From Inflammation to Conception: Solving the Fertility Puzzle

Coming up on this episode of the Dr. Hyman Show.

But if you have omega-3s at adequate levels, it lowers inflammation, it lowers reproductive system inflammation, and it supports hormone function. Now, if you if you're a guy and you have omega-3s in your diet or from supplements, it affects sperm quality, sperm count, sperm motility, the amount of semen you make, your testosterone levels and.

Even the rates of in vitro fertilization. So just taking fish oil or eating.

A lot of sardines can have all these benefits.

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Health journey, visit my website at drhyman.com for a summary of my favorite and thoroughly tested products. 93.2% of Americans have some level of metabolic dysfunction, meaning they're on somewhere in the spectrum from insulin resistance to pre-diabetes to type two diabetes. And this is the thing that screws up both men and women's fertility. Now, sex hormones are regulated by our diet. You may not have known that, but sex hormones are directly regulated by what you eat. And pretty much everything is regulated by what you eat. If you don't know by now listening to me, ultra processed foods and sugar and starch are causing massive shifts in our sex hormones. And that's the infertility crisis. Our SAD diet or standard American diet is 60% or more from ultra processed foods. The average American consumes anywhere you look at it from 113 to 150 pounds of sugar and about the same amount of flour every year per person. That's almost a pound a day of sugar and flour per person. And that is not something we're used to eating. That's a pharmacologic dose of sugar that's causing dramatic hormonal shifts in our biology. The spiking sugar leads to high insulin levels. That leads to insulin resistance. And then we get blood sugar and hormone imbalances as results. So what happens? What is the biology here for women? Let's talk about it. It's a little bit different for men and women. When women have high sugar and starch, it drives the insulin. That leads to increased androgen production. Androgens are testosterone. That leads to free testosterone being increased. And that will lead to all sorts of problems like PCOS, for example, which causes irregular, painful, heavy periods, so clotting, heavy bleeding, weight gain, hair loss on your head, hair growth on your face, acne, lack of ovulation, as we mentioned. And so this is really not a fun problem to have for women. but it is often solvable by addressing the root causes of diet and lifestyle. Endometriosis is another factor we talked about that can be driven, but not necessarily by the high sugar diet. Although there's some evidence that this is an autoimmune disease, which can be caused by leaky gut and other drivers of inflammation caused by our diet. Now what happens with men when they have too much starch and sugar? Well, they get insulin resistance, and that leads to the opposite, leads to low testosterone levels in men. That leads to damage to their blood vessels because of the insulin resistance that causes inflammation, and blood vessels are needed to have good erections, they get erectile dysfunction. And it also, because of low testosterone, affects sperm quality. And what's even worse, when they gain body fat as a result of insulin resistance, they make more estrogen because there's an enzyme in your fat tissue called aromatase that converts testosterone to estrogen. So that's really bad. They get higher body fat, they lose the hair on their bodies, and they have low sex drive, low sex function, low fertility, low sperm count, and the list goes on. So when you have this higher body fat, you get all these problems, and that leads to more inflammation. And then more inflammation for men and women leads to more infertility. more endometriosis, more PCOS, worse pregnancy outcomes, even if you're using IVF or advanced fertility treatments, ovulation problems, as I mentioned, you get poor quality of eggs and sperm. So the very seed of a new life is being damaged by your diet. And we're going to talk about that. This can also lead to miscarriages, or inflammation can lead to that, and also birth defects. So all around our toxic diet, lifestyle, environmental toxins are driving so much of these problems. As I mentioned, inflammation is a big driver in fertility. So what's causing inflammation? Of course, inflammation, as you know, listening to me forever, driving almost every known chronic disease, heart disease, diabetes, cancer, dementia, autoimmune diseases, the list goes on, depression. And it's not just driving those things, it's driving fertility issues, right? So it's our processed, SAD diet, it's excess sugar, it's the insulin resistance that results, the blood sugar imbalances, the chronic diseases that result, type two diabetes, obesity, and damage to our gut microbiome. We're gonna talk about how the gut microbiome plays a big role in hormones and fertility, at least a leaky gut. Also, our sea of environmental toxins is not good for our hormones, the sea of industrial chemicals and pollutants, sometimes latent infections can cause inflammation, but those are the main causes. And then we also see damage to our mitochondria because anything that causes inflammation will affect our energy production. And energy production is essential for every factor of life, including healthy sperm and eggs. So we need healthy mitochondria to have healthy sperm and eggs. It's our energy factories. It's involved in ATP production and ATP is the energy. It's the gas. So sperm have to swim, right? Eggs have to grow mature. That takes energy and we lose energy and that leads to more fertility issues. After fertilization, if you're lucky enough to have a fertilized embryo, then the embryo has mitochondria from the mother and that's good. If you don't have healthy mitochondria from our diet and from toxins and so forth, we can't have proper embryonic development. We can't have proper cell division and differentiation, which is necessary for the developing fetus to grow into a healthy baby. Also, sex hormone synthesis takes place in the mitochondria. So poor mitochondrial function is connected to hormone balance. The estrogen and progesterone are produced in special cells inside the ovaries and these cells require mitochondria functioning at a good level to do this. Testosterone is also produced in cells called the lytic cells, which contain mitochondria. Those are your testicles and that is necessary for producing testosterone. So you can see the whole hormone production cycle requires energy and we do a lot of things that cause mitochondrial dysfunction. Again, our poor diet, it's all the same stuff, right? It's not like different things causing different problems. It's all the same stuff. It's our diet, nutrition, lack of exercise and some resistance, inflammation from all the causes, oxidative stress, chronic diseases, environmental toxins, all these things aging will affect the quality of sperm and egg. Microbiome, another big factor in causing infertility. Again, these things are not addressed. Think about it. Who's addressing mitochondria? Who's addressing inflammation? Who's addressing the issues around microbiome when it comes to fertility? These are not things you're going to hear about when you go to your fertility specialists, but they're critically important in providing the right environment for having a healthy baby. So what is problems in your microbiome cause dysbiosis. That's imbalances in the flora. That's bad bugs. Symbiosis is good bug, good balance, right? Dysbiosis is bad, bad influences. And this influences inflammation and causes inflammation throughout the body, including your reproductive organs. It can cause even other things like obesity, even having bad bugs in your gut can make you gain weight. And this negatively impacts the microbiome. It causes ovarian inflammation. It affects the gene expression in your eggs. It causes poor egg quality. Dysbiosis also affects estrogen levels. One of the things we see and this is really important, is that your gut microbiome plays a role in regulating estrogen levels. And often when you have high estrogen levels, it causes something called estrogen imbalance or estrogen dominance, where you have too much estrogen, not enough progesterone. And that is often found in PCOS. And when you have certain bad bugs in your gut that produce an enzyme called beta-glucuronidase, a little technical here, but I'll explain it. What happens is that enzyme takes the estrogen that you excrete from your liver that's already packaged and ready to be pooped out. and unpacks it. That enzyme cleaves the estrogen from its basically carrier molecule. Then estrogen becomes free in your gut and you reabsorb it into the body, into the intestinal circulation, and then it goes into your body, creating higher levels of estrogen, leading to more estrogen dominance and hormone imbalances. And then other problems like estrogen related cancers, breast cancer, ovarian cancer, uterine cancer, endometriosis, worsens PMS, worsens pregnancy complications. When you look at the data actually probiotics can be very helpful in improving pregnancy outcomes and even IVF outcomes. So giving probiotics when you're getting your fertility treatments can be a good thing. It also affects not only women but men too. So having bad bugs in your gut affects your testosterone levels. Antibiotics and hormonal contraceptions will affect the gut microbiome. So a lot of things will mess up your gut microbiome. Taking the pill, antibiotics, stress, certain acid-blocking drugs which you take all the time, obviously alcohol and other things are not good for fertility too. Obviously you you not smoke, you shouldn't have too much pot, all those things are bad for you. Certain medications can be problematic, obviously. Birth control pills, antidepressants, antipsychotics, obviously anabolic steroids. If you're taking testosterone as a guy, it's going to decrease your sperm production. Calcium channel blockers, because we need different pathways in our biochemistry to make things work. So these are blood pressure pills, but they can affect sperm motility. Antibiotics can interfere with menstrual cycles. All this stuff is just to say that there's a lot of factors that we have control over that affect our fertility that are not being addressed from inflammation, to metabolic health, to mitochondrial function, to dysbiosis, to the medications we're taking.

And all those things can be addressed.

So let's talk a little bit more about where conventional medicine just misses the mark. No pun intended. Why does it miss the mark? Well, it doesn't get to the root causes of the hormone imbalances and other factors that cause this decline in fertility. It doesn't address diet, inflammation, mitochondrial health, dysbiosis, environmental toxins, stress, autoimmunity. And they give you general advice, okay, lose weight, eat more veggies. quite personalized. It doesn't really measure what needs to be measured to understand what's going on in your biology. You know, you look at, at, at farmers, they're testing the soil. They want to know what nutrients are in there, what the levels of nitrogen, potassium, phosphorus, they're so deep into understanding soil health as a way to predict what's going to be happening to the plants that they're growing in there. How do we not test for what's going on in a woman or a man to find out whether or not the sperm and egg are going to be healthy or whether the baby's going to be healthy? Right. They don't check inflammation levels. They don't check nutrient levels. They check toxin levels. So we really need to do proper testing for fertility, looking at all sorts of things from metabolic health to hormonal health, to nutrient status, to toxin levels, looking at something called AMH, which we'll talk about for women, which measures the quality of their eggs. So we kind of have to look for what's really going on and not just ignore the symptoms, right? We need to look at how is a woman doing? Does she have hormonal imbalance clues, right? Does she have painful periods? Does she have PMS? Does she have weight gain, acne? Is she on the pill? You know, what's going on that that we need to address that can help to regulate hormones better. So, you know, when women have hormonal issues, they don't really address in conventional medicine the root causes. They just kind of treat you with hormones, right? They give you the birth control pill. So, the first sign of hormonal imbalance is there's painful periods, PMS, heavy bleeding, clotting, acne, PCOS, boom, you get the pill. That does not get to the root cause. It doesn't address how we regulate our hormones. actually help us support our natural cycle. There's a lot of side effects with these digestive issues. It causes yeast overgrowth in the gut. It balances the microbiome. It depletes nutrient levels that you need for pregnancy like folate, B12, B6 and vitamin B2, as well as vitamin C and E and magnesium, selenium and zinc. All these are necessary for fertility. Traditional approaches kind of fail in my view. And I've worked with so many women and so many couples and helped them have healthy babies simply by addressing these these phenomena. What is the functional medicine approach then? What do I do? What is the functional medicine approach? It's really important to overall health, right? Not just looking at hormones. You need a deep dive on your biomarkers. And this is really what we do at Function Health. This is why I co-founded the company Function Health, which is a way for you to get access to all this data about yourself, to get over 110 biomarkers, including all the things we're talking about today for less than 500 bucks. It's a membership model. We have a big waiting list, but you can jump the line if you go to functionhealth.com/mark and you can sign up and get a lot of these diagnostic tests and most of these things are not going to be tested by your doctor when you go in for your fertility checkup or your pregnancy pre-pregnancy exam, or they're not going to look at the man. And it's really important to do a deep dive and correct these things. And this is what I do all day long in my practice. And it's why I see such good results. So first you need to test for nutrient deficiencies. The most important is folate. It's critical for egg quality for implantation of the egg in the womb. Deficiencies can lead to increased levels of something called homocysteine, which is a marker of folate insufficiency as well as B12 B6. again, something not tested typically. I'm just going to share a quick story with you about a woman who I was working on a film with. She was the director of this film called Fed Up. I think it came out in 2014. It's still on Netflix about childhood obesity. She told me this story where she had had miscarriage after miscarriage after miscarriage and even had babies that were born with anencephaly, which means no brain, terrible condition. And she told me this story that she read this article I wrote about methylation and about the importance of checking homocysteine and B vitamins and the genes that regulate this. called MTHFR. And so she went to her doctor and she made him test for this and she found very high levels of homocysteine. She made him test the gene called MTHFR, which we know affects about 35% of people that have this variation in this gene that can cause this problem. And we know that these problems of deficiency in folate lead to all sorts of bad pregnancy outcomes, including infertility and miscarriages. So she said to the doctor, well, this is what I want. And she got the test and sure enough, she was positive. And he said, okay, just take prenatal vitamin with folate. Dr. Hyman says, I need to take methylfolate. because I read in this article and I want to take the right kind. So she took the right kind. And when I saw her during the publicity tour for the movie, she had this beautiful 10 month old baby and we were hanging out before going on TV and stuff. And I was like, wow, you know, this is an amazing miracle story, but it's not a miracle. It's just using good science. Men also need to worry about folate because folate is important for sperm, DNA and integrity. So low levels can also lead to decreased sperm counts and motility issues. So sperm aren't great swimmers. Vitamin D also important. It Since it's the production of estrogen and progesterone in women and also sperm quality and testosterone in men and deficiencies in vitamin D have also been associated with PCOS and get this guys, erectile dysfunction. Now low levels, less than 40, I would say, you know, the lab says less than 30, but less than 40 is really probably what's considered low, maybe in 45. But low levels of less than 40 in published data show there was an increased risk of infertility if your level was under 40. And this is probably accounting for 80% of the population who are not taking vitamin D supplements. and we test this as part of your functional health panel. Super important. Vitamin D supplementation in infertile women in another study significantly increased clinical pregnancy rate outcomes and pregnancy outcomes. So just taking a simple vitamin D makes a huge difference. What about B12? B12 is another important one. It's required for the development of your nervous system, for DNA synthesis, for cell division, cell tissue formation, new red blood cells. And if you don't have adequate levels of B12, it can affect ovulation, it can cause trouble with implantation of the embryo, and you can check your homocysteine levels as well and all also called methylic acid, what we check with, with function health panel. And if you had high levels of homocysteine, it has high rates of miscarriage, as I mentioned in this recent story I told you, at increased risk of birth defects, we call neural tube defects like spina bifida and the baby, and also affects sperm motility and concentration and prevents DNA damage. And B12 also has amazing benefits. It increases sperm motility, it increases the concentration of sperms, you got more sperm, and it prevents DNA damage in the sperm. So you have healthier sperm. Homocysteine, an important thing to check in your blood, really important. As I mentioned, it can increase the risk of preeclampsia by threefold. This is a high blood pressure condition in pregnancy. It's very dangerous. And the best way to test for B6, B12 and folate is to measure your homocysteine level. What about iron? Iron, another important nutrient. Really important because you get a lot of blood loss during menstrual cycles and the deficiencies of iron are so common. It affects so many women. We saw so many people in our function health cohort that are iron deficient. This leads to problems of ovulation and ovulatory cycles where you don't ovulate, you can get anemia, you can have trouble with fetal development and making red blood cells. And get this, 35% of women, less than 50, are iron deficient. Over a third of women trying to get pregnant are iron deficient and listen to all the bad things it does. The next thing is important to test and measure in it's important to understand is omega three fatty acids. Now, there's a lot of reasons for that. But if you have omega threes at adequate levels, it lowers inflammation, it lowers reproductive system inflammation and it supports hormone function. Now, if you if you're a guy and you have omega threes in your diet or from supplements, it affects sperm quality, sperm count, sperm motility, the amount of semen make your testosterone levels and even the rates of in vitro fertilization. So just taking fish oil or eating a lot of sardines can have all these benefits for women. Also important, it helps egg quality and the metrial health, which is the lining of your uterus, critical for implantation and maintaining an early pregnancy so you don't have a miscarriage. It helps uterine blood flow, helps the embryo implant, helps pregnancy rates again, just from eating sardines or taking omega threes and two thirds of adults are not meeting the dietary guideline requirements of two servings of fatty fish or week or 250 milligrams of EPA and DHA per day. This is from British Medical Journal Open. That's two-thirds who are not meeting the dietary guidelines. But the dietary guidelines are the minimum amount of something you need to not get a deficiency disease. So 90% plus, I'm sure, are low in this. And we know this from other data. Another important nutrient, magnesium. Again, all these things we test for and your typical prenatal visit or your fertility visit will not be checking these things. Magnesium is critical because it balances estrogen and progesterone. It helps a lot with menstrual cycles and cramps. helps a healthy uterine lining, it helps with DNA synthesis and repair, helps with healthy egg production, and of course it's the relaxation mineral because it makes everything in your body relax. So I call it the stress reduction mineral. And of course, stress adversely affects fertility. Magnesium helps with blood sugar control and insulin sensitivity, PCOS, really important. It's also essential for sperm production, development of healthy sperm, and magnesium is really important because it's linked to sperm motility and quality. All these nutrients play a role in reproductive health. What about zinc? Zinc is really important for ovulation in women and menstrual cycle. And if you don't have enough zinc, it can affect all these processes affecting fertility for men. It's even more important. It's important for sperm quality and sperm deficiency can lead to low sperm count and low testosterone levels. So that's not good. Selenium, another important mineral. Again, something we test for and function Health. We can look at all these things. We can see what's going on. And selenium is important for thyroid function, which it regulates hormones necessary for fertility in men. It's important for sperm motility. and sperm health. And if you don't have enough selenium, it can impair these functions. And many soils are depleted in selenium. If we're not taking a multivitamin, selenium are often low. And again, it's something we can test for. So it's so important not just to check for nutrient levels, but also your hormone levels. So women, obviously you want to check estradiol, which is the main female hormone, regulates the menstrual cycle. It prepares you to aligning for pregnancy. And if you're having abnormal levels, it can kind of give you a clue that there's problems with the ovaries, with your menstrual cycle, fertility. Often infertility can be explained by what we call estrogen estrogen dominance. Estrogen dominance means you have too much estrogen, either relative or absolute in relation to progesterone. And you get a lot of symptoms from that. Heavy bleeding, breast tenderness, fluid retention, premenstrual migraines, PMS, blood clotting, fibroids. I mean, it's kind of a mess, and it's not normal. And there's a lot of causes for it. Our high sugar starch diet, alcohol, environmental toxins, changing our microbiome, all things that we can treat. For men who are actually having high estrogen levels, which they can because they're eating a lot of sugar, starch and alcohol, all that will increase men's estrogen levels that will affect their fertility. So if you have high levels, it can disrupt the balance of testosterone. It affects sperm production, it makes you have low sex drive and erectile dysfunction and infertility and weight gain. So it's just bad news. As I mentioned, the fat tissue is a site that has this enzyme called aromatase and it converts testosterone to estrogen. And that can lead to all sorts of problems with men, like I mentioned, like loss of body hair, libido, all the things we talked about. And it's really driven by a high sugar, high ultra processed food diet. Another important hormone to check is progesterone. Really important for women. This is called progesterone for a reason. It's the progestational hormone and it prepares the uterine lining for an egg and it supports early pregnancy. So you need adequate progesterone and often women don't have this, particularly in their later reproductive years. And if you have low levels after ovulation, it can affect your ability to maintain a pregnancy or to conceive. So it's really important and you want to look at the estrogen progesterone ratio. You want to test it at the right time of the cycle, usually about.

18 to 23 days of your cycle.

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Just go to bioptimizers.com/hymen and use code HYMEN10 at checkout. Don't wait. Your body will thank you. There was actually a recent published study out of Mount Sinai that looked at over a thousand women and it researched blood levels of PUFAs between 2015 and 2017, and they found up to a 40% decrease in fertility. And so that can be overwhelming because you hear the word endocrine disrupting chemicals, forever chemicals, they're omnipresent, and everything from your nonstick cookware, waterproof clothing, the Lycra, food packaging, the lining inside your coffee cup, coatings on your carpet, upholstery, you're like, wait, my whole life is covered in this stuff. But what I always like to give is a promise of hope, and that is when we look at urine excretions of PUFAs, if someone removes these endocrine disrupting chemicals, they can see the decrease of the urine excretion of PFAS by half within a few days or a week. So we have so much power in our ability to make decisions around these forever chemicals that cause oxidative stress to our body and our, you know, future, the DNA that we'd be passing down for future children. So when it comes to these types of chemicals, there are so many things you can do from using, storing your food in glass, swap out nonstick cookware, even just taking a stainless steel coffee mug to your coffee shop or sitting down and having it in instead of in a to-go mug, in a to-go cup, have it at the coffee shop, avoiding those plastic water bottles. A lot of these like pufas, these are made to make things resistant to water, oil, and grease, whereas phthalates make plastic malleable. Free things you can do, open your windows, take your shoes off at your door, all of these are going to lower a lot of those forever chemicals that are made making their way into our house. You know, it is critical in those three months or four months prior to conception to really think about, well, where would I be coming in contact with these things the most? And how do I lower my exposure to them? Because we do have so much power in the decisions we're making every single day.

That's true. You know, it's, it's what we're eating. It's what we're eating from, like the containers.

Right.

It's our household cleaning products, and that's our body care products. And, and those things we have control. And, you know, I don't know if you know this, I'm on the board of the Environmental Working Group. There you go, skin deep. Yeah, skin deep. And you go to ewg.org and they have guides on body care products, household cleaning products, foods, vegetables, fruits, animal products, how to reduce your exposures from every potential source of environmental chemicals. And so you can't be perfect, but it's something you can actually have a fair bit of impact in. Like you say, if you reduce these consciously, you see a drop in the urine levels very quickly. Now, Kelly, you know, most of the fertility doctors focus on women, but the truth is it takes two. And even though men are 50% of the equation, they're not really often considered. Even 25% of the men in infertility couples are not even evaluated as part of dealing with infertility. So, you know, what are your thoughts for how men need to think about fertility? to and how they need to think about improving their likelihood of conceiving a baby with their partner.

Yeah, well, men are 50% of the equation and how their lifestyle factors, how they're taking care of themselves, their nutrient status, their health is going to have an epigenetic effect on the DNA that they're passing down. And so it's critically important that they take care of themselves, especially during that spermatogenesis period, which is around 74 days on average to produce sperm. And so for men, men, fertility does drop and it drops about 52% in their early to mid 30s. And so just like women, they're experiencing a drop in fertility around the same amount of time. And what we've seen in studies over and over and over again is that introducing antioxidants into the diet, these are, you know, leafy greens, things that are going to provide vitamin C, you know, your wild fish, your lean pasture raised meats, all the things you talk about, even Even when you think about your book, Forever Young, a lot of those.

Steps- Young Forever, Young Forever.

That was Bob Dylan. That was Bob Dylan. When you think about all of the ways that we are protecting our own health, we're protecting our men are protecting their sperm's health. And so, when we look at it, we can see that vitamin C, vitamin E, L-carnitine, zinc, all of these nutrients are critical in producing sperm. And when we look at sperm, we're looking at quantity, we're looking at morphology, we're looking at DNA, and their lifestyle is impacting it. You know, we look at the research and we can find that men who walk over 4,000 steps a day versus those who have less than 4,000 steps a day have an increase in their testosterone levels. But what's so interesting is a thousand more steps a day on top of that 4,000 increases testosterone seven nanograms per milliliter. And when you look at that, that's pretty powerful, like getting out there and getting active, increases the quality of your sperm that you're passing on to your children. And testosterone does that, which is so great because we have power to make these healthy choices to increase the nutrients and antioxidants on our plate, to move our bodies, to sleep to decrease stress. You know, I think we forget that stress doesn't just come in the form of endocrine disrupting chemicals and in the form of our lifestyle choices or undiagnosed issues. It's coming psychologically too, and sleep and activity really combat that. And it is just equally as important for the man and the woman to get active and get healthy together prior to conception.

And definitely exercise helps. But watching sports may not because one study actually showed that if you're team one, your testosterone level one up. But if your team lost in the sports game, your testosterone level went down. So, bit of exercise. Yeah. Now, one of the things that's important is sperm quality. And, you know, I think, you know, people think, oh, you know, men don't really have a time clock, right? They're not, they don't have a biological clock, but they do. And, and men can conceive. I think the oldest man ever to conceive was 96, which I think is pretty impressive. But it's not the same as men get older in terms of the quality of the sperm, their fertility rates, or the consequences for their offspring. I think we see more autism rates with older fathers. So can you tell us more about men's sperm health and why we see this decline and what do we know about how to address it?

Yeah, well, one study looked at the genetic changes in sperm health from young men to older men. And what we see is you are going to see the DNA involved there. is going to have an increased risk of autism, Alzheimer's, type two diabetes, even heart disease. And when those genes are implicated based on the man's lifestyle choices, they're actually passing that down to their children. And if they end up having a baby girl, they're actually passing those genetic changes down to their grandchildren. And so what we really want to do for men is to increase the antioxidant status. When we look at men who increase their antioxidant status by taking things like L-carnitine, vitamin C, zinc, all of those nutrients of concern that I talked about, even CoQ10. CoQ10 is shown to improve sperm concentration, quality, motility, and morphology. And when you pair that with B12, it actually lowers the rate of DNA damage, which is also really impressive because we have this control. We can add NAC to our diet. We can look at our vitamin D status in the same way women will prior to pregnancy, it's equally as important. And I think this research is building and building. And that's why you see companies like We Natal, which I know, you know, both of that both of us love very much coming out with prenatal for men because we can protect sperm quality, we can protect the morphology, and we can increase the chances that someone gets pregnant. And actually, men on antioxidants, they have a four times higher rate of getting getting their wife pregnant and a five times higher rate of that woman having a live birth when they're taking antioxidants prior to conception.

Your gut microbiome plays a huge role in hormone regulation and fertility. Now researchers are discovering there's a lot of roles for gut microbes and optimal gut health and how it contributes to obesity, to PCOS, to hormone imbalances and lots more. So it's important to tend your inner garden and I always talk about that, but it's really important to learn how to take care of your inner garden. And you need gut supporting foods, things like fermented foods that are have probiotics in them. There are other things that are great in there like fiber and, and great probiotics. Prebiotic foods are important like fruits and veggies and you get 8 to 12 servings of non starchy fruits and veggies. Uh, certain gluten free whole grains can be helpful. Cruciferous vegetables also really important for the gut health. Um, because cruciferous vegetables like broccoli, collards, kale, Brussels sprouts, collard mucor greens. They help to regulate excess estrogen in the body. They help with estrogen dominance, which is something that happens commonly as women enter their later reproductive life where they get higher estrogen than progesterone, they're relative or absolute, and that can help lower beta-glucuronidase, which is a really important compound that's produced by certain bacteria in your gut that can actually lead to higher estrogen levels and more problems with cancer and fertility. So there's a lot of really important things to, to kind of consider. Also, there's another class of foods that are great for your gut, which Garlic family, garlic, onions, leeks, shallots, they're anti-inflammatory. Certain gluten free cold grains can add fiber like, amaranth, teff, buckwheat, I like Himalayan, tarty buckwheat. I like my Himalayan tarty buckwheat sprouted powder, which is great. I put it in my smoothie. Uh, wild rice is great. Oh, it's technically not a grain. Uh, black rice, quinoa, all they're fine. Fermented probiotic rich foods are great. Sauerkraut, goat or sheep yogurt, kefir, kimchi, natto, tempeh, miso, all these are great for helping your gut health. So you really need to learn how to take care of your inner garden. And you might even need to take probiotic supplements. Now, if you have a messed up gut, it's important to work with somebody on this. If you have leaky gut or irritable bowel, you want to work with a good functional medicine practitioner to fix it. And you need to learn how to do that with the 5R program, which is avoiding the minimizing the foods that create problems using pre and probiotics and gut repair tools. All right, so once you've dialed in your nutrition and you're focusing on eating specific foods to support your hormones, your reproductive health, your sperm and egg health, it's really important to clean up your diet, not just add the good stuff, but take out the bad stuff and reduce your intake of more problematic foods that cause insulin resistance, oxidative stress and inflammation, which definitely reduce fertility and cause impaired fertility. And what are those foods? No surprise if you're listening to me, right? Ultra processed foods, basically foods that contain ingredients that you wouldn't have in your kitchen and that are made in factories and are deconstructed science projects. You do not want to eat those even though they may look like food, they're not actually food by definition. Refined grains, refined flours, added sugars, all bad. Potato chips, crackers, pretzels, candy, microwave popcorn, muffins, donuts, sandwich bread, I mean it's not even really bread. Cookies, flavored yogurts, putting these foods, why are they bad? Well, they contribute to the epidemic of metabolic dysfunction, which affects 93% of the population and is somewhere on the trajectory of insulin resistance. They lead to oxidative stress. They reduce the chance of fertility. They increase PCOS. They cause sexual dysfunction, erectile dysfunction, and poor blood flow. Yep, that's true, guys. That's what happens when you drink. And it contains a lot of forever chemicals. these endocrine disrupting chemicals that you don't want to be having in your body, like BPA and others, you want to get rid of all those. Those are very much significant endocrine disruptors. We call this whole class of chemicals endocrine disruptors because they disrupt your hormone system. They also contain a lot of bad stuff, chemical additives, artificial sweeteners, emulsifiers, thickeners that all contribute to inflammation through damaging the gut lining leading to a leaky gut. They also often contain low quality fats like trans fats and inflammatory oils like soybean oil, sunflower canola, vegetable seed GMO, corn, soy, all that crap. Sugar sweetened beverages, definitely a no-no because that'll drive in some resistance including sodas, diet soda, although artificial sweeteners work in a different way. Fruit juice, green juices, unless they're truly green juices, a lot of them are just jacked with pineapple juice and sugary fruit stuff which is just as bad. Of course there may be more antioxidants and other good stuff in there, but it's a lot of bad stuff. Obviously don't have soft drinks, lemonade, iced teas that are sweetened, alcohol, sports meal replacement drinks, protein drinks like Boost, Fairlife, Core, protein powers, SlimFast are all garbage. There are good plant proteins out there. There are good animal protein products out there, but just be careful. And also be careful with the plant milks. They can be flavored, sweetened, they can have emulsifiers, thickeners, they can be some good ones, but make sure they're just simple ingredients like almonds, water, salt, for example. Energy drinks definitely do not have those. Those are full of colors, dyes, artificial sweeteners, flavored coffees. I mean, you go to Starbucks, you're getting tons of sugar, probably as much sugar sugars, a can of Coke, or sometimes more, depending on what you're getting. Fruit juices, creamers that are weird creamers, just stay away from all that. Also, you want to stay away from conventional dairy. Dairy is a hugely hormonally disruptive food, unless you're eating sheep or goat cheese, which is less. Most conventional dairy has antibiotics, hormones, pesticides, a lot of hormone-disrupting compounds in them. And it's one of the things for women who have menstrual issues or hormonal issues, I very strongly recommend they avoid. Caffeine can be fine, but be careful of too much. you can wear out your adrenal glands. Alcohol, definitely not a good thing for fertility. It affects your obviously liver and your ability to regulate hormones through your liver can cause dysregulation of estrogen, testosterone, many other hormones. And now alcohol and consumption in men can lead to lower testosterone levels and higher estrogen levels, which can cause all sorts of issues like lower libido, fertility issues, you can increase breast size in men, it can cause loss of hair in the body. It's just not a good good thing. So, what are the practical dietary adjustments for enhancing fertility? Let's go through them a little bit one by one here. What are the practical tips for creating a diet that's incorporating fertility boosting foods into your everyday meals? Build your meals around protein and veggies and fiber, which makes you feel full and less likely to overeat. Try food stacking. Start the day with protein and fat for breakfast. You can have a savory breakfast, you're gonna have a protein shake. That's really fine to do. I mean, I don't know why we've sort of in America gotten to a place where we think sugar for breakfast is a good idea, but it's the worst possible thing that's ever happened to us. So, what can you have for breakfast? What does that mean? Well, eggs are great. They're rich in vitamin D, B12, and protein. They're great for hormone balance. You can have an omelet with spinach, tomatoes, added folate, vitamin C. You can have poached or hard-boiled eggs. I like, for example, shashuka, which I buy the kind of jarred version and I put the eggs in there and put in the oven and cooked in like 10, 15 minutes pretty quick. Don't eat those quick cooking oats. Get rid of those. Um, if you're gonna eat oats, only have steel cut oats, but you wanna add protein and fat. So flax seeds, chia seeds, almonds, nuts. You can also put in some butter in there, grass fed butter or some other kind of oil like flax oil. You wanna get protein, fat and fiber in there. Chia seed pudding is a great breakfast. coconut yogurt, berry smoothie with protein powder. I like that one. It's my favorite. What about snacks? Well, I don't really snack that much, but if you're hungry, nuts and seeds are great. A handful of almonds, walnuts, pumpkin seeds are great snacks that have zinc, selenium, lots of good fats. Meat sticks are great. I like the Maui Nui, Paleo Valley. They're great. Raw veggies and homemade hummus is an option. Low glycemic fruit is fine. Berries, apples, cherries, citrus fruits. What about lunch and dinner? well, salads are great. They're, you know, you can put a base of leafy greens like arugula or just dark leafy greens, mixed greens. You can use spinach or kale to increase folate intake. You can add avocado for healthy fats, sprinkle some sunflower seeds for vitamin E. And I, I basically use olive oil. So you get a fat salad with nuts and protein and fat, and you can even add a can of sardines. or salmon on there. It's also great. You can include fatty fish like salmon mackerel. I get some of the canned salmon from mackerel. I love that with my salad. That helps boost your omega-3s it helps.

Sperm quality and your reproductive health. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review and subscribe to the Dr. Hyman Show wherever get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening. Don't forget, there's a way to listen completely ad free. With Hyman Plus on Apple Podcasts, you can enjoy every episode without any breaks. Just open Apple Podcasts and tap Try Free to start your seven-day free trial.