Naturopathic Topics in Women's Health

Supplements to take while breastfeeding

Lactating mothers require a higher intake of calories and fluids. The milk secreted in four months represents about the same amount of energy used by your body to maintain the pregnancy during the nine months. Nutritional deficiencies are found in breast fed infants. You might find that a fruit smoothie with protein powder convenient and helpful. It is important for the mother to eat a nutrient dense diet (no empty calories) diet. Women need approximately 500 extra calories throughout lactation. As far as supplementation goes some of the more important nutrients include:

• Vitamin K - Babies are born with bacteria free bowels. These normal flora produce most of the vitamin K in humans, breast milk is also low in this vitamin. Most infants are given vitamin K injections at the hospital to protects them against vitamin K dependent hemorrhage disease of the newborn. If your baby was not given the injection oral vitamin K can be given to the infant for months one, two and three or mom can take the vitamin K. In addition to help blood form clots vitamin K a necessary for normal bone development.
• Essential fatty acids (EFAs)/ DHA - Infants need these fats for nervous system development. Approximately 25% of the brain is composed of DHA. The proportion of fatty acids in breast milk reflects dietary intake. Although the World Health Organization recommends up to .5% supplementation of infant formula by weight the FDA bans its use in US formulas. We recommend that lactating moms supplement with a high quality Cod Liver oil providing at least 200 mg/ day of DHA. This will also supply vitamin A and D.
• Vitamin D - Levels in human milk are low and each year children with rickets are seen in US hospitals. Sunlight can help your baby create vitamin D and only need 30 min per week if in diaper only or 2-hours/ week if clothed with no hat. Maternal exposure to sunlight does not affect vitamin D levels in breast milk.
• Continue to take your prenatal multivitamin - We recommend that mom stays on the prenatal multivitamin throughout lactation. Increasing the mother's intake of nutrients to levels above the RDA ordinarily does not result in unusually high levels of the nutrient in her milk.

Infertility seems to be a growing problem despite the worldwide population explosion. 
Only one in five couples trying to conceive will be successful in a given month and ~20% of couples have difficulty conceiving or maintaining a pregnancy. The other 80% can be reassured by the fact that more than 85% will become pregnant within the first year. 

Male related factors are to blame up to 40% of the time! Among women, pelvic conditions account for 30% to 40% of cases, while problems with ovulation and the cervix each contribute another 10% to 15%. Approximately 5% are due to other causes. Roughly 10% remain unexplained even after thorough investigation.

Infertility has a number of causes many of which are not treated by herbs or nutrition. Naturopathic doctors focus on treating the cause of the problem not just the symptoms. However, if your physician has done a complete work up and no abnormalities were found the below recommendations could be implemented and /or discussed with your physician while you try to conceive.

Recommendations

1. Take a high quality prenatal multivitamin. Taking a multivitamin/mineral supplement has been shown to increase female fertility. Also, see your doctor to check for iron deficiency. Even subtle deficiency of iron has been tentatively linked to infertility.19
   
2. Decrease stress: Stress may lead to infertility, and treatments for reducing stress might help increase fertility. ,
   
3. Diet: Eat a balanced, unprocessed, whole foods diet with emphasis on organically grown foods. This makes good sense as a general health measure. There is also some evidence that certain agricultural pesticides and plastics used in packaging can act as "xenobiotics", either increasing or decreasing normal sex hormone levels in the body. We recommend that women trying to get pregnant avoid caffeine. Studies have shown that alcohol consumption can negatively affect the chance of conceiving and caffeine may actually enhance alcohol's negative effect. Consumption of one to four cups of coffee per day in some studies has been associated with delayed conception in women trying to get pregnant. , , Caffeine consumption at more than two cups of coffee per day has been associated with an increased incidence of infertility due to tubal disease or endometriosis and a 50% reduction in fertility.
   
4. Avoid cigarette smoke: Smoking has been linked to reduced fertility and increased risk of miscarriage. , Because of this possible danger; you should avoid second-hand smoke as well.

Herbs and Eastern medicine?

Vitex (Vitex agnus-castus) Vitex is useful as an herbal treatment for infertility in cases where the second half of the menstrual cycle (Luteal Phase) is abnormally short and flow is irregular or absent. High levels of the hormone, prolactin can also be found. Elevated prolactin levels can also cause a woman's period to become irregular and even stop. Vitex works by suppressing the release of prolactin from the pituitary gland. In one study, 48 women diagnosed with infertility (ages 23 to 39) took vitex once daily for three months.21 Seven women became pregnant during the study, while in 25 of the women, progesterone levels normalized, which may increase the chances for pregnancy.

Acupuncture: Problems with ovary function can lead to infertility. Acupuncture may be helpful. In one study, women who did not ovulate were treated with acupuncture 30 times over three months. Acupuncture lead to marked improvement in ovulation in the majority of these women. . Ear acupuncture was compared to standard hormone therapy for treatment of infertility. In both the acupuncture and hormone therapy groups, 15 out of 45 patients became pregnant. Although the pregnancy rates were similar with either treatment, acupuncture has no negative side effects.

Progesterone: Often we test for hormone status using salivary tests. These tests give us a ratio of progesterone to estrogen, as well as the absolute amount of free, circulating hormone. From clinical experience, we have found that a low progesterone to estrogen ratio is common among women who suffer from infertility, although their absolute progesterone levels may be 'normal'. By supplementing with a low dose progesterone, we often find that women have an extended luteal phase as well as lower rates of miscarriage.

There are other naturopathic botanical preparations that we may use to tonify the uterus and normalize menses when these are some of the causes of infertility. We are always seeking to balance the disharmony which may be contributing to the infertility.

As a new mother, athlete, and a professional, you wake up Monday morning tired and in need of that high-octane cup coffee to get you going. With breakfast to go, you get the baby ready for daycare and run out the door to work. You work until lunch and have a Zone bar for quick energy as you suit up and head out for a run or a ride. You get back to the office and quickly inhale a small sandwich or soup as you get back into work. You begin to get tired around 2pm and nibble on a piece of chocolate or a small cup of black coffee to give you the lift you need to make it through the day. After work, you rush to pick up the baby from daycare before they close and then rush home to make dinner for your family. After dinner you put the baby to bed and then catch up on work in your office or connect with your partner until it is time for bed. You crash at 9pm thinking, ‘I’ve got to get to bed because the baby will wake me at 6am’. You wake up at 1am or 3am and cannot sleep. You are wide-awake, and lay wondering if you will be able to sleep. Finally, you fall back to sleep and then wake at 6:30am, TIRED and ready for that cup of high-octane coffee to start the day.

Fatigue is a symptom of dis-ease. It is a signal that tells us that we are pushing ourselves too much or that the body system is out of balance. In Steadman’s medical dictionary fatigue comes after ‘fatal’ and before ‘fat-pad’. Steadman’s goes on to define fatigue as: ‘that state, following a period of mental or bodily activity, characterized by a lessened capacity for work and reduced efficiency of accomplishment, usually accompanied by a feeling of weariness, sleepiness or irritability’. 

 Fatigue can be caused by emotional, mental or physical stress and strain (or a combination of all three). Fatigue can be a natural, short-term signal that we are behind on sleep, trained hard, or have done too much without enough recovery time. Fatigue can also be caused by underlying physical conditions such as anemia, thyroid dysfunction, poor glucose regulation, heavy metal toxicity, or digestive problems to name a few. When fatigue goes on too long, adrenal hypo function can begin to set in.  When this occurs, the attempts one makes to find energy may be ineffective in quickly alleviating the fatigue. Adrenal hypo function is a theory outlined by Hans Seyle, which describes stages of adrenal fatigue. This is not widely accepted among mainstream medical professionals, but I have found it to be clinically relevant when helping patients with fatigue in my practice.

As I said earlier, fatigue may be caused by emotional, mental and/or physical stress. A good doctor will listen to your lifestyle and run some tests to determine what is causing the fatigue. Blood tests to check for anemia, cholesterol, glucose and thyroid function are common. Often I include a salivary cortisol test to check the daily rhythm of the adrenal glands. Further testing can be done if your personal story may suggest toxic exposure to heavy metals or environmental toxins. There are a number of tests, which can determine what your toxic load may be. I feel this is an important aspect of an athlete’s health because we accumulate toxins at a greater rate when we are exercising outdoors. Just as there are many causes of fatigue, there as just as many tests. A health care professional can help you determine the best ways to find the underlying cause of your fatigue.

6 Ways to begin alleviating fatigue:

• Rest! Take a day to yourself without work, baby or exercise.
• Rejuvenating Exercise. If you have to exercise for sanity or competition, make it easy and rejuvenating such as an easy hike with a friend, yoga or stretching. Don’t push yourself!
• Make quality food choices. Eat whole foods with lots of fresh fruits and vegetables for the nutrient rich quality they provide.
• Avoiding sugar, caffeine and alcohol will do wonders for a tired body. These 3 substances are an added stress to our bodies.
• Green tea as an antioxidant and energy boost. This plant has been shown to help the body recover from extreme stress as well as many other health benefits.
• Adrenal support nutrients such as:
  • Vitamin C (did you know that the adrenal glands concentrate the most vitamin C in the entire body!)
  • B5 or Pantithenic acid
  • Licorice Root (only if you do NOT have high blood pressure)
  • Schizandra, Siberian Ginseng and Ashwaganda