Search

Fertility Talk for College Girls

Several months back I gave a 2-hour talk for college girls, covering many factors in health and fertility, available on Podbean and Apple Podcasts.


For those who prefer to read, here's the transcript! It's long, because recording is long. Hope this is helpful!

Fertility Talk Transcript
.doc
Download DOC • 176KB

Fertility Talk for College Girls


JEN: I think I got fifteen RSVPs and 7 of them were in the last 48 hours, but this is even more than 15 people, obviously. So, how many of you are engaged?

AUDIENCE: [laughing]

JEN: One, two, three … okay. Okay. So, actually, it’s a minority who’s actually engaged here. Is anybody hoping to be engaged in the next 6 months?

AUDIENCE: [laughing]

JEN: Oh, yeah. I guess you don’t want to raise your hand; that’s kind of like bad luck.

STUDENT: Hoping!

ALL: [laughing]


JEN: So, for many years now, I’ve thought about teaching a class for girls who were engaged, getting engaged, getting ready to get married, getting launched, and I thought that would be a great time to go in-depth on cycle stuff before you start trying to get pregnant so you can solve some problems in advance. But even if you’re not engaged, this is still good to know and you can still benefit from improving your cycle, even if there’s not supposed to be any babies on the way. I think you guys probably all know me from the health class; I am Mrs. Dunlap, I graduated in 2003 from TAC, and I have 5 girls – three of whom are at Rabalais right now and the other two are home with my husband. We live outside of town, and we both like this area so much. That’s why we decided to stay here after we got married.

My oldest is 15 and she made these pretty handouts for me with her little graphic design skills. I thought maybe we’d just start by talking about your monthly hormone. I made this chart. So, when we’re tracking cycles, we always count the first day of bleeding as Day Number 1. Most people bleed on average 4 to 5 days, so this is a theoretical 28-day cycle, even though we all know that most people’s cycles are not exactly 28 days most of the time. Somewhere around Day 14 we ovulate, and in the picture that I put in your folders there’s a picture of an egg popping out, just to remind you.


AUDIENCE: [giggling]

JEN: You might notice some mucus at this time, you might notice your underwear’s wet, or when you wipe it’s wet, and that is normal. That’s totally normal, that’s not a yeast infection; some people I know get concerned. Then, as you can see, your body makes all these hormones and then they start dropping about Day 21 when your body realizes, “I’m not pregnant. We’re not going to need this lining to do any more thickening because there’s not going to be any embryo implanted in it.” Then it starts processing those hormones, and when they drop below a certain threshold, that’s when you are able to start your next period and bleed. Your hormones have to drop for you to bleed. If you are bleeding, presumably your hormones have dropped. Sometimes people’s hormones drop in the middle. If you’re spotting in the middle of your cycle, that’s because your hormones are dropping in the middle of your cycle. Sometimes people always spot a little bit in the middle of their cycle and they still have 10 kids; it’s not a problem. But if you were trying to have kids and you weren’t able to, that would be one of the things you would troubleshoot. It can also be just kind of irritating.

So, this is the theoretical 28-day cycle, but really it can last anywhere from 21 days to maybe 40, 45, or longer. So, where you get the variation is mostly in two places. If you don’t have the resources in your body to ovulate on time, then you won’t ovulate on time. If you’re too stressed out, your body decides, like, “Whoo! Too much going on out here. Let’s wait to ovulate.” So, if for some reason you’re short on nutrients or you’re really stressed here, that can delay your ovulation. The other thing where you can get a delay –once you’ve ovulated, if you have enough hormones in your body, it’s going to be another 14 days before you start bleeding again – so if your ovulation gets pushed back to Day 18 or 20 or 25, then add 14 days to that, if you have enough hormones. You won’t have a period for 12 to 14 days after whenever you ovulate. So, if you’re having long periods, it could be that you’re always ovulating late. That’s a pretty common reason to have long periods.

The other way you can get a long period is if you ovulate on time but then you eat a bunch of rich food and basically lay in bed for this week. It’s going to be a lot harder for your body to process those hormones and you can get a delay on this end. Even if you ovulated on time, you can get a delay in getting that hormone level down low enough to actually bleed, and this will be a very bad several days because you’ll feel very moody, very weepy, depressed, cranky, whatever, ...

[00:05:37]


AUDIENCE: [laughing]

JEN: … bloated. If your hormones are backed up and they’re not going down at a steady clip, you’re probably not going to feel great. So, those are the two main areas where you get cycle variations.

Another thing that can happen is that when you have your period you could bleed for a long time and it could take a long time. You’re supposed to stop bleeding as your body starts raising your hormones again, but if for some reason it can’t raise your hormones – there’s not enough nutrients, you’re too stressed, you’re on an extreme diet, you’re exercising, you’re in a war, who knows what –then you will bleed for longer and that will push this whole thing back as well.

So, those are the different areas where you might get the variation. So, when you’re tracking your own cycle and trying to learn something to help it be better, you’re going to try to find out where the weak points are. A couple of things you can consider: there are people who had periods in Auschwitz, and had babies in Auschwitz, and there are people who have one short night of sleep and it sets their ovulation back 5 days. People vary tremendously in their sensitivity to environmental cues and how much that’s going to change their cycle. My mother-in-law said she’s one of those people who could practically set the clock by her cycle. It was 28 days and 4 hours or something. She almost could predict it down to the hour.


AUDIENCE: [gasps]

JEN: It was so reliable, no matter what was going on in her life. She’s kind of a high-hormone person. She’s short and very busty, so obviously her body made plenty of hormones when she was growing. If you have a lot of hormones, you will tend to be shorter and curvier. If you have fewer hormones, you will tend to be taller and bonier. You can tell that I’m bonier and, until I had kids, I was almost flat-chested. So I was definitely the lower-hormone type. It’s partly just genetics, it’s partly exercise or different things like that, but you can look at your body and probably get an idea of what your type is. If you have a body that’s more sensitive to environment, there are a lot of things that can throw your cycle off and you have to be aware of those. If you learn through experience by tracking them, then you’ll have a sense of, “Oh, I’ll probably ovulate late this month.”

So, why would you want to know? Well, if you’re married, sometimes you’re trying to get pregnant and you don’t. I’ve know people who’ve said, “I got married. As soon as my period ended we’d be doing it all the time and then we’d kind of get bored of it about ay 10 or 11 and then we’d take a break, and I couldn’t figure out why I wasn’t getting pregnant.” Well, that egg wasn’t coming out ‘til day 14 or 15, so they just weren’t hitting it on time. If you want to get pregnant you might need to time it, which doesn’t sound very romantic, but it’s what a lot of people do.

Conversely, if for some reason you need to not get pregnant – if you have a C-section, if you have a baby that is in the hospital getting their heart fixed, or something like that; these are things that happen to people I’ve known – if you have a reason to not get pregnant, then you would not do anything from about Day 7 or 8 until you know the egg has already come out. The egg only lasts for about 2 days. So, you wouldn’t do anything from here to here. Otherwise, your option would be not doing anything ever until that baby gets his heart defect fixed, which is not great for marriages. So, that’s why people typically track it when they’re thinking about getting married. If you’re not thinking about getting married and you’re just trying to have a healthier cycle, then you’re getting a lot of information from that. For instance, if you’re bleeding a long time, there are a couple different reasons you could be bleeding. One could be, you just have a ton of hormones and you make really thick linings so you’re just going to bleed a lot when you bleed. Another reason could be that, when you bleed, your body can’t get your hormones back up. Maybe you’re anemic. Maybe you don’t clot very well because you’re not getting enough vitamin K in your diet. If you find what makes your ovulation late or changes your ovulation, that’s really good information to have, to know, “Oh, I’m only sensitive to time zone changes. It doesn’t matter if I lose a night of sleep, it doesn’t matter if I have coffee, it doesn’t matter if I exercise more or less.” That’s really great information to know.

If things are running pretty normally, that’s a sign of overall health. It’s supposed to be pretty consistent like that. Again, this could be the cranky week, right? That last week before your period you can feel bloated, so this is a week to really put some extra attention into what you’re eating and how much you’re exercising. For most people who are your age, just exercising, drinking a lot of water, and eating a lot of vegetables will mean that you don’t really get PMS or cramps and, conversely, if you drink coffee and alcohol and eat a lot of cheese and chocolate and sit still and watch movies for that week, it’s only going to make it more so. You’re not helping your body to process these hormones and get them down to the low level that they’re supposed to be.

I’m not saying never have chocolate or watch movies, but just be aware. If this is a bad time for you because you have a lot of hormones in your system, this can be a really rough week. For somebody who has fewer hormones in their system like me, is about Day 5. So, maybe I run a little anemic. On the last day or two of my period, I am just ravenously hungry. This just happened last week and I thought, “Why do I keep eating?” I’m not normally just eating all day. I’m 38. My metabolism is not that fast. I’m not that hungry all the time. I thought, “Oh, yeah. It’s the Day 5 munchies.” Day 5 is the day where everything sounds good: “Ooh, Fritos! Sour Patch Kids!”


AUDIENCE: [laughing]

JEN: “Donuts,” things that don’t normally call my name. Any calories sound great on Day 5. But I think I’m always behind the curve because my body doesn’t make a ton of hormones. So by the time I’m done with my period, I’ve lost some blood and I’m behind the curve. If you make a lot of hormones, you might feel great as soon as your period starts, like, “Finally! Finally the levels are down.” You might feel great during your period or you might feel awesome at the end of your period because you’ve just released a bunch of hormonal material and things haven’t gone back up yet. So, knowing what your own tendencies is really, really helpful. My mom used to say, “Are you on your period?” when I would start crying on Day 5, and I’d say, “No, I’m not on my period.” But, now I know that I’m just super, super hungry and kind of tired, and that that is what would make me emotional when I was a teenager.

Any questions? There are probably lots of questions. Yes?

STUDENT: I have a quick question. You said the last bit can be hormonal and hard before you start your period and to watch your exercise. Do you mean not exercise too much or make sure you’re exercising?


JEN: No, make sure you’re exercising. If there’s any time of the month to exercise too much and really push yourself, it’s the last week. If you normally exercise but you find you’re feeling cranky at this time of the month, exercise more. I was talking to a girl who would exercise 40 or 45 minutes at a time, and I said, “Well, why do you pick 45 minutes as your stopping point?” and she said, “Well, that’s the place where I just feel kind of nice and relaxed but not too tired. “ But she was still getting pretty bad cramps, so I said, “Well, that week you would need to exercise an hour and a half. You need to push yourself until you are wiped, but then you won’t be cranky.” Exercise also tends to help cramping a lot, so in addition to making this week better, it makes the next week better.


STUDENT: I asked that question because I love to run, but when I run a week before my period, I’ll start running and I’ll feel fine, but then once I stop I get this really bad pain in my, like, down …


JEN: Do you get cramps normally?

STUDENT: Not normally, no. It’s not so much a cramp, it’s more just like a really sick-y, almost crampy feeling, and it happens if I run intensely right before my period. So, I was wondering, is that a bad sign?

JEN: Well, sometimes people will get nauseous right before their period even without running, and generally that’s thought to be excess hormones. So, if you ate more vegetables and if you tried drinking a couple glasses of water before you went running and then a couple glasses right after, it could be that the running is really moving everything around in your lymphatic system but your body’s kind of like, “Oh, I just got this dump of hormones and now I have to do something with it.”

Your lymphatic system is like your fluid circulation in your body – it’s different from your blood—and when you exercise, it helps your body move everything around and process it. Also, eating fiber helps you poop out things that you don’t need, like the excess parts of hormones that your body says, “Nope, we don’t need this.” When your body breaks things down, it’ll reuse them sometimes but sometimes it’ll just excrete them as well. So, eating plenty of fruits and vegetables and staying really regular can also help your mood a lot and tends to make you less bloated because the potassium in the fruits and vegetables helps balance out the salty stuff you want to eat and you don’t retain as much water. It’s not the salt that’s the problem, but if you eat salt and it’s not balanced by potassium, that’s not a good balance. All fruits and vegetables have potassium, not just bananas.


[00:15:49]

AUDIENCE: [chuckling]


JEN: Bananas have a marketing campaign behind them, but all fruits and vegetables have potassium. A fairly common thing that girls experience with their cycles is polycystic ovary syndrome, called PCOS. That tends to go with very, very irregular cycles, putting on weight, having skin problems, having thinning hair, and kind of a collection of other signs. The reason it happens is that your body is not processing sugar or your calories well, and then over time you become insulin resistant, which means the cells don’t want to let the sugar in. When you eat your food, the sugar is floating around. Your body sends out insulin, like diabetics need insulin. The insulin is supposed to open up the cells to put the sugar and nutrients in the cells. If you’ve been eating more than you need, particularly more sugar or salt than you need – so, basically, a lot of processed foods – it can tend to start this pattern of eating too much and the cells being very unhappy with your body trying to force the stuff in there. They’re like, “We’ve got plenty.” So, if you have that tendency, then you’re going to have to probably watch your carbs and exercise more.

I’ll tell you a story of somebody I know who had this polycystic ovary syndrome, or PCOS. She had very irregular cycles. She’d go months without a cycle. The reason that happens is because when your insulin is too high, all of your hormones end up too high and your hormones never get low enough to allow you to bleed. So, she would have an epic period, a 10 to 12-day period every 3 or 4 months, and she would bleed a ton because of her hormones, and she would feel pretty gross for a lot of the time as her hormones got up and they stayed up. You can go on medications to regulate this, but ultimately what she ended up doing was going on a very-low carb diet because her body tolerated carbs so poorly that that’s what she had to do. It’s not recommended for everybody, but in her case that was the right kind of diet. After she’d been on this diet for some time, she got pregnant, which she hadn’t been able to before, and then after she had that baby, she got pregnant right away without doing any low-carb diet, which is very often the case. As she’s gotten older, she’s been on the low-carb diet, exercised more, built her muscle mass to increase her metabolism and help everything run better; she now has regular cycles. In her 30s, she has perfect 28-day cycles, where in her 20s her periods were just a mess because she hadn’t figured out how to eat and exercise for her body type.


STUDENT: Is she still on a low-carb diet now?


JEN: I don’t think she has to be as low-carb now as she did for that period of time, but for some people, going on a very low-carb diet allows their body to relax and heal from that, and then over time she eats more of a moderate-carb diet and it’s fine. But she also exercises a lot more and she’s really fit. You figure out what works for you. She is short and curvy and has a lot of hormones; that’s just how she’s built. So, she would go run 2 or 3 times a day the week before her period. Her family would say, “Please, go. Just leave already and go running again. Yes, again!”

She also really, really liked coffee. She wouldn’t give up her coffee and that is not helping her body to process. Your liver can only do so much. Your liver has so much to do processing all the different substances you take in; one of those is coffee. So, if it already has a bunch of hormones to process, drinking a pot of coffee a day is not going to help you feel better.

Another thing that some people have is called endometriosis, commonly thought of if you have extremely painful periods. A couple of my friends had such painful periods that one of them said childbirth was a piece of cake, because she would sometimes pass out from her painful periods and pass big clots. Since I’m on the low-hormone end, my periods were never that bad, so childbirth was quite an experience.


[00:21:03]

AUDIENCE: [chuckling]


JEN: We don’t totally know why endometriosis happens but women who have it seem to get a lot of inflammation in the lining of the uterus and pieces of uterine tissue start growing in other places in their body. The weird thing about endometriosis is, it should be able to happen to anyone because your uterus and ovaries are an open system. It’s not tightly sealed, and little bits of your menstrual tissue could theoretically make it into your circulation every single month, and they probably do. For most people, though, their immune system is always looking around and it kills any cells that are in the wrong place. One of the theories for endometriosis that makes the most sense to me is that there’s a defect of the immune system. Something is suppressing your immune system for a period of time and those cells that are supposed to find things that are where they’re not supposed to be and get them out of the way don’t get things in time. Then you get little bits of endometrial tissue – the lining of the uterus tissue – that grow in other spots, usually in your pelvis. They grow in other spots and that’s part of what causes period pain, because those little spots of tissue will also grow in response to the hormones and then you’re bleeding inside or you get big clots. It’s very, very painful.

There are a lot of dietary things you could do for endometriosis. The most common thing is to go on a very, very clean diet, usually low-dairy and tending towards, if not completely, vegan; lots and lots of vegetables. These tend to be people that make a lot of hormones. So, if there were a war and a famine, they might be the only people that would have kids, but in our affluent society where we can all eat as much as we want, people like me who make less hormones get the advantage. We can eat whatever and we’re not going to get endometriosis.

People who get endometriosis seem to be people who have gone through an extremely stressful period of their life or who have another immune disease such as celiac or an autoimmune condition. They often seem to go together. We know that if you have severe food intolerances, that tends to impair your immune system because it is busy dealing with this food that you don’t process very well. That might be what opens the door to endometriosis. Stress is also not great for your immune system. I’ve known people who had moderately bad cramps. Maybe they had that tendency to endometriosis. After they went through an extremely stressful year or two, they developed endometriosis so badly that they were looking at surgery. In the surgery, they go into you and try to find the bits and take them out, or, if you’re trying to get pregnant, they go in and scrape your uterus out, because the lining tends to accumulate and be inflamed. Many people who have endometriosis miscarry the first time they get pregnant, but after that they get pregnant very easily. So, some doctors had the brilliant idea, “Well, if we know you’re more likely to get pregnant after a miscarriage because the lining sheds so completely, then why don’t we just pretend you had a miscarriage – basically, scrape your uterus out – and then you try to get pregnant in the 6 months after we’ve done that.” It works a fair amount of the time. So, there are solutions, but the solution that will mean you don’t have to be in pain every month is to figure out what you need to do for your diet. My sister dealt with this a lot and she’s tried many different things and gotten pregnant without getting that scraping surgery, just through eating a really clean diet with lots of juicing vegetables.

Yes?


[00:25:14]

STUDENT: How common is that?


JEN: Oh, I don’t know; maybe it’s 5 percent. It’s not extremely common, but I definitely know several people with it. With polycystic ovary syndrome, it’s hard to get estimates because there are overweight people who don’t have any insulin problems, who have no trouble getting pregnant, and have regular cycles. Other people could be overweight enough for their frame. You can be “skinny fat” and still have that insulin resistance situation. I knew someone who, for the first 5 years of her marriage she didn’t get pregnant. She did not look overweight, but you couldn’t see her wrist bones. So, she’s a very small person; she was very fine-boned. She was talking to me about not being able to get pregnant. She had fairly regular cycles, but something was not quite right, and she had skin trouble. Once she got pregnant with her first kid, though, as in most cases, it wasn’t a problem after that. When you nurse a baby, it takes so much sugar out of your blood that, for people who have polycystic ovary syndrome, if they can just get pregnant the first time, they’re good after that. Getting pregnant the first time might mean eating a low-carb diet; there’s medications that help manage your blood sugar; just exercising a ton.

I know someone who has polycystic ovary syndrome who was never particularly overweight, but she had to work out really hard to not be overweight. Her skin didn’t look bad, but I found out that she had a very careful skin care regimen just to have normal skin. When you’re 25 or 30, hopefully you should not have to be that careful about your skin. I don’t use anything. I just wash my face with water, put some moisturizer on, and that’s the end of it. If you’re still using Proactiv when you’re 25 or 30, that might be a sign that your blood sugar is not quite right, because that tends to manifest in your skin. She also had the thinning hair on the top. Actually, it was her hairdresser who said, “You know, it’s pretty thin on the top here. That can often be associated with hormone problems. I think you should get that checked out.”

So, that finally got her going down that path. She’s used medication and gotten pregnant with that. She’s also had times where she wasn’t using any medication but she’s gotten pregnant during Lent and Advent because she cut back on some of her treats, and that was the deciding factor to cutting out the couple chocolate bars or the bowl of ice cream. It wasn’t like her diet was awful. She just cut out the little treats and that is what flipped the switch for her. It’s surprising sometimes; you can go for years and feel like this is a huge, insurmountable problem, and then one Lent you give up chocolate and you get pregnant.


AUDIENCE: [laughing]


JEN: I’ve seen this happen to people. [laughing] I’ve also known people that have very irregular cycles or who have very long cycles and have 5 or 6 kids. Then you meet people who seem to have regular cycles but aren’t getting pregnant. As you can imagine, it could be a question of timing. They might not be timing things right, because the sperm only lives so long and the egg only lives so long. It could be that a person isn’t ovulating every month if they have a 28-day cycle but they’re not getting pregnant. The other thing that can happen is you might have a 28-day cycle, but you actually ovulated on Day 20 or 21. So, if you were to ovulate here, the egg that’s supposed to pop out here actually pops out here, but your hormones then drop very fast. If the egg had been fertilized, there are not enough hormones to support a pregnancy.

I know people who had reliable cycles and when they got married, they’d been, like, “Oh, whatever. I don’t need to track it.” But then they couldn’t get pregnant or kept miscarrying and when they tracked their cycles they could see, “Oh, my luteal phase that’s supposed to be 12 to 14 days is only 9 days.” If your luteal phase is too short, you will miscarry. There’s just not enough hormones to keep you pregnant. So, those people tend to get progesterone supplements. Or, you can change your diet to help your body make more hormones. But that’s a really nice thing to know before you get married. If you’ve tracked your cycles and you can see, “Oh, yeah, every month it’s 28 days, but I’m ovulating on Day 20. I only have an 8-day luteal phase.” That is a nice thing to know before you try to get pregnant and then miscarry many times and have that unnecessary heartbreak. It’s a very, very easy fix.

Many doctors are familiar with charts like this now, but older doctors probably are not. You go to your doctor and bring in your chart or they’ll check your progesterone in your blood, and they’ll say, “Ah, you’re right. You don’t have enough.” If you are good at negotiating with your doctor, you can get your progesterone prescription in advance. Some people, if they’re trying to get pregnant, will time when they’re sleeping with their husband and then watch their temperature go up. Your temperature kind of goes like this: it’s steady the whole month, then after you ovulate it goes up. If you get pregnant, it goes up another step.

So, if you’re taking your temperature every morning, you can tell when you’re pregnant before you would be able to take a test. Some people who are trying to get pregnant time it; they look for that extra temperature bump. Then they know they got pregnant and they start taking progesterone before they even would’ve missed their period. That’s how they stay pregnant.


STUDENT: Whoah!


JEN: Yeah! Just giving you a sense of all the different options there are out there. You don’t have to just wait. I’ve known people that for whom waiting until they missed their period, on Day 28, was too late. “Well, now I’ll find out if I’m pregnant.” They would take a pregnancy test, go to the doctor, get the progesterone prescription, and then they’d miscarry two days later.


STUDENT: Geez!


JEN: They hadn’t gotten the progesterone in time. They had such a severe deficiency that they needed it before they would’ve even been able to take a test.


STUDENT: Is this shortened luteal phase the same thing you were talking about earlier when you were saying ovulation would get bumped back 5 days or so?


JEN: It’s possible. Sometimes ovulation gets bumped back and then your whole luteal phase will still be 14 days.

STUDENT: Oh, okay.


JEN: Then your whole cycle ends up longer. Overall, that’s overall a simpler problem because it means somewhere in here before you ovulated, you got too stressed out, busy, or forgot to eat or something similar. If your luteal phase is short, you’re probably very low on nutrients, particularly protein. I know a few people who have this problem. Some of them had low progesterone in their 20’s already. One had gone through an anorexic phase, which is not good for your hormones, because you lose too much body fat. It tires out your body. Another one of them was very, very cheap about what she would buy. I think she was just living on oatmeal and beans and rice for years, which is enough to sustain life, but not enough protein for optimal fertility for most people. Another exercised really, really hard and ate a low-fat diet when she was young. So, two of these women found that as they got older and more affluent, and as they ate more protein and fat, and they put on a little more body fat – because your fat actually makes hormones – that they didn’t need progesterone the same way. You would think that if your hormones weren’t great in your 20’s, it’s only going to be downhill from there, but these people actually found that their hormone systems worked better in their 30s since they had figured out more of what worked for them regarding nutrition.

But, again, the progesterone supplement is there. It’s a very safe supplement, and occasionally people who aren’t even trying to get pregnant will get it for a period of time because it just helps them feel better. If you had the short luteal phase, you might also have the problem of poor sleep quality, or anxiety. Progesterone is a very calming hormone. I wouldn’t say in your 20s to use progesterone all the time. People use it for a period of a few months. They use it just in this last week or two of their cycle once they’ve ovulated. Don’t use it before you’ve ovulated, because it interferes with ovulation, but if you’re fairly confident that you’ve ovulated, through looking at temperature and mucus signs, then you could use progesterone in this last phase just to feel calmer or sleep better. Women in menopause often use progesterone for that reason. If for some reason your hormones aren’t working very well when you’re young, it’s still a possibility.


[00:35:36]

STUDENT: I have a question.


JEN: Yes?


STUDENT: Do you have anything about Hashimoto’s thyroid disease?


JEN: Yeah, actually there’s a handout on that.


STUDENT: Real quick, what are the letters? Are those different types of hormones?


JEN: Yes. So, FSH is called follicle stimulating hormone, this is estrogen, and this is progesterone.


STUDENT: What’s LH? Sorry.


JEN: Oh, luteinizing hormone. This is the one that spikes the most when you’re about to ovulate. If you use an ovulation predictor kit, where you pee on these strips to figure out when you’re going to ovulate, the strips are detecting the LH. Basically, the line won’t show, then the line gets darker, and then – oh! – it’s very dark, and the day after that the line’s light again. It’s very clear, if you’re ovulating. People also usually figure out, “Oh, I’m not actually ovulating. Something’s inhibiting ovulation.” The funny thing is that only one or two eggs get released each month, but the egg selection process begins 6 months prior. There are eggs that are pre-selected and then primed, and then one egg – there’s like maybe 5 or 10 or 15 eggs that are ready to go that your body ripens – but one pops out and that becomes The Egg. So, there’s one that would be ahead of the game, but the pre-ripening process actually happens quite a few months before. That’s why it can take several months of better nutrition to actually improve your fertility, because the process actually begins earlier on.


STUDENT: You mentioned vitamin K earlier. What is that in?


JEN: Cheeses and green leafy vegetables, mostly. If you’re eating a really good variety, you’re going to get vitamin K. It would usually be in a good multivitamin as well.

Hashimoto’s, or low thyroid, is an autoimmune disease where your body attacks your thyroid. We don’t totally know why, but we can definitely draw a strong connection with Hashimoto’s and prolonged stress. If it’s autoimmune, it means your body is attacking itself, which means something has gone haywire; your body is not supposed to do that. Sometimes, if you can get your body to settle down, it will stop hurting itself like that. You could also have a low thyroid without having Hashimoto’s. Hashimoto’s is a pretty common cause of a low thyroid, but it’s not the only case. You could have a low thyroid without your body attacking itself. Your thyroid’s simply low.

There are a lot of dietary things you can do for Hashimoto’s. The most important thing is just to notice when it’s happening because you can slowly start to feel worse and worse and not realize why. I had a friend that this happened to. She’d already had a few kids, but Hashimoto’s runs in her family and she just started to feel like crap. She was dragging herself through the day, felt weird, had palpitations and – ugh!– just gross. It took her a while to figure out that’s what it was. She’s treated it with diet on and off. I don’t she’s ever going on medication. She was first diagnosed about 5 years ago, and she’s found that it comes and goes for reasons she can’t explain. It does make her cycles unreliable. She still has 7 kids [chuckles] in spite of this, so it’s not a deal-breaker in terms of fertility. It does make it a little harder to chart and avoid having kids, but since her fertility was unreliable they just decided to not worry about it.

If you have low thyroid, there’s a whole list of symptoms. We don’t know why women are so much more prone to thyroid problems than men, but about 90% of people diagnosed with thyroid problems are women. It’s just something we’re more prone to. Men are more prone to heart disease and some other things when they’re young.

[00:40:23]

STUDENT: What exactly is a thyroid?


JEN: Oh, yes. So the thyroid is a little gland around your neck.

STUDENT: Okay.

JEN: It is a big part of what regulates your metabolism.

STUDENT: Ok.

JEN: Of course, it’s not the master of your metabolism. It’s getting signals from your brain and different organs in other parts of your body. One thing we know that will cause low thyroid in women is if you eat a low-carb diet for a longer period of time than you need. If you’re not solving a problem like polycystic ovary syndrome and you think, “I’m going to eat a low-carb diet so I can be 16% body fat because I’m a model,” over time your body’s like, “Whoo! There’s not much carbs in this environment.” There’s clearly an energy shortage because eating a mix of foods tells your body, “There’s all sorts of foods out here in my environment. You can keep my metabolism up at the regular rate and it’ll be fine.” But if you’re never eating carbs and you’re exercising a ton and you’re very lean, that tells your body, “Whew! Normally, people who are exercising want to eat carbs. If she’s not eating carbs, they must just not be there. Clearly there’s an energy availability issue in this environment and I’m going to slow down her metabolism because she’s not getting enough.”

So, if you don’t have a particular metabolic problem that you’re trying to solve and you’re eating low-carb just for weight loss, a really common way that women make sure their thyroid doesn’t get the wrong message is to have carb reefed days, 1 or 2 days a week where you eat more carbs. It doesn’t have to be junk food. You could eat a ton of sweet potatoes, mango sorbet, or a pile of strawberries, but you don’t watch your strawberries. You eat your potatoes. You just eat a lot of healthy carbs, and of course some bread and whatever else you want to have. If you’re eating low-carb for months to years, that in itself can cause a low thyroid, even if it was a great idea at first.


STUDENT: So, like, for a time that’s okay, but do vegetables count as carbs?

JEN: A lot of vegetables don’t really count. If you’re an epileptic who has to stay in ketosis and only be burning fat, maybe you want to track your potatoes. I don’t think anyone in America has gotten fat from eating potatoes. Potatoes by themselves are not that exciting. Even though potatoes have carbs and sweet potatoes have carbs and oranges have carbs, how many oranges can you really eat?


AUDIENCE: [laughs]


JEN: Orange juice you can eat too much of, and potato chips you can eat too much, because the fiber is gone and it’s easier to just keep going. Most foods with the fibers included are just not worth agonizing about how many carbs they have, especially if you’re going to eat that potato with some protein and salad. For most people, if you have anything like a normal metabolism, it’s not an issue to have your potato with your salad and your meat. You’re probably not going to eat 5 potatoes at one sitting. I can sit there and eat 8 oranges. When I’ve tried eating paleo, I’ll be like, “Oh my gosh, I need paleo carbs,” and then I sit there and eat 8 oranges as my carb refeed.


STUDENT: Does that count? That’s so funny.


JEN: It would count. You’re getting about 150 grams of sugar from your oranges if you eat a ton of them. I mean, that’s a healthy way to binge on carbs if you want to, because it comes with all these vitamins and fiber. But, my point is that’s not really how most people do it. My husband laughs at my bowlful of oranges for my treat. He’s like, “Oh, you and your treats!”


AUDIENCE: [chuckles]


[00:44:19]

JEN: So, when I was in college I tried something called the Zone Diet, which they actually have a book on the shelf over here. That’s a moderate-carb diet where you have about a one-to-one ratio of carbs and protein. That would mean you would balance out an orange with two eggs; so it’s pretty low-carb. After I lost the initial 10 or 15 pounds that I needed to lose from my “Freshman 15”, I needed to add back in more carbs and fat. I couldn’t eat endless amounts of protein because I wasn’t bodybuilding. I wasn’t that hungry for huge amounts of protein every day. Once I had lost the extra weight and my insulin and blood sugar had normalized, then I started putting olive oil in my eggs and eating 2 pi