 500, maybe only 250, but with um, you know.
Speaker 2:Jumping back to dosage, I would say if you've got, you know, depending on your mth, fast snip you want to be up to probably at least a thousand fifteen hundred maybe,000 with autoimmunity. Like that's the level you need to get to, I would say, for the good outcomes we see in clinic. So you've got to work the person up and if you can't do it with methylfolate, you'd look into how you can. You try to clear the pathways and do all the work that needs to be done. But if that isn't possible then you've got to do it, you know, with folinic acid.
Speaker 1:Sonia, just as a last question, we tend to focus on female subfertility and female supplementation. What about taking us through, maybe, the issues of male subfertility? Where do you start? Do you always look at their work environment, for instance?
Speaker 2:So, with a fertility consult generally, I'll do a two-hour consult as the first opening gamut, which obviously is quite long, but we get a lot done. It's both the female and the male and quite a lot will have been filled out before they come in. So you know what are they both eating, how are they, you know how's sleep, how's going to the bathroom, what their jobs are. So I generally know, you know, and I will check with that, you know, are they cycling? You know, 150 kilometres a morning? Are they landscape gardeners? So I'll know all that information coming in which I see is really important and, generally speaking, I'll have bloods from both as well.
Speaker 2:So, and it's a big deal, you know, they sort of think that we're on track by 2050, that you know, fertility is going to be a huge, huge deal because of men's subfertility. So you know we really need to. You can't sort of, you know, put the responsibility on the female. That's gone. They think, you know, potentially it's edging over the 50%, more than male subfertility, and the good news is there's so much that can be done. So all the things that we've spoken about we'd be looking at, you know B12, vitamin D, zinc and copper, be looking at reducing inflammation. What's the fasting glucose like? What's cholesterol look like, do a really big workup. And the amazing thing is, with males, once they're on the right sort of track, they would generally be super compliant and it's amazing what you can do to turn around. Um, you know, especially if you've got a sperm analysis to start with and you know an example might be some wonderful clients I'm dealing with at the moment the gentleman we had an analysis done sort of mid last year and you know he's gone from sperm concentration of 10.7 to 45, like that.
Speaker 2:It's in about a six month period. His normal forms went from four to 10. His progressive motility 13 to 47. I think he is now like unbelievable, but that was a big change. With diet, that's not. That's just not supplements. The main thing I would say with him was diet. He's highly stressed at work. His diet was terrible, his sleep wasn't great. But you know they've got such a better chance now of conceiving and before that they've been trying for quite a long time and they were never going to get there, probably because no one had really looked into it from the male side. So I think it's so important, especially for people who've been trying a long time.
Speaker 1:Takes two people to tango, as they say. What about um frequency of sex, for instance? A couple of people I've spoken to them about. Maybe it's worthwhile trying to abstain for a little bit rather than going bull at a gate.
Speaker 2:Forgive the pun yeah, look, I think, um, generally speaking, like it's a very busy world we live in, so I guess it's another thing to think about. Right, we've got to leave it. I sort of you know a very old GP of mine once said you know, I generally just give the advice of try every second day between day 10 and day 20. You can't really go wrong. I know I'm like who has the time to do that, but I um, I do think, depending on um, what the quality is, I'm not 100% sure of the ins and outs of waiting, but I think definitely every day you know that's probably not going to be useful every two to three days during that sort of ovulation window, I would think. You know, I think working on the quality of the sperm and seeing it in an analysis, you know, is probably better than just saying, you know, wait three days or I think, just have the quality there. But yeah, I'm not 100% sure of the difference it would make between two and three days.
Speaker 1:What about performance issues? I've had a young male who had performance issues and you know there was some sort of data about using ginseng, for instance. Do you tend to favour the herbs here rather than nutrients? Do you tend to focus largely on their psychosocial issues? Tell me how you navigate that one.
Speaker 2:Yeah, I think if you can get, you know, actual hormones to have a look at, to see what is actually going on hormonally. So testosterone, SHBG, free testosterone, you know, or have a look look at that, is it actually a hormone thing which could be going back to a b12 and a folate thing, because they both are really important for hormones? Um, I would look at it from that angle and then I would look at you know, um, from from more the stress level as well. I think you know stress plays a really big deal with that. And to support, yes, in answer to your question, I potentially would use some support, but I'd be putting in those building blocks first, like you know, just the methylation nutrients, looking at diet, looking at sleep, you know, potentially looking, does the person need to sort of see a counsellor or a psychologist? You know what else is going on that is causing that, particularly if it's a young person, like there might be. You know that that's a little bit more unusual, I guess, than a bit of an older gentleman.
Speaker 1:And I said last question but what about male autoimmunity? Do you find that males with autoimmune conditions, like fertility issues, once they have the reason, you just wind them up, let them go and they're really compliant? Or do you find that if they've got autoimmune conditions that it's a little bit more of a got to get them on board, got how you have to get them motivated?
Speaker 2:yeah, I think with autoimmune it's it's a marathon, not a sprint. So if it's an autoimmune condition, they've got it's for life. So you're getting a male getting their head around. You know, staying gluten free, you know, not too much alcohol, all of those sorts of things. Some will be. I feel so much better, sonia, I'll do it other people you can only get them on board for three to six months and they're amazing. And then, you know, the switch gets turned off. But I think explaining to them and and tell you know, sort of showing them the data of okay, here's these autoimmune antibodies. Before, this is four months after an anti-inflammatory diet. Look at what's happened. It's gone from 1,000 to 100. Like you can bring it down, you're still going to have the autoimmune disease, you know. But your body is handling it much better based on what you're eating.
Speaker 1:Yeah, oftentimes it takes that falling off the wagon to make people not just males, make patients realise, oh hell, that really was doing something that was really working, and that's the switch to get them back on.
Speaker 2:Exactly, especially if they can feel it Like I think with anything we do, you know, there's got to be some sort of result. They've got to feel something pretty fast, otherwise they you know, you can lose them pretty easily, but often it's within days.
Speaker 2:Like, you know, a diet change you can feel different within days, or at least you know, two weeks. So I think what we do has a pretty direct you know. You can get a pretty direct outcome. To a certain extent, that's enough for the person to invest to say, hey, you know, I think she's onto something or I'm onto something by changing my you know lifestyle, which is, you know, which is really rewarding.
Speaker 1:Sonia Savage, thank you so much once again for taking us through fertility, autoimmunity and folate or methylation issues. There's so much more to learn, obviously. So you can't handle, you can't become expert in one podcast, but you've taken us through some real key points in helping our patients, particularly those people that are going through multiple miscarriages or ongoing fertility issues. I really thank you so much for your expertise in this area and for showing us just how you can help patients with regards to methylation.
Speaker 2:Pleasure. Andrew. Thanks so much for having me Lovely to catch up again.
Speaker 1:And thank you everyone for joining us today. Remember you can find all the other podcasts and indeed the show notes for this podcast on the Designs for Health website. I'm Andrew Whitfield-Cook. This is Wellness by Designs.