EP 303 The Impact of Stress and Gut Health on Fertility | Dr. Melissa Levy

I am thrilled to have one of my practitioner certification graduates and fellow acupuncturist, Dr. Melissa Levy. Dr. Levy is a practitioner with a passion for health, wellness, and fertility. Originally from the Philadelphia area, she ventured to Florida to pursue her education at the University of Tampa.

A personal health journey changed the course of Dr. Levy's life. Facing health issues that Western medicine couldn't address, she discovered holistic practitioners who listened and considered the full body as a unit. This holistic perspective helped her understand her body better and manage her hormonal imbalances through acupuncture. This transformative experience inspired her to become a Doctor of Acupuncture and Functional Medicine Practitioner.

Dr. Levy holds numerous certifications, including Certified Functional Medicine Practitioner, Certified Health Coach, and Certified Fertility Coach. As a board-certified diplomate of Oriental Medicine by NCCAOM and a licensed Acupuncture Physician in Florida, she founded the Integrative Wellness Center (IWC) in 2019. Her vision was to create a healing sanctuary for individuals, especially those who have lost hope. Her evidence-based practice model combines patient values, the best research evidence, and her clinical expertise to offer exceptional care.

Initially, her onsite clinic in Jacksonville allowed her to help only local patients. Realizing the need to reach more people, she created online programs and coaching services to share her knowledge with individuals in different locations.

Dr. Levy's goal is to provide the best comprehensive care to those who need it and are willing to make changes to better their health and lives. She aims to change how healthcare is delivered by providing exceptional, holistic care.

Her mission extends beyond treatment; she strives to educate all her patients about the advantages of living a holistic life. Each encounter is an opportunity for her to positively impact her patients' lives, and she approaches this with unwavering dedication and care.

Dr. Levy offers in-person appointments at her clinic in Jacksonville and provides virtual functional medicine consultations for Florida residents and functional health coaching for individuals everywhere. 

Websites:

https://www.healthbymelissa.com

https://www.iwcjacksonville.com

Instagram: @dr.melissa_levy

For more information about Michelle, visit: www.michelleoravitz.com

The Wholesome FertilityFacebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/

Instagram: @thewholesomelotusfertility

Facebook: https://www.facebook.com/thewholesomelotus/

Transcript:

Michelle (00:00)

Welcome to the podcast, Dr. Melissa Levy. I'm so excited to have you on.

Melissa Levy (00:04)

Yes, I'm so excited. I'm looking forward to this, being able to talk with you again and just dive into what I do and the world of fertility.

Michelle (00:12)

Yes, and I'm so I was lucky enough to work with Dr. Melissa Levy and she was one of my students for my fertility practitioner course. I have to say, I just have to say this. Well, she's kind of stands on her own anyway. Yes, she got an extra certification, but she's like just a phenomenal like knows what she's doing type of practitioner and

I mean, you really like went into everything like no stone unturned. I just love your motivation, your passion. Like, and it was it's legit. I just want to say that.

Melissa Levy (00:46)

Well, I think we even talked about this, like we're kind of just a lifetime learner. even though, you know, when I saw this course that you had, I was like, well, why not learn a little bit more? You know, I'm always diving into something, learning something new. And it just, the field that we're in, it's just kind of never ending of things you can learn and kind of better your education and further it. So it was great to just learn a little bit more and then the more you learn, the more you're open to and the more people you meet. So it was a great experience. So thank you.

Michelle (01:13)

Yeah, and I feel like you were already well versed. I mean, you stand alone on your own. So it was just awesome working with you. But I would love for you to share your background and how you got into wanting to do this

Melissa Levy (01:26)

Yeah, of course. I just remember being, I think most people have a similar story is like growing up, you're not really taught anything about your cycle. I had issues with my cycle. It's probably about 16 and I really didn't get my cycle yet. So I just remember going to the OB and they're saying, oh, all right, well, here's birth control. And I'm thinking in my head, great, now I'll be normal and...

you know, have a normal cycle. And so I didn't know any better and most people don't. So from the age of 16, I was on birth control to help regulate my cycle. And then also having ovarian cyst, I had surgery, I believe my junior year of high school for like a big ovarian cyst, which they thought was endometriosis. So, you know, I'm 16 and they're telling me, hey, you've endometriosis without even looking, you know, looking at anything, just throwing names out there, which I think is something that happens a

You know, people just kind of throw diagnoses and needs out there without really having an idea of exactly that's what it was. So being young thinking, I've endometriosis. What is this? You know, looking it up, being scared, and then getting surgery and them telling me it was a dermoid cyst, which is completely different, which was still kind of weird. But so that was just my first experience. And I just never had normal cycles really ever. And then going.

Michelle (02:32)

Wow. Yeah.

Melissa Levy (02:41)

into my college years. I was always an athlete, so I was personal trainer. I was working a lot, really stressed, a lot of stress on my body. So I just didn't feel good. I ended up getting Bell's palsy, which would not get better. And I was just on antibiotics and steroids for about a year or two years, just seeing tons of different doctors.

Michelle (03:00)

wow.

Melissa Levy (03:03)

not getting any answers. I think the thing that really frustrated me the most was going to a neurologist that I drove two hours to see and saw him for maybe five seconds. So it was just taking medicine, being on birth control, being on prednisone for that long, you feel terrible. So my gut health, my skin health, acne, hormones, nothing felt right. And I look back at pictures of myself from those years and

Michelle (03:14)

Wow.

Melissa Levy (03:29)

thinking I was healthy because I was a trainer and constantly working out and I had a lot of stress in my life as well. Looking back, I just looked unhealthy. I looked puffy and just all the medicines that they had me on, I didn't know any better until I got into the world of more holistic healing and learning more, being in that fitness and health. I was a personal trainer, group fitness instructor, yoga. I always wanted to help people and I think...

Michelle (03:42)

with her.

Melissa Levy (03:54)

this experience really helped me want to understand the body more and I know there's a better way of healing. So I was introduced into more like holistic health and acupuncture. And then from there, I just kind of fell in love with the medicine. when I started acupuncture school, as a student, you're able to get, you know, like $5 treatment. So we were getting treatment constantly and I was actually able to get off birth control and regulate my cycle, which took a little bit going off birth control. skin was...

a hot mess, probably because being on the antibiotics for so long, not even thinking twice about it. But I think within like the three months of just Chinese medicine, herbs, and getting acupuncture pretty consistently, I was finally able to get at least a regular cycle and, you know, just been working on it and haven't really had too many hormonal issues, you know, since then, but it's just a lot. You learn a lot about yourself, I think. And in a way, it's a good thing because then it brought me to where I'm

and I can have a lot of empathy for my patients and saying, hey, you I've been there, you know, I had the horrible migraines, I had the horrible skin and all things I just were told were normal. And last thing I'll say, I'll never forget. I remember I went, I was in acupuncture school. So I was learning a lot, as you know, you start learning things, you know, things that, you know, maybe aren't right that doctors sometimes may tell you. I remember I went to the OB and I was like, hey, you know,

I was told I had, I had an ultrasound done and the tech told me, Hey, it looks like you PCOS. Once again, just throwing things out there. And I was like, so I brought it up to my doctor. was like, I had an ultrasound. said it looked like I had something called PCOS. She's like, no, you don't. You just probably have endometriosis. take some Advil and birth control. And that was my conversation. I, I just left and I was like, what in the world? was because I knew better at that point. And I just left.

Michelle (05:21)

Wow.

my god. Wow.

Yeah, so you could recognize, yeah, that wasn't cool.

Melissa Levy (05:43)

Never going back to this doctor again and not saying everyone's like that. But I think for women, just, we're so, we're just, we're told that, you know, that's just normal, you know, having pain from menstrual cycles, having hormonal balances, all that stuff's normal. you know, Advil and birth control are the solutions to everything. the more I learn and especially getting into functional medicine now, you know, having the acupuncture practice for several years,

I've got more into functional medicine and I think that really connects the dots a lot for me too. I'm getting in hormone health and know, detoxification. So there's so much that as women that we're not even taught about our cycles or so I think just spreading the awareness, I think more women are wanting to know more and

Michelle (06:28)

Yeah, for sure. I know one of the things that really struck me when I was going to school. Of course, I had a very similar situation as you or story where I was given birth control pills as well. I think our stories are actually very common. A lot of people go through this. Yeah, I was so many. I've had so many guests, just guests tell me this, but then I've also had patients come to me and say that they've been put on birth control for this, that and the other.

Melissa Levy (06:42)

Really?

Michelle (06:54)

that had nothing to do with like their actual like root cause. Yeah, it's crazy. It really is crazy. being told, you know, or believing that certain menstrual cycle irregularities are normal. I think that that was the biggest aha for me when I was going to school is that certain things that we thought were normal, like having diarrhea if you have your period or constipation before or breast tenderness

Melissa Levy (06:59)

That's crazy.

Mm -hmm.

Michelle (07:20)

PMS or even cramps that it's actually common. So we think it's normal, but it's actually not normal. So, so what are some of the things that kind of like you saw that you felt like, my God, like I can actually resolve

Melissa Levy (07:26)

Yeah.

Yeah, I think a lot of it was just the mood stuff too. Like I would turn into like just a different person. Like along with that, just hormonal stuff like PMS, just all that stuff that we're told is just normal. I just like dread it heading my cycle all the time. And so I think it gets to a point where it might not always be perfect. know, things happen, whether it's stress induced, you know, if you're having a

month, you know, maybe some of those symptoms pop up and it's a way of your body telling you like, Hey, maybe, you know, check in with yourself, check in with your hormones. What's going on this month that some of these symptoms came back. And I think what you said is definitely true is I'll even do my interviews with my patients and I'll say, so how's your menstrual cycle? it's like perfect. It's normal. Okay, good. So what's that like? Tell me like, do you have PMS? yeah. Yeah. I always have PMS. had

My breasts hurt so bad. I get really moody the first day and cry. I'm like, you know, so that we're told that that's still normal, which is still a thing, but yeah.

Michelle (08:24)

Mm

Yeah, it becomes almost like a background thing that's just like, oh, that's just that. Like it's normal, it's okay. And I think another thing too is just having that something I frequently see, oh, I have a perfect 28 day cycle like textbook, so everything's perfect. But then you start to really dig in like, when are you ovulating? You know, is it early or you know, nobody really knows because they'll either just do LH or not really look into

Melissa Levy (08:35)

Yeah.

Michelle (08:59)

if it's confirmed ovulation, because you could still get a bleed. So there's a lot of those little intricacies that you often don't find in mainstream medicine.

Melissa Levy (09:08)

And I think that's another thing is like we're never taught to really understand our cycle. So when I am working with fertility patients, I'm saying, oh, are you ovulating every month? Yeah, on day 14. Okay. Are you checking your basal body temperature to see that rise in progesterone? No, no. Like I just, on day 14, I just ovulate. know, so it's, some people don't even understand that there are signs that our body tells

And it's not just day 14 that we ovulate, which could really impact fertility because then we could be missing our fertility windows. So there's just that lack of education and how we need to understand. we're never taught, I mean, no one ever taught me that. I had no idea until I got into this medicine that, day 14, or what is cervical mucus? Am I having that? And sometimes I ask women, do you have cervical mucus? Oh, I have no idea.

One of those things that were never, I mean, no one's taught me. And I just think there's not enough time, obviously, in appointments and with your regular OB. So I think that definitely impacts fertility for sure.

Michelle (10:05)

Yeah, I often find too that people don't even really know much about their blood because they use tampons the whole time. That's another thing that I often talk about because it is, first of all, I don't love shoving anything up there. When your body's trying to release, you're basically putting a stopper in a sense. I mean, of course it doesn't stop, it absorbs, but still it's not quite the same.

Melissa Levy (10:12)

Mmm, yeah.

Yeah.

Michelle (10:29)

as really letting it out and letting it flow and letting that gravitational pull release, whatever, not stagnate it. But if you have to, if you must, I'm not saying everything's 100%, but seeing what the blood looks like actually can tell you so much about your period or tell your acupuncture so much, but even you, there's a lot of information out

Melissa Levy (10:36)

Yeah, of course.

Of course, mean, once again, lot of my patients, unless they've been coming to me for a while, they know to look. Otherwise they're like, you said, I have no idea. I use a tampon. Are there clots? I have no idea. know, it's those things that, know, until, unless you've had acupuncture, you're probably not looking for it. And it tells us.

a lot. Our body gives us these signs and symptoms, the tongue, the pulse, the color of the nails, the skin. So all those things give us lot of information, especially the blood. What does it look like? How many days are you bleeding? Are you clots? it spotting? Are you bleeding a lot? Little, is it scanty? So definitely that's a great point. And same thing with the tampons. It's a really good point about stopping and not stagnating the blood.

Michelle (11:34)

Yeah. And I think that because our life is so busy, it's like, you know, it's almost like too busy and really kind of, it's important to allow yourself that rest if you can, with the menstrual cycle. I think that we don't really get that accommodation often just in the world. But yeah, you know, so you see a lot of those kinds of things just from asking people questions and how did you decide you wanted to work with fertility? What was your

your initial pull.

Melissa Levy (11:59)

Yeah, so I was.

pretty much a general seeing a little bit of everything. And I still do, but I think women's health is something that I've always had that love for just because there is such a lack of it and such a need for it. And then I think once I had my son, it kind of gave me that extra like fuel and that like just to learn more and more to, because it's such an amazing love to be a mom. And I want to be able just to give that to as many people and help as many women as I can. So I think that is the thing that really kind

pushed it to kind of dive all into fertility. What all can I learn? How many people can I help? And what is going on? And why is our fertility issues seem like it's kind of becoming more common. And it's one of those things where like cycle issues are an issue or they're prevalent. But now it seems like same thing fertility. It's just like, yeah, I'm having trouble getting pregnant. So it seems one of those things that's just becoming a normal common thing, which I think is sad.

Michelle (12:51)

Yeah, yeah, for sure. What are some of the things that you see just clinically? Like what are some of the things that you notice that might be contributing to people having trouble conceiving?

Melissa Levy (13:03)

Yeah, definitely. So I see stress, definitely, as you probably know. know, we've been, acupuncture has been saying for thousands and thousands of years, the connection between our uterus and our shin, which is our mind. So most women, we have a lot of responsibility.

Michelle (13:06)

Mm -hmm.

Right, and just if people don't know, the heart houses the mind. So the heart houses Shen, which is kind of like the spiritual aspect. Well, spirit, mind, combined.

Melissa Levy (13:26)

Mm -hmm. Yeah, and it's so we've known this for about 3 ,500 years or more. But I think nowadays women are living in a more stressful environment. There's so many responsibilities that we have. Some women have multiple kids already and they're juggling work and family and.

just the pressure. So there's definitely a lot more stress. And if your body's in that fight or flight, you know, it's not going to prioritize, you know, reproduction. If your body thinks, my gosh, I'm in immediate danger. Your body's not like, okay, well it's great time to get pregnant. So I think definitely stress is something I see. I see gut health definitely. you know, so many things come down to our gut and they say, you know, they talk about, you know, our

Michelle (13:51)

Yes.

I want to talk about that. That's a good, yeah, it's important.

Melissa Levy (14:10)

hormones or our body kind of being like that bathtub analogy where, you know, our gut is kind of like that sewer line kind of taking everything out. And if things are clogged up and backed up due to underlying gut infections, which I see very common and, you know, from a Chinese medicine perspective, we look at that as the dampness, the spleen. So the other thing I find so cool and interesting is, you know, Chinese medicine has been talking about all this stuff for 3500 years. And then when you learn like more of the conventional and

functional medicine, it's the same stuff, you know, just in different terminology. So gut health is so important for fertility. And then from a Chinese medicine perspective, we talk about the spleen and the stomach, and it has a huge relationship to our fertility and our overall health. So that's deficient. And we've known that forever. So it's one of those things where I think gut health is so common and such a big topic right now. But it's not a new thing. I think it's something that we've known for so long,

Michelle (14:53)

Yeah.

Melissa Levy (15:04)

Now we're recognizing, wow, our gut is really, important. And so I think that's huge.

Michelle (15:10)

for sure. I will say too, like the gut mind connection, also that's spleen and stomach, they govern thoughts. So literally our thoughts can impact our digestion. Like if there are stressful thoughts, overwork, overworrying, that can impact our digestion. But now they're seeing it's fascinating because I've been researching it, the enteric system, which is your gut nervous system. And then the CNS, which is essential nervous system, which is connected to the brain.

Melissa Levy (15:17)

Mm -hmm.

Mm -hmm.

Michelle (15:36)

And so how your thoughts can impact your via the vagus nerve, like there's this back and forth bi -directional communication. And it's fascinating how like Chinese medicine has been saying this forever. And now we're like literally seeing that they're seeing that people with certain types of mental disorders have a different gut microbiome than...

Melissa Levy (15:49)

I know.

Mm -hmm, so interesting.

Michelle (16:00)

It's fascinating. And then also they're saying that people that meditate for a long time have a different gut microbiome that's more diverse and more rich, enriched.

Melissa Levy (16:10)

Yeah, I mean, our mind is, I you talk about that so much, and it's like, how much can we stress it? It plays a big role in, it's sometimes not something that's easy to overcome, and it takes sometimes time to maybe make some lifestyle changes or be able to do things that, sometimes you obviously can't change your environment around you if it's situational, but do things for your body that can kind of offset some of that stress. And then also, working with the gut.

Michelle (16:34)

Yes.

Melissa Levy (16:36)

going to be really important. it's kind of like that vicious cycle of, if your guts impaired, then it can affect your mind and your mind is going to affect your gut. So it kind of just rotates through. So, you know, when we talk about holistic medicine, we're talking about not just singling in on one thing. We're looking at everything. We're looking at the gut, right? Because if you just want one, you know, you're forgetting about everything else and everything is so connected. So you have to look at everything.

Michelle (16:54)

Yes. Yeah.

It is, without a doubt. It's a, cause you were just mentioning two like major things, which is stress and then the gut. But those things are interconnected. They're like pieces of a puzzle. And that's, that's really the beauty I think of Chinese medicine is that, and also functional medicine is that it looks at things holistically, like in all the different parts. And I love that you also do functional medicine and testing. And because I think it's really important to really look beneath the hood.

and see what does your gut microbiome look like. So what could people get from like say a gut testing?

Melissa Levy (17:37)

so much. So your whole gut microbiome, can tell us so much. So what I see a lot is I'll have a patient come in and they'll say, hey, you know, I'm not feeling good. My hormones are a mess. I can't get pregnant, but my blood work, everything looks fine. So then, you know, I look at it. Yes, everything looks fine. Yeah. And then as an acupuncturist, we take two seconds. We look at their tongue and pulse and we can say, whoa, there's definitely a lot going on. And

Michelle (17:53)

So then they get the unexplained infertility diagnosis, right? And then they come to you.

Melissa Levy (18:04)

I like to order things like the GI map, which definitely is my favorite test by far, because it doesn't just say yes or no, you have something. It will give you the value. So it's qualitative PCR. So it looks at all the gut microbiomes, looks at parasites. It looks at H. pylori, which is so common. Yeah, so our gut microbiome. And it's not even like looking at...

know, what can we do to fix it? So sometimes I've had patients, looks at beta glucuronidase. It looks at calprotectin levels. it looks at so many different things to see if there's any gut inflammation in the body. is there dysbiosis? Is there maldigestion? Maybe you're not absorbing all the nutrients. So there's definitely a lot. And, if people even have cycle issues, I've had patients who have irregular cycles and we don't do anything else, but do a GI map and heal the gut. And their cycle regulates by itself on that. So there's so

Michelle (18:53)

That's amazing.

Melissa Levy (18:54)

much if you have someone that can actually read the GI map and knows how to understand it and what the patterns are, it is so beneficial. So I really love the GI map. It could tell us so much about the gut.

Michelle (19:04)

Amazing. And so what are some of the things or implementations and just to kind of give us examples of different conditions. And clearly this is not a one size fits all, which is why you have to test. Cause you could see like what's going on specific to the patient.

Melissa Levy (19:10)

Yeah.

Of course. Yeah, exactly.

Yeah, so I mean, I would say some things that I see a lot on the, just on the GI map, for example, like I'll see H. pylori a lot. And then with H. pylori, you'll see things like strep and staph infections as well in the gut. And what that does a lot of times is cause hypochlorhydrial low stomach acid, which is sometimes called things like parasites. You're not killing off things if you have low stomach acid and then maldigestion issues. So just doing things like mindful eating. So taking time and chewing your food, digestive.

enzymes are really important. And then I love antimicrobials like olive leaf and oregano. They're really great. Olive leaf is antioxidant. It's antimicrobial, antiparasitic, anti -yeast. So that's something I use a lot with my patients that have any type of dysbiosis or overgrowth or opportunistic growth in their GI map.

Michelle (20:08)

Have you heard of Mastic for... Yeah. Rachael.

Melissa Levy (20:10)

Yeah, mastectomy. Yes, that's really common. And usually if you have, it depends like what bacteria or overgrowth you have. For example, like H. pylori typically means at least like three types of urge to kill because it is very stubborn. So usually using mastectomy, leaf, oregano, black cumin seed oil is amazing. And that is good against H. pylori. It also helps regulate blood sugar, which is another huge thing I see with fertility issues is blood sugar regulation.

That's another thing that can affect our cortisol levels and our hormones. So I put a lot of people on black cumin seed oil as well, and that's antioxidant as well. So those are things that I definitely recommend for things, but it really depends on what bacteria, what overgrowth, what patterns you're showing. But just common things I see is like hypochloridia, low stomach acid. I see a lot of like dysbiosis, leaky gut, and then really just taking the measured measures and really just putting it into phases

what can we do, remove the gut infections and then build up that gut wall and build up that diverse microbiome again. So it takes time. It's not something that happens overnight. But then I also think looking at why, why do we have this in the first place? Why do we have these gut infections? Why is it stress? it our diet, environmental things as well?

Michelle (21:19)

Right, right.

Yeah, you think of like Sleen Yang deficiency because the fire, know, that digestive fire really is in Ayurvedic medicine, Agni, fire is really what kind of kills off all of those opportunistic bacteria and infections. But if we don't have that digestive fire, all the things that we learn about don't eat ice cream, don't have ice cold drinks, because what you're doing is you're actually diluting that fire.

Melissa Levy (21:28)

Yeah, exactly.

Mm -hmm. Yeah.

Yeah, no, I love that. never thought about that as like the that looking at that as like the stomach acid and that's such a great, great way to look at that. And that's the thing I always come back and find these awesome like relationships between Chinese medicine and conventional or functional medicine. It's like, it's all the same stuff. We just called it different things in a sense. it's, and now that we've all this research that shows and validates everything we've known for a long time. So I do like, you know, combining the two of those in such a great.

Michelle (22:06)

Yeah. Yes.

Melissa Levy (22:17)

great practice to be able to do

Michelle (22:18)

Yeah, no doubt. when it comes to certain conditions, have you had people where you suggested, okay, you you'd need antibiotics for this because it is kind of like really strong where they sometimes they need a stronger one. And then with that kind of help to navigate and kind of work it out with probiotics.

Melissa Levy (22:38)

Yeah, so I haven't had to really refer out for any antibiotics because most herbs and supplements usually are. There's research that shows that they are pretty good at eradicating most things and they have multiple functions and a more broad spectrum. But then, yeah, then adding in the probiotics and different types like espilarity is really good at helping with H. pylori and then doing, that's another thing I love about the GI map is it'll let you know like what's overgrown, what's deficient. So let's say you're a

Michelle (22:49)

Mm -hmm.

Mm

Melissa Levy (23:04)

huge overgrowth of lactobacillus because of maybe hypochondria, right? You're not breaking down the food, so then it starts fermenting and you get that overgrowth patterns, which we see a lot. Then you probably might not want to take lactobacillus probiotic. You probably want to do something a little bit more diverse.

Michelle (23:22)

Right, or maybe a spore -based, right? A spore -based.

Melissa Levy (23:24)

Yeah, or like a school -based probiotic, which are getting more popular now. But then another thing I see a lot too, which I've been seeing a lot more recently is there's something called acromantia. And I see a lot of people that have none detected at all in their gut. And that's a really good thing. And that helps with our gut mucosal lining. And also they show that people have low acromantia, have more things like insulin resistance and obesity. And that's something I keep seeing a lot is there's...

Michelle (23:38)

wow.

Wow.

Melissa Levy (23:52)

like zero detected in the gut.

Michelle (23:53)

Wow, that's so interesting. You know, I have learned a lot that some of the ingredients that we see in processed foods actually shift the gut microbiome dramatically. And I wonder, I mean, if it's like that or toxins that we're exposed to, I mean, there are things that are really literally like we don't even realize have a role or play a role in our

Melissa Levy (24:04)

Yeah, I believe it.

Yeah. And I think another thing is like we, that I see a lot too, is we get into like routines of food and we'll eat the same food over and over again. And I remember like Chinese medicine school, they talk about that. They say your body doesn't want to eat the same thing over and over again, like mix it up. Don't eat, you know, chicken and broccoli for every, you know, every lunch the whole week, because your body wants that diversity. And now we see that with the gut microbiome is like the more diverse you eat, the more different foods you're eating, the more diverse your gut microbiome. You don't want to keep eating.

Michelle (24:34)

Yeah, it's

Melissa Levy (24:44)

the same seven foods all week long, you and I know some people kind of get into that routine of things is that's all they eat.

Michelle (24:48)

Yes.

Right, and they talk about eating for seasons too, because during that season, whatever that weather or the climate, your body's reacting and what will grow around you, the food that grows typically is there to balance that

Melissa Levy (24:54)

yeah.

Mm -hmm. Yeah, like the seasons and that's something I mean, I think a lot of people don't do as well as eating up the seasons and it's one of the things we don't think about.

Michelle (25:06)

fascinating.

you don't think about it because you don't even know because everything gets shipped from everywhere. So you're like, I don't know what's growing now, like here, you know, and I think that that that's like another thing that that and also the endocrine disruptors, all these things that you have to do a little more homework for, but it's not as intimidating as it originally sounds. It seems a lot worse. This is actually why I will say worth hiring a fertility coach.

because you have a lot of that extra time, like all of that is done for you. And, you know, that's the benefit.

Melissa Levy (25:44)

Yeah, for sure. And I also think, like everything's so individualized too. Like what might be good for one person, you know, isn't the main focus that someone else needs. There's so much and it can definitely be overwhelming. Like when you start to think about it, like detoxification and basal body temperature and ovulation, the food, it's like, sometimes that stresses people out and it's like, we don't want this to be stressful. And I also have had patients that'd be like,

Michelle (26:00)

Yeah. Yeah.

Melissa Levy (26:07)

you know, they're like, well, this person get pregnant and they're not eating, you know, super, super healthy, but everyone's bodies are different. You know, we have epigenetics and different stress and everyone's bodies can handle things differently and like that toxic load. And so it's hard to compare yourself to someone else, which is never a good thing to

Michelle (26:14)

Right. Yeah.

It's true.

no, absolutely. somebody might be less tolerant for one thing, but more tolerant for another. And that might be completely opposite from the next person. So you just never know. You really need to like honor your own like body's personality type, I like to kind of say, because it has its own signature, its own personality. Like everything is unique, you know, even though we have the same makeup, you know, we all have like the same organs

Melissa Levy (26:34)

Yeah, exactly.

Yeah.

Exactly.

Michelle (26:53)

of but each person responds differently really to food, environment. I love the saying, one man's

is another man's poison, it's could be something incredibly healthy, but one person could be allergic to it and have a horrible reaction to

Melissa Levy (27:02)

yeah.

Yeah, exactly. even going, I always go back to Chinese medicine, but no, it's like food therapy and you know, I have patients come in and they're like, I look at their tongue and pulse and I'm like, well, you shouldn't be eating these foods. They're like, yeah, but they're so healthy, blah, blah, blah. I'm like, they are healthy foods, but not healthy for you at this time of what you have going on in your body. If you've got a heat and inflammation and you're eating spicy, hot, warming foods, you're going to feel a little worse, right? Versus someone who's maybe a little bit more deficient.

Michelle (27:35)

bright.

Melissa Levy (27:37)

and really needs more of that warming food. it always comes down to individuality, whereas everything similar is yes, we want to make sure we have a good healthy gut and blood flow and mind, but everyone's situation is going to be a little

Michelle (27:50)

totally. Like it makes me think of like the somebody who's really thin and like super cold all the time, but all they want to eat is raw foods and salads and like juice. You know, all of that has such a cold nature. You're just exacerbating like the symptoms and making it worse.

Melissa Levy (28:06)

yeah. Yeah. It's not as people don't want to hear that. I'm like, well, stop juicing. And I'm like, well, it's so wealthy. going eat a little bit more soups in it. And it's not like you can ever do it, but it's all about balance. And I think, you know, things always come back to balance. And we live in a world now where everything's such an extreme, we're either completely vegan or completely keto or completely, you know, one thing and it's, we're working out so hard and won't do anything or we're not working out at all. So it's how can you find that balance

Michelle (28:17)

Yes.

Right, yeah.

Melissa Levy (28:34)

eating a whole diet and maybe doing more yin or calm or exercises during certain part of the cycle and then doing more intense if you want. everything comes back to balance, which is something I think is hard.

Michelle (28:47)

Yeah, no doubt. But it's an art. then once you figure it out, because I think that we're primed for it, we're designed for balance, our bodies know, and our bodies communicate with us when things are out of balance. If we're too hot to want to cool down and vice versa. So it knows what to do. It's always communicating. Sometimes we want to ignore that communication. Over time, we stop hearing it, but it's kind

Melissa Levy (29:03)

We have.

Michelle (29:11)

coming back to it is a lot easier than I think a lot of people think because we're primed for it. We're designed to be connected to that. So I know that you work with a lot of people online. So you're able to basically have consultations with people and do testing of all kinds, like different functional testing based on that either customize, but also that you have a program for people who may not commit to like

Melissa Levy (29:35)

yeah.

Michelle (29:37)

a one -to -one, but they can also just take your course as

Melissa Levy (29:41)

Yeah, of course. So, yeah, so I wanted to try to make a course that was like great for like good for anyone, right? So it's easy to understand, but it kind of covers a little bit of everything. A lot of education, like I said, a lot of it is sometimes women don't understand their cycles or even know when they're ovulating. So there's modules that talk about cycle education. How can we, you know, increase our sperm or egg qualities to talk about the man and the woman talking

functional tests. So if you're like, hey, I want to get some testing, but I don't want to work with someone or I don't know anyone or my doctor won't run these, you can go online to our Rupa store and just put in your own order. You know, I always recommend obviously going over with it with a doctor, but I give you the option, the option of like functional ranges and the standard ranges, which are going to be different. Functional ranges are like optimal where we want you to really be. And we talk about yoga, mindfulness.

supplements. So we talk about a lot in the program. It's self -paced, which is so nice. So had people say, I love it because I can go back and listen to it over and over and over again. And so it was a really fun to make and I love being able to provide that information to people.

Michelle (30:50)

Awesome. And I actually got to see behind the scenes, look at it and it is really, really very thorough. It has a lot of information, really, really well done. I have to say, I really admire you as a practitioner. think you are amazing at your craft, like truly. Really so honored to have been able to work with you and like get to know you, but you really are amazing at what you do. I think that part of it

Melissa Levy (30:58)

Thank you.

Michelle (31:15)

just being really passionate, but also having that drive to keep learning and learning and learning. And I think that that's what keeps us going as practitioners.

Melissa Levy (31:23)

Yeah, definitely. thank you. So sweet. Yeah. We love what you do. You just want to keep learning and it's fun.

Michelle (31:30)

It is fun, right? Well, that's what you want to find. You want to find a coach or has fun doing what they're doing because that's that's ultimately it's a good sign that they love what they do and they're good at it. So, Melissa, such a pleasure having you. If people want to find you, how can they find you?

Melissa Levy (31:37)

Yeah.

Yeah, of

Yes, thank

So I actually have a clinic in Jacksonville. Then I also work online with people with Health by Melissa .com or Integrative Wellness Center of Jacksonville .com. do virtual and in -person visits.

Michelle (32:01)

Awesome. Melissa, thank you so much for coming on. was such a pleasure talking to

Melissa Levy (32:04)

Yes, thank you. Thank you. 

EP 290 The Ultimate Pre-Pregnancy Checklist |Alexandria Devito

Alexandria DeVito, MS, CNS, is a functional nutritionist who specializes in fertility and preconception health. She is the author of 9 Months Is Not Enough: The Ultimate Pre-pregnancy Checklist to Create a Baby-Ready Body and Build Generational Health. She is also the founder and CEO of Poplin, the first pre-pregnancy wellness company. Prior to founding Poplin, Alexandria worked in management consulting at McKinsey & Company. She holds an MBA from Harvard Business School. She also has a master’s degree in nutrition; extensive training as a doula, yoga teacher, and personal trainer; and is an Institute for Functional Medicine Certified Practitioner, all of which inform her approach to pre-pregnancy wellness.

https://getpoplin.com

https://www.instagram.com/getpoplin/

https://www.facebook.com/getpoplin

Click here to find out how to get the first chapter of "The Way of Fertility" for free.

For more information about Michelle, visit www.michelleoravitz.com

The Wholesome FertilityFacebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/

Instagram: @thewholesomelotusfertility

Facebook:https://www.facebook.com/thewholesomelotus/

Summary of this episode:

Alexandria DeVito shares her journey from working in the corporate world to becoming a fertility health advocate. She obtained an MBA from Harvard and a master's degree in nutrition while working in healthcare. She then trained in functional medicine and started seeing clients as a nutritionist. Many of her clients were struggling to conceive, which led her to focus on fertility health. The conversation explores the challenges of fertility struggles and the lack of preconception health guidelines in clinical practice. It highlights the emotional, physical, and financial toll of fertility struggles and the need for better preparation and support. The conversation discusses the importance of preconception care and the impact it can have on the health of both parents and future generations. It highlights the challenges faced by females in accessing comprehensive medical care, which often focuses on contraception rather than preconception care. The conversation emphasizes that there is no such thing as starting preconception care too early or too late. Our bodies were designed to conceive, but our modern environments create a mismatch. Factors such as nutrition, supplements, and stress can affect fertility. 

Transcript:

Michelle (00:00)

Welcome to the podcast, Alexandria.

Alexandria DeVito (00:03)

Thank you so much for having me.

Michelle (00:05)

So we just had a really great pre-talk and we definitely are on the same page on so many things. And what I love about you is that you are here really to empower couples on the fertility journey. I got to look at your book. I was very excited because I feel like I really resonate with the

And I just love the fact that you really approach it from such an empowering perspective. Absolutely love that. But for the listeners, I would love for you to share your background, how you got into the work that you do.

Alexandria DeVito (00:38)

Hmm, you got it.

Yes, I mean, I think there's a lot of alignment philosophically about, you know, just how much more agency we have over our reproductive health and all the different ways that we can prepare to conceive, which I'm sure we will talk all about. So I came into the world of fertility actually, initially through the corporate world. So I was doing corporate consulting and was working in healthcare, largely with pharmaceutical companies and medical device companies. So I kind of learned the healthcare landscape from that lens.

enjoyed working in healthcare. I thought it was just such an incredibly impactful field. And at some point I decided that I wanted to switch from what I felt was operating in a more reactive model of healthcare to a more proactive one. And so that was the impetus for me to go back to school. I went back and got my MBA from Harvard and then I also did a part-time Masters in nutrition on the side.

while I was doing my MBA. And that was my way of adding more tools into my toolkit that were more holistic in nature. And then I finished both of my master's degrees, and I did training and functional medicine, and started seeing clients one-on-one as a nutritionist. And basically what ended up happening was I had a lot of clients that were struggling to conceive, and they had been on fairly long journeys, sometimes a year, two years, three years, and they were being

ping-ponged between different providers and they still weren't getting the answers that they so deeply desired and they were not getting pregnant. And it really struck me, why was this happening? And so you know initially they were saying like do you have any other suggestions? Can you tell me what I should be doing? And this was also happening with friends. Friends of mine were also struggling coming to me not in a professional capacity but in a personal capacity asking for my advice and guidance.

And initially I was really perplexed, right? This seems like an important problem. This seems like a solvable problem. What the heck is going on here? And so inspired by my functional medicine training, I started running these really broad panels of tests that.

essentially were screening mechanisms. I looked at the clinical literature and saw all the reasons that could potentially interfere with someone's ability to get pregnant. And once I started running these broad screening tests, a whole bunch of things started flagging that my clients, other providers, had never even tested in the first place.

And that was what really inspired me to say, wait a minute, like, why are we waiting until someone is several years into a fertility struggle? It is emotionally, physically, financially draining in most cases. Why are we waiting to find out these things that we could have found out before they even started their journey? And so that really inspired my exploration of preconception health, which is essentially the preparation period before and between pregnancy is, which we can talk more about.

And I realized that there have been preconception guidelines over 40 years at this point, but they're not being implemented in clinical practice. And then certainly, if we think about ancient practices, which this is your specialty, these have been around for thousands and thousands of years. But we're not implementing them.

And so I just felt that there was an opportunity to rewrite the dialogue and to really give people so many more tools to prepare to get pregnant like they prepare for any other major milestone, a wedding, a career, right? Even buying a house today has more infrastructure and support. And so that's really been my journey and the impetus and really spreading the word around this concept of preconception health and all the things that you can do on both a macro level and a micro level.

to optimize it and build generational health.

Michelle (04:25)

I mean, I love this topic and I just, you know, it pains me that it's not mainstream, that this is just not information that people get. And I feel like they do get it after digging and finding. it would be so nice if people just knew this information because it's so important. And so let's go to that topic of really preparing the body.

Alexandria DeVito (04:33)

Mm-hmm.

Michelle (04:52)

because I think that is just something that most people don't even consider. Nobody really is told that. It's not something that anybody really has access to. I mean, the only access that you really have is like high school health education, where they tell you not to conceive and that anybody blinks and they get pregnant. And so just about your body and how it really works. And then,

Alexandria DeVito (05:07)

Hahaha

See you soon.

Michelle (05:20)

it's that like the red pill that we swallow and realize like what's really happening and what's the reality and it's so different than what we've been told. So let's talk about preconception care like why is it important and how long do people really need to consider preparing themselves before conception?

Alexandria DeVito (05:42)

You had so many important points in what you just said that I, you know, I think it's actually really helpful. I want to elaborate on them and, you know, and amplify what you said. First, right, I think it's true. We don't get updated sexual education information in most cases, right? The last time most people had any sort of sexual education, it may have been in middle school or in high school, where presumably the goal is to prevent teen pregnancies. So the message that we are giving people...

in that context is very different from the message that we might want to give to someone who's in their 20s, 30s, 40s, who's actively trying to conceive, right? But there aren't great mechanisms to update that information, right? And so I think that's one of the first challenges. I think the second challenge is that we are very bifurcated in our medical care for females, where we're either focused on contraception, so preventing pregnancy, or pregnancy.

right, managing a pregnancy that is already in process. But this intervening period, this preconception period, when once we are stopping contraception and pursuing pregnancy, is almost been forgotten about. And I think it deserves its own conversation. And that's why I'm so happy to be here today talking about it, is I didn't even know preconception was a thing before I started researching it. And proper preconception care has

big benefits. Number one is it makes it easier to get pregnant, and then number two, it increases the likelihood of having a healthy pregnancy and a baby. And it's certainly been known, been shown to reduce the complications of any sort of birth complications, pregnancy complications, and then also fertility challenges. And so this is relevant, whether it's your first pregnancy or your fifth pregnancy.

it's relevant whether you're 23 or 43, right? And sometimes it can be even more relevant for subsequent pregnancies because a female's body can be so depleted of nutrients in a previous pregnancy or hormones may be dysregulated. I'm sure this is something that you see a lot of the time as well, right? And so what you do in the preconception window is incredibly important because it's been shown to affect the lifelong trajectory of the health for your child through the epigenetic markers in egg.

and sperm. So it's just such a profoundly impactful time period where you're not only affecting your health and your reproductive partner's health, but that of your future child and even your child's children and beyond. It's wild.

Michelle (08:18)

Right. I know, isn't that crazy? The thought of that. Yeah. It's pretty wild. So how long would you say, generally speaking, how long do you think people should really consider pre-conception care, like before even conceiving?

Alexandria DeVito (08:34)

Yes. So what I generally say is, look, there's no such thing as too early. So if you're an overachiever and you want to start this early and you're thinking about pregnancy even in a couple of years, no such thing as too early. There's also no such thing as too late. Even if you've already struggled to conceive and or are about to pursue an assisted reproductive cycle, you can still be making these changes. Your body is incredibly, incredibly resilient. That being said, generally speaking,

what I recommend is usually about a year, right? So kind of what you're doing in the three, six, 12 months prior to conceiving is the timeframe that your body is gonna be most susceptible, either positively or negatively, to what's going on in and around your life cycle. And that is true on the female reproductive side, where the last stage of egg maturation is around three to four months and kind of their susceptibility to what you're eating.

environmental toxins and you're stress-loaded in that period of time, and sometimes we need multiple of those cycles. And the same thing for male sperm development. That's around three months, so again we may need multiple cycles depending on our starting point. But it actually takes about a year, the current literature is saying, for an egg to kind of move from its you know essentially sleeping beauty like state all the way through to ovulation. So that's just the time periods when we're thinking biologically what we want to keep in mind.

Michelle (09:58)

And so what are the things that you would suggest or what are some of the things that you would say people should look at? I mean, I know there's so and I know nutrition's a huge part in certain supplements, but I'd love to get your, your thoughts on that.

Alexandria DeVito (10:12)

Absolutely. Yeah, so here's what I would generally say. Our bodies were designed to conceive, but our modern environments were not. Right? And so there's a mismatch now between our genes and our environment.

and our environment today is communicating to our bodies that we are in a reso unsafe environment on a pretty regular basis. And when we are in a reso unsafe environment, our body down-regulates reproductive function because it says, wait a minute, probably not the best environment into which to bring a child, so let's put it on pause right now. And so when I think about what are the factors that are driving

as auspicious to conceiving. There's the macro level and then you know kind of what's going on for most of us, and then there's the micro level. So I'll split it into those two. On the macro level, you certainly alluded to several of these, right? We're eating a lot of food and we're getting not very much nutrition, right? So we're eating more food-like substances, less food, less nutrient density of food, less balanced.

Michelle (11:13)

Mm-hmm.

Alexandria DeVito (11:20)

diets, more blood sugar imbalanced diets, right? So these sorts of things are not conducive to fertility, and that's become the norm, not lately. A second big one is environmental chemicals that are coming at us through our food, our water, our air, our personal care products, our home care products, and I think particularly for females who are using, tend to use more personal care products than our male counterparts. You know, if

One of your products has these endocrine disrupting chemicals in them, probably not that big of a deal, but when it's kind of like our shampoos and our conditioners and our makeup and you know our lipstick and our soaps and right, you know, it starts to add up and our bodies were just not designed to deal with this level of toxic load. Our bodies can naturally detoxify, but when it's all day every day, it becomes much, much harder for our body to excrete these compounds that we're not meant to be dealing with. So environmental toxins are another one.

Stress levels, I think are another important one. We are more stressed and stretched than ever before. The data suggests this. We are sleeping less soundly and less cumulatively. And what happens there is our sex hormones and our stress hormones are in the same biochemical pathway. And our bodies will always prioritize survival over procreation. So kind of what, to what I was saying earlier, if your body thinks, oh, this is, we're in war basically, or we're in an unsafe environment,

it's going to down-regulate reproductive function and switch from making your sex hormones to making your stress hormones because it thinks it's adaptive, it thinks it's protecting you. And what happens then is you don't have the raw materials, A, to get a regular menstrual cycle and ovulate, but then B, to carry a baby, right? So that's a big one that I see. And then the last kind of big one that I'll touch on is just movement. We've...

significantly increase the sedentary-ness of our jobs even, and we you know we don't have to walk more than five feet if we don't want to right there's planes, trains, automobiles, right even scooters can kind of get us from point to point, and so when we think about movement the important thing about movement is that when we are moving we are getting you know this is very much in your realm right we don't have stagnation right so

whenever we have good blood flow, that means we're moving oxygen, we're moving nutrients throughout our body. When we're sitting for long periods of time, we're essentially compressing our reproductive organs and creating stagnation, which is not great for kind of getting the things to go where they need to go. So those are the big ones on the macro level that I see, and I'll just briefly touch on the micro, which is that part of what was the impetus for me building the pre-pregnancy testing company that I now run, Poplin, is that

know, it was inspired by what I saw working as a nutritionist, that there's all these things that we can test in advance to understand what's going on for you uniquely. Right now in fertility we treat in many cases all 25 year olds as equal, all 35 year olds as equal, and that's cellularly just not true. So if we can understand what's going on in your unique body, then we can have a much better intervention plan rather than kind of doing all the things you can do, the specific things that are relevant to you and your physiology.

Michelle (14:24)

Right. Yeah.

Oh my God. Yeah, for sure. And a lot of people are not really getting the tests, even if they are available mainstream. I'm always like surprised when people get there just the TSH and very high and nobody looks to see is it antibodies that's causing that. Like, there's no antibody testing. And I've even had patients go to their doctors and ask for it. And they're like, I don't know why you need it.

Alexandria DeVito (14:57)

Mm-hmm.

Michelle (15:05)

And I'm like, really? Like just, it boggles my mind. So it's again, a shame that people have to really search it and seek it, but if you are able to, I definitely highly suggest that. I think it's a game changer to be able to really see what's going on and to do the functional testing. Cause functional testing is a lot more detailed than what we'll see in just like a doctor's office or So I think it's huge.

Alexandria DeVito (15:32)

I agree and I'm obviously hugely biased here so you know everyone has to take you know my opinion with a grain of salt but I've just seen you know because we're testing such a wide array of markers like I've never seen a test come back without something that you know someone could be working on and I've never had someone say you know I wish I didn't do that testing right

Michelle (15:50)

Yeah.

Alexandria DeVito (15:50)

it's really empowering. I think sometimes we can get scared and say, well, what if we find something out? And, you know, I don't want to know. But the things about the testing that we do, at least, is that everything on the test, except for blood type, is modifiable, which means you can do something about it. It's not some test result where you then are just, you know, sitting there, twiddling your thumbs, wondering, you know, what to do. You can modify it through diet, lifestyle, supplementation.

Michelle (16:05)

Right.

Alexandria DeVito (16:19)

Alternative therapies like the work that you do, right? Enhancing blood flow, managing stress levels, all of these things can really improve these biomarkers and you can see it in black and white, right? You can take the test, you can make lifestyle interventions and then you can take it again and you can watch your progress.

Michelle (16:19)

Mm-hmm.

Yeah.

Not only that.

I feel like people feel a certain way or they feel sluggish and they think it's them or something's wrong with them. And when people get that confirmation, and this is kind of like, I mean, it's obviously related because everything's related to fertility. Because you were saying what you said was so true. And I say the same thing. It's your body's going to want to survive. And if it doesn't have the means, regardless of the fact that it's going to also influence reproductive health, but it also influences your quality of life.

Alexandria DeVito (16:44)

Hmm

Michelle (17:06)

people actually see that and they realize, oh my God, this is what explains it. Because I think there's nothing more frustrating than getting that unexplained diagnosis. And when you actually see beneath the surface what's really happening and it gives you an explanation, I feel like that by itself is so empowering.

Alexandria DeVito (17:14)

Very funny.

Michelle (17:26)

And I agree a lot of times with functional medicine, yes, we can change diet, we can address what's going on. We can see the inflammation. And then let's talk about gut health, because I know that that's like a big thing. A lot of people hear about gut health. And at first, I think when people start the fertility journey, they think it's just, let's focus just on fertility. But then you don't realize, like, there are so many different factors that come into play.

Alexandria DeVito (17:36)

Yeah.

Michelle (17:51)

And there are different systems and all the systems come together to create the whole of you. And gut health is incredibly important, even in Chinese medicine, you know, the clean stomach or the center, really the center that makes the blood, supports your body's processes and energy. So I wanted to get your perspective on gut health and also to explain it to people who are first hearing about it. Like why does gut health

matter so much when it comes to fertility health.

Alexandria DeVito (18:22)

And I want to hear more from your perspective too, because I think this is where it's so beautiful to hear that the different modalities and how they're looking at things differently. And in a lot of ways, there's just this underlying similarity between the philosophies too. So I think, you know, what you said is spot on, right? Fertility is an extension of our overall health.

A lot of times we treat fertility as this below the waist conversation, or we treat it as solely a function of your hormones. And it is those things. It does involve your reproductive organs, and it does involve your hormones. But if we're just looking at those things, we're just kind of like looking through, you know, at-

20-30% of the equation, we're missing all of the other stuff going on in your body. And that's why when we look at testing, we're looking at your blood status, your hormone status, your metabolic status, your nutrient status, your immune status, all of these things affect your fertility. And you're talking about gut health, incredibly important.

thing. When we think about gut health, just to give a few examples with my nutritionist hat on, just because you're eating, let's say, a quote unquote healthy diet does not mean you are digesting and assimilating those nutrients. So if we're eating in a stressed state, if we're eating while we're standing up, if we are judging the food that we are eating, all of these things actually decrease the amount of nutrition that we can extract from that meal. So that's just

Michelle (19:30)

Right.

Alexandria DeVito (19:46)

first really important principle.

The second one is if you have happened to have been on hormonal birth control for any period of time, the literature is fairly clear that hormonal birth control can disrupt our microbiome. And so if we're not taking compensatory action to address that, then you're likely to be dealing with a disrupted microbiome. And then again, right, that may feed certain cravings. It may mean you're not, again, extracting nutrients as effectively from the foods that

eating. It may mean that you're dealing with symptomology like bloating and gas and discomfort after meals that are certainly...

not very pleasant right? And so you have kind of all of these different components when we think about gut health and if you just think about it from like a nutrient perspective, our gut is the way that our body helps us digest and assimilate. So if we're eating all these foods and we're not actually getting the benefit of the foods that we're eating, we're more likely to be in a nutrient deficient state. And nutrient deficiencies can delay time to pregnancy and they can also affect

And so what we're kind of consuming in the three to four months prior to conceiving is what you actually have to offer to that baby in that first trimester. So ensuring that your nutrient stores are replete before that period of time is incredibly important.

Michelle (21:12)

Oh yeah, absolutely. Chinese medicine, It actually is what extracts into blood and blood is really important for women, uterine lining, but it also feeds the ovaries. So yeah, and it's amazing how now we're starting to find out a lot of things with research. And I love that. And it's also interesting because people do go on the birth

not only impacts the gut microbiome, but also impacts your nutrients in your body, depletes certain nutrients. So for people who have been on the birth control pill for many years, I think that that's one of the things in mainstream they'll say, oh, you could be on the birth control pill for many years. And then the second you stop, you could just go ahead and get pregnant. So what

has been your experience for people who have been on birth control pill and some people for over 10 years. And what are some of the things that you would look at and want to address to regulate and prepare people for conception? Yeah.

Alexandria DeVito (22:16)

Such a great question. So I mean, I think there's the talking about birth control can be such a.

an important and also sensitive topic because I think it's, you know, I have such reverence for the freedoms that it has afforded myself for many years and also many, many women to pursue their lives as they deem fit, pursue their careers. And at the same time, I think we now have a generation of women who have been on hormonal birth control, as you said, from very early reproductive years, and we now have more information about the side effects.

you know, I'm a big believer in this concept of informed consent, which means you get to decide what is best for you, and the only way you can decide what is best for you is if you're given all of the information to evaluate the pros and cons of this. And for, you know, many women, even understanding some of the things that we're about to talk about, they still may make the same decision, but that is not the point of informed consent. The point of informed consent is that you get to know all of this information and then decide what is best for you. And so what I think

about hormonal birth control. Certainly what was not communicated to me is that, as you said, there are very well established nutrient depletions. And we've known this, you know, for almost 50 years now, by the way. So like the nutrient depletion side of this has been very clear. So nutrient depletions in many B vitamins, vitamin C, vitamin E, and then also in certain of the minerals, so like magnesium, selenium, and zinc.

And so what I would say there is you have a couple options, but number one is supplementing alongside hormonal birth control if you're still on hormonal birth control and are thinking about getting pregnant, not imminently, but in the future. And also if you go off of birth control, making sure that you're repleting those nutrients, because those are nutrients that are incredibly important for fertility and pregnancy.

Michelle (23:58)

Right.

Alexandria DeVito (24:11)

So I would say that as one piece, right? Certainly around the microbiome, we talked about that. And so giving your gut additional support might be helpful, right? Eating.

probiotic foods, eating prebiotic foods, sometimes adding additional supplementation may be necessary. And you can understand if you're experiencing any sort of digestive upset, that may suggest that there's something going on with your gut. So a lot of yeast infections can sometimes indicate, okay, there's an imbalance in what's going on in your gut.

Michelle (24:41)

Mm-hmm.

Alexandria DeVito (24:45)

If you're having immune challenges, a lot of times that can actually be linked to what's going on in your gut. Issues with digestion or motility, a lot of people don't even realize that the daily bowel movements are normal, and so if you're not having daily bowel movements, that actually means you're constipated, and so many people are walking around constipated and not even realizing it. So all of these things can be manifestations of, you know, A, our lifestyle, and then also can be a function of long-term

hormonal birth control use. So just understanding that. And what I generally say is that coming off of hormonal birth control, if you've been on it for many years, is an active rather than a passive process. So if you are just aware of some of these side effects of being on hormonal birth control, you can be a much more empowered user to take compensatory actions to address them.

Michelle (25:36)

That's such a good point because I think in many cases people don't really feel like they have an option, but they need to still learn about what they can do in order to empower themselves. It's definitely such a good point to bring up. I was going to ask you just kind of a side note, what are your thoughts? Because I'm reading a lot about it as of late, systemic enzymes, enzymes are really, really important, but I'm reading a lot about how

Alexandria DeVito (26:04)

Hmm.

Michelle (26:06)

amazing it is for the body, for inflammation.

Alexandria DeVito (26:11)

bit about them too. I haven't done the requisite deep dive that I would need to give a really thorough opinion here. It does seem to be showing some promise and you know I think there are some potentially interesting applications out there, but you'll have to stay tuned on that one because I need to research them a little bit more before I get into thinking about kind of what are the best suggestions for folks and kind of what are the specific instances that I think they can be.

Michelle (26:27)

Yeah.

Alexandria DeVito (26:37)

used in? What do you think is the most intriguing application so far?

Michelle (26:41)

It's incredible. So for example, wobe enzyme, which as of late, it's been out of stock for so many, but there are a lot of different places that do offer systemic enzymes. And basically what they do is they really break apart fibrin and you know, even plaque in our circulation system and our veins and arteries. And

it could really help lower inflammation. There's been a lot of research on specifically whoope enzyme and they've even researched it for recurrent miscarriages which I find really interesting. it can also help in certain cases of autoimmune conditions has been shown to help with Hashimoto's. There's so many things that I'm reading about it and I'm really fascinated. So I'm starting to dig in a little bit more.

and finding it to be a really amazing thing. And I think what happens is as we get older, we decrease the amount of enzymes our bodies have and enzymes are so brilliant, your body's so brilliant. It knows what to basically clean out and it will never affect your tissues. So it's really fascinating stuff.

Alexandria DeVito (27:50)

It is. The autoimmune conditions are the ones that I've seen some applications for. And it is really interesting to think about because certainly we're seeing autoimmune conditions on the rise and pretty precipitously. And autoimmune conditions are disproportionately present in the female population. So it's something that's important to be aware of. I think it's 80% of autoimmune diagnoses are in females. And on average, it takes about

immune diagnosis. So it's just, it's wild. It's wild to think about that. And a lot of times, autoimmune conditions can have non-specific symptoms, which is why sometimes it can be hard to address. We do autoimmune screening, testing it at Poplin, and one of the reasons that we do it is because there's been such a precipitous rise in autoimmune conditions, and we're seeing a lot of people flagging for indications of autoimmune conditions. And it's not a diagnosis. You have

Michelle (28:21)

Isn't that crazy? Yeah.

Mm-hmm.

Alexandria DeVito (28:50)

diagnostic testing to get an autoimmune diagnosis, but it's a first step to say, okay, might there be some autoimmune processes going on? And a lot of times that will initiate people into conversations around family history that they, you know, weren't aware of but that they then become aware of around autoimmune conditions. And, you know, there are certainly plenty of things once you know that you're dealing with it that you can start to do to manage it in collaboration with your doctor.

Michelle (28:51)

Mm-hmm.

Alexandria DeVito (29:16)

So I think that's an area that's certainly right for a lot more research. And I'm excited to see that there are potential other alternative therapies as well.

Michelle (29:23)

Yeah, it's pretty fascinating and really looping back to the gut health, there's such a connection with gut health and autoimmune conditions. And right now we know that so many of the ingredients that we find in processed foods impact our gut health. I mean, some of the medications we take. So it's kind of like you were saying earlier, even just environmental.

Alexandria DeVito (29:28)

Yes.

Michelle (29:45)

It impacts our gut. it's not something that we can avoid, which makes sense to why so many people are experiencing that. You also have to be proactive in, like you said, like the environment. We're not living in a very fertile friendly environment. So you have to be proactive in looking into it and researching it and then figuring out what's going on with your specific body and then what you can do about it.

Alexandria DeVito (30:10)

Absolutely, I think it's true. You know, I wish it weren't the case. I wish we had, you know, better regulations in this in this area. And I wish that we could play in a safer sandbox, I guess, is the is the way I would say it, you know, but you know, unfortunately, until regulations catch up, or, you know, until we are in a place where these, these chemicals aren't around us in such a profound way, we have to take a lot more personal responsibility. And so, you know,

Michelle (30:22)

Yeah.

Alexandria DeVito (30:38)

it can sometimes feel overwhelming because there's a lot to learn around, you know, trying to understand, okay, well, what are the things that I want to be keeping in and around me? What are the things that I don't want to be keeping in and around me? And I just, you know, generally encourage people to be gentle with themselves as they maybe go kind of room by room, starting to look at the different things that are coming in, identifying potentially major sources or things that you're using frequently to start to minimize all these assaults that we have on our system, right? Because our body

as I was saying earlier, and it was designed to regenerate and heal. And so it's really our job to figure out kind of what are the fertility blockers in our environment, right? And to remove those, because once you remove those, the body heals itself, right? It's miraculous. And so it's, you know, systematically finding, okay, where are these things in and around my environment that are not so consistent with my goals right now?

Michelle (31:21)

Mm-hmm. It does.

It's so funny. I feel like we're like mentally related because a lot of things that you're saying are things that I felt for forever. I mean, I really like relate and I say it over and over again, because it is really true. It's just that hope that knowing that your body's incredible. It's so intelligent. It's beyond intelligent. And it's just a matter of really finding things and anything's possible. Truly, if you put your mind to it.

And for just for people to hear about, I would love, and I would love to know also, what does poplin offer? Like what are some of the things that people can get tested?

Alexandria DeVito (32:13)

Mmm.

So Poplin's designed a pre-pregnancy test for females and for males, and the idea is that we look at a vast array of biomarkers that are like 70 plus. So the idea is essentially that we're looking across five different categories of health. So I mentioned them earlier, blood status, your hormone status, your immune status, metabolic status, and nutrient status. And within each of those categories, I'll just talk briefly about some of the most common things that we see, but the idea is to identify things that could be red flags or yellow flags,

with your ability to get pregnant or sustain a healthy pregnancy and have a healthy baby. So in blood status, this is where we're looking at the health of your blood cells, red blood cells, white blood cells. And so a lot of times there, we'll also look at iron storage, so your ferritin levels. And in your world, I'm guessing you see this manifested in a slightly different way, but we see a ton of iron deficiency. And a lot of times people are just coming in and

Michelle (33:09)

Mm-hmm.

Alexandria DeVito (33:14)

requisite iron is going to be really hard to, you know, to get pregnant and to sustain a pregnancy. It's a really important nutrient. So that's one that we see really commonly when we think about hormone status. That's the category that most people think about when they think about fertility. We're looking at a lot of different hormones there. As you, as you mentioned earlier, we look at TSH. We also look at seven other.

thyroid function markers, right? So we are looking at thyroid antibodies, but then we're also wanting to look at what else is going on with your conversion of thyroid hormone, and sometimes your TSH is not as sensitive of a marker as some of the others, and so it will change later in the disease process, and so using markers that are a bit more sensitive to catch things earlier is important.

Michelle (33:37)

Mm-hmm.

Mm-hmm.

Alexandria DeVito (33:59)

When I think about metabolic function, we look at blood sugar in that category. We also look at cholesterol. So a lot of times blood sugar function can interfere with regular ovulation. So we wanna understand what might be going on there that could interrupt.

ovulation or even egg quality. I know this is something that you've covered before, right? Our blood sugar is intimately related to certainly our hormone function, but also egg quality and sperm quality. And then nutrients we've talked a lot about, but I'm still consistently seeing low vitamin D, low omega-3s. So these are things that are fairly easily addressable if you know that they're present. And so those are ones that we are seeing commonly. And our, you know,

Michelle (34:33)

Mm-hmm.

Alexandria DeVito (34:44)

choose to address that, in some cases through diet and in some cases through additional supplementation.

Michelle (34:51)

And are people able to just go on and do it for themselves or do they need a provider to access the tests?

Alexandria DeVito (34:58)

people can access it directly themselves. That's exactly what we're designed for. I think what I realized when I was working as a nutritionist and I was trying to get some of these tests like have other providers run the testing was that a lot of providers wouldn't run the testing. They wouldn't run as comprehensive of a panel as I thought was necessary. And it's really not their fault. It's because in most cases, insurance is driving care. Care is not driving what is reimbursed through insurance. And so providers are stuck even if they wanted to run it,

they don't have the codes to be able to do it. So it is, you know, offered out of pocket. You can use HSA or FSA dollars for it. But the idea is that you know exactly what you're getting, you know exactly what you're paying, and then you can have this information. And most of the time, even though most doctors will not necessarily run the tests up front, once you get the results, you can bring those tests to your doctor and they...

will engage with you and can help you address what might be going on, whether or not that's chronic disease management, medication, or further conversations about the patterns that are being seen. And with the purchase of your test, you also get a call with one of our pre-pregnancy educators, so you can talk about next steps as well to make sure that you're equipped for what would be most helpful.

Michelle (36:14)

Okay, so that you'll have somebody to explain to you really what the test means.

Alexandria DeVito (36:19)

Yes, and it's also explained in our app as well. So for each item, it says kind of what is this and what is the implication on fertility as well. So the idea is to just give you some context for what you're looking at, and then you could also speak with someone to ask additional questions about if there's anything that's still confusing.

Michelle (36:41)

Awesome. I mean, I think that's great. I think it's great for people to be able to do it for themselves if they don't, if they're not working with somebody and, have that accessible for so many people because going through this could be so daunting and then just not really understanding. And then just getting, you know, doors closed, like, no, you can't continue looking into this, or it's just unexplained. So like, what else is going on?

Alexandria DeVito (37:06)

That's so well said. I mean, I think I'm consistently surprised at how dismissive sometimes people can be about getting information about your own body. And I really do believe, like, don't let any, if you desire information about your body, don't let anyone tell you that you don't have a right to that. I think that is, you know, just not true.

And so everyone has a different relationship with data. For some people, they feel it is empowering. Most people, I find, feel it is empowering to understand what is going on for yourself. And if that's you, if you feel like you want to understand, okay, what is my baseline? What is my pre-pregnancy wellness? What am I working with? Then I'd invite you to look into that because I think it's so much more impactful to have that information and then have paths to follow than be dealing with this kind of black box, right?

Michelle (37:46)

Mm-hmm.

Alexandria DeVito (37:59)

to be a black box, though we often treat it as such. There's so many indicators that our body is giving us through our menstrual cycles, through our symptoms, and then through, you know, physiologic testing like blood testing and urine testing. There's so much information that our body is giving us about what's going on that we can use to understand earlier indicators of fertility than just getting pregnant.

Michelle (38:21)

Absolutely. So for people who want to find out more about you, and do you work with people one on one still what do you offer?

Alexandria DeVito (38:32)

Yeah, absolutely. So if people are interested in the book, that's...

at 9mon the number nine, and that has all the information about kind of how to prepare to get pregnant and many of the factors that I talked about. I also talk about testing in the book as well. If people are excited about getting tested and are interested in getting tested, that's through Poplin, and the website for that is getpoplin.com, G-E-T-P-O-P-L-I-N. I'm not working with clients one-on-one anymore. It's only through Poplin these days, so if that's something that you're interested in,

encourage you to come join us. We have an incredible set of pre-pregnancy educators as well who are deeply passionate about the space just like you and I are, Michelle. And so if you want to get a little bit more insight into what's going on with your body or your reproductive partner's body, that's what we're here for.

Michelle (39:24)

Awesome. Well, Alexandria, I feel like we're on such similar pages on our approach to fertility And I love the fact that you're all about empowerment and education and getting people to really understand.

that their body is incredible and so intelligent and so powerful and that you can actually do something about it. So I had such a great conversation with you today and thank you so much for coming on.

Alexandria DeVito (39:52)

Thank you so much for having me. It's such a pleasure. And please keep doing what you're doing. It's absolutely incredible spreading the word and serving in this space. It's beautiful.