PRECONCPETION

003: Nutrigenomics And Epigenetics In Preconception Health w/ Alex Swanson, MS

003

003: Nutrigenomics And Epigenetics In Preconception Health w/ Alex Swanson, MS

Welcome to the Healthy Happy Mami podcast!

Our guest today is Alex J. Swanson, MS. He is the founder of Nutrition Genome (a nutrigenomic DNA testing company), a second-generation nutritionist, and creator of the blog The Health Beat.

Or listen on Apple Podcasts | Spotify | Stitcher | TuneIn

In today’s episode we are talking about nutrigenomics: the study of how foods affect our genes, and how genetic differences affect the way we respond to food.

Many of you may have heard about MTHFR, but there are many other genes that play a role in our health.

Genes can give us hints and insights about:

  • Digestion, 
  • Energy, 
  • Hormones, 
  • Stress
  • Brain health
  • Inflammation
  • Longevity
  • Detoxification
  • Athletic Performance

We are big fans of using nutrigenomics in our practices to help identify unique nutritional needs and vulnerabilities — especially as it relates to preconception health.

Highlights:

  • Why should you care about nutrigenomics?
  • Why is MTHFR important?
  • If you have MTHFR (especially C677T), what might you look for in terms of nutrition, and possibly in a prenatal vitamin?
  • How are the FUT2 genes connected to B12 levels and bifida bacteria levels?
  • What genes affect the thyroid?

Important Links

Find Alex online

GET 10% OFF the Nutrition Genome DNA Test Kit + Whole Body Health Report with code heymami10

Find Nutrition Genome on Facebook | Instagram

Find The Health Beat online

Find The Health Beat on Instagram

Quotes

“MTHFR677, so there’s actually two, there’s a 1298 and a 677. The 677 is the one that’s really most relevant to folate metabolism and as we know with pregnancy, folate is one of the major stars along with choline.”

“What’s really fascinating about choline is not only is it really important for liver and gall bladder health during pregnancy (and we see gall bladder issues during pregnancy), but vulnerability to toxins.”

 

003: Nutrigenomics And Epigenetics In Preconception Health w/ Alex Swanson, MS TRANSCRIPT

Dr. Maren:                          Welcome back to the Healthy Happy Mami Podcast. In today’s episode, we’re talking about nutrigenomics. This is the study of how food affects our genes, and how genetic differences affect the way we respond to food.

Dr. Maren:                          Many of you may have heard about a gene called MTHFR, but there are many other genes that we’re going to talk about today that play a huge role in our health. Not only our unique nutritional needs, but also give us hints and insights into things like digestion and energy and hormones, stress and brain health, inflammation, longevity, detoxification, and even athletic performance. Dr. Alex and I are both big fans of using nutrigenomics in our practices to help identify unique nutritional needs and vulnerabilities in our patients, especially as it relates to better preconception health.

Dr. Maren:                          I have learned a ton personally myself through using nutrigenomics, and a kit that I love called Nutrition Genome. So today, our guest is Alex Swanson. He’s the founder of Nutrition Genome and a second generation nutritionist. He’s also the co-owner of Swanson Health Center and the creator of the popular blog called the Health Beat. So listen in, he’s going to cover all things nutrigenomics and talk about some of the most important genes with regard to your health if you’re preconception or even pregnant, because it’s never too late. So, welcome!

Dr. Carrasco:                      Welcome!

Alex:                                      Thank you so much. I appreciate it. Thanks for having me.

Dr. Maren:                          Thanks for being here. So just give us an overview as to why somebody should care about nutrigenomics.

Alex:                                      Well, what we have found now with genetic research is we’re starting to understand the differences between all of us, from all over the world. We knew that there was conflicting results with different diets, and we didn’t really know why. Why did one work so well for one, but not another?

Alex:                                      And now, we’re starting to understand that. And nutrigenomic testing kind of shows you where there’s higher needs for vitamins, minerals, and compounds, where there’s more sensitivities, maybe, why someone does well on a Mediterranean diet, why someone does well on a higher fat diet. We can now explain this. And so it takes a lot of the guess work out and it can really help pinpoint exactly what you’re trying to do, what you’re trying to accomplish. And so that’s what’s really exciting about the research.

Dr. Maren:                          Yeah, we love that. I mean, research as related to nutrition can get really complicated because everybody says to do something else, right? Alex and I write about this in our guide when it comes to nutrition. But one of our principles is listen to your body, we’re not all the same. We all have unique needs. Alex, what do you want to add?

Dr. Carrasco:                      Yeah, I would just say that when I explain it to my patients, I tell them that the nutrigenomic component is like the scaffolding of the system, and that you can find the weak links within the scaffold, and then you can try to strengthen that through lifestyle and nutrition and try to fix things upstream. Or not fix them, but try to create better outcomes downstream so that upstream, you don’t have a bigger effect or a clinical symptom, or God forbid, a disease.

Dr. Maren:                          Yeah, for sure. Okay, we want this episode to really help guide some of the women who might be listening and maybe have run a nutrition genome on themselves, and are wondering, “What does all this information mean?” It is an awesome report, I will tell you out the bat. It’s a really good report.

Dr. Maren:                          I think it’s very user-friendly. I mean, I guide patients along and we read it, my nutritionist looks at it and we help people understand what it means and get the big picture. But I think even if you don’t have a clinician really interpreting for you, I think it’s still useful. So I hope this episode will help people to understand what to look for. So let’s talk about the superstar, which is MTHFR. Tell us why that’s important.

Alex:                                      MTHFR677, so there’s actually two, there’s a 1298 and a 677. The 677 is the one that’s really most relevant to folate metabolism and as we know with pregnancy, folate is one of the major stars along with choline. And what’s so fascinating to me about MTHFR is understanding the ancestral history of this gene. For a long time, we looked at it as there’s some kind of defect, something’s wrong, why is it going so much slower? Why do these people need so much higher methyfolate requirements? And we start to look at that history of the Mediterranean, for example.

Alex:                                      And that’s where we see these giant clusters of homozygous genotypes, is because you’re in a place that is basically, you’re exposed to a lot more sun and you have a lot more folate-rich plants growing. And so one of the theories is that that higher folate intake down regulated that enzyme, and the higher amount of what’s called thymidine was produced to basically create more UV protection so less damage was done.

Alex:                                      Another theory was in South Asia, in Eastern Mediterranean, is that from the parasite that causes malaria, that there was an adaptation there to help lower folate levels to be protective against malaria. So when you understand that context, it takes away the fear of it, right? There’s not something wrong with you. Understand where you’ve come from, and that’s why you need to incorporate these little strategies based on what the environment was providing, no matter where you live now. It changes that. And that’s what I think people will enjoy understanding about this report, is understanding your history is big part of it.

Dr. Carrasco:                      And I think that’s probably consoling to a lot of people, because these are places that are very long lived, with robust health. So it doesn’t mean that you’re going to have a bad outcome.

Alex:                                      Exactly.

Dr. Maren:                          Yeah, I think that’s such an important piece, and I find that some other tests, people sometimes come to me saying, “Well, all this is wrong with me because I have MTHFR,” but it’s really like, “No, MTHFR just helps us understand how your genes evolved, and what nutritional needs you might have more of.” And there is some benefit, and there’s some risk and we just have to decipher what those things are, so I really appreciate that the Nutrition Genome Report outlines that. I mean, I recently saw it pops up under strengths and weaknesses now. And I’m like, “Oh, the weakness is you might be more vulnerable to UV light,” right?

Alex:                                      Mm-hmm (affirmative). Correct, yeah. For the wild type, so the wild type is actually more common in Northern latitudes. So when you have someone from the North come down to places that are very hot, have a lot of UV exposure, they’re going to be more sensitive to that damage.

Dr. Maren:                          Yeah, interesting. Okay, so tell people if they do have MTHFR, that more significant one, especially the C677T, what might they need to look for in terms of nutrition and maybe a prenatal vitamin, when they’re looking at specific nutrients?

Alex:                                      So the biggest thing is to look out for synthetic folic acid. So you could see that in a lot of cheap prenatals. You’ll see it in fortified foods. And the reason is that that can bottleneck very easy with a slower enzyme. Higher circulating levels have been correlated with a bigger risk of autism, also a bigger risk of breast cancer. And so that’s the first thing you have to look out for.

Alex:                                      The second thing is if you are buying a prenatal, look for methylfolate in that form. And also, there’s a long list of foods that contain actual, natural methylfolate. And so in our grocery list, we outline that. And that’s what you want to really zone in on and be like, “Okay, this is really important. Build your diet around these foods, to make sure that you’re getting enough during pregnancy.”

Dr. Maren:                          And one of the labs Alex and I both test is homocysteine. So homocysteine, for those of you listening, can be a functional marker for some of your B vitamins. It’s not perfect. When it’s normal, it doesn’t rule out a problem. But when it’s abnormal, we know you need more probably B2, and more methylfolate. Maybe sometimes, it’s B6 or B12 or choline as well. Alex, what else do you want to-

Dr. Carrasco:                      No, I think that’s about right [crosstalk 00:07:51].

Alex:                                      No, that’s all. Yeah, right. Oh, sorry.

Dr. Maren:                          Yeah, sorry, you’re both Alexes.

Alex:                                      Two Alexes.

Dr. Maren:                          I’ll call her Dr. Carrasco.

Alex:                                      Dr. Alex.

Dr. Carrasco:                      Yeah, either one. Either one. Either one. Yeah, I agree. I think it just gives us a clue into that cycle isn’t working well, and that we have to try to parse it out. But I think probably all of those nutrients are pretty important, so we try to hit them hard in my practice.

Dr. Maren:                          Yeah. Okay, so let’s move on to one of our other favorites, which is a gene called PEMT, which has got choline.

Alex:                                      Yes, so this is another one that has roots in latitude. And so, with MTFHRs, we talked about the variants are more common in Mediterranean. With PEMT, the variants are more common in northern latitudes. So, Northern Europe, Northern Asia. So with this one, when you have variants in it, you have a much higher need for choline. And what’s really fascinating about choline is not only is it really important for liver and gall bladder health during pregnancy, and we see gall bladder issues during pregnancy, but vulnerability to toxins.

Alex:                                      It plays a big role in detoxification. It plays a huge role in the mental health of the child later in life. So, this is one I feel like has been ignored for a long time in a way, because we went to this no cholesterol, and no saturated fat, avoid these foods. And a lot of these foods are ones that had choline in them. So we went to egg whites and chicken breasts, and we got rid of choline. So I think this shift back to it is really important, and this is especially true when you’re not getting enough folate, or not… the choline comes in as a back up.

Alex:                                      Now, let’s say that you struggle getting enough choline. You’re like, “I don’t like eggs, or I have an allergy to eggs,” some of these cuts of meat, you don’t eat meat, whatever the reason is, betaine is one that basically acts as a back up to choline. So they’re all working together, and betaine’s high in spinach. It’s high in beets. It’s high in different grains. And so-

Dr. Carrasco:                      Like beet juice?

Alex:                                      Beet juice, there you go, getting your methylfolate and your betaine in one. Very smart hack. So, yeah. So there’s all these different ways to strategize to help assist this gene. But I think that when we see variants in this, something else we have to think of is that pathway is also enriched with DHA. And so as you increase choline, you’re actually benefiting DHA. There’s a synergy there. And so for brain health or brain development, the two are just so crucial.

Dr. Maren:                          That’s awesome. I also-

Dr. Carrasco:                      No, I was just going to say, we were talking about how appalling it is that we didn’t even recognize choline as a nutrient until the late ’90s. So medicine’s barely catching up to this, in the last couple years, unfortunately.

Dr. Maren:                          Yeah, our last episode, we talked with Sarah Morgan about choline and choline in prenatals, and how most prenatals don’t even have it, and leading prenatals have 10 milligrams or 17 milligrams or something silly like that. So ladies who are listening, go back and listen to that podcast and know that your prenatal can have somewhere upwards, 300 plus milligrams of choline at least, with the specific one we recommend, we like it because there’s a lot of choline in there.

Dr. Maren:                          But they also use this thing betaine, which is also called trimethyl glycine to help hack that cycle and it’s just developed in a really intelligent way to help with all that. I also love that choline is a big player with sleep. So do you think it helps with sleep? I mean, in pregnancy, a lot of people struggle with sleep. So I don’t suppose that’s necessarily something specific to pregnancy, but I wonder since our choline needs are going up when we’re pregnant, if maybe that’s playing a role sometimes?

Alex:                                      Yeah, I mean, acetylcholine plays a role in the REM cycle, so it does absolutely influence it. And I think also what happens maybe post-pregnancy, with memory. I think there’s a big part of it having to do with this massive depletion that occurs. And if your reserves aren’t high enough, I mean, I could see it really affecting memory.

Dr. Carrasco:                      I see it clinically very powerful to help people restore their cognition post-partum, but even also in men, it’s pretty impressive. Just with a month of supplementation, people turn things around pretty quick.

Alex:                                      Amazing.

Dr. Maren:                          Yeah, agreed. 100%. Okay, so one of our other favorite nutrients especially with regard to preconception health and pregnancy is vitamin A. So can you talk about the gene that helps us understand how we utilize vitamin A and what our levels might look like?

Alex:                                      Sure, yeah. The gene is BCMO1 and it has to do with conversion of beta-carotene, so plant-based, to vitamin A. And that conversion in general is affected by thyroid health, it’s affected by fat intake. But this gene, it can change that conversion by up to 57%, based on the variants in it. And so, vitamin A, it’s so critical during pregnancy or before getting pregnant, but also for lung development of the child. And so it’s really easy like choline, not to get enough vitamin A in your diet when you look at what foods are high in it.

Alex:                                      It could be a lot of foods that people are avoiding. And so, I think that in terms of how you’re getting that, again, it’s eggs, it’s organ meats, it’s cod liver oil. Those are really the big ones. Full fat dairy, you could easily have somebody not getting any of those. And with a lot of prenatals, you’ll see beta-carotene listed as vitamin A. It is not vitamin A. And that is a very big misconception that I think people, women a lot of times that are taking these are thinking, “I’m getting plenty, it says right here, 100%.” Well, that can change a lot with the genetic variants, but also the fact that it’s not really true vitamin A.

Dr. Carrasco:                      Yeah, I just was looking at a supplement yesterday, one that’s big and marketed right now. And all their vitamin A is beta-carotene, and I was just sitting there thinking, “Wow, how many people think that this is actually going to benefit them? And how many people are not going to get a benefit from this, unfortunately?”

Dr. Maren:                          Yeah, totally. And I think there is an important point too, we don’t want women supplementing with a whole ton of vitamin A. I mean, obviously, we’d prefer they get it from food. But we still like to make up for that difference with a good prenatal that has some vitamin A in it, rather than just straight beta-carotene. We also like to test for it. I mean, it’s a pretty easy test.

Dr. Maren:                          It’s just a fasting lab that we can get at Quest or Labcorp, and you can check somebody’s vitamin A level and see where they’re at. I especially do this in women that are vegan or vegetarian, because of as you mentioned, most of the preformed vitamin A comes in the form of animal foods. And if they have the BCL1 snip or maybe two, they’re homozygous for that gene, then they might have issues with getting adequate vitamin A. Whereas in America, mostly, we’re kind of discouraging people from taking it, right?

Alex:                                      Yeah. And I think that came from what they also found with Accutane during pregnancy and birth defects. And really, when you’re starting to look at the certain forms that are used, how much was used, all of that played a role. And so I think when you look at the research, you start to see well, if it’s under this certain amount, it’s in the right form. It is safe. But these high doses were very dangerous.

Dr. Carrasco:                      I have a question, and I don’t know if you would know the answer. But when people eat a lot of beta-carotene, they get these carotenemia on their hands and on their feet, where their soles turn… the hands and the feet turn orange. I wonder if there’s a correlation between that and this gene as well? And I don’t know if there’s an answer to that, but just thought of that.

Alex:                                      Yeah, I think there is. I think it’s a very poor conversion rate is what you’re seeing. I haven’t read that in the literature, but that is what I was thinking as well.

Dr. Maren:                          Good question. All right. So I always look at these two genes in combo. So just like we use beta-carotene, we need to convert it to vitamin A, the same thing happens when we use plant-based A-linolenic acid from flax seeds or walnuts. And we need to convert that to EPA and DHA. We know in much of the literature surrounding prenatal health and health during pregnancy, and even post-partum, DHA in particular is a really important nutrient. So tell us a little bit about this gene.

Alex:                                      So, yeah. There’s two genes called… It’s FADS1, FADS2, and so they’re both connected to that version of ALA to EPA and DHA. And what’s fascinating again about this one is there may be ancestral roots here, in terms of if you had more coastal migration roots in your family, you’re going to see a better… or actually, I’m sorry. You’re going to see a worse conversion rate. You’re going to see a higher requirement for animal-based EPA and DHA, if you’re more inland, you’re more mountainous, you’re going to probably see a better conversion rate of ALA to EPA and DHA.

Alex:                                      So, when you see again those variants, you think, “Okay, there’s not something wrong. This has to do with where my family has come from.” And I think it’s a really important one for pregnancy, because obviously, we think of folate, we think of DHA as the big ones that are talked about. And how much DHA? That’s also a question too. Like, what is the right amount per person? And I think this helps determine are you on the upper end? Are you in the middle somewhere, or are you lower? But I think that for also post-pregnancy when we look at DHA levels in breast milk, what we’ve seen in research is that in North America and Canada, they had the lowest levels of DHA. And then Japan, they have the highest.

Dr. Maren:                          Wow.

Alex:                                      And so if DHA is being rapidly depleted and we’re not again, keeping that reserve high enough, that’s probably what we’re going to see in the breast milk as well.

Dr. Carrasco:                      That’s fascinating.

Dr. Maren:                          Yeah, agreed. Okay. So let’s move on a little bit and talk about one of the other big genes. I see this come up a lot, especially in patients who struggle with IBS symptoms and it’s the FUT2 genes. Tell us a little bit about that one.

Alex:                                      Yeah, so this one is connected to B12 levels, and it’s connected to bifida bacteria levels. And it’s another one that we call a trade-off gene, in that there’s reasons that we have the good and the bad with it. And so, if you have the wild type, which is the most… wild types, when you say that, it’s the most common in a studied population. And the wild type has naturally lower B12 levels, so that’s something to check to make sure it’s not too low because that’s an important one during pregnancy. But also, they have higher bifidobacteria levels, which has a lot of benefits like immunity. And then you’ve got the homozygous version, which has high B12 and low bifidobacteria. And so, this is one where they have more protection against the norovirus, the rotavirus, H. pylori.

Alex:                                      But they’re also more susceptible to other infections. And also, during pregnancy, more issues with digestion, you may see more intestinal permeability, things like that, more sensitivities. And then of course, that influences the child from the birth canal and the breast milk and everything else. So, they may have a higher need for prebiotics during this time, to help increase that bifidobacteria level and influence that. And then maybe B12 is less of a focus for this person. So it’s a pretty fascinating gene, in that it has a pretty large impact. And I think knowing that is really helpful during pregnancy.

Dr. Maren:                          Yeah, I’m a homozygous FUT2, which is no surprise given my digestive stuff. So I do think I have to pay special attention to prebiotic foods, but before I added any of those in, I really had to make sure I treated the underlying gut infection piece, so I could tolerate them. So if you’re listening and you don’t do well with prebiotic foods like onions and garlic and leeks and sun chokes and maybe even resistance starch, green bananas and stuff like that, you might want to… If those kinds of things make you bloated, often is a sign of this underlying gut infection that needs to be treated first.

Dr. Carrasco:                      Which is hard if you’re pregnant though, so.

Dr. Maren:                          Yes.

Dr. Carrasco:                      And even for those people, maybe even supplementing just with a bifido through pregnancy, through nursing, and then postpartum after they’ve stopped nursing, then a good time to work up. Because I think a lot of times too, patients are like, either they want to get pregnant in one month or they’re pregnant and they’re learning all these things.

Dr. Carrasco:                      And then there’s just not a lot that you can do, you have to wait until you’ve gone through the birth and through nursing. So all those things can also be handled in the future, but there are things that we can also do to support you along the way. So I think for those folks, probably just bifido supplementation would be smart. And I wonder if there’s a correlation with FUT2 having colicky babies.

Dr. Maren:                          Yeah, that’s a good question. I don’t know. I don’t know.

Dr. Carrasco:                      Just things I think about. Don’t [crosstalk 00:21:00].

Dr. Maren:                          I know. That’s good questions. Yeah, I think that my favorite probiotic is MegaSpore, and I still use it in my pregnant patients a lot. And a lot of times, people tolerate it pretty well if they have underlying gut stuff. But yeah, like you said, it’s super hard to treat somebody’s gut infections when they’re pregnant and then nursing. I mean, it just goes on to show being pregnant and breastfeeding a child is pretty hard on our health. So the more you can get ahead of that and solve these issues before you get pregnant, the better. But obviously, it’s not always an option, so. It’s never too late, though.

Dr. Maren:                          Okay, so let’s move on to talk a little bit about some of the genes that affect thyroid. Tell us a little about those ones.

Alex:                                      Yeah. So DI01 is a gene that is influenced as the… or it encodes the enzyme for the T4 to T3 conversion. And something that I find really fascinating about this gene is that they actually did a study with pregnant women that looked at the organochlorine pesticide exposure and PCBs, and how that affected the T4 and T3 conversion based on genotype.

Alex:                                      And what they found was that the homozygous genotype actually had much lower T3 levels, higher T4 levels and therefore, disrupted thyroid function much more in these people. So they’re more susceptible to those toxins. And so, you could see higher blood pressure during pregnancy. You could see more miscarriages, you could see more problems with fertility connecting to that chemical exposure based on this gene alone, which I thought was pretty interesting.

Dr. Maren:                          Yeah, thyroid is something we will talk about in great detail, because it’s huge with regard to fertility, with regard to successful pregnancy… excuse me, decreasing rate of miscarriage, especially first trimester. I mean, it’s a huge one. And Dr. Alex and I test people’s T4 and T3, most people don’t necessarily have these things tested by their conventional doctors. But we see a lot of conversion issues, and that… It’s not always tricky to manage, but it’s got to be managed when you [crosstalk 00:23:18]-

Dr. Carrasco:                      I think you just have to look at it, recognize it, and manage it. It’s not the hardest thing to do. It’s just recognizing it. Although I will say, I do think our OB/GYN colleagues are really doing a better job in really trying to keep a tight control with their patients. So I’ve seen that in the last few years, definitely, since the ACOG guidelines changed to support a tighter TSH.

Dr. Maren:                          Awesome. Okay. So the last one we want to cover has to do with vitamin D. So tell us about you better understand vitamin D needs.

Alex:                                      Sure. So this gene is CYPTR1, and variants are connected to lower circulating vitamin D levels. And I think vitamin D research has been evolving quite a bit over the last decade, in terms of our understanding what are the optimal ranges, how does that actually change by race? Because it does. How does it change through bone density based on race? There’s a connection there.

Alex:                                      But also, I think there was this push for, “We need a lot more sun,” simply based on lower vitamin D levels. But if you look again at different latitudes, you’ll see okay, much father north, you have people with very high vitamin D levels but very low levels of sunlight. But they were getting a lot more through their diet. And you’ll see ranges, even in the higher ranges, in the northern spots, between 50 and 80 in some people, but it is getting a lot of… or certain regions that are getting a lot of vitamin D in their diet.

Alex:                                      So I think that dietary vitamin D or even supplemental vitamin D for people with more northern heritage, and then maybe people that have more Mediterranean, it is more sunshine. They can handle that. It’s not causing them much damage. It’s increasing their levels naturally. But it is very common, and you’ll see a lot of low vitamin D levels, and as we’ve talked about with COVID, it’s a major deal to be below a certain level. And it’s a big deal for pregnancy. I mean, it makes a huge difference to make sure that those ranges are optimal.

Dr. Maren:                          Yeah, and it’s also a really easy one to test. So listeners can really just ask your provider to test your vitamin D level, and I think most of the time, they’re totally willing to do that.

Dr. Carrasco:                      Can I throw you on the spot and ask you about two more genes that are interesting to me?

Alex:                                      Yeah.

Dr. Carrasco:                      The first one would be the ACE gene, just in regards to preeclampsia. And I think there’s a lot of things we can do to manage preeclampsia, but I think it’s very nice for people to know before they go into pregnancy that they have that homozygous gene, because then we can support them through the process.

Alex:                                      Yeah, what’s challenging with blood pressure is that we know that it’s about 30% genetic, 70% environmental, diet. And there are a lot of genes that influence blood pressure. And so as I was going through, we just reported on one called AGTR1, that was connected to blood pressure levels and carbohydrate and fat intake, how that influenced it.

Alex:                                      And then you’ve got DI01, with T4 and T3, how that influences it. So I think it can be challenging to narrow down the exact cause as to where it’s coming from, because there’s so many ways it can happen. And so that’s where I’ve found it challenging, is how do we narrow it down per individual for their subset of high blood pressure? But I think with pregnancy, I think hormones can play a pretty big role in understanding that.

Dr. Maren:                          Yeah, great. And then the other one I want to talk to you about that we probably should do a whole show on someday is COMT, just because so many women deal with anxiety before conception, like they’re not getting pregnant fast enough and anxiety goes through the roof or postpartum, so supporting women with those mutations before and after having a baby, or during.

Alex:                                      Yeah, COMT I think is one of the most fascinating ones, because it has such a large impact for a single gene. So I think what we look at with COMT in terms of understanding how do we modulate dopamine and adrenaline levels? Because that’s really what it’s governing. And the co-factor is magnesium, so when you see somebody with a homozygous variant, you’re going to see a much higher magnesium need to help balance that response. Vitamin C is another one that helps modulate dopamine levels.

Alex:                                      I think that again, the homozygous one is going to respond very well to any kind of weight training. That actually has a pretty big impact on modulating that pathway, in terms of bringing those levels down. And then you have the other end of it too, where you have the wild type, where it’s a lower dopamine, lower adrenaline. But if estrogen is spiking or way out of range, it can really push those levels very hard. So modulating the estrogen pathway, Omega-3, vitamin D, iodine, all of those really help balance that out. And so I think that’s another factor that we don’t all talk about with COMT, but I think is important.

Dr. Carrasco:                      Fascinating. I think we can deep-dive into that one, because I think it really does affect a lot of us. Especially all women, even if you don’t have a homozygous variant, we’re all going to be influenced by estrogen, so.

Alex:                                      Right.

Dr. Maren:                          Yeah, for sure. And I think one of our favorite things to use in pregnancy is magnesium. It’s a safe one we can use, and can really help that gene, so awesome. Well, any last words of advice, or anything else that you want to let women know who are thinking about preconception and wondering if they should test their nutrigenomics?

Alex:                                      I would say that I think this is one of the most powerful tools we have now. This is a very exciting time to be alive and to be having a child, because of this knowledge and the fact that we can influence up to four generations through this information, I mean, to me is extremely exciting. Because we can start to see all of these different diseases that are diet and environmental related, we can start to reduce these dramatically starting in pregnancy, and I’m excited to help be a part of that.

Dr. Carrasco:                      It’s amazing to be at that cutting edge.

Dr. Maren:                          Yes, epigenetics is super cool and we love it. So we would encourage anybody listening to grab a kit, because they’re awesome. But we also want to thank you because Alex has been super generous and offered you all a discount on this really amazing resource. So there is a 10% off coupon code. We’ll put it in the show notes, but it’s HEYMOMMY10. And you can get 10% off the kits, so thank you for doing that.

Alex:                                      Of course. Thank you so much for having me.

Dr. Maren:                          Yeah, we’re big fans. Cool.

Dr. Carrasco:                      Thank you so much.

Dr. Maren:                          Thank you.

Male fertility issues contribute to about 50% of all infertility cases. So knowing how to support fertility and better sperm health is important for healthy conception.

Our guest today is Geo Espinoza, ND, a naturopathic functional medicine doctor who is recognized as an authority in urology and men’s health.

Alejandra Carrasco M.D. and Christine Maren D.O.

Hello! We are Alejandra Carrasco M.D. and Christine Maren D.O. We founded Hey Mami because we felt a lack of support for fellow mamis. As physicians, we see women every day who struggle with fertility, are forgotten about postpartum, and have put their health on hold for years while they raise a family. We’re here to change that.

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