Practically Fertile
If you wanted to get pregnant yesterday, but you're confused and overwhelmed by all the noise on the internet, then this is the right podcast for you. Hosted by Dr. Adrienne Wei, Doctor of Acupuncture and Chinese Medicine, Fellow of the American Board of Oriental Reproductive Medicine (ABORM), functional medicine practitioner, and functional nutritionist. Here, you'll find zero fluffy, useless information or rah-rah motivation. You'll only find practical strategies and "how-tos" for identifying the root cause and amplifying your fertility by using a proven method of combining science with tradition.
Practically Fertile
Episode 9 - What You Need To Know About These Super Fertility Herbs: Evening Primrose Oil, Vitex, Maca, and Tribulis
If you've been trying to conceive with no success, it's very normal to think that it's because you're not doing enough, or something is seriously wrong with your hormones. As a result, you try everything that a well-meaning blogger or influencer or friend suggests. However, what they night not know is that some of these tips and tricks are not appropriate for everyone, and can actually delay the entire process.
In this episode, we explore the evidence behind these popular fertility super herbs, and discuss whether or not they really help with fertility.
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Website: www.adriennewei.com
Welcome to the Practically Fertile Podcast. I'm Adrienne Wee, doctor of acupuncture and Chinese medicine, functional medicine practitioner and functional nutritionist. I specialize in using an evidence-based method, blending principles of East Asian medicine and modern functional medicine to help women optimize fertility and get pregnant. I believe in a world where every woman who wants to be a mother becomes one. If you're tired of being told that you're infertile and you want to take the right steps to get pregnant naturally and quickly, this podcast is for you. Hey, fertile friend, I wonder if you feel the same way, but there's no shortage of information on how to boost fertility on the internet these days. But there's just so much information and you have to sort through all of this data and then figure out what's right and what's wrong. But in order to do that, you would have to do more research, and that brings up more information and cause more help and cause more overwhelm. So then, we rely on bloggers, influencers and other women who have found success to see what has worked for them, and I believe this is where myths like eating McDonald's french fries after IVF transfer comes from, or eating pineapples can help with the implantation. You hear personal stories like I ate pineapple cord during my two-week wait and now I'm pregnant. So just to be clear, I'm not here to tell you to stop doing these things because, hey, pineapple is delicious, it's a healthy fruit. If you'd like to eat it, be my guest, even though, from hundreds of food sensitivity tests that I have done, I would say that more than 50% of the time someone has a sensitivity to an enzyme found in pineapple. If you're just having a few pieces, I don't see any harm, but there's zero evidence that it actually helps with implantation. And you know, if eating McDonald's fries make you feel like you're proactively doing something to boost fertility, even though it's unhealthy once in a while, is not going to hurt you.
Speaker 1:What I want to talk about today isn't the food-based rituals. I want to talk about super herbs for fertility that are very popular but cause more harm than good, specifically evening primrose oil or EPL, maca, vitex and trebulus. Again, these herbs have anecdotal success stories associated with them and no doubt they can work for some people, but just taking them without understanding what they do to your body is a recipe for disaster. Again, I'm not here to be a Debbie Downer and scare you. I just need you to listen to the pros and cons and then see for yourself whether it's worth the risk. Now I am a trained Chinese medicine herbalist. To begin with, I want to talk about the differences between Chinese medicine herbs and these superfood herbs, and then we'll get into how each of the superfood herbs work and how they affect your body and explore the evidence behind these claims.
Speaker 1:Chinese medicine herbs are never taken alone. For starters, chinese medicine herbs are never taken by themselves, with very few exceptions. There are some herbs that are everyday foods, that you can grab a handful and throw them into a soup or a tea, like goji berry, chinese red dates. Those are the two that came to mind immediately. The majority of the time, Chinese herbs are combined together to form a formula. Each formulation typically contains as few as four herbs and as many as 15 to 20, sometimes even more. A lot of topical formulas will use more herbs, but the point is you wouldn't see Chinese herbs given out by themselves.
Speaker 1:Each herb in the formulation has a very specific purpose. They're strategically combined to balance each other and minimize side effects. For example, if a formula has a lot of hard-to-digest herbs, you'll often see an herb called fuling or poria in the formulation If you need the effects of the herbs to reach many places in the body. You would often see licorice to help guide the herbs to where they need to go, because licorice has the ability to reach all 12 energy pathways in the body. And lastly, chinese herbal medicine addresses the root causes. They aim to resolve a pattern of imbalance, not just one specific symptom, because the idea is by resolving patterns of imbalances, the body will become healthier, more resilient and restore its natural ability to heal, including hormone balance and getting pregnant. Yes, by regulating bowel movements, by improving sleep, by getting rid of night sweats, you will improve your fertility.
Speaker 1:When I give you an herbal formulation, I get predictable results. I know what to look for. When you take a random herb. You don't know what you're going to get. It could be a mixed bag of results. The biggest problem I have with these superfood herbs is how they're marketed. The attraction to them is to claim that they balance hormones. That has become a buzzword and if you're trying to get pregnant with no success, it's natural to think that is because your hormones are not balanced. But my question is which hormones are you trying to balance? And remember, hormones don't work alone. If something is not working correctly, it can be caused by many other factors. So if you're just grabbing these herbs off the shelf and taking them without digging deeper to finding the root cause, it can set you back. So let's deep dive into these herbs.
Speaker 1:We'll start with the first one, evening primrose oil, epo. The claim is that it helps with cervical mucus production. Epo is actually a plant that's native to North and South America and some parts of Europe and Asia. In addition to the claim that it helps with the egg white cervical mucus production, it's also suggested for the use for rheumatoid arthritis, dermatitis, irregular periods, pms. It's recommended for use vaginally to induce labor. Clinically, vaginal use of EPO alone has never proven to help any of my patients, and I've been in practice for 16 years. Proven to help any of my patients and I've been in practice for 16 years.
Speaker 1:So the active ingredient in EPO is an omega-6 fatty acid GLA gamma-linoic acid. Gla is a precursor to the production of prostaglandins, which are hormone-like substances and, depending on the type, it could either be anti-inflammatory or pro-inflammatory. Epo produces the anti-inflammatory prostaglandin 1. Prostaglandin type 2 is the type that causes inflammation and can cause PMS menstrual cramps because it actually stimulates uterine contractions. So using it for labor induction doesn't make sense because EPO doesn't produce the prostaglandin that would stimulate contractions. Epo actually doesn't produce any hormones or directly influence estrogen or progesterone. There was a study on the effects of EPO for women who experience IBS prior to the onset of a period and 53% reported improvement after three months of continuous use. I also looked at seven clinical trials on EPA and how it could help with PMS symptoms and none of these studies found EPO to work for any of the participants.
Speaker 1:There's definitely no doubt that EPO does have some anti-inflammatory properties, but there are potential downsides for using it, especially regularly. For example, it can interact with blood thinners and anti-seizure medication, antidepressants and high blood pressure medications. It can also cause GI issues and everyone will react a little bit differently. Again, no doubt that EPO has worked for some people, but taking EPO is no different than taking a medication that covers the root cause of a symptom.
Speaker 1:Next up, let's talk about Vitex or Chesterberry, so so, so popular and so so, so overhyped. The results from Vitex are really unpredictable and it can make things worse by causing irregularities with your cycle. Unlike EPO, vitex actually does directly affect hormones, but not estrogen or progesterone. It acts on the hormone prolactin, and this is where the results from taking Vitex gets dicey. If you fall into the category of having high prolactin, or even if your prolactin is in the normal range but it's on the higher end, then you might be one of the success stories from taking Vitex. Because Vitex lowers the prolactin level and that can help you get back into balance and help with the production of progesterone in the luteal phase after ovulation. It might also help with regulating ovulation because high prolactin suppresses the GNRH, the gonadotropin-releasing hormone. If your prolactin is high enough, you won't have a period. We learned back in episode one. The GNRH is the first hormone that acts to start a menstrual cycle. But the problem here is that we don't know exactly how the prolactin levels affect your cycle and hormones, because one person's high might be just right for another person and we also don't know how your body will react to the Vitex. It might be perfect for the exact right person, but it might cause problems for another.
Speaker 1:What most bloggers don't talk about is the serious side effects of Vitex. For one, if your prolactin level becomes too low, that can affect your glucose metabolism, adipose fat storage and increase your risk for developing insulin resistance, weight gain, non-alcoholic fatty liver disease. Low prolactin levels have a well-known link to the development of type 2 diabetes and other metabolic disorders. This is one of the reasons why, depending on which type of PCOS you have, VITAX can make things much, much worse for you. Same with EPO, vitax won't solve the problem of egg quality issues. It might lengthen the luteal phase and help with progesterone. Of egg quality issues, it might lengthen the luteal phase and help with progesterone, but if the egg quality wasn't great to begin with, it's not going to help you sustain a pregnancy. There is a supplement company that makes a prenatal with Vitex, and the instruction is to wean off Vitex once you're pregnant and not stop it abruptly. The concern is that stopping the Vitex suddenly can cause the progesterone to drop, but keep taking Vitex during the weaning process. There's no well-established study that tells us exactly how early pregnancy hormones will be affected by Vitex, so it could be causing more harm. We just don't know and, to be clear, there hasn't been evidence that Vitex causes miscarriage in the first trimester or during pregnancy. But knowing that during pregnancy the prolactin level increases to prepare for breast milk production and that low prolactin can have consequences, I would think twice before taking this herb.
Speaker 1:Okay, next up is maca, another popular herb. Maca is actually a root vegetable native to the Andes and it's often marketed as a superfood for fertility. Most studies on maca are small and mostly on animals in postmenopausal women, not on women trying to conceive. Most of the effects of MACA reported are increased energy, libido, enhanced mood. Maca does not act directly on any fertility hormones. It's actually an adaptogen, which means it could potentially have an effect regulating the HPA axis the hypothalamus pituitary adrenals axis and might help to reduce the cortisol level. So is that the reason for increased energy in libido? Maybe Could that indirectly help with fertility and hormone regulation, potentially.
Speaker 1:We know that cortisol is necessary for survival, but the problem with our modern world is that cortisol stays elevated and that can trigger the fight-or-flight response, therefore affecting fertility. So should you take maca for reducing cortisol? Not so fast. The biggest reason why you shouldn't take maca is it contains goitrogens. I came across a blog promoting maca and that the goitrogens can help with thyroid function. That's false. Goitrogens are toxic to the thyroid. They disrupt thyroid hormones and cause goiters. Goitrogens cause goiters and goitrogens are found in many cruciferous vegetables like kale, broccoli, brussel sprouts. Another reason to cook these vegetables, since heat will destroy the goitrogens. So maca contains these goitrogens actually can be very toxic to the thyroid. There's another reason why we might want to think twice before taking maca, and that's taking too much. Maca can possibly cause the hyperstimulation of the HPA axis and that could have the opposite effect, because instead of reducing cortisol, it could stimulate your adrenal glands to produce more.
Speaker 1:From a Chinese medicine perspective, we talked about how each herb is paired together strategically, and that's because we take into consideration the properties of the herbs, like which organs does it affect, what does it taste like, what's the temperature, what's the function, what's the contraindication, and remember how we talked about the yin and yang energies and how they balance each other. Because of the activating properties of maca, it's considered an herb that's very young and very hot in nature. If you need an energy boost, it might work for you short term, but herbs that are very young in nature are very drying, which means it will start to affect the cooling and lubricating yin energy in your body. Hopefully you remember from the previous podcast that yin energy is like estrogen and directly affects the egg quality, and I've had patients that have taken maca for an extended period of time and they notice that their egg white cervical mucus starts to dry up as well, and that's again because maca is very young and very drying in nature. I have one more herb that I want to discuss, because a patient also asked me about it, and that is tribulus.
Speaker 1:Tribulus is said to help with fertility because it can potentially increase testosterone production, boost blood flow and has anti-inflammatory properties. Tribulus is actually an herb that we use in Chinese medicine. The Chinese name is baiji li. Tribulus is combined with other herbs to treat imbalances of the kidneys and the liver. Combined with other herbs to treat imbalances of the kidneys and the liver, that translates to symptoms like impotence, low libido, low sperm count due to low testosterone levels and stress. It can also be used to treat dizziness, headaches, vertigo, that are typically associated with liver imbalances.
Speaker 1:For men, tribulus might be safer, especially if the problem is low testosterone. But when an herb has a direct impact on hormones, that result can either be really good or really bad. For women, some testosterone might be helpful for certain situations. In fact, for IVF, some doctors will recommend testosterone before starting the stimulation. That's because testosterone is a precursor to making estrogen. So the idea is, if the testosterone levels are low, you might have low estrogen as well, but it doesn't take a lot for the scale to tip the other way.
Speaker 1:One of my patients did end up taking too much and for too long. She started to notice facial hair more sweating and also a lot of irritability. Although tribulus isn't exactly taking actual testosterone hormone, there's absolutely a risk that you could end up taking too much. Research evidence on tribulus and boosting testosterone is also very inconsistent. That makes sense, right? Everyone is different. If you don't have a testosterone issue, this herb isn't going to help you. Okay, we are nearing the end of this episode.
Speaker 1:My goal is not to scare you At the end of the day. If you feel like taking one of these herbs is going to help you, that's totally fine by me. At least, I've done my job to give you the information that you need. When I begin working with a patient, I will typically do a supplement audit and take them off of these herbs. My philosophy is if these herbs are not specifically tailored to you, then I'm not sure what kind of effects it will generate. It will take longer for you to get pregnant because you might have to spend more time to reverse the unwanted side effects, and maybe you've been on this journey for a while and you're feeling frustrated, but very often it's not because you're not doing something. On the contrary, I think you need to give yourself grace and do less Taking an herbal supplement because someone said it would help with fertility, but they know nothing about your specific situation. It's just one more thing that you can take off your list.
Speaker 1:All right, fertile friend, I hope you found this episode helpful. Please do reach out to me if you have questions, and I have a huge favor to ask. Please leave me a five-star review on the podcast. It'll help the podcast to reach more people, as always. Thank you for spending some time with me. Until next time, take care of yourself and your amazing body. You are one fertile cycle away from getting pregnant.