By Beth Heller, MS

The word “diet” can mean “food or drink regularly consumed,” or “a regimen of eating and drinking sparsely so as to reduce one’s weight.” The latter definition is one that inspires fear in the hearts of many who have tried unsuccessfully to lose weight by “going on a diet.”One of the most common questions we get at Pulling Down the Moon is “how do general diet programs like Weight Watchers stack up for fertility?”   How diet impacts fertility was also the subject of a daylong symposium at the most recent meeting of the American Society for Reproductive Medicine.  Clearly, overweight is a challenge to fertility and can also block women from access to advanced medical fertility treatments like IVF.  But are diets the answer?

How Do Diets Measure Up?

In our view, for a diet to be fertility-friendly it must a) help women to attain and maintain a healthy weight for fertility b) target the specific ways in which overweight negatively impacts fertility:  poor blood sugar regulation, inflammation and the negative hormonal impact of excess body fat  c) eliminate overly-processed foods and encourage the consumption of minimally processed foods.  So how do “diets” stack up?

A) Help women to attain and maintain a healthy weight for fertility

While it may sound ridiculous, dieting does not seem to be the best way to lose weight.  An extensive 2007 review of weight-loss programs published in American Psychologist concluded that:

Dieters were not able to maintain their weight losses in the long term, and there was not consistent evidence that the diets resulted in significant improvements in their health. In the few cases in which health benefits were shown, it could not be demonstrated that they resulted from dieting, rather than exercise, medication use, or other lifestyle changes. It appears that dieters who manage to sustain a weight loss are the rare exception, rather than the rule. Dieters who gain back more weight than they lost may very well be the norm, rather than an unlucky minority.

Even well established programs like Weight Watchers struggle when we take a closer look at success and maintenance.  There is recent clinical data suggesting that Weight Watchers may be more effective than other diet programs at helping people lose weight and keep it off.   A 2008 study published in The British Journal of Nutrition reported looked at a sample of 976 “lifetime members”(defined as people who met and maintained their goal weight for at least 6 weeks) to see how many remained below their goal weight at 1 (26%), 2 (20.5%) and 5 (16%) years after they successfully completed the program.  On the surface this sounds encouraging but a closer look reveals this study has significant biases that make it next to impossible to generalize the findings.  Only about 6% of people who try Weight Watchers successfully attain and maintain their goal weight and meet the criteria to become lifetime members.  This study looked only at their most successful dieters and only 16% of that already small minority kept the weight off for 5 years.

The other problem with assessing the efficacy of WW is that we do not know what’s happening to the other 94% people who try the program and fail.  Are they experiencing the clinically relevant negative effects of dieting, including gaining back more than the weight they lost after a failed diet?

With these numbers in mind, there is a very good chance that many women who are told they need to lose weight in order to increase their odds of pregnancy have already failed at Weight Watchers.  Diets, it seems, are not the answer.

B) Provide ample amounts of nutrients that are important for good nutrition function and target the specific ways in which overweight negatively impacts fertility:  poor blood sugar regulation, inflammation and the negative hormonal impact of excess body fat

Major components of commercial diet programs – eating “low fat,” using artificial sweeteners, mass-prepared processed foods to support portion control and optimize convenience and emphasis on low fat dairy and “diet” foods – fly in the face of what we believe lie at the heart of healthy eating in general.  For women to find true success and optimal health they need to “un-learn” many of the dieting habits they have picked up over the years.  This means that frozen processed diet meals are out, as are the sugar-free and low-fat processed snacks.  Diet soda and artificial sweeteners are another crutch that needs to be discarded.  These overly processed food products may conveniently cut calories and “soothe the sweet tooth” (unfortunately artificial sweeteners may actually sharpen a sweet tooth in the long term) but they do not address the underlying causes of infertility – inflammation and poor blood sugar control – associated with overweight.

You can review a head-to-head comparison of a “healthy” low-fat diet versus a fertility-friendly menu in our blog A Tale of Two Diets to learn more about our contention that many of the “healthy” eating habits that have become conventional diet wisdom are simply wrong.   In our estimation an ideal fertility-friendly diet contains about 10% more fat and 10% less carbohydrates than a “typical” healthy diet.  The fats come from foods that naturally have fat in nature – full fat dairy in small amounts, fats from nuts, seeds and oils, as well as fats from grass raised meats and fish in small quantities.  Many of the fat-soluble nutrients and essential oils needed for optimal health are found in these natural fats.

C) Discourage overly processed foods and encourage the consumption of minimally processed foods.

We all seek convenience in our meal preparation but often to the detriment of the food we put in our bodies.  While Jenny Craig, Nutrisystem and Weight Watchers all provide recipes, they  also do a brisk trade in maximally processed meals and snack foods, none of which we feel we could endorse as fertility-friendly.  Processed, packaged in potentially toxic plastics and “fortified” with added vitamins and minerals – they aren’t true foods.  Read the ingredients of any of them for a tongue-twisting array of chemicals, preservatives and colorings.

Furthermore, we encourage women who are trying to conceive to eat organic and hormone-free as much as possible. The cardboard, plastic and Styrofoam packaging that wrap up convenience foods and snack-size packs are not good for our environment, either, and may be contributing to the chemical stew that is negatively impacting fertility in the first place.

What’s the Solution?

As we mentioned above, most women who have been told they need to lose weight in order to conceive or undergo IVF have likely tried dieting in almost every form possible and do not want to try another one.  So what to do?

Our answer lies in the concept of “nourishing up.” Nourishing up is the process of learning how to feed our bodies with real food that includes healthy fats and does not rely on processed low fat, sugar free or diet foods.  With nourishment come satiety, great digestion and optimal nutrition.  In obese and overweight women weight loss is not the goal of nourishing up but it is almost always a by-product.

Our therapeutic intervention for overweight and obesity, First Line Therapy for Fertility, introduces women to highly nutritious and satisfying eating guidelines based on the Mediterranean dietary pattern, which several studies have associated with potential protection against infertility (3, 4).  This dietary pattern emphasizes low-glycemic load, minimally processed foods and healthy oils from vegetable and fish sources.  Refined sugars and treats play a minimal role in this dietary pattern as do “diet foods” like processed low-fat dairy, and sugar free or fat free foods.  First Line Therapy has been shown to promote weight loss as well as improve markers of metabolic syndrome, such as decreasing LDL (bad) cholesterol, in women (5).

Dietitians who have received additional training in fertility nutrition and are up to speed on ART treatments lead the FLTF Program.  We educate women about Fertility Go (eat lots every day), Whoa (okay in moderation) and No (let’s skip these) foods, making it easy for women to customize their program to optimize sources of essential fertility nutrients (iron, omega-3 fats, B-vitamins and antioxidants).   In addition there is education and emphasis on foods and supplements that limit inflammation, which is implicated in many different infertility conditions including endometriosis, Polycystic Ovarian Syndrome (PCOS) and poor egg quality. With FLTF, we will help women choose foods that will nourish their bodies with the vitamins and minerals needed to maximize their fertility and help them feel satisfied, while at the same time helping them achieve a healthy weight.

Currently we have two groups of 5 women, one group in Chicago and one in DC Metro, who are participating in the FLTF program.  Stay tuned to our site for more information about their progress, to share their stories, challenges and successes, and to learn more about First Line Therapy for Fertility.

Sources

1.  Mann et al.  Medicare’s search for effective obesity treatments:  diets are not the answer. American Psychologist (2007), 62: pp 220 –233.

2.  Lowe et al. Weight-loss maintenance 1, 2 and 5 years after successful completion of a weight-loss programme.  British Journal of Nutrition (2008), 99: pp 925-930.

3.  Toledo et al. Dietary patterns and difficulty conceiving: a nested case–control study.  Fertility & Sterility (2011), 96: 1149-53.

4.  Vujkovich et al. The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment increases the chance of pregnancy.  Fertility & Sterility (2010), 94: pp 2096-101.

5.  Jones et al. A Mediterranean-style low-glycemic-load diet improves variables of metabolic syndrome in women, and addition of a phytochemical-rich medical food enhances benefits on lipoprotein metabolism.  Journal of Clinical Lipidology (2011) , 5: pp. 188-96.

Margaret Wertheim M.S., R.D., L.D.N.

Margaret Wertheim, MS RD LDN

Here at Pulling Down the Moon, we are launching our new weight loss program entitled First Line Therapy for Fertility (FLTF). I couldn’t be more excited about this program, and in preparation I’ve been doing the program myself. I’m not trying to lose weight, but simply following the eating plan with a goal of maintaining my weight. First let me tell you a little bit more about how the program works, and then I’ll fill you in on my experience.

Once you enroll in FLTF, you will come in for an initial consultation with me in Chicago or with Laura in Rockville. During that consultation we’ll review your goals, medical and fertility history and current diet in detail. We will also take your weight, measure your waist and hip circumference and your body composition using near infrared or NIR. The NIR measurement will tell us what percent of your body is fat versus lean body mass, which means muscle, bone and everything else that isn’t fat. It will also give us your BMR or basal metabolic rate, which tells us how many calories your burn at rest. That number will be adjusted based on your activity level to a calorie amount to promote weight loss. Don’t worry, that’s where our attention to calories begins and ends. There will be absolutely no calorie counting in this program. Instead after we calculate your calorie goal, we’ll translate that into a certain number of servings from each of the different food groups. We’ll come up with a meal pattern that works for you. It’s entirely customizable and tailored to you.

So back to my experience.  I’ve been on a weight maintenance FLTF plan for about 4 weeks now and I feel great! I am a Nutritionist who walks the talk, and I’ve always been a great vegetable eater, but FLTF took even me to a whole new level.  Here’s what I’ve noticed while on the FLTF plan:

1. I have more energy and never feel tired after eating. You know that carb coma fatigue you feel after a large meal of pasta or pizza, where all you want to do is veg out on the couch. You won’t feel that at all during the FLTF program. The reason is your blood sugar is going to remain so well-regulated that your energy will be steady. The majority of your carbs will mostly be coming from fruits, vegetables and beans with very limited grains and dairy. You will also always pair carbs with protein, which slows the absorption of sugar (created by the breakdown of carbs) into your bloodstream and prevents blood sugar peaks and valleys. The peaks and valleys are what leave you feeling really good 15 minutes after eating candy and tired, cranky, and searching for the next sugar fix after that. Don’t be scared off by limiting your grains and dairy. You can do it, and I’m going to help you.

2. Not eating sweets isn’t as hard as you may think. This plan has no sweets in it. Many weight loss programs promote jelly beans, “skinny” frozen desserts or other low-fat or sugar-free sweets. Instead I’m going to ask you to pretty strictly limit your sweets, but you’ll have fruit as well as sweet-tasting low glycemic index protein shakes to satisfy that sweet tooth. It may be hard to limit sweets at first, but it will get better. Once you cut out those sweets, the cravings will gradually disappear and you’ll be so excited about how great you feel and look, you won’t want to go back.

4. I’m eating more fruits and vegetables than ever: We are all constantly being told to eat more fruits and vegetables to improve our overall health and prevent disease. When it comes to cancer prevention, the recommendation from the American Cancer Society is at least 2 ½ cups of fruits and vegetables daily. I bet that while doing FLTF you will not only meet with recommendation, but go well above and beyond.

Let’s take a look at what I ate yesterday  – oatmeal, full-fat yogurt, walnuts, grassfed beef, tomato sauce, spaghetti squash, cannellini beans, kale, garlic, apple, almond butter, grapes, lentil soup, Brussels sprouts, butternut squash, blueberries. This day was jam-packed with nutrients and antioxidants! Let’s see how I did with eating a variety of different colors – red (grapes, apple skin, tomato sauce), orange/yellow (spaghetti squash, butternut squash, carrots in my lentil soup), green (kale, Brussels sprouts), blue (blueberries), white (cannellini beans, onions, garlic), brown (lentils, mushrooms, almond butter).

Here’s something that’s very important. Much of this may sound hard. I’m going to ask you to limit some pretty common foods, but I will tell you to always remember the 80/20 rule. What you do 80% of the time is what really matters. The other 20% is less important. Here’s an example: I’ve been doing FLTF, and I went to my sister’s house for dinner, and she was serving homemade pizza. Pizza has 2 things that I’m limiting –grains and dairy. What did I do? I ate the pizza, and I enjoyed it. I loaded up on veggies on the side. I’d been sticking to the plan most of the rest of the time, so it’s fine. In the beginning, it’s best to stick to the plan as closely as possible for maximum benefit, but there will always be meals that you can’t control. One meal is not going to make or break anything.

Because I’ve done and continue to do this program, I know the challenges and I’ll be able to give you recipes and tips to guide you through. I know you can be successful and you’ll have my support as well as the support of the other program participants.  The program costs $210 and includes a one-on-one session with a Registered Dietitian and seven group follow-up sessions.

FLTF launches in Chicago and Rockville on May 1^st, so call 312-321-0004 (Chicago) or 301-610-7755 to get more information or to sign up. Can’t wait to meet you and guide you through this exciting journey.

Cathleen McCauley L.M.T.

By Cathy McCauley, LMT, NCTMB

Spring has officially sprung and a multitude of signs show the season is upon us. Take a walk through your neighborhood and you see crocuses blooming and green buds taking shape. The earth is fertile and bursting with life.

With spring here, it’s the time for rejuvenation and cleansing. The longer days bring a renewed boost of energy. With spring, you receive the opportunity to release any stagnation that has accumulated during the winter and start fresh in mind and body. You can look ahead and make plans for the coming year.

A Chinese proverb says, “Make your whole year’s plans in the spring, and your day’s plans early in the morning.”  The proverb comes from the fact that farmers sow their seeds in early spring to ensure a good harvest and highlights the importance of being proactive.  Applying this concept to fertility, you can see the importance of starting early in taking care of your reproductive health. When you begin to pay attention to your bodies’ rhythms, cycles, signs and symptoms, your chances can increase in creating a fertile environment.

If you haven’t been as proactive about fertility as you’d like, spring is the perfect time to make plans for the future. It might be time to talk to your doctor about a fertility blood work up to determine what’s really going on with your hormones. You could make an appointment with a nutritionist to overhaul your eating habits to be more fertility friendly or take a yoga class to learn some breathing and relaxation techniques for stress reduction.

Click here to learn about the Fertility Awareness Check-Up available from Fertility Centers of Illinois for just $90

Also, the concept of spring cleaning our bodies can become an important ritual. You need to clear out the toxins and rejuvenate any stagnate energy in the body to boost immunity and increase fertility health. Since spring is the time for new beginnings, it’s a good opportunity to experience something new. Acupuncture helps balance the energy in the body and stabilize the organs and bodily functions. Reiki, a gentle form of vibrational energy healing, helps restore harmony in the body, mind and soul and clears emotional blockages. Fertility massage focuses on opening up the abdominal and reproductive organs to promote the immune system and assist in blood flow. Massage also greatly reduces tension and helps you feel great.

In the spring, people begin to feel better as the temperatures increase, the sunlight shines and the world turns green. Pour some of that warmth and light into your reproductive health to invigorate and rejuvenate your personal fertility journey.

We’re here to guide you along your path and hope to see you soon!

 by Beth Heller, MS RYT

Chicago has had an amazing winter and a very early spring.  This past week has found us meditating on flip-flops…in March!

 While it’s super fun to slip on a pair of summery wedges and paint our toenails pink, open toed shoes and flip-flops aren’t the only reason to pay attention to our piggies.  When it comes to the holistic view of fertility  feet occupy a place of honor.  If you’ve ever had fertility acupuncture you know that many of the points that support the reproductive system are located in the feet and ankles.  Reflexologists assert that the feet literally provide a map of the body and that we can use foot manipulation to impact different physical organs.  Yoga, too, teaches that healthy feet are important for better menstrual function, dispelling toxins and improving immunity.

So what’s so special about our feet?  In yoga, the feet are seen as the foundation of our being that is connected with the earth.  The most basic of yoga poses, mountain pose, challenges us to simply stand and find balance from our feet to the top of our head.  If we close our eyes in mountain pose, we can visualize the outlines of our feet on our yoga mat…literally our footprint in the world.  One of the strangest things for the new yoga practitioner is exercising in bare feet rather than sneakers.   Postures are practiced barefoot to maximize our awareness of our feet.  Yoga postures also stretch and stimulate different points on the feet that are associated with different organ systems in the body.

Symbolically, the challenges of fertility lead us away from our feet into our head as we spin our mental wheels searching for the silver bullet that will blast us past “trying” time into mommy time.  Our feet, particularly when we practice yoga asana, bring us home from our imaginings and projections to the here and now.

On an energetic level, the feet are associated with our first chakra.  Chakras are energy wheels located along our spine and each chakra is associated with both physiological functions and spiritual life-lessons.  On a psycho-spiritual level the first chakra is associated with security, trust and our sense of belonging.  Physically, the first chakra governs our immune system, gut health and lower back.  The feet are also very important for the flow of apana energy, the energy current in our body that moves downward from the pelvis to the soles of the feet, governs the menstrual cycle and the ability for our body to dispel toxins.

So, be kind to your feet.   Try not to cram them into uncomfortable shoes and make sure they  are frequently touched or nurtured.   Here are some tips for fertility-friendly feet:

1.  Shake hands with your feet once a day.  To do this, take your fingers and thread them between your toes (pinky finger between pinky and second toe, ring finger between second and middle toe, etc.).  Once your fingers are threaded, gently squeeze and massage the ball of the foot.   Repeat on the other side.
2. Keep your feet warm.  Cold feet mean decreased circulation.  With summer coming we face “air conditioner freeze syndrome.”  Keep a pair of fuzzy socks in your bag or desk for the days when you feel like you work in a refrigerator!
3. Experiment with reflexology, the science of foot massage.  Either see a professional reflexologist or try out “reflexology socks,” that actually outline the different areas of the foot and their associated organ system.
4. Try yoga.  If you’re a runner or walker, your feet may need a good stretch.  Time spent in yoga class in bare feet can help feet become more flexible and improve circulation to these important fertility “organs.”  Click here to view our upcoming Yoga for Fertility schedule for DC Metro and Chicagoland.

by Beth Heller, M.S.

To fully comprehend the latest research on omega-3 fatty acids and embryo quality it’s important to understand that the goal of medicated fertility cycles is not simply to make a lot of eggs.   In fact mild ovarian stimulation that results in fewer follicles seems to provide the best results.  This approach allows only the healthiest follicles and oocytes to develop.  Since developing follicles produce estrogen, fewer developing follicles also mean lower estrogen levels during the cycle.  This is also potentially beneficial as higher estrogen levels may negatively impact uterine receptivity and deter embryo implantation.

New research suggests that a higher intake of omega-3 fatty acids ALA, DHA and EPA may support this objective (1).  In 225 women undergoing IVF diet data was collected using a food frequency questionnaire.   Intake of  the omega-3 fatty acids ALA,EPA and DHA were calculated, as well as omega-6 (LA) intake and the ratio of omega-6 to omega-3 fats in the diet.

In this study, the women with the highest dietary intake of omega-3′s had lower estrogen response, developed fewer follicles and had better quality embryos, even after controlling for confounders like age and BMI.  A higher omega-6 to omega-3 ratio was associated with higher numbers of follicles.  If the goal of fertility treatment is to help women produce fewer, higher-quality eggs, this research suggests that women undergoing ART  should strive to increase consumption of omega-3 fatty acids and decrease the amount of omega-6 they consume.

As a result of these findings, the research team recommends that twice-weekly fish intake should be encouraged in women during fertility treatment.  While generally useful, this recommendation does not take into consideration the risk of toxicity from fish consumption – especially in the perinatal period.  In fact,  the fish richest in omega-3 fatty acids are the ones most likely to contain mercury and other contaminants.  For this reason, our recommendation at Pulling Down the Moon is that women work to lower their intake of omega-6 fats (found in snack and fast foods, factory/grain-fed red meat and processed oils), increase  their intake of leafy greens, nuts and seeds and supplement their diet with a high quality, purity tested fish oil supplement.

Supplements are only a small part of fertility nutrition, however.  For more information about fish oil, diet and egg/embryo quality, schedule a consultation with one of our nutrition specialists. Learn more about omega-3 fatty acids here.

1.  Hammiche et al. Fertility and Sterility. Vol. 95, No. 5, April 2011 1820-23

Beth Heller, MS, RYT

At the Moon we are constantly striving to increase our E.Q.I.Q. (Egg Quality I.Q.) and for years we have believed that nutrition can play a role in eqq quality.  However, until recently there were few studies to support this claim so we needed to temper our recommendations with the phrase “but there isn’t any clinical evidence for this yet.”   Now, several new investigations have shown that, yes, certain nutritional supplements may make a difference in egg quality.  The goal of this blog is to summarize the latest clinical news,  discuss the substances that are now showing potential benefits for women with poor egg quality and help you make choices about which supplements may be right for you.  As with any supplement protocol, you should always consult your physician before starting.

1.  Myo-inositol (MI)

Very recently two clinical trials were published that clarified a lot of the unknowns about myo-inositol, a product we use at PDtM under the name of FlowPro.   Myo-inositol (MI) is a part of the B vitamin complex and is a known insulin-sensitizer.  It has also been shown to improve both physical (hirsutism and acne) and reproductive (anovulation and amenorrhea) manifestations of Polycystic Ovarian Syndrome (PCOS).  In addition, myo-inositol plays a role in cell growth and early studies indicated that higher levels of MI in the follicular fluid was associated with better egg quality.

Several exciting new studies have emerged that have shed new light on MI and its role in fertility, particularly Assisted Reproductive Technology.  The latest study of interest demonstrated that treatment with 4 g per day of MI for three months prior to IVF improved egg quality in women who had failed a previous IVF due to poor egg quality. In this study the treatment also included 3g per day of melatonin, which I will talk about next.

But first, a note about inositol.  For some time there has been a debate as to the efficacy of d-chiro vs. myo-inositol for fertility.  We have chosen to use MI in our products because a) this is the form that has been used in all the clinical research we have seen to date on PCOS, egg and embryo quality and b) it is less expensive than the d- form.  Now, a new study confirms that myo-inositol seems to be more effective than d-chiro for egg and embryo-quality. On another happy note, MI  has also been shown to have a positive therapeutic effect on mood disorders that are responsive to SSRI’s (serotonin selective reuptake inhibitors) including depression, panic and OCD – a potential plus for the anxious, depressed fertility patient!

2.  Melatonin

Melatonin is a hormone that is secreted by the pineal gland.  It regulates our sleep/wake cycle as well as other hormones, in particular the hormones of the female reproductive cycle.  New studies like the one above suggest that melatonin supplementation at a level of 3 mg per day may help to improve egg quality when taken with MI for several months prior to IVF.

There are caveats to the use of melatonin.  Side-effects may include exacerbation of depression symptoms and patients who struggle with depression should make sure to  discuss this side-effect with their physician.  Melatonin should not be used with patients using thyroid medication as it can impact thyroid hormone levels.  It can also suppress ovulation at high doses so in general we only recommend this supplement for women who will be using ART and a trigger shot to stimulate ovulation and/or retrieval.

Finally, melatonin should NOT be taken while pregnant or nursing.  In general we do not recommend melatonin use for longer than 3 months without taking a break.  It can also cause marked drowsiness and is best taken just before bedtime.

3.  DHEA

DHEA (not to be confused with the omega-3 fatty acid DHA) is a hormone that serves as a precursor of steroid hormones testosterone and estrogen.  Research indicates it may also stimulate follicular development.  Several studies have shown supplementation with 75 mg of DHEA daily to improve egg quality and pregnancy outcome in women who were “poor responders” to IVF stimulation medication. Another study suggests that DHEA supplementation may reduce the risk of aneupoloidy.

DHEA should be used with caution as it is a pretty powerful hormone and when used at high levels and over a long term it may damage the liver.  Women who are pregnant or nursing should not take DHEA, nor should women with PCOS as this could exacerbate the condition.  Like melatonin, we recommend a three month treatment period.

4.  CoQ10

CoQ10 is a naturally occurring fat-soluble nutrient that is essential for energy production. CoQ10 has potent antioxidant properties and cell membrane stabilizing effects that make it beneficial for egg and sperm quality, specifically sperm motility. CoQ10 works within the mitochondria (the cellular power stations) in the cells and is essential for energy production. Until recently, CoQ10 was not thought to be a nutrient that required supplementation, as all normal tissue manufactures its own CoQ10; however, this production decreases naturally with age and is also lowered by certain drugs, including statins. When CoQ10 levels in the cells are low, energy production may be reduced and oxidative stress increased as a result.

CoQ10 has been shown to improve sperm quality and is now under investigation for potential use with women of advanced reproductive age undergoing ART to improve egg/embryo quality. The oocyte has among the highest concentrations of mitochondria of all body cells and uses immense amounts of energy in the process of maturation and ovulation. Researchers hypothesize that supporting the oocyte with CoQ10 may improve egg quality (Bentov et al. 2010).

The recommended dosage for overall health is 100-300 mg/day, or as directed by a nutritionist. The dosage under investigation in studies looking at egg quality is higher: 600 mg/day. CoQ10 appears to be a safe supplement: Studies have used supplementation of CoQ10 up to levels of 3,000 mg per day without adverse side effects. At present, the only risk to taking CoQ is the cost, as this supplement can be pricy, and no data currently exists on its usage in high doses during pregnancy.

5.  Omega-3 Fatty Acid (EPA/DHA)

There is still no direct clinical evidence that omega-3 fatty acids improve egg quality but we are convinced they are a good bet and include them in our Egg Quality Protocol.  Eicosapentaenoic acid (EPA) forms the backbone of many of the chemicals that halt inflammation in our body and also serves to support the health of our cell membranes.  Docosahexaenoic acid (DHA) (not to be confused with DHEA above) is important for brain health and adequate stores of DHA are thought to be beneficial for the early cognitive development of the fetus.  DHA may also be helpful for depression.   Look for purity-tested products.

This is exciting news indeed but you should always speak with your physician  before beginning a supplementation regimen of any kind. Of course, we would also be remiss if we didn’t mention that providing your body with the highest quality diet is also important for fertility.  If you are specifically seeking to improve your egg quality you should also consider re-thinking your diet to limit inflammation, achieve good blood sugar control and get ample antioxidant nutrients from food sources. Our nutritionists at Pulling Down the Moon are specialists and will tailor their recommendations to your fertility diagnosis.

For more information about any of the supplements or info in this blog, please feel free to contact me at beth@pullingdownthemoon.com.  These supplements and other fertility-related products are available at our online store.

Cathleen McCauley L.M.T.

By Cathleen McCauley, LMT

At Pulling Down the Moon, we often advise clients on ways to clear the body of toxicity. Detoxification helps eliminate harmful substances in your body, boosts your body’s systems to function properly and optimally, and enhances your body’s ability to handle the toxins of every day life.

Pulling Down the Moon’s Cleanse the Body massage session is one way to assist you in detoxification. The session incorporates lymph drainage massage to stimulate the lymphatic system, purify the body and build immunity. It helps prepare your body before attempting pregnancy or beginning fertility treatments. And in between treatments or after a miscarriage, lymph massage helps to clear your body of old medications and hormones.

The Lymphatic System

I like to describe the lymphatic system as your body’s garbage collector and filtration system. A network of organs, nodes, ducts, and vessels, the lymphatic system produces a substance called lymph and transports it from tissues to the bloodstream. As lymph circulates the body, it absorbs fluid, waste products, dead cells, bacteria, viruses, fats, and proteins and promotes the production of immune cells. Working closely with the circulatory system, it delivers nutrients, oxygen and hormones to the body’s tissue.

When a client experiences poor health or stress, eats a poor diet, takes medications or is surrounded by chemicals, pollution or free radicals, the lymph system may become overtaxed, sluggish or stagnant. As toxic buildup occurs in your body, it may become difficult for your body to balance hormones, build immunity and create energy.

Lymphatic Drainage Technique

Unlike the circulatory system, which uses the heart to pump blood through the arteries and veins, the lymph system does not have a central pump. It does, however, have minor contractile ability with a “pulse” of one to 30 beats per minute.  Muscle contraction─ through movement like exercise—and diaphragmatic or belly breathing are the key methods for pushing lymph through the body; light massage techniques also acts as a pump to stimulate the lymphatic system.

During the Cleanse the Body massage session, a series of light, repetitive movements are used to encourage lymph fluid to flow through the system. The technique kick-starts the removal of waste and toxicity and delivers nutritive substances and hormones to your body. By promoting lymph flow to the nodes, filtration and purification occurs enhancing liver function, building the immune system and increasing fluid movement to and from organs and tissues.

The Client Experience

Often, clients say they feel very little happening when they receive a lymphatic drainage, especially those clients who typically receive deep massage treatments.  But shortly after the session begins, clients are lulled into a deep state of relaxation by the light and rhythmic nature of the work.

Each client’s response to lymphatic drainage differs depending on the body’s individual toxicity levels. Some clients feel a deep sense of relaxation; others experience a burst of energy; and a handful of clients may experience fatigue or mild flu-like symptoms. These are normal responses that may last up to two days. Drinking extra water can help to eliminate toxins and flush the system.

For more information about the Cleanse the Body massage session or the benefits of lymph drainage, please contact me at cathleen@pullingdownthemoon.com. I look forward to hearing from you!

References

Osborn, K. (2005). Lymph Massage, Armoring the Immune System. Retrieved May 30, 2011 from http://www.massagetherapy.com/articles/index.php/article_id/937/Lymph-Massage

Rattray, F; Ludwig, L. (2000). Clinical Massage Therapy: Understanding, Assessing and Treating Over 70 Conditions. Toronto, Talus Incorporated.

Shier, D.; Butler, J; Lewis R. (2007). Hole’s Human Anatomy and Physiology, 11th Ed. New York, McGraw-Hill.

West, Z. (2011). Massage, Manual Lymphatic Drainage. Retrieved May 30, 2011 from http://www.zitawest.com/area.php?section=14&item=88

by Beth Heller, MS RYT

The first time I experienced Shiva Nata, or the Dance of Shiva (DOS), was in 2002 when Andrey Lappa, a visiting yoga master from the Ukraine, introduced this practice to the Chicago yoga scene.  At the time I thought it was very interesting and exotic, but with Andrey leaving town there was not much opportunity to study the system so I never continued with practice.

Flash forward to 2011.   Out of the blue, our friend Neil Keleher sent a message from Taiwan where he practices and teaches DOS to ask whether Tami and I had considered sharing the Dance of Shiva with our students at Pulling Down the Moon.  Neil had studied Shiva Nata extensively with Andre in Chicago back in the day, and had continued to work with it in his personal practice these many years.  Neil was finding that this practice repeatedly helped his students move past stuck points into more positive life situations that aligned with their heart’s purpose.  In essence, Neil suggested, the Dance of Shiva was helping to “birth” his students’ intentions.  Needless to say  I was intrigued.

Symbolically this practice is spot on for fertility.  In the Hindu pantheon Shiva is one third of the Trimurti, the primary aspects of the divine represented by Brahama (the creator), Vishnu (the sustainer) and Shiva (the Destroyer).  In this tradition, Shiva governs the shedding of old patterns, structures and beliefs to make room for new life-affirming directions.  Much of the deep work we do at the Moon comes through re-evaluating the habits and beliefs our students have brought with them to the point in time in which they are experiencing crisis (infertility).  The techniques we use at Pulling Down the Moon – yoga, Traditional Chinese Medicine, therapeutic massage and nutrition – work to make us aware of patterns of harmony and disharmony in our lives; to consciously choose what we want to keep and what we want to discard.  On a visual level the symbolic connection of Shiva to fertility is even more obvious.  Shiva is often represented as a lingham and his partner Shakti is represented as a yoni.  They are often depicted together as a divine representation of procreative energy.

So what is the Dance of Shiva?  Basically it is a set of movement patterns that you learn that becomes a form of moving meditation.  It looks like the love-child of yoga and martial arts and DOS practitioners claim that the practice stimulates insight, creates a sense of mental calm and helps the practitioner enter a state of flow where she is present in each moment as it arises.  Epiphanies that arise from practice break down outmoded structures and lead the way to change, calm and flow help us move in life-affirming directions.

I asked Neil how he felt the DOS could help with fertility and here is his response:

“If a woman is struggling with conscious or unconscious negative thought patterns about her fertility,” says Neil, “Doing the Dance of Shiva may help her become more aware of these thought patterns and move beyond them. ”  This is because the practitioners of DOS believe the initial memorization and practice of the movements creates new neural pathways.

Furthermore, the Dance of Shiva is very grounding and returns a woman to her body.  The practice may also have a profound physical benefit as well.

“The concentration required to do the DOS requires you to focus on feeling your body and this focus forces you to be truly present and in your body,” Neil continues.  ”Another benefit for fertility is that the DOS helps you practice knowing what you want to do (intention) and helps you arrange things so you can do it.”

Over the past few weeks I have begun a DOS practice in earnest and, surprisingly, have found these spiraling movements to be meditative and interesting.  I have even experienced a few powerful epiphanies.  Placebo effect?  Perhaps.  But I think not.  The DOS is mathematical, which I am NOT, so I find that my brain is both challenged and energized by new neural connections.  The movements haunt me during the day and I find myself imagining and visualizing these spirals as I wait in line at the grocery store or drive my car.  In my experience this means this practice is penetrating on an energetic level and having an effect on my physical and energetic body.

Regarding fertility, my hunch is that this IS a very powerful practice for helping us reach our goal of creating family so stay tuned over the coming weeks for more updates, video and further commentary.

If you need more now, visit Neil’s website and blog at http://thedanceofshiva.com.

By Beth Heller, M.S.

Cauliflower is a fantastic fertility food.  Walnuts, lean protein and berries are terrific too.  But if you do not consume, digest and assimilate these foods effectively they cannot help your fertility.   This process of consumption, digestion and assimilation  (and we’ll also add elimination) is what nutritionists call gut function.  Good gut health is important for many health conditions, including fertility. Let’s take a closer look at these variables:

Consumption: Both Traditional Chinese Medicine and Ayurveda place a great deal of emphasis on how we consume our food.  On the surface this means mindful eating, not eating in the car or standing in front of the microwave.  In addition, choosing food that is locally grown and in season is recommended by these traditional systems.  The taste buds, too, are an important part of the gut.  To be fully satisfying, traditional medicine systems teach a meal should contain six vital tastes:  sweet, sour, salty, pungent, bitter and astringent.  In fact, “western” scientists are now learning that certain tastes convey specific health benefits.  For instance flavonoids, the powerful antioxidants found in red wine, green tea and citrus that are believed to convey important health benefits, are bitter in flavor.   Interestingly, our taste for bitter foods increases with age – as our body’s innate antioxidant systems are losing their efficacy.  Nutrition researchers even hypothesize that a preference for bitter taste in aging animals may be evidence of an evolutionary advantage.  Sadly, our Western diet emphasizes primarily the salty and sweet tastes – leaving the pungent chilis and bitter melons and fruit to other cultures.   Bottom line:  we should consume food mindfully – from eating in a calm environment to paying attention to the range of flavors in the food we eat.

Digestion: In yoga’s sister medical science Ayurveda, we are taught to stoke “agni”  (digestive fire) prior to meals.  This can be done with yoga, exercise and in cases where the digestive fire is weak, an herbal aperitif. The digestive fire is so important that Ayurvedic lore says “if agni is strong we can convert poison into nectar; if agni is weak, we convert nectar into poison.”  Eating too much can also dampen agni, just like throwing a big log on a fire.  Eating too many cold foods can also dampen agni.  Use the Appetite Scale at the end of this blog to help you use agni to your advantage.  For optimal digestive power, eat when you are at a level of 2-3 and stop eating when you are at 7.

Assimilation:  The old adage is true.   The best way to get optimal amounts of vital nutrients is to eat a balanced diet filled with minimally processed fresh foods.  This is because the macronutrients (fat, protein and carbohydrates) as well as the micronutrients (vitamins, minerals and other beneficial chemicals) in food work best in combination with each other. Food sensitivities, health conditions and even chronic stress can impact how we assimilate nutrients.   For instance, when we are very nervous we may find that food just “sits” in our stomach like a rock.  This is because the flight or flight stress response has down-regulated the digest/nest body functions and is shunting blood to the skeletal muscles rather than the stomach.

Elimination:  When food rushes through the digestive tract (diarrhea) or stagnates there (constipation) we experience discomfort.  Poor digestion may also put us at risk for disease.  Diarrhea may speed food through the gut too quickly for vital nutrients to be absorbed.  It can also wreak havoc on the beneficial bacteria in our gut.  Constipation, on the other hand, allows for potentially toxic substances (including hormones and carcinogens) to be “re-digested” from fecal matter and returned to the body.  Imbalances in the intestinal and vaginal flora can also make women vulnerable to conditions like bacterial vaginosis that are associated with infertility and early pregnancy loss.  We can support gut bacteria by eating sources of soluble fiber (oats, lentils and beans) that support “good” bacteria and limiting the consumption of refined sugar and saturated fat, that nourish “bad” bacteria.

So, this week as you fill your refrigerator and your plate with fertility-friendly foods, notice  how you are consuming your food and  pay attention to your gut function.  Eat when you are hungry, stop when you are full.  Enjoy a full range of flavors at every meal – searching beyond your habits for pungent, sour and bitter flavors.  Finally, pay attention to how your body is eliminating waste and strive for the Goldilocks’ approach of “not too fast, not too slow.”   These actions can be truly transformative.

Working with an integrative nutrition specialist trained in fertility can be very helpful for resolving issues related to menstrual and reproductive function.  Call 312-321-0004 to learn more about Pulling Down the Moon’s nutrition specialists.

Agni Gauge:

0 Starving

1 Hunger Pains

2 Very Hungry

3 Hungry

4 Could Eat

5 Neutral

6 Could Stop

7 Full

8 Uncomfortable

9 Over-Filled

10 Stuffed

A new study compared the effect of electro-acupuncture (EA), physical exercise and no intervention on testosterone levels, menstrual frequency, acne and hirsutism in women with PCOS.  After 16 weeks of treatment, the researchers found both EA  and exercise lowered testosterone and increased menstrual frequency, with EA having a significantly greater impact than exercise.  After a further 16 weeks of EA treatment or exercise,  improvement was noted in hirsutism and acne symptoms, again with electro-acupuncture having a greater impact than exercise.

Lifestyle treatment including diet, exercise, stress reduction and Traditional Chinese Medicine for PCOS makes sense.  If you have been diagnosed with PCOS, we encourage you to come in for a consultation and work with our expert practitioners.  Our comprehensive and targeted approach to PCOS includes specific dietary recommendations and supplementation, yoga and relaxation for stress reduction  and Traditional Chinese Medicine acupuncture treatment.  You do not need to be struggling to conceive to benefit from our expertise.  In fact, getting a handle on PCOS before you are “trying” is essential. PCOS is often under-diagnosed in teenage girls and the acne, irregular periods and weight gain are chalked up to puberty.

For more information about PDtM’s comprehensive approach to PCOS, call 312-321-0004 to book a complimentary face-to-face or phone session with our Patient Advocate.