What is IBS?

Unfortunately, in Western medicine, the cause of IBS is unknown, and until now, there really haven’t been any definitive tests to determine whether or not one has IBS. Oftentimes, after ruling out a slew of other illnesses, many sufferers are diagnosed with IBS and made to believe that for the most part, it’s all in their head. However, there has been a very recent development of two new simple blood tests that measure the amount of antibodies in the blood. These tests aren’t perfect, but they’re a big step in the right direction.

How is IBS Treated with Western Medicine?
Those with mild IBS symptoms are taught to control their symptoms by learning to manage stress, altering their diet and eliminating “trigger” foods, getting enough rest, exercising, and drinking plenty of fluids. Patients with moderate to severe symptoms oftentimes need medicinal aids such as fiber supplements, anti-diarrheal medications, antispasmodic medications (these can increase constipation, cause difficulty urinating, and are cautioned for people with glaucoma), antibiotics, and anti-depressants and/or counseling if symptoms include depression. There are also two medications specifically for IBS on the market, namely Alosetron (Lotronex) (which was removed from the market and reintroduced, but only for women with severe cases of predominantly diarrheal IBS who haven’t responded to other treatments) and Lubiprostone (Amitiza) which has been approved for women with constipation and IBS. Neither of these medications have been approved for men.

How is IBS Treated with Traditional Chinese Medicine?
According to Traditional Chinese Medicine, there are several possible causes for IBS. One is an imbalance in the spleen. In Chinese medicine, the spleen is the organ that is mainly responsible for digestion and assimilation of food and liquids as well as producing blood from the food it breaks down. It is easily affected and weakened by antibiotics, poor diet, a weak constitution, overwork, lack of exercise, or excessive worry. A second possible cause is an imbalance in the liver. According to Chinese medicine, the liver is connected with emotional health. Anger and stress directly influence the liver’s function and drugs/medications, alcohol, and/or a poor diet further compromise its operation. A compromised liver’s energy in turn will “attack” the spleen. If the spleen is already in a weakened state, it can be easily overcome, resulting in possible stress-induced IBS.

An imbalance in kidney yang (the energy that provides warmth to the body and spleen to aid in the digestion and breakdown of food) may also be a culprit for IBS symptoms. Early morning diarrhea and possibly cold limbs, urinary incontinence, a sore back and weak knees may all be signs that kidney energies are compromised.

Once a thorough intake and exam has been completed, the acupuncturist will have a clearer picture of the root imbalance(s) that lead to IBS symptoms. This knowledge will assist the acupuncturist in pinpointing and addressing the organ and meridian systems that are contributing to the patient’s IBS. Additional therapies such as dietary changes, herbs, and breathing techniques/exercises may be recommended in order to maximize the healing process.

Sources:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930986/

http://mayocl.in/1HUWDwQ

Cinnamon (Chinese cassia, Chinese cinnamon, or Gui Zhi) is regarded as one of the most significant circulatory herbs in Traditional Chinese Medicine (TCM). The Shennong Bencao Jing (the first Chinese herbal book dating back to approximately 2700 B.C.) included cinnamon as one of its 365 noted herbs. In TCM, cinnamon is valued for its warming qualities and has long been revered for its properties that aid in various circulatory issues, digestion, menstrual and abdominal irregularities, and treating the common cold and upper respiratory congestion. It is also rich in fiber and contains manganese, iron, and calcium . . . all essential minerals.

Some medical uses for cinnamon are as follows:

~ Polycystic Ovary Syndrome (PCOS) – Dr. Daniel Kort, a postdoctoral fellow in reproductive endocrinology at Columbia University Medical Center, headed up a small study that found that women with polycystic ovary syndrome (PCOS) who took cinnamon supplements on a daily basis had nearly twice the menstrual cycles over a six-month period over their counterparts with PCOS who were given a placebo.

~ Menstrual disorders (endometriosis, uterine fibroids, heavy menstrual bleeding) – Cinnamon has properties that activate the uterus and encourages menstrual bleeding. One would think that this would mean that heavy bleeding would occur, but the opposite happens and flow is normalized.

~ Lower blood sugar & reduce cholesterol – In a meta-analysis published by the Annals of Family Medicine, patients with type 2 diabetes who were given specific cinnamon doses were shown to have reduced levels of fasting plasma glucose, total cholesterol, and triglycerides and an increase in HDL-C levels.

~ Indigestion – Cinnamon can be used as a digestive aid and is effective for nausea, diarrhea, indigestion, and upset stomach. It also contains carminative properties which help with flatulence and removing gas from the stomach and intestines.

~ Wound healing – Cinnamon contains essential oil which may hold the key to its anti-inflammatory, antioxidant, and antimicrobial properties.  In a study utilizing a Ceylon cinnamon ointment, wounds treated with the ointment healed much more quickly than placebo and controls.

Looking for ways to incorporate cinnamon into your diet? Add it to herbal tea, yogurt, oatmeal or your morning cereal, toast, or sprinkle it into your morning cup of joe. Of course, it can also be found in apple pie and cinnamon buns!

**Please note: If you are planning on using cinnamon as a supplement, please check with a professional regarding dosage and types of cinnamon. Some research has indicated that cassia cinnamon contains courmarin, a naturally occurring organic compound that, when used in high amounts, can cause liver damage. Ceylon cinnamon, a milder form of cassia can be used, however, studies on the efficacy of cinnamon have mainly been done on cassia. Cinnamon in moderation is safe for everyone.

Resources:

http://www.livestrong.com/article/480706-cinnamon-for-excessive-menstrual-bleeding/

http://www.wsj.com/articles/SB10001424052702303376904579135502891970942

http://www.truthistreason.net/healing-powers-of-cinnamon

What Causes Meniere’s Disease?
The cause of Meniere’s is not known, but it is believed to be linked to an overabundance of fluid in the inner ear (endolymphatic hydrops)and/or from potassium sitting in an area of the inner ear where it doesn’t belong. There are several theories regarding the cause Meniere’s which, according to the Mayo Clinic, are as follows:

• Improper fluid drainage (either because of a blockage or an anatomic abnormality)
• Abnormal immune response
• Allergies
• Viral infection
• Genetic predisposition
• Head trauma

Other contributing factors include tension and anxiety, high salt intake, migraine headaches (there’s a direct link in 30% of cases), high cholesterol levels, syphilis, glandular or hormonal imbalance (including hypothyroidism), fluid retention from PMS, and common factors such as alcohol, chocolate, smoking, dairy products, and wheat.

How Does Western Medicine Treat Meniere’s Disease?
Unfortunately, there is no cure for Meniere’s disease, therefore, treatment runs along the lines of management, symptom reduction, and minimization of the disease’s long-term impacts. Treatment typically aims at combatting vertigo which includes medications that are geared towards motion sickness and/or nausea and medication injections into the inner ear. Other tactics for tackling Meniere’s include diuretics which aim to relieve fluid pressure in the middle ear, hearing aids, and vestibular rehabilitation which focuses on balance and coordination. Dietary measures to reduce cholesterol, added salt, and fluid intake and stop alcohol consumption and cigarette smoking may also be suggested. In cases where symptoms are more severe and don’t respond to treatment, surgery may be needed.

How Can Acupuncture Help Someone With Meniere’s Disease?
The main aim of acupuncture when dealing with Meniere’s Disease is to reduce the amount of fluid that builds up in the inner ear. Once fluid is decreased, ear pressure, dizziness, and vertigo subsides and hearing loss is restored. Acupuncture also naturally increases blood flow and circulation, stimulates the body’s natural painkillers and healing system, and reduces anxiety.

Resources:
http://www.castanet.net/news/Needle-Notes/64993/Meniere-s-disease
http://www.nlm.nih.gov/medlineplus/ency/article/000702.htm
https://www.acufinder.com/Acupuncture+Information/Detail/Acupuncture+Treats+Vertigo+and+Meniere’s+Disease
http://acupuncture-relief.com/menieres_disease
http://en.wikipedia.org/wiki/M%C3%A9ni%C3%A8re’s_disease

Do you feel as if your input is important to the acupuncturist and the staff? Is your input welcomed and considered in your treatment plan? It sure is! I feel that both the acupuncturist and staff listen to and care about my needs. I truly appreciate how kind and considerate they are of my needs.

Did you have angst or fear with respect to a therapy that employed the use of needles? If so, was the fear relieved after your first visit/ treatment? Not at all. Even if I did, the needles are so tiny that you barely feel them.

Would you consider acupuncture for other health concerns which may arise in the future? Of course I would. I wholeheartedly believe in acupuncture. It has helped me with any ailment that I have had from anxiety to allergies to back pain. I have been receiving acupuncture treatments for about 3 years now and it will always be part of my healthy lifestyle.

Did you experience any unexpected impact on your overall health as a result of the acupuncture? I feel great after each session. Like I did something wonderful for my body and health!

What is Arthritis?
Arthritis is inflammation of the joint in one or more areas of the body. Osteoarthritis, the most common type, occurs when cartilage between the joints breaks down. It usually affects the hands, hips, knees, neck, and/or low back. Aging, being overweight, a joint injury, genetics, and putting stress on a joint through repetitive motion are all factors that can increase your risk for osteoarthritis.

Rheumatoid arthritis (RA), on the other hand, is a disease in which the immune system erroneously attacks healthy cells such as the synovial membrane (synovium) which in turn causes inflammation and pain in the joints. RA is symmetrical, meaning that it affects the same joints on both sides of the body. Joints may feel warm, swollen, or tender, and according to the Arthritis Foundation, “you’re likely to feel fatigued and you may become anemic, lose your appetite, and run a low-grade fever.”

How Can Acupuncture Help?
Western medicine’s treatment of arthritis offers the use of anti-inflammatory drugs and other medications, physical therapy, self-care, and sometimes, surgery to attempt to alleviate pain and prevent further joint damage. Acupuncture, on the other hand, offers a whole-body approach and a safe, natural, effective way to curb joint pain, inflammation, and other symptoms. Traditional Chinese Medicine doesn’t look at arthritis as a particular syndrome, but rather, it aims at treating the symptoms that are specific to the individual patient. Your acupuncturist will take into account your full health history and perform a physical exam to determine your body’s imbalances. A combination of acupuncture, herbal remedies, stretching, and massage may be recommended.

Acupuncture Proven to Be Effective
In 2012, the results of a large-scale data analysis were published which concluded that acupuncture is “effective for the treatment of chronic pain and is therefore a reasonable referral option.” Acupuncture was found to be superior to both sham acupuncture and no-acupuncture controls. The data analysis, which focused on the effect of acupuncture on back and neck pain, osteoarthritis, chronic headache, and shoulder pain included information from 29 randomized controlled trials and 17,922 patients.

What You Can Do
Unfortunately, there’s no quick fix for arthritis, however, there are some lifestyle changes that may help you to find relief faster.

~Exercise to help strengthen bones and muscles, increase flexibility, and maintain a healthy weight.

~Work on lowering your stress by identifying stressors and incorporating breathing exercises, yoga, meditation, etc. into your routine. Reducing stress can improve your health and your state of mind.

~Add a daily dose of turmeric, a powerful, natural anti-inflammatory, and ginger to your diet to reduce inflammation and pain.

~Stick to a healthy diet of largely unprocessed, organic foods.

~Alternate heat and cold for pain relief. Heat soothes tired muscles and stiff joints while cold numbs painful areas and decreases inflammation.

~Maintain balance in your life by alternating periods of relaxation with periods of exercise and activity.

Do you suffer from arthritis? If so, what has worked for you and what hasn’t?

Sources:
http://www.arthritis.org/
https://www.acufinder.com/Acupuncture+Information/Detail/Acupuncture+for+Arthritis
 

What Is Turmeric?
Curcuma longa (turmeric) is a small herb which belongs to the ginger family. It is native to India which is where most of the world’s supply of this spice is cultivated and is best known as one of the ingredients used to make curry. There are many rhizomes on its root system which are the source of both curcumin, its medicinal extract and the active compound of the turmeric root, and turmeric, its culinary spice. Due to its golden hue, turmeric is used to give yellow coloring to mustard, cheese, and other foods and is a significant ingredient in many commercial curry powders.

The Buzz
Turmeric has a long history of being used for medicinal purposes in China, India, and Indonesia. It has been valued for its anti-inflammatory properties and its ability to invigorate the blood. In both Chinese and Ayurvedic medicine, turmeric has been used as a digestive bitter and carminative (agent that expels gas from the stomach and intestines and relieves flatulence) and as an antiseptic to clear infections and inflammations on the inside and outside of the body.

Modern medicine has started to warm up to the potential benefits of turmeric over the past fifty years. There are claims ranging from its antioxidant properties and immune system support to its ability to promote healthy skin and ease the pain of arthritis. Below are a few of the many bright spots on the horizon for research into the possibilities of what can be done with this golden yellow spice.

Cancer Prevention and Treatment
The University of Texas MD Anderson Cancer Center has been doing research on the benefits of curcumin which has shown promise as both preventing and treating cancer. According to the wording in one of their studies done on the anticancer properties of curcumin,   “. . . curcumin has been described as a potent antioxidant and anti-inflammatory agent. Evidence has also been presented to suggest that curcumin can suppress tumor initiation, promotion and metastasis.”

~Teams from the University of South Dakota and Stanford University, led by researchers Dr Subhash Chauhan and Dr Meena Jaggi, have found that pretreatment of ovarian cancer cells with a nanoparticle formulation of curcumin makes the cells more susceptible to chemo and radiation treatments.

Reduction of Alzeimer’s Cases and Symptoms
Interestingly enough, India, where turmeric consumption is widespread, has one of the lowest prevalence rates of Alzheimer’s disease in the world. The rate is less than one-quarter that of the United States. This has given rise to a growing interest in the possibility of turmeric consumption contributing to the reduction of Alzheimer’s cases and symptoms. A journal publication of Ayu (an international quarterly journal of research in Ayurveda) on the “Effects of turmeric on Alzheimer’s disease with behavioral and psychological symptoms of dementia” describes three patients whose symptoms were “improved remarkably” as a result of consuming 764 milligram of turmeric (curcumin 100 mg/day) for 12 weeks.

Powerful Anti-Inflammatory
Dr. Randy J. Horwitz, Medical Director of the Arizona Center for Integrative Medicine and Assistant Professor of Clinical Medicine at the University of Arizona College of Medicine wrote in an article in the Pain Practitioner that “Tumeric is one of the most potent natural anti-inflammatories available . . . .“ Horwitz pointed to a 2006 University of Arizona study where pretreatment of rats with turmeric inhibited the onset of rheumatoid arthritis in the rats as well as well as significantly reducing pre-existing symptoms of the disease.

How Is It Taken?
Turmeric can be taken in a variety of ways. It can be incorporated into your daily diet by sprinkling it on vegetables or mixing it into dressings, curries, and soups. You can make a tea out it or mix up some turmeric milk if you have a cough or cold. There are also turmeric and curcumin supplements that are widely available. Please note that the absorption of curcumin is enhanced by the presence of piperine which is a constituent of black pepper, so if you’re looking for supplements, try to find one that contains piperine or black pepper abstract.

Have you used turmeric for a specific issue? If so, please comment below.

Sources
http://www.kew.org/plant-cultures/plants/turmeric_history.html
http://curcumalonga.com/
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665200/
http://botanical.com/site/by_you/article_tumeric/turmeric.html
http://www.huffingtonpost.com/andrew-weil-md/turmeric-health-have-a-happy-new-year_b_798328.html
http://zeenews.india.com/news/health/health-news/turmeric-component-opens-up-resistant-cancers_7912.html
http://www.ncbi.nlm.nih.gov/pubmed/12680238
http://organicindia.mercola.com/herbal-supplements/turmeric.aspx

The Lowdown on Stress
Stress – it’s a part of life and we’re wired for it. Psychology Today states, “Stress is simply a reaction to a stimulus that disturbs our physical or mental equilibrium.” A stressful event causes our body to naturally release a burst of energy (adrenalin) which enables us to have a better chance at surviving the situation (fight) or escaping it all together (flight).  A little bit of it can actually be rather exciting – it can help you perform under pressure and motivate you to do your best. Chronic stress, on the other hand, can be detrimental to your health and cause a whole host of issues both physically and emotionally. We are usually unable to control the stressors in our lives, but we can alter our reaction to them.

Stress Symptoms
The effects of stress vary and we all have different stressors. An example of this is public speaking. Public speaking really stresses me out – I get shaky and sweaty and my stomach gets tied up prior to having to speak. One of my friends, on the other hand, rather enjoys speaking publicly – it doesn’t phase her in the least. People also handle stress differently, thus, the symptoms of stress will be manifested in different ways. There are four categories in which stress tends to affect us: cognition, emotional, physical, and behavioral. Helpguide.org lists the following common symptoms for each category:

Cognitive

Emotional

• Moodiness, irritability, and/or short temper
• Agitation, inability to relax, feeling overwhelmed
• Sense of loneliness and isolation, depression or general unhappiness

Physical

• Aches and pains, frequent colds
• Diarrhea or constipation, nausea, dizziness
• Chest pain, rapid heartbeat, loss of sex drive

Behavioral

• Eating more or less, sleeping too much or too little
• Isolating yourself from others, procrastinating or neglecting responsibilities
• Using alcohol, cigarettes, or drugs to relax, nervous habits (e.g.; nail biting, pacing)

*Please note that many of these symptoms can be found in other psychological or medical problems, so please check with your doctor to determine the cause.

Left unchecked, chronic stress can raise blood pressure and cause or exacerbate heart problems and heighten the risk of depression and anxiety, immunity issues, diabetes, and Alzheimer’s disease. There’s also evidence that chronic stress can actually rewire the brain in ways that promote its persistence.

And Then There’s Acupuncture
Upon reading everything above, it makes a strong case for trying to steer clear of stress and its symptoms and striving for ways to manage stress in a healthy manner. Numerous studies have pointed to the considerable benefits of acupuncture in the treatment of stress. One such recent study published in the Journal of Endocrinology can be found here: Acupuncture’s Effect Against Stress Response.

Acupuncture improves blood circulation which cycles out cortisol and other waste chemicals and oxygenates the tissues. Due to the calming nature of acupuncture, one’s heart rate is decreased, blood pressure is lowered, and muscles are relaxed. Regular acupuncture treatments can strengthen the body so you feel better equipped to handle the day-to-day stresses of life. Acupuncture can also help heal stress-related conditions and improves the body’s immunity to defend against potential illnesses.

There are other techniques that can be used in conjunction with acupuncture to help  manage stress effectively such as exercise, meditation, yoga, massage, breathing exercises, and even laughter. Take time for yourself to cultivate the energy, skills, and techniques you need to handle your stress more effectively. Oh, and try acupuncture!

Have you found acupuncture to be beneficial for stress relief?

Sources:
http://www.helpguide.org/mental/stress_signs.htm
http://www.nytimes.com/2009/08/18/science/18angier.html?_r=0
http://bit.ly/1h0M416

Issues That Affect Our Skin
Environmental influences such as wind, heat, cold, humidity, temperature, and exposure to the sun are reflected by the skin. Stressors (good or bad) tend to worsen acne and psoriasis. One’s lifestyle choices/issues such as dietary intake, exercise, dealing with strong emotions, sleep habits, and drug and alcohol usage also have a significant effect on our immune and nervous system as well as our hormonal functioning. These, in turn, have an effect on our skin. A person’s constitution also adds to the mix and those with much greater skin sensitivity require more rigorous skincare.

Traditional Chinese Medicine (TCM) considers environmental, physical, and emotional factors when treating skin conditions. In order to assess the whole picture, the acupuncturist will ask in-depth questions, observe your tongue and skin, and take your pulse. Unlike Western medicine, TCM works by addressing both the cause and symptoms of the presenting condition on an individual basis. Depending on the condition, treatment may be acupuncture, Chinese herbs, or a combination of both.

Acne
Four out of 5 teens, 1 out of 20 adult women, and 1 out of 100 adult men get acne. From the perspective of TCM, heat (inflammation), dampness (water retention), and toxins build up in the skin to cause pimples, blackheads, and acne cysts. These can can be the result of hormonal changes, improper diet, emotions, and other lifestyle factors. Acupuncture works to strengthen digestion and/or immunity, reduce heat, and move stagnant energy. When acupuncture makes these whole-body changes, the acne is resolved from the inside out.

Eczema and Psoriasis
Eczema is a general term for any type of dermatitis or itchy rash and approximately 1 in 18 people or 15 million Americans are affected by it. Psoriasis is a skin disease that is the result of excess skin production that causes scaling and inflammation which can be both itchy and painful. According to the National Psoriasis Association, as many as 7.5 Americans (approximately 2.2 percent of the population) have psoriasis.

An overactive immune system response is partially responsible for many inflammatory skin conditions such as eczema and psoriasis. The exact mechanisms that cause these types of skin conditions are still unknown, but oftentimes, people with these skin conditions also have additional immune-related issues such as asthma or allergies. Acupuncture helps to regulate the overactive immune response, reduces inflammation, and can also address some underlying factors for these inflammatory skin conditions such as stress, hormone imbalances, food sensitivities, and poor diet.

Rosacea
Rosacea is a common chronic facial inflammatory disorder that affects roughly 13.5 million people in the US with a prevalence rate of approximately 5 percent. It is characterized by redness, broken blood vessels, and pimples primarily on the nose, cheeks, forehead, and chin and is often accompanied by a sensation of heat and easy flushing. Rosacea is considered to be a kind of heat in your body according to Chinese medicine. Determining and eliminating the source of the heat and causes of flare-ups is part of the treatment for rosacea and getting to the root of the issue involves an assessment and history of the condition, lifestyle factors, diet, and triggers.

Other Skin Conditions
This is by no means an exhaustive list of skin conditions, but even so, the number of people affected by them is rather large. Acupuncture can be used for other skin conditions as well such as shingles, vitiligo, uticaria (hives), warts, and dry skin. If you are having issues with your skin, it’s worth contacting a licensed acupuncturist to see how they can help you.

Have you tried acupuncture to treat a skin condition?

Sources:
http://visual.ly/50-incredible-facts-about-skin
http://www.rightdiagnosis.com/e/eczema/stats.htm
http://www.psoriasis.org/learn_statistics
ttp://morganhillwellness.com/acupuncture-treats-inflammatory-skin-conditions/
https://www.clinicalkey.com/topics/dermatology/rosacea.html
http://www.prevention.com/beauty/beauty/acupuncture-acne

If your condition was/is pain related, would you now consider acupuncture for health concerns other than pain therapy?
Yes, absolutely. My husband and I have both experienced dramatic improvements in chronic pain conditions since beginning regular acupuncture treatments. It seems very reasonable to continue treatment for other conditions as well. In the West, we sometimes focus on specific symptoms rather than the underlying cause of the condition. I believe acupuncture can achieve wonderful results by way of its integrative nature and emphasis on total body/spirit harmony.

How long have you been utilizing acupuncture as a therapy?
We’ve been visiting Tian Shi Acupuncture for over two years.

Did you experience any unexpected impact on your overall health as a result of the acupuncture?
Yes, while the exact measurement of certain conditions is difficult, we do believe that since beginning acupuncture treatments our overall energy levels have improved and sleep is more refreshing.

Would you recommend Tian Shi Acupuncture to a friend or family member?
We would highly recommend Tian Shi Acupuncture to anyone seeking to improve and maintain good health. Batbayar Damdin is an exceptionally skilled and compassionate individual who is earnestly concerned with improving the quality of life for all. He and his staff have always made us feel welcome and provided the very best care.

As a physician who included obstetrics in my practice in Canada, I cared for women pre-conception, during pregnancy, delivery and postpartum. Of course, I also cared for the newborns along with the whole family. I’ve seen the impact of lifestyle on conception rates, the course of pregnancies, and the health of the newborns. There is an abundance of research about optimizing fertility and the health of new babies, yet sadly, much of it is not shared with prospective parents. For this discussion, I will focus on the lower tech aspects to consider pre-conception, not just for those struggling with infertility, but for anyone hoping to conceive. The balance of viewing a pregnancy in terms of creating an optimal environment for the fetus, but without obsessing excessively about every little detail, is an approach that makes the most sense to me.

For those couples planning a pregnancy, employing an integrative approach in optimizing health can optimize not only fertility, but the pregnancy outcomes and health of the baby.

An integrative approach can:

Make it easier to get pregnant

Reduce the risk of miscarriage

Reduce the risk of pre-term birth

Reduce the risk of birth defects

Enhance the health of the baby.

What is an integrative approach to fertility? In simple terms, it includes the high-tech diagnostics, medications and procedures that modern medicine offers but also includes the low-tech approaches such as nutrition, exercise, stress reduction, traditional Chinese Medicine and acupuncture to achieve the best outcomes for women and their babies.

There is no question that we have seen declines in human fertility in recent decades. Average sperm counts have decreased. Infertility rates even in young women have increased. There are many known contributors to reduced fertility. These include age, genetics, general health, anatomical problems, nutrition, hormonal status, stress, and environmental toxins. There may be male factors. Occasionally, undiagnosed celiac disease is the cause. There may be no identifiable factors. It makes sense to modify what we can. And even when we need to include the high-tech interventions like IVF (in vitro fertilization), we shouldn’t ignore the low-tech, because it all matters.

Anatomical Problems – Anatomical problems such as uterine fibroids, blocked fallopian tubes, and endometriosis need to be addressed from a surgical perspective in many cases.

Problems with Ovulation – Ovulatory dysfunction arises from hormonal problems including PCOS (polycystic ovarian syndrome) or from abnormalities of thyroid or pituitary hormone function. Stress can cause or contribute to this. While a reproductive endocrinologist or gynecologist may need to offer some help with hormonal manipulation, medications, and/or procedures, there are situations where nutritional support, mind-body medicine, and other interventions such as acupuncture, can have an impact on ovulation to improve success rates.

Weight – If we look at the body weight of a woman, we know from the research that the ideal BMI (body mass index) is between 20 and 24. Too thin or too heavy makes it harder to conceive. Higher BMI lowers pregnancy and live birth rates with IVF as well and increases risk of pre-term birth. Obese women who do become pregnant have more complications including more miscarriages, more pregnancy-induced hypertension, more gestational diabetes, and more congenital anomalies in their children. Children of obese women have an increased risk of obesity, diabetes, and heart disease.

In men, higher BMI is associated with lower sperm counts, lower sperm concentrations, poor sperm morphology, lower sperm motility, and lower testosterone levels, all of which reduce fertility. We also know that if the father is overweight at the time of conception, the future weight of his daughter will be affected.

When both partners are overweight the miscarriage rates are higher with both spontaneous conceptions and in assisted reproduction.

Male factors – This focuses mainly on sperm counts, motility and morphology. These are impacted by body weight, hormonal factors, and nutrition.

Smoking – While quitting smoking before trying to conceive seems to be obvious, it is worthwhile to understand exactly why. Smoking makes conception more difficult; it speeds up the process of ovarian egg depletion and shortens the total number of fertile years. IVF failure is more common. Smoking while pregnant increases the risk for a long list of pregnancy complications and low birth weight. Children have higher rates of brain and behavioral problems such as anxiety, depression, ADHD, and lower IQ.

Alcohol - Low levels of alcohol intake of less than 1 drink daily in women appear to have no effect on conception rates. One or more drinks per day does decrease fertility. Alcohol use during pregnancy is well known to cause fetal alcohol syndrome with a variety of congenital defects and lowered IQ.

In men, alcohol use can lower fertility by reducing sperm concentration, volume, and motility.

Environmental chemicals – This is a huge concern. Many chemicals are endocrine disrupting, meaning that they have hormone-like actions in the body, disrupting normal hormone function and therefore fertility. But the concern of chemicals goes well beyond the issue of fertility. The developing fetus is exquisitely sensitive to toxic chemicals, much more so than the adult. The evidence is growing that prenatal exposures to a whole range of chemicals cause and contribute to disease later in life. We cannot control all of these exposures but we can minimize exposures to some extent.

Seafood – Fish and other seafood can contain mercury, PCBs, other organophosphates. Limiting exposure is facilitated by using online resources that list less contaminated types of fish.

Pesticides – Pesticide exposure at home and from food can be minimized. Choose not to use pesticides in and around your home. Organically grown produce minimizes pesticide exposure but due to availability and expense, it isn’t that easy to consume 100% organic. The Environmental Working Group annually updates a list of the most and least pesticide-contaminated produce items. These are called “The Dirty Dozen” and “The Clean 15″. These lists are available on their website ewg.org. Smartphone apps are also available. Look for “Dirty Dozen”.

When choosing animal-based foods, such as eggs, dairy and meats, organic is very important since environmental toxins can be concentrated. Pastured and conventionally-raised animals have very different nutritional profiles.

GMO foods – This is a complex topic, too complex to address here, other than to say that the associations with infertility are strong. These foods are best to be avoided and are, for the most part, heavily sprayed with pesticides. The easiest way to avoid genetically modified foods is to buy organic.

Plastics and phthalates – Plastics and phthalates are endocrine-disrupting. These negatively impact fertility and the developing fetus. These are everywhere: food packaging, cans, bottles, plastic storage containers, etc. Phthalates are in plastics but also in personal care products, cosmetics, and cleaning supplies.

Nutrition – Studies have shown is that couples with the greatest adherence to a Mediterranean diet have a lower incidence of difficulty with conceiving; also that couples undergoing IVF have a higher conception rate. Since this diet also reduces the risk for cardiovascular disease, cancer, dementia, obesity, diabetes, hypertension, dyslipidemia and autoimmune diseases, it is unquestionably good dietary pattern to adopt for the long-term. This diet is nutrient-dense with healthy fats, some fish and more plant-based than animal-based protein.

For those women who are overweight or have PCOS, paying extra attention to the glycemic load of the diet becomes more important. Glycemic load of a meal refers to the measure of the rise in blood sugar after a meal, the sugar load, which causes a rise in insulin. Having chronically high insulin levels is associated with many adverse effects, including impacting fertility and making it more difficult to lose weight. Carbohydrates that metabolize into sugar quickly include grains processed into flour (both gluten-grains and non-gluten grains), so keeping flour products and sugars to a minimum is important. Fruit juices have a high glycemic index whereas whole fruits have a little lower glycemic index, so whole fruits are a better way to consume them.

Additional research findings on nutrition specific to better fertility:

Lower trans fat

Lower sugar

Higher plant-based protein than animal-based

Higher fiber

More high-fat dairy/less low-fat dairy (low-fat dairy is higher in androgens, IGF-1 and prolactin)

Vitamin D – Vitamin D deficiency is associated with reduced fertility as well as pregnancy complications. Supplementation is best guided by the results of lab testing pre-conception, during pregnancy and during lactation. The amount in most multivitamins may not be enough.

Iron – Iron supplementation pre-conception also reduces ovulatory infertility. The amount in a prenatal multivitamin will usually be enough. Men should not supplement with iron.

Multivitamin – Multivitamin users, both prospective mothers and fathers, have higher conception rates. Birth weight and pregnancy outcomes are also improved. Risk of pediatric cancer is reduced. One study showed that women who took a multivitamin for just 1-3 months before conception lowered their risk of having a child with autism or severe language delay.

n-3 fats (omega-3 fats) - Higher intake of n-3 fats from fish oil or marine algae is known to improve the morphology of the embryo with IVF. Fertile men have higher blood and sperm levels of n-3 fats; supplementation improves sperm counts and concentration in men with low sperm counts. n-3 fats, especially DHA, are critical for brain and eye development of the fetus, so the woman should try to have her levels replete. Low levels are also associated with a higher risk of post-partum depression.

Vitamin B12 – Vitamin B12 deficiency is more common in vegans or in women who have been on metformin or proton pump inhibitors. Deficiency increases the risks of repeated miscarriage and birth defects. The amount in a multivitamin often won’t be enough to correct this deficiency.

Vitamin C - There is some evidence that Vitamin C supplementation improves fertility in women with a luteal phase defect.

Other supplements – There are a number of other supplements, including CoQ10, N-acetyl-cysteine, myo-inositol, acetyl-L-carnitine, DHEA, melatonin and botanicals (herbs)  that are used in men or women in specific circumstances.

Exercise – For women, exercise impacts fertility with an upside-down U-shaped curve.  Moderate exercise improves fertility, while too little or too much exercise decreases it. More vigorous exercise also appears to reduce fertility. In men, fertility is less impacted by exercise.

Stress – The link between stress and female fertility exists even when there are no measurable changes in stress hormones. Stress activates the HPA (hypothalamic-pituitary-adrenal) axis which impacts the gonadal hormone axis and other hormones as well. Stress impacts sperm quality and motility as well.

Stress management (or mind-body techniques) have been shown to increase pregnancy rates with IVF (where it has been more intently studied). More time relaxing and de-stressing is never a bad thing.

Acupuncture and Chinese Medicine – Chinese medicine offers much to women struggling with infertility. A long anecdotal record among Chinese medicine practitioners is now being supported by research. In 2012, a meta-analysis of 24 studies of acupuncture in fertility, which included 5,800 patients, revealed significantly higher pregnancy rates in the acupuncture groups. The evidence for improved pregnancy rates is significant enough for it to be routinely recommended in mainstream fertility clinics.

The Chinese approach to enhancing fertility is to normalize the menstrual cycle, and ensure the abundance of qi, blood and essence. Attention is paid to harmonizing and balancing yin and yang. The uterine environment becomes more hospitable to a fertilized egg. The female body is supported well beyond what standard fertility approaches do. Many acupuncturists find that women seek their help only during IVF surrounding embryo transfer, but find that earlier intervention is often better.

Final Comments
When prospective parents optimize their own health, they optimize their fertility as a couple as well as the health of their child. An integrative approach to fertility includes the high-tech diagnostics, medications and procedures that modern medicine offers but also includes the low-tech approaches such as nutrition, exercise, stress reduction, traditional Chinese Medicine and acupuncture to achieve the best outcomes for women and their babies.

Connie Deline, MD, is a Canadian-trained physician who relocated to the USA after several years of practice as a family physician in northern Ontario, Canada. She is board certified in family medicine in both countries. Her longstanding interest in lifestyle, environmental and social influences on health, along with an understanding of the limitations of conventional treatment approaches, led her to fellowship training in integrative medicine through the University of Arizona, established by Dr. Andrew Weil. She is also board certified by the American Board of Integrative Holistic Medicine. Connie offers part-time integrative medicine consulting and can be reached at 717.545.1717. Her website is http://www.santeim.com/