Dr. Mark Hyman (0:00)

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

Kelly (0:02)

But if you have omega 3s at adequate levels, it lowers inflammation, it lowers reproductive system inflammation and supports hormone function. Now, if you if you're a guy and you have omega 3s in your diet or from supplements, it affects sperm quality, sperm count, sperm motility, the amount of semen you make, your testosterone levels, and even the rates of in vitro fertilization. So just taking fish oil or eating a lot of sardines can have all these benefits.

Dr. Mark Hyman (0:28)

Are you feeling stressed, sluggish or struggling with sleep? You might be low in magnesium and trust me, it's a bigger deal than you think. Most magnesium supplements miss the mark. But magnesium breakthrough by Bioptimizers gives you all seven essential forms in one capsule. So your body gets the full benefits. Better energy, stress relief and deep restorative sleep. I take it every night and it's a total game changer.

Kelly (0:49)

Try it now with an exclusive discount.

Dr. Mark Hyman (0:51)

Go to bioptimizers.com hyman and use code HYMAN10. Your body will thank you.

Kelly (0:56)

Before we jump into today's episode, I'd.

Dr. Mark Hyman (0:57)

Like to note that while I wish I could help everyone via my personal practice, there is simply not enough time.

Kelly (1:02)

For me to do this at scale.

Dr. Mark Hyman (1:03)

That's why I've been busy building several passion projects to help you.

Kelly (1:07)

If you're looking for data about your.

Dr. Mark Hyman (1:08)

Biology, check out Function Health for real time lab insights.

Kelly (1:11)

And if you are in need of.

Dr. Mark Hyman (1:12)

Deepening your knowledge around your health journey, check out my membership community the Hymenhive. And if you're looking for curated and trusted supplements and health products for your health journey, visit my website@drhyman.com for a summary of my favorite and and thoroughly tested products.

Kelly (1:27)

93.2% of Americans have some level of metabolic dysfunction, meaning they were on somewhere in the spectrum from insulin resistance to pre diabetes to type 2 diabetes. And this is the thing that screws up both men and women's fertility. Now sex hormones are regulated by our diet. You may not have known that, but sex hormones are directly regulated by what you eat. Pretty much everything is regulated by what you eat. If you don't know by now, listening to me, ultra processed foods and sugar and starch are causing massive shifts in our sex hormones and that's driving having the infertility crisis. Our SAD diet or standard American diet is 60% or more from ultra processed foods the average American consumes anywhere you look at it. From 113 to 150 pounds of sugar and about the same amount of Flour every year per person. That's almost a pound a day of sugar and flour per person. And that is not something we're used to eating. That's a pharmacologic dose of sugar that's causing dramatic hormonal shifts in our biology. The spiking sugar leads to high insulin levels, that leads to insulin resistance. And then we get blood sugar and hormone imbalances as results. So what happens? What is the, what is the biology here for women? Let's talk about it. It's a little bit different for men and women. When women have high sugar and starch, it drives the insulin that leads to increased androgen production. Androgens are testosterone. That leads to free testosterone being increased. And that will lead to all sorts of problems, like pcos, for example, which causes irregular, painful, heavy periods or clotting, heavy bleeding, a weight gain, hair loss on your head, hair growth on your face, acne, lack of ovulation, as we mentioned. And so this is really not a fun problem to have for women, but it's often solvable by addressing the root causes of diet and lifestyle. Endometriosis is another factor we talked about that can be driven, but not necessarily by the high sugar diet, although there's some evidence that this is an autoimmune disease, which can be caused by leaky gut and other drivers of inflammation caused by our diet. Now, what happens with men when they have too much starch and sugar? Well, they get insulin resistance. And that leads to the opposite, leads to low testosterone levels in men. That leads to damage to their blood vessels because of the insulin resistance that causes inflammation. And blood vessels are needed to have good erection. So they, they get erectile dysfunction. And it also, because of low testosterone, affects sperm quality. And what's even worse, when they gain body fat as a result of insulin resistance, they make more estrogen because there's an enzyme in your fat tissue called aromatase that converts testosterone to estrogen. So that's really bad. They get higher body fat, they lose the hair in their bodies, and they have low sex drive, low sex function, low fertility, low sperm count, and the list goes on. So when you have this higher body fat, you get all these problems, and that leads to more inflammation. And then more inflammation for men and women leads to more infertility, more endometriosis, more pcos, worse pregnancy outcomes. Even if you're using IVF or advanced fertility treatments, ovulation problems, as I mentioned, you get poor quality of eggs and sperm. So the very seed of a new life is being damaged by your Diet, and we're going to talk about that. This can also lead to miscarriages, Inflammation can lead to that, and also birth defects. So all around our toxic diet, lifestyle, environmental toxins are driving so much of these problems. As I mentioned, inflammation is a big driver in fertility. So what's causing inflammation? Of course, inflammation. As you know, listening to me forever. Dr. Almost every known chronic disease, heart disease, diabetes, cancer, dementia, autoimmune diseases, the list goes on depression. And it's not just driving those things, it's driving fertility issues. Right? So it's our processed SAD diet. It's excess sugar, it's the insulin resistance that results the blood sugar imbalances, the chronic diseases that result, type 2 diabetes, obesity, and damage to our gut microbiome. We're going to talk about how the gut microbiome plays a big role in hormones and fertility that leads to leaky gut. Also, our sea of environmental toxins is not good for our hormones. The sea of industrial chemicals and pollutants, sometimes latent infections can cause inflammation, but those are the main causes. And then we also see damage to our mitochondria because anything that causes inflammation will affect our energy production. And energy production is essential for every factor of life, including healthy sperm and eggs. So we need healthy mitochondria to have healthy sperm and eggs. It's our energy factories. It's involved in ATP production. And ATP is the energy, it's the gas. So sperm have to swim, right? Eggs have to grow, mature. That takes energy and we lose energy, and that leads to more fertility issues. After fertilization, if you're lucky enough to have a fer embryo, then the embryo has mitochondria from the mother. And that's good. If you don't have healthy mitochondria from our diet and from toxins and so forth, we can't have proper embryonic development. We can't have proper cell division and differentiation, which is necessary for the developing fetus to grow into a healthy baby. Also, sex hormone synthesis takes place in the mitochondria. So poor mitochondrial function is connected to hormone balance. The estrogen progesterone are produced in special cells inside the ovaries, and these cells require mitochondria functioning at a good level to do this. Testosterone is also produced in cells called the Leydig cells, which contain mitochondrial mitochondria. Those are your testicles, and that is necessary for producing testosterone. So you can see the whole hormone production cycle requires energy. And we do a lot of things that cause mitochondrial dysfunction. Again, our poor diet, it's all the same stuff, right? It's not like different things causing different problems. It's all the same stuff. It's our diet, nutrition, lack of exercise, insulin resistance, inflammation from all the causes, oxid, chronic diseases, environmental toxins, all these things. Aging will affect the quality of sperm and egg microbiome, another big factor in causing infertility. Again, these things are not addressed. Think about it. Who's addressing mitochondria, who's addressing inflammation? Who's addressing the issues around microbiome when it comes to fertility? These are not things you're going to hear about when you go to your fertility specialist, but they're critically important in providing the right environment for having a healthy baby. So what is problems in your microbiome cause dysbiosis. That's imbalances in the floor. That's bad bugs. Symbiosis is good, good balance, right? Dysbiosis is bad. Bad influences and this influences inflammation and causes inflammation throughout the body, including reproductive organs. It can cause even other things like obesity. Even having bad bugs in your gut can make you gain weight. And this negatively impacts the microbiome. It causes ovarian inflammation, it affects the gene expression in your eggs, it causes poor egg quality. The dysbiosis also affects estrogen levels. One of see, and this is really important is that your gut microbiome plays a role in regulating estrogen levels. And, and often when you have high estrogen levels, it causes something called estrogen imbalance or estrogen dominance where you have too much estrogen, not enough progesterone. And that is often found in pcos. And when you have certain bad bugs in your gut that produce an enzyme called beta glucuronidase. A little technical here, but I explain it. What happens is that enzyme takes the estrogen that you excrete from your liver that's already packaged and ready to be pooped out and unpacks it. That enzyme cleaves the estrogen from its basically carrier molecule. Then estrogen becomes free in your gut and you reabsorb it into the body, into the intestinal circulation and then it goes in to your body, creating higher levels of estrogen, leading to more estrogen dominance and hormone imbalances and then other problems like estrogen related cancers, breast cancer, ovarian cancer, uterine cancer, endometriosis worsens pms, worsens pregnancy complications. When you look at the data, actually probiotics can be very helpful in improving pregnancy outcomes and, and even IVF outcomes. So giving probiotics when you're Getting your fertility treatments can be a good thing. It also affects not only women, but men too. So having bad bugs in your gut affects your testosterone levels. Antibiotics and hormonal contraceptions will affect the gut microbiome. So a lot of things will mess up your gut microbiome. Taking the pill, antibiotics, stress, certain acid blocking drugs, which you take all the time. Obviously alcohol and other things are not good for fertility too. Obviously you should probably not smoke, you shouldn't have too much pot. All those things are bad for you. Certain medications can, can be problematic. Obviously birth control pills, antidepressants, antipsychotics, obviously anabolic steroids. If you're taking testosterone as a guy, it's going to decrease your sperm production. Calcium channel blockers, because, you know, we need various pathways in our biochemistry to make things work. So these are blood pressure pills, but they can affect sperm motility. Antibiotics can interfere with menstrual cycles. All this stuff is just to say that there's a lot of factors that we have control over that affect our fertility that are not being addressed, from inflammat to metabolic health, to mitochondrial function to dysbiosis to the medications we're taking. And all those things can be addressed. So let's talk a little bit more about where conventional medicine just misses the mark, no pun intended. Why does it miss the mark? Well, it doesn't get to the root causes of the hormone imbalances and other factors that cause this decline in fertility. It doesn't address diet, inflammation, mitochondrial health, dysbiosis, environmental toxins, stress, autoimmunity, you know, and they give you like, you know, general advice, okay, lose weight, eat more veggies. I'm not quite personalized. It doesn't really measure what needs to be measured to understand what's going on in your biology. You look at farmers, they're testing the soil, they want to know what nutrients are in there, what the levels of nitrogen, potassium, phosphorus. They're so deep into understanding soil health as a way to predict what's going to happen to the plants that they're growing in there. How do we not test for what's going on in a woman or man to find out whether or not the sperm and egg are going to be healthy or whether the baby's going to be healthy. They don't check inflammation levels, they don't check nutrient levels, they don't check toxin levels. So we really need to do proper testing for fertility, looking at all sorts of things from metabolic health to hormonal health to nutrient status to toxin Levels looking at something called amh, which we'll talk about for women, which measures the quality of their, their eggs. So we kind of have to look for what's really going on and not just ignore the symptoms. Right. We need to look at how is a woman doing? Does she have hormonal imbalance clues, right? Does she have painful periods? Does she have pms, does she have weight gain, acne, Is she on the pill? You know, what's going, that we need to address that can help to regulate hormones better. So, you know, when women have hormonal issues, they don't really address in conventional medicine, the root causes, they just kind of treat you with hormones, right? They give you the birth control pill. So the first sign of hormonal balance is there's painful periods, pms, heavy bleeding, clotting, acne, pcos. Boom, you get the pill. That does not get to the root cause. It doesn't address how we regulate our hormones. It doesn't actually help us support our natural cycle. There's a lot of side effects with these digestive issues. It causes yeast overgrowth in the gut and balances the microbiome. It depletes nutrient levels that you need for pregnancy like folate, B12, B6 and vitamin B2, as well as vitamin C and E and magnesium, selenium and zinc. All these are necessary for fertility. Traditional approaches kind of fail in my view and I've worked with so many women and so many couples and help them have healthy babies simply by addressing these, these phenomena. What is the functional medicine approach then? What do I do? What is the functional medicine approach? It's, it's really important to best overall health, right? Not just looking at hormones. You need a deep dive on your biomarkers. And this is really what we do at Function Health. This is why I co founded the company Function Health, which is a way for you to get access to all this data about yourself, to get over 110 biomarkers, including all the things we're talking about today for less than 500 bucks. It's a membership model. We have a big waiting list. But you can jump the line if you go to functionhealth.com/forward/mark and you can sign up and get, get a lot of these diagnostic tests. And most of these things are not going to be tested by your doctor when you go in for your fertility checkup or your pregnancy pre pregnancy exam or they're not going to look at the man. And it's really important to do a deep dive and correct these things and this is what I do all day long in my practice and it's why I see such good results. So first you need to test for nutrient deficiencies. The most important is folate. It's critical for egg quality, for implantation of the egg in the womb. Deficiencies can lead to increased levels of something called homocysteine, which is a marker of folate insufficiency as well as B. Again, something not tested typically. I'm just going to share a quick story with you about a woman who I was working on a film with. She was the director of this film called Fed Up. It was, I think came out in 2014, it's still on Netflix about childhood obesity. She told me the story where she had had miscarriage after miscarriage after miscarriage and even had babies that were born with anencephaly, which means no brain, terrible condition. And she told me the story that she read this article I wrote about methylation and about the importance of checking homocysteine and B vitamins and the genes that regulate this on called mthfr. And so she went to her doctor and she made him test for this. And he she found very high levels of homocysteine. She made him test the gene called MTHFR, which we know affects about 35% of people that have this variation in this gene that can cause this problem. And we know that, that these problems of deficiency and folate lead to all sorts of bad pregnancy outcomes, including infertility and miscarriages. So she said to the doctor, well, this is what I want. And she got the test and sure enough, she was positive. And he said, okay, just take, you know, prenatal vitamin folate. Dr. Hyman says I need to take methylfol because I read in this article and I want to take the right kind. So she took the right kind. And when I saw her during the publicity tour for the movie, she had this beautiful 10 month old baby and we're hanging out before going on TV and stuff. And I was like, wow, this isn't a miracle story, but it's not a miracle, it's just using good science. Men also need to worry about folate because folate's important for sperm DNA and integrity. So low levels can also lead to decreased sperm counts and motility issues. So sperm aren't great swimmers. Vitamin D also important, it influences it's a production of estrogen and progesterone in women and also sperm quality and testosterone in men. And deficiencies in vitamin D have also been associated with pcos and get this guy's erectile dysfunction. Now, low levels, less than 40, I would say. You know, the lab says less than 30, but less than 40 is really probably what's considered low, maybe even 45. But low levels of less than 40 in published data show there was an increased risk of infertility if your level was under 40. And this is probably accounting for 80% of the population who are not taking vitamin D supplements. Supplements. And we test this as part of your Function Health Panel. Super important vitamin D supplementation in infertile women in another study significantly increased clinical pregnancy rate outcomes and pregnancy outcomes. So just taking a simple vitamin D makes a huge difference. What about B12? B12 is another important one. It's required for the development of your nervous system, for DNA synthesis, for cell division, cell tissue formation of red blood cells. And if you don't have adequate levels of B12, it can affect ovulation. It can cause trouble with implantation of the embryo. And you can check your homocysteine levels, also called methymalonic acid. What we check with with Function Health Panel. And if you had high levels of homocysteine, it has high rates of miscarriage. As I mentioned in this recent story, I told you at increased risk of birth defects we call neural tube defects like spina bifida and the baby. And also affects sperm motility and concentration and prevents DNA damage. And, and B12 also has amazing benefits. It increases sperm motility, it increases the concentration of sperm so you got more sperm. And it prevents DNA damage in the sperm so you have healthier sperm. Homocysteine, an important thing to ch your blood. Really important. As I mentioned, it can increase the risk of preeclampsia by threefold. This is a high blood pressure condition in pregnancy. It's very dangerous. And the best way to test for B6, B12 and folate is to measure your homocysteine level. What about iron? Iron, another important nutrient, really important because you get a lot of blood loss during menstrual cycles. And the deficiencies of iron are so common. It affects so many women. We saw so many people in our Function Health cohort that are iron deficient. This leads to problems with ovulation and ovulatory cycles where you don't ovulate. You can get anemia. You can have trouble with fetal development and making red blood cells. And get this, 35% of women less than 50 are iron deficient. Over a third of women trying to get pregnant are iron deficient. And listen to all the bad things. It does the next thing that's important to test and measure, and it's important to understand is omega 3 fatty acids. Now, there's a lot of reasons for that, but if you have omega 3s at adequate levels, it lowers inflammation, it lowers reproductive system inflammation, and it supports hormone function. Now, if you, if you're a guy and you have omega 3s in your diet or from supplements, it affects sperm quality, sperm count, sperm motility, the amount of seme you make, your testosterone levels, and even the rates of in vitro fertilization. So just taking fish oil or eating a lot of sardines can have all these benefits for women. Also important, it helps egg quality, endometrial health, which is the lining of your uterus, critical for implantation and maintaining an early pregnancy so you don't have a miscarriage. It helps uterine blood flow, helps the embryo implant, helps pregnancy rates. Again, just from eating sardines or taking omega 3s. And 2/3 of adults are not meeting the dietary guideline requirements of two servings of fatty fish or a week or 250 milligra of EPA and DHA per day. This is from British Medical Journal Open. That's two thirds who are not meeting the Dietary guidelines. But the dietary guidelines are the minimum amount of something you need to not get a deficiency disease. So 90% plus, I'm sure, are low in this, and we know this from other data. Another important nutrient, magnesium. Again, all these things we test for, and your typical prenatal visit or your fertility visit will not be checking these things. Magnesium is critical because it balances estrogen and progesterone, it helps a lot with menstrual cycles and cramps, helps helps a healthy uterine lining, it helps with DNA synthesis and repair, helps with healthy egg production. And of course, it's the relaxation mineral because it makes everything in your body relax. So I call it the stress reduction mineral. And of course, stress adversely affects fertility. Magnesium helps with blood sugar control and insulin sensitivity. PCOS really important. It's also essential for sperm production, development of healthy sperm. And magnesium is really important because it's linked to sperm motility and qualities. All these nutrients play a role in reproductive health. What about zinc? Zinc is really important for ovulation, women and menstru cycle. And if you don't have enough zinc, it can affect all these processes affecting fertility. For men, it's even more important. It's important for sperm quality. And sperm deficiency can lead to low sperm count and low testosterone levels. So that's not good. Selenium Another important mineral, again, something we test for and function, health. We can look at all these things, we can see what's going on. And selenium is important for thyroid function, which it regulates hormones necessary for fertility and man. It's important for sperm motility and sperm health. And if you don't have enough selenium, it can impair these functions. And many soils are depleted in selenium. If we're not taking a multivitamin selenium, we're often low. And again, it's something we can test for. So it's so important not just to check for nutrient levels, but also your hormone levels. So women, obviously you want to check. Estradiol, which is the main female hormone, regulates the menstrual cycle. It prepares uterine lining for pregnancy. And if you're having abnormal levels, it can kind of give you a clue that there's problems with the ovaries, with your menstrual cycle. Fertility, often infertility can be explained by what we call estrogen dominance. Estrogen dominance means you have too much estrogen, either relative or absolute, in relation to progesterone. And you get a lot of symptoms from that. Heavy bleeding, breast tenderness, fluid retention, premenstrual migraines, pms, blood clotting, fibroids. I mean, it's kind of a mess and it's not normal. And there's a lot of causes for it. Our high sugar, starch diet, alcohol, environmental toxins, change in our microbiome, all things that we can treat for men who are actually having high estrogen levels, which they can because they're eating a lot of sugar, starch and alcohol, all that will increase men's estrogen levels, that will affect their fertility. So if you have high levels, it can disrupt the balance of testosterone, it affects sperm production, it makes you have low sex drive and erectile dysfunction and infertility and weight, weight gain. So it's just bad news. As I mentioned, the fat tissue is a site that has this enzyme called aromatase, and it converts testosterone to estrogen. And that can lead to all sorts of problems with men, like I mentioned, like loss of body hair, libido, all the things we talked about. And it's really driven by high sugar, high star starch, ultra processed food diet. Another important hormone to check is progesterone, really important for women. This is called progesterone for a reason. It's the pro gestational hormone and it prepares a uterine lining for an egg and it supports early pregnancy. So you need adequate progesterone and often women don't have this, particularly in their later reproductive years. And if you have low levels after ovulation, it can affect your ability to maintain a pregnancy or to conceive. So it's really important. And you want to look at the estrogen progesterone ratio. You want to test it at the right time of the cycle, usually about 18 to 23 days of your cycle. And that' give you a sense of where you're at. Did you know that over 75% of.