The relationship between hormones and the immune system is complex but critical for female reproductive health. Immune cells within the reproductive system must protect the body but also create a supportive environment for reproduction.  

 

This delicate balance is further complicated by sex hormones like estrogen and progesterone, which change throughout the menstrual cycle. These hormonal changes can influence how various immune cells function, including T cells, which help coordinate the immune response; macrophages, which act as scavengers by clearing away debris; natural killer (NK) cells, which quickly respond; and mast cell function.¹

 

Therefore, understanding how the immune system functions within the female reproductive tract is crucial for promoting women's health, as it sheds light on how immune responses can influence fertility and long-term health. 

 

A Foundational Relationship Between Ovarian Hormones and the Immune System

 

The connection between the immune system and ovarian hormones, particularly estrogen and progesterone, is fundamental to female reproductive health.² Research indicates that certain immune cells possess receptors for sex hormones, like progesterone, allowing them to respond directly to hormonal changes throughout the menstrual cycle.³

 

For instance, in the endometrium, or uterine lining, natural killer (NK) cells increase later in the menstrual cycle and are even more pronounced during the early stages of pregnancy. These NK cells, along with regulatory T (Treg) cells, are essential for the growth of blood vessels, movement of cells that form the placenta, and tolerance of the immune system during pregnancy.⁴

 

The Innate versus Adaptive Immune Systems and Reproductive Health

 

The epithelial cells lining the human female reproductive tract act as a physical barrier and govern the functions of both the innate and adaptive immune systems.⁵

 

The innate immune system serves as the body's first line of defense, providing a quick general response. Key players in this system include defensins, enzymes like lysozyme and lactoferrin, and other antimicrobial peptides, all of which help protect the body and support overall well-being.⁶

 

Conversely, the adaptive immune system is characterized by its ability to recognize unwanted microorganisms and provide a targeted response. It employs antibodies and T cells to target more accurately.

 

Research indicates that sex hormones can significantly influence both branches of the immune system. However, our understanding of their impact on the female reproductive system and how hormonal changes may shape both components of immune support in women's health is still emerging.⁶

 

 

Hormonal Influence on the Immune System Throughout the Menstrual Cycle

 

The menstrual cycle, averaging 25 to 30 days (though this can vary), is divided into three distinct phases: the follicular phase (first half), ovulation (midpoint), and the luteal phase (second half).

 

Each stage is regulated by fluctuations in sex hormones, primarily estrogen and progesterone. Since these hormones also significantly influence the immune response within the female reproductive tract, the immune response may change throughout the cycle.

 

For example, some white blood cells undergo significant changes throughout the menstrual cycle, closely correlating with hormonal fluctuations.¹Research has demonstrated that certain immune-supportive proteins—such as human defensin-5 and secretory leukocyte protease inhibitor (SLPI)—vary in concentrations depending on the cycle phase. 6These proteins play a crucial role in promoting a healthy reproductive environment.

 

Notably, the amount of SLPI in cervical mucus fluctuates, increasing during ovulation and in amniotic fluid during pregnancy. Additionally, studies indicate that cells from the uterine lining produce more SLPI after ovulation compared to before. ⁶

 

During the follicular phase, estrogen appears to enhance immune responsiveness. At the same time, progesterone alters immune function during ovulation and the luteal phase to create a more hospital environment for a potential pregnancy.¹²³

 

The immune system also undergoes a recalibration during pregnancy to foster tolerance and protect the developing fetus.⁴ These changes highlight the profound effects of the menstrual cycle on immune health within the female reproductive system.

 

Takeaway

 

The relationship between immune health and reproductive health is complex and deeply interconnected. Research demonstrates that these two systems influence one another, underscoring the importance of nurturing both immune function and reproductive health for overall well-being. Recognizing this link not only enhances individual health but also paves the way for healthier future generations.

 

Caitlin Beale, MS, RDN is a registered dietitian and freelance health writer. She has a master's degree in nutrition and over ten years of experience as a registered dietitian.  

 

⁺The views expressed in this article are those of the authors. They do not reflect the opinions or views of Pure Encapsulations®.  

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1 Gameiro CM, Romão F, Castelo-Branco C. Menopause and aging: changes in the immune system--a review. Maturitas. 2010;67(4):316-320. doi:10.1016/j.maturitas.2010.08.003

2 Zwahlen M, Stute P. Impact of progesterone on the immune system in women: a systematic literature review. Arch Gynecol Obstet. 2024;309(1):37-46. doi:10.1007/s00404-023-06996-9

3 Hughes SM, Levy CN, Katz R, et al. Changes in concentrations of cervicovaginal immune mediators across the menstrual cycle: a systematic review and meta-analysis of individual patient data. BMC Med. 2022;20(1):353. Published 2022 Oct 5. doi:10.1186/s12916-022-02532-9

4 Wang W, Sung N, Gilman-Sachs A, Kwak-Kim J. T Helper (Th) Cell Profiles in Pregnancy and Recurrent Pregnancy Losses: Th1/Th2/Th9/Th17/Th22/Tfh Cells. Front Immunol. 2020;11:2025. Published 2020 Aug 18. doi:10.3389/fimmu.2020.02025

5 Lee SK, Kim CJ, Kim DJ, Kang JH. Immune cells in the female reproductive tract. Immune Netw. 2015;15(1):16-26. doi:10.4110/in.2015.15.1.16

6 Wira CR, Fahey JV. The innate immune system: gatekeeper to the female reproductive tract. Immunology. 2004;111(1):13-15. doi:10.1111/j.1365-2567.2004.01796.x

7 Hall OJ, Klein SL.. Mucosal Immunol. 2017;10(5):1097-1107. doi:10.1038/mi.2017.35

8 Mahajan D, Sharma NR, Kancharla S, et al. Role of Natural Killer Cells during Pregnancy and Related Complications. Biomolecules. 2022;12(1):68. Published 2022 Jan 4. doi:10.3390/biom12010068

9 Monin L, Whettlock EM, Male V. Immune responses in the human female reproductive tract. Immunology. 2020;160(2):106-115. doi:10.1111/imm.13136

10 Wira CR, Fahey JV. The innate immune system: gatekeeper to the female reproductive tract. Immunology. 2004;111(1):13-15. doi:10.1111/j.1365-2567.2004.01796.x

Perimenopause is the transitional phase between a woman's reproductive years and menopause. Menopause itself is defined by a single moment: one year after the last menstrual period. The years leading up to this point, known as perimenopause, involve natural hormonal changes that bring about various physiological shifts in the body.

 

Understanding why these changes occur can be essential for maintaining well-being when hot flashes, mood swings, and sleep disturbances are common. This period also presents an opportunity to nurture your body and establish healthy habits that will support you now and in the future.

 

Here's what you need to know about the changes you may experience during perimenopause and the steps you can take to lay a strong foundation for this next chapter of life.

 

Perimenopause Changes Explained

Perimenopause can begin as early as the mid-to-late thirties, although the average onset age is around 45 and lasts up to ten years before reaching menopause.¹

 

The hallmark of perimenopause is changing hormone levels, particularly the fluctuation of estrogen and progesterone, which can cause an array of physical and emotional changes. Over time, estrogen and progesterone levels drop, accompanied by higher follicle-stimulating hormone (FSH) levels.²

 

Early signs of perimenopause can be subtle. Menstrual cycles may become heavier before eventually getting lighter, or the cycle might become shorter. These changes are due to the fluctuating and unpredictable levels of estrogen and progesterone, which in turn impact ovulation.

 

Many women also find it harder to lose weight during perimenopause. Sex hormones significantly affect insulin sensitivity, impacting blood sugar regulation. As estrogen levels drop, cells can become less responsive to insulin, making weight management more challenging. Additionally, lean body mass declines, slowing metabolism.³

 

The changing hormone levels during perimenopause can also impact bone health. Bone mineral density (BMD) loss accelerates near the end of perimenopause and continues through early menopause, making it crucial to pay attention to bone health.⁴

 

In addition to physical symptoms, many women notice significant changes in mental health, with more mood swings or irritability compared to reproductive years.⁵

 

Difficulty sleeping, night sweats, and hot flashes are also typical signs that become more evident as perimenopause progresses. Up to 80% of women report experiencing vasomotor symptoms such as hot flashes and night sweats during this time.⁶

 

Not every woman will experience all these symptoms but recognizing that they exist can help you find the support you need if you aren’t feeling like yourself.

 

 

 

Tips for Natural Perimenopause Support

 

You can adopt these daily habits anytime but starting as soon as possible may help ease your transition and promote long-term health benefits.

 

Add More Movement

 

Regular physical activity can help support healthy weight management and bone health.¹ Strength training is essential for supporting lean muscle mass to counteract the natural decline during perimenopause and menopause. Lean muscle is critical for strength and a healthy metabolism. 

 

Exercise can also support restful sleep patterns. Getting a good night's rest can be elusive during perimenopause, but exercise may offer relief. A meta-analysis found that regular aerobic exercise and gentle movements like yoga, Qi Gong, or walking can significantly improve sleep quality. The researchers found that exercising for 30 to 60 minutes at least three times a week is beneficial, and interestingly, this duration appears more effective than longer sessions lasting 70-90 minutes.²

 

Experiment with Intermittent Fasting

 

Intermittent fasting (IF) might help during perimenopause by supporting key health markers, possibly more than traditional calorie restriction.³ Intermittent fasting refers to a set pattern of eating and fasting, the most common being 16 hours of fasting with an eight-hour eating window.

 

A study comparing two groups of perimenopausal women found that the IF group lost slightly more weight and had a lower BMI, though fasting blood sugar levels increased in the fasting group.⁴  Another meta-analysis found that fasting can aid weight loss while preserving lean body mass.⁵

 

It's important to note that while intermittent fasting may have benefits, everyone’s body is unique, so responses can vary. Some individuals may find that IF doesn't sync well with their bodies, demonstrating the importance of personal experimentation to discover what works best for your body.

 

Bump Up Fiber for Healthy Hormone Support

 

Increasing dietary fiber intake can support hormone metabolism, weight management, and healthy blood sugar function.⁶ Fiber supports the microbiome (the collection of microbes that live in the gut), which is pivotal for metabolizing hormones efficiently.⁷

 

Fruits and vegetables, whole grains, nuts, and seeds are among fiber-rich foods. Aim for at least 25 grams of fiber per day.

 

Pair Carbs with Proteins to Help with Satiety and Blood Sugar

 

Combining carbohydrates with protein at each meal or snack can enhance satiety and support healthy blood sugar levels, aiding in weight management and metabolic health. Protein, vital at any age, becomes increasingly important as we age, helping preserve muscle mass and support metabolic function.⁸

 

Examples of protein-carb pairings include apple slices with string cheese, whole grain toast with avocado and eggs, or roasted chickpeas and vegetables.

 

Increase Intake of Essential Fatty Acids

 

Incorporating more essential fatty acids, particularly omega-3s, into your diet through food or supplements can provide numerous benefits. Omega-3 fatty acids have been shown to support mood, vasomotor changes, and cardiovascular health.^{9 10}

 

The best sources of omega-3s include fatty fish like salmon, mackerel and, sardines, as well as chia seeds, flaxseeds, and walnuts. If you don't consume these foods regularly, consider taking a high-quality fish oil supplement.

 

Consider Supplements

 

Starting with food sources is always the best approach to meet your nutrient needs, but supplements can provide additional support. Certain supplements can support overall health and well-being during perimenopause:

 

• Calcium, Magnesium, and Vitamin D: Calcium, magnesium, and vitamin D are three nutrients essential for bone health. These bone-supporting nutrients work together to maintain strong bones.¹¹  Magnesium helps with bone health and helps the body metabolize nutrients.

 

• Royal Jelly: Produced by honeybees, royal jelly is a substance known for its potential health benefits. Studies suggest that supplementing with royal jelly may provide antioxidants and balance the hormone activities of women transitioning through menopause.^{12 13}

 

• Ashwagandha: Ashwagandha is an adaptogenic herb that may support mood and provide a sense of calm.¹⁴ Known for its properties that help the body deal with stress, ashwagandha can be a valuable supplement for those looking to support mood and manage occasional stress more effectively.

 

• Passionflower: Passionflower is another natural remedy that may help promote a sense of calm and relaxation, aiding in the pursuit of a restful night's sleep.¹⁵ Often used in teas and supplements, passionflower can be an effective part of your nightly routine to promote relaxation and improve sleep quality.¹⁶

 

The Bottom Line on Navigating Perimenopause Naturally

 

Exercise, nutrition, and certain supplements may offer substantial benefits during perimenopause. Many of these suggestions also support healthy aging, so the benefits go beyond the menopause transition. 

 

Every person's menopausal experience is unique, and what works for one may not work for another. Working with a healthcare professional before making significant changes or starting new supplements can help you find the best approach for your specific needs. With the right lifestyle choices and support, menopause can be a time of growth, empowerment, and newfound wellness. 

 

Caitlin Beale, MS, RDN is a registered dietitian and freelance health writer. She has a master's degree in nutrition and over ten years of experience as a registered dietitian.  

 

⁺The views expressed in this article are those of the authors. They do not reflect the opinions or views of Pure Encapsulations®.  

 

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1 Coleman CJ, McDonough DJ, Pope ZC, Pope CA. Dose-response association of aerobic and muscle-strengthening physical activity with mortality: a national cohort study of 416 420 US adults. Br J Sports Med. Published online August 11, 2022. doi:10.1136/bjsports-2022-105519

2 Zhao, M., Sun, M., Zhao, R., Chen, P., & Li, S. (2023). Effects of exercise on sleep in perimenopausal women: A meta-analysis of randomized controlled trials. Explore (New York, N.Y.), 19(5), 636–645. https://doi.org/10.1016/j.explore.2023.02.001

3 Harvie, M. N., Pegington, M., Mattson, M. P., Frystyk, J., Dillon, B., Evans, G., Cuzick, J., Jebb, S. A., Martin, B., Cutler, R. G., Son, T. G., Maudsley, S., Carlson, O. D., Egan, J. M., Flyvbjerg, A., & Howell, A. (2011).. International journal of obesity (2005), 35(5), 714–727. https://doi.org/10.1038/ijo.2010.171

4 Lin, Y. J., Wang, Y. T., Chan, L. C., & Chu, N. F. (2022). Effect of time-restricted feeding on body composition and cardio-metabolic risk in middle-aged women in Taiwan. Nutrition (Burbank, Los Angeles County, Calif.), 93, 111504. https://doi.org/10.1016/j.nut.2021.111504

5 Qiu, Z., Huang, E. Y. Z., Li, Y., Xiao, Y., Fu, Y., Du, J., & Kan, J. (2024). BMC cardiovascular disorders, 24(1), 210. https://doi.org/10.1186/s12872-024-03863-6

6 Jovanovski, E., Mazhar, N., Komishon, A., Khayyat, R., Li, D., Blanco Mejia, S., Khan, T., L Jenkins, A., Smircic-Duvnjak, L., L Sievenpiper, J., & Vuksan, V. (2020). Can dietary viscous fiber affect body weight independently of an energy-restrictive diet? A systematic review and meta-analysis of randomized controlled trials. The American journal of clinical nutrition, 111(2), 471–485. https://doi.org/10.1093/ajcn/nqz292

7 Barber TM, Kabisch S, Pfeiffer AFH, Weickert MO. The Health Benefits of Dietary Fibre. Nutrients. 2020;12(10):3209. Published 2020 Oct 21. doi:10.3390/nu12103209

8 Gregorio L, Brindisi J, Kleppinger A, et al. Adequate dietary protein is associated with better physical performance among post-menopausal women 60-90 years. J Nutr Health Aging. 2014;18(2):155-160. doi:10.1007/s12603-013-0391-2

9 Ciappolino V, Mazzocchi A, Enrico P, et al.. Int J Mol Sci. 2018;19(7):1849. Published 2018 Jun 23. doi:10.3390/ijms19071849

10 Mason RP, Libby P, Bhatt DL. Emerging Mechanisms of Cardiovascular Protection for the Omega-3 Fatty Acid Eicosapentaenoic Acid. Arterioscler Thromb Vasc Biol. 2020;40(5):1135-1147. doi:10.1161/ATVBAHA.119.313286

11 Bailey RL, Zou P, Wallace TC, et al. Calcium Supplement Use Is Associated With Less Bone Mineral Density Loss, But Does Not Lessen the Risk of Bone Fracture Across the Menopause Transition: Data From the Study of Women's Health Across the Nation. JBMR Plus. 2019;4(1):e10246. Published 2019 Nov 15. doi:10.1002/jbm4.10246

12 Sharif SN, Darsareh F. Effect of royal jelly on menopausal symptoms: A randomized placebo-controlled clinical trial. Complement Ther Clin Pract. 2019;37:47-50. doi:10.1016/j.ctcp.2019.08.006

13 Bălan A, Moga MA, Dima L, Toma S, Elena Neculau A, Anastasiu CV. Royal Jelly-A Traditional and Natural Remedy for Postmenopausal Symptoms and Aging-Related Pathologies. Molecules. 2020;25(14):3291. Published 2020 Jul 20. doi:10.3390/molecules25143291

14 Gopal S, Ajgaonkar A, Kanchi P, et al. Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study. J Obstet Gynaecol Res. 2021;47(12):4414-4425. doi:10.1111/jog.15030

15 Miroddi M, Calapai G, Navarra M, Minciullo PL, Gangemi S. Passiflora incarnata L.: ethnopharmacology, clinical application, safety and evaluation of clinical trials. J Ethnopharmacol. 2013;150(3):791-804. doi:10.1016/j.jep.2013.09.047

16 Al Alawi AM, Majoni SW, Falhammar H. Magnesium and Human Health: Perspectives and Research Directions. Int J Endocrinol. 2018;2018:9041694. Published 2018 Apr 16. doi:10.1155/2018/9041694 

17 Gold EB. The timing of the age at which natural menopause occurs. Obstet Gynecol Clin North Am. 2011;38(3):425-440. doi:10.1016/j.ogc.2011.05.002

18 Santoro N. (2016). Perimenopause: From Research to Practice. Journal of women's health (2002), 25(4), 332–339. https://doi.org/10.1089/jwh.2015.5556

19 Davis, S. R., Castelo-Branco, C., Chedraui, P., Lumsden, M. A., Nappi, R. E., Shah, D., Villaseca, P., & Writing Group of the International Menopause Society for World Menopause Day 2012 (2012). Understanding weight gain at menopause. Climacteric : the journal of the International Menopause Society, 15(5), 419–429. https://doi.org/10.3109/13697137.2012.707385

20 Lo, J. C., Burnett-Bowie, S. A., & Finkelstein, J. S. (2011). Bone and the perimenopause. Obstetrics and gynecology clinics of North America, 38(3), 503–517. https://doi.org/10.1016/j.ogc.2011.07.001

21 Badawy, Y., Spector, A., Li, Z., & Desai, R. (2024). Journal of affective disorders, 357, 126–133. https://doi.org/10.1016/j.jad.2024.04.041

22 Delamater L, Santoro N. Management of the Perimenopause. Clin Obstet Gynecol. 2018;61(3):419-432. doi:10.1097/GRF.0000000000000389

Fertility is a complex issue influenced by various factors, including nutritional status. For those trying to conceive, understanding the most common nutritional deficiencies that can affect fertility is crucial. In this blog post, we will explore key nutrients, their impact on reproductive health, and practical recommendations for supplementation.

 

Key Nutritional Deficiencies

 

1. Vitamin D

 

Vitamin D deficiency can significantly impact fertility. 

 

Vitamin D is a fat-soluble vitamin that can be stored in the body for long durations. It is vital for a range of physiological processes and exists in two primary forms: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Of these two, vitamin D3 is recognized for its superior ability to elevate blood levels of vitamin D. Consequently, supplements containing vitamin D3 are considered to be the more effective option for enhancing vitamin D status in the body.¹

 

Rather than guessing the best dosage of Vitamin D3 supplements, it is highly recommended to get tested for vitamin D levels. The 25-Hydroxy Vitamin D test is a blood test designed to assess Vitamin D levels and provides valuable insights into whether your Vitamin D levels are within the optimal range, indicating if they are excessively high or insufficiently low. The test typically costs less than $50 at your nearest lab and is well worth the investment. 

 

Monitoring vitamin D is essential to ensure that you are taking the right dose and to be aware of potential toxicity. Low levels of vitamin D have been associated with fertility challenges², and in my practice, I have found that the fastest way to increase vitamin D levels is by taking a daily supplement in the right dose with food.

 

As a fat-soluble vitamin, it should always be taken with meals and a liquid vitamin D can be particularly beneficial for those experiencing pill fatigue, which is common among couples taking multiple supplements during their fertility journey.

 

2. B Vitamins

 

B vitamins, particularly B12 and B6, are vital for reproductive health. Research suggests that high levels of vitamin B6 can lower the chance of miscarriage by 50% and improve fertility rates by as much as 120%.³

 

Ensuring adequate intake of these vitamins is crucial for both men and women. A B6 complex that contains important B vitamins like Thiamine, Riboflavin, Niacin, Vitamin B6, Folate, and Vitamin B12 is recommended. 

 

I recommend my patients use a  formula that contains at least 200 mg of B6, 400 mcg of Folate, and 1000 mcg of B12 to maximize the benefits for fertility health. You should consult your healthcare provider for the ideal dosing for your needs. 

 

3. Other Key Nutrients to Consider

 

Nutritional deficiencies in Vitamin C, magnesium, antioxidants, folate, omega-3 fatty acids, amino acids, and iron can also impact fertility.

 

 

Enhancing Fertility Through Supplements

 

The top supplements I consider when working with fertility patients include:

 

• Folic Acid (Folate): For the inhibition of embryonal neural tube defects (NTDs).⁴
• Omega-3 Fatty Acids: Known for their anti-inflammatory properties.⁵
• Antioxidants like Coenzyme Q10 and NAC: Help combat oxidative stress that can affect egg and sperm quality. ⁶

 

Considerations When Choosing a Supplement:

 

When selecting supplements, prioritize high-quality, pure ingredients supported by credible scientific evidence. Specifically, for omega-3 supplements, opt for products that have undergone thorough testing for environmental contaminants, such as heavy metals, polychlorinated biphenyls (PCBs), dioxins, and furans, which are often present in our waters.

 

How Long for Noticeable Improvements?

 

The time it takes for supplements to show noticeable improvements in fertility can vary. Generally, it may take a few months of consistent supplementation to observe changes, but this can depend on individual health conditions and nutrient levels. 

 

Most couples will find themselves taking healthy doses of multiple supplements until they receive a positive pregnancy test, after which they may reduce most supplements to a high quality prenatal with folate, omega-3 fish oils, probiotics, vitamin D, and magnesium.

 

Lifestyle Changes and Dietary Recommendations

 

Accompanying fertility supplementation with lifestyle changes is vital. Here are some recommendations:

 

• Balanced Diet: Focus on a nutrient-dense diet rich in fruits and vegetables that provide antioxidants, which are important for combating oxidative damage to eggs and sperm. 
• Adequate Protein: To support healthy energy levels (required to make a baby), ensure each meal has about 20-30 grams of protein.
• Adequate Fiber: Consume a diet rich in fiber and aim for 25-35 grams daily, with a combination of soluble and insoluble fiber.
• Healthy Fats: Adding healthy fats to meals and snacks can help balance blood sugars and supports healthier hormones. Consider olive oil, coconut oil, avocado, grass-fed butter, ghee, nuts/seeds. 
• Regular Exercise: Engage in moderate physical activity to maintain a healthy weight and avoid intense exercise during the two week wait if you have a history of miscarriage. It is important to avoid excessive exercise, especially late-night intense workouts, as they can negatively impact hormonal health.
• Stress Management: Incorporate stress-reduction techniques such as yoga or meditation. It is essential to find what works best for you; if yoga is not for you, seek other activities that help regulate your nervous system and bring you joy.

 

Monitoring and Adjusting Supplement Dosages

 

During the fertility journey, it is essential to monitor and adjust supplement dosages as needed. Regular check-ups and blood tests can help assess nutrient levels and guide appropriate adjustments. 

Collaborating with a healthcare provider is a good idea for more personalized recommendations.

Nutritional supplements can also be tailored to your unique genetic profile, making genetic testing a valuable option if you seek a personalized fertility supplement strategy. For example, individuals with a genetic variation in the MTHFR gene may need a specialized form of folate. Those with this variation might face difficulties in converting folic acid into its active form, folate.⁷

Genetic testing can reveal such genetic variations and guide specific supplement recommendations, ensuring that individuals receive the optimal support and best outcomes for their fertility needs.

 

Success Stories

 

Many patients have experienced positive outcomes through fertility supplementation. While individual results may vary, I’ve witnessed improvements in hormone levels, enhanced ovulation, and successful pregnancies following the incorporation of targeted nutritional strategies. 

One of my patients dedicated 12 years to her journey of trying to conceive. Her unwavering commitment to the right supplements was pivotal in her success, ultimately resulting in the birth of a healthy baby boy.

Often people expect immediate results and may feel discouraged when they do not see quick changes. However, achieving lasting change often requires time, as various systems in the body can be out of balance. In this case, my patient demonstrated remarkable perseverance. Before embarking on her final round of IVF, she sought my guidance. Together, we implemented a regimen of high-quality supplements for both her and her partner, which resulted in a healthy pregnancy.

 

Conclusion

 

Addressing nutritional deficiencies is a vital component of enhancing fertility. By understanding the role of key nutrients, considering appropriate supplementation, and making lifestyle changes, individuals can take proactive steps towards improving their reproductive health.

 

Check out Dr. Celik’s interview on this topic with Tonic Radio here (18:46): https://open.spotify.com/episode/5UNO9czx3UOWQhU8UyMRpQ?si=MwKWFsvTR9-c7eaFLNA5oA

 

About the Author:

 

 

Dr. Sara Celik is a Canadian licensed Naturopathic Doctor with 15+ years of experience in Ontario. She is a leading educator and media health expert, appearing on various platforms and contributing to major publications. Dr. Sara offers personalized healthcare with a focus on Women’s Health and Fertility. Her approach emphasizes lifestyle changes and active patient involvement, rejecting the "quick-fix" approach to healthcare. 

 

 

 

References:

 

1. Pilz S et al. The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data. International Journal of Environmental Research and Public Health. 2018 Oct 12;15(10):2241

 

2. Grundmann, M., von Versen-Höynck, F. Vitamin D - roles in women's reproductive health? Reprod Biol Endocrinol. 2011 Nov 2; 9(146). https://doi.org/10.1186/1477-7827-9-146 

 

3. Alayne G Ronnenberg et al. Preconception B-vitamin and homocysteine status, conception, and early pregnancy loss. American Journal of Epidemiology. 2007 Aug 1;166(3):304-12.

 

4. Niccolò M et al. Folate Supplementation in Fertility and Pregnancy: The Advantages of (6S)5-Methyltetrahydrofolate. Alternative Therapies Health Medicine. 2022 May;28(4):12-17.

 

5. Steinbery ST et al. Effect of omega-3 supplements or diets on fertility in women: A meta-analysis. Heliyon. 2024 Apr 6;10(8):e29324.

 

6. Panagiota F et al. Does coenzyme Q₁₀ supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials. Journal of Assisted Reproduction and Genetics. 2020 Oct;37(10):2377-2387.

 

7. E Ferrazzi et al. Folic acid versus 5- methyl tetrahydrofolate supplementation in pregnancy. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2020 Oct:253:312-319.

 

Digestive health is fundamental to optimal health and wellness. When functioning as it should, the gastrointestinal tract is a complex system that provides essential nourishment, eliminates waste, and houses cells foundational to immune system health. Many factors can influence digestive wellness, from stress to diet and sleep patterns. Fortunately, nature provides us with a powerful ally in supporting digestive comfort: polyphenols.  

 

Polyphenols are plant compounds found in a variety of foods. These compounds have been shown to possess properties that support the digestive system in numerous ways. This article will explore the specific ways in which polyphenols can help support digestive comfort and overall wellness. 

 

Understanding Powerful Polyphenols 

 

Polyphenols are bioactive compounds found in many foods, from colorful fruits and vegetables to tea and red wine. Berries and pomegranates are especially rich in polyphenols (which contribute to their vibrant colors). 

 

In plants, polyphenols exist to protect the plants from physical, chemical, or biological stress, but we now understand that these phytochemicals can also be beneficial for human health due to their antioxidant properties.¹ 

 

Polyphenols act like prebiotics, passing through the GI tract undigested (up to 95 percent of polyphenols in the diet aren’t absorbed in the small intestine).² Once they reach the colon, these undigested polyphenols can influence the composition and diversity of the gut microbiota.^3,4  They also are converted to metabolites that affect the health of the gut.⁵ 

 

Polyphenols support the health of our digestive system through an array of mechanisms. 

 

 

Gut Barrier Protection 

 

The gut lining is the initial barrier separating the interior of our bodies from the outside world. A healthy, properly functioning mucosal membrane acts as a selective filter and provides a physical barrier to bacteria, toxins, and other harmful substances while allowing for nutrient absorption.⁶ 

 

Polyphenols have been shown to support this critical function through their antioxidant properties. They may help protect the gut lining from oxidative stress to support the barrier function. 

 

One study examining older adults found a diet high in foods containing polyphenols like berries and pomegranate juice supported a healthy intestinal barrier by producing short-chain fatty acids (SCFAs). SCFAs are metabolites that, among many other benefits, provide protection and fuel for the cells lining your gut.⁷

 

Support Digestive Comfort  

 

Digestive health relies on the proper movement of food through the GI tract, ensuring that food is efficiently processed and waste is eliminated. Research suggests polyphenols contribute to digestive function⁸ and help with overall digestive comfort, impacting overall quality of life.⁹

 

Promote Gut Flora Diversity 

 

The diversity of the gut microbiome, or the number of different beneficial species in the gut, is a sign of gut health. Plant variety in the diet plays a significant role in the types of microorganisms living in our large intestine.¹⁰  

 

Since polyphenols are not digested but rather "eaten" by our microbes, they help promote a diverse community of bacteria and may also help limit the growth of pathogenic bacteria, leading to better digestive comfort.^4,11

 

Polyphenols in Berries and Fruit 

 

Anthocyanins, a polyphenol found in blueberries and other dark berries, are particularly noteworthy for their digestive health benefits. Their prebiotic activity has been shown to positively impact the health of gut microbes and influence the production of SCFAs in the gut.¹²

 

A recent study found that a daily intake of blueberry powder (equal to about 1.25 cups of fresh) supported better markers of well-being, quality of life, and daily functioning, in addition to promoting digestive comfort compared to placebo.¹⁰Researchers in this study believe that the polyphenols in the berries helped due to their antioxidant and neuroprotective properties that support gut microbiota and intestinal barrier health. 

 

Studies have also shown that blueberries can support intestinal barrier health, reduce gut permeability (where substances move inappropriately out of the intestine and into the bloodstream), lower oxidative stress in the gut, and improve overall bacterial diversity.^13,14 

 

Like blueberries, pomegranates are a rich source of polyphenols, particularly resveratrol. Resveratrol is known for its antioxidant properties, which have been shown to support digestive comfort by protecting against oxidative stress that could disrupt gut health.¹⁵

 

 

Adding Polyphenols to Your Daily Routine 

 

Adding polyphenols to your diet is relatively simple. To boost your intake of polyphenol-rich foods, you can incorporate simple additions like a daily handful of berries or a cup of green tea.

 

Other foods with polyphenols include: 

 

• Fruits: Blueberries, pomegranate, strawberries, raspberries, apples, and cherries 
• Vegetables: Spinach, artichokes, red onions, and broccoli 
• Legumes: Black beans, lentils, and soybeans 
• Beverages: Green tea, coffee, red wine 

 

Adding a polyphenol supplement can also benefit those who may not eat enough of these foods or need a concentrated dose of polyphenols for specific health goals. Discuss dosage with your healthcare practitioner to support your needs. 

 

Caitlin Beale, MS, RDN is a registered dietitian and freelance health writer. She has a master's degree in nutrition and over ten years of experience as a registered dietitian.   

  

⁺The views expressed in this article are those of the authors. They do not reflect the opinions or views of Pure Encapsulations®.   

 

References

 

1 Deledda A, Annunziata G, Tenore GC, Palmas V, Manzin A, Velluzzi F. Diet-Derived Antioxidants and Their Role in Inflammation, Obesity and Gut Microbiota Modulation. Antioxidants (Basel). 2021;10(5):708. Published 2021 Apr 29. doi:10.3390/antiox10050708

 

2 Martinez KB, Mackert JD, McIntosh MK. Polyphenols and intestinal health. InNutrition and functional foods for healthy aging 2017 Jan 1 (pp. 191-210). Academic Press.

 

3 Calabriso N, Massaro M, Scoditti E, Carluccio MA. Dietary Polyphenols and Their Role in Gut Health. Nutrients. 2023;15(12):2650. Published 2023 Jun 6. doi:10.3390/nu15122650

 

4 Dueñas M, Muñoz-González I, Cueva C, et al. A survey of modulation of gut microbiota by dietary polyphenols. Biomed Res Int. 2015;2015:850902. doi:10.1155/2015/850902

 

5 Mithul Aravind S, Wichienchot S, Tsao R, Ramakrishnan S, Chakkaravarthi S. Role of dietary polyphenols on gut microbiota, their metabolites and health benefits. Food Res Int. 2021;142:110189. doi:10.1016/j.foodres.2021.110189

 

6 Aleman RS, Moncada M, Aryana KJ. Leaky Gut and the Ingredients That Help Treat It: A Review. Molecules. 2023;28(2):619. Published 2023 Jan 7. doi:10.3390/molecules28020619

 

7 Peron G, Gargari G, Meroño T, et al. Crosstalk among intestinal barrier, gut microbiota and serum metabolome after a polyphenol-rich diet in older subjects with "leaky gut": The MaPLE trial. Clin Nutr. 2021;40(10):5288-5297. doi:10.1016/j.clnu.2021.08.027

 

8 Della Lucia CM, Oliveira LA, Dias KA, Pereira SMS, da Conceição AR, Anandh Babu PV. Scientific Evidence for the Beneficial Effects of Dietary Blueberries on Gut Health: A Systematic Review. Mol Nutr Food Res. 2023;67(15):e2300096. doi:10.1002/mnfr.202300096

 

9 Wilder-Smith CH, Materna A, Olesen SS. Blueberries Improve Abdominal Symptoms, Well-Being and Functioning in Patients with Functional Gastrointestinal Disorders. Nutrients. 2023;15(10):2396. Published 2023 May 20. doi:10.3390/nu15102396

 

10 Heiman ML, Greenway FL. A healthy gastrointestinal microbiome is dependent on dietary diversity. Mol Metab. 2016;5(5):317-320. Published 2016 Mar 5. doi:10.1016/j.molmet.2016.02.005

 

11 Corrêa TAF, Rogero MM, Hassimotto NMA, Lajolo FM. The Two-Way Polyphenols-Microbiota Interactions and Their Effects on Obesity and Related Metabolic Diseases. Front Nutr. 2019;6:188. Published 2019 Dec 20. doi:10.3389/fnut.2019.00188

 

12 Mithul Aravind S, Wichienchot S, Tsao R, Ramakrishnan S, Chakkaravarthi S. Role of dietary polyphenols on gut microbiota, their metabolites and health benefits. Food Res Int. 2021;142:110189. doi:10.1016/j.foodres.2021.110189

 

13 Della Lucia CM, Oliveira LA, Dias KA, Pereira SMS, da Conceição AR, Anandh Babu PV. Scientific Evidence for the Beneficial Effects of Dietary Blueberries on Gut Health: A Systematic Review. Mol Nutr Food Res. 2023;67(15):e2300096. doi:10.1002/mnfr.202300096

 

14 Ntemiri A, Ghosh TS, Gheller ME, et al. Whole Blueberry and Isolated Polyphenol-Rich Fractions Modulate Specific Gut Microbes in an In Vitro Colon Model and in a Pilot Study in Human Consumers. Nutrients. 2020;12(9):2800. Published 2020 Sep 12. doi:10.3390/nu12092800

 

15 Hu Y, Chen D, Zheng P, et al. The Bidirectional Interactions between Resveratrol and Gut Microbiota: An Insight into Oxidative Stress and Inflammatory Bowel Disease Therapy. Biomed Res Int. 2019;2019:5403761. Published 2019 Apr 24. doi:10.1155/2019/5403761

The botanical Withania somnifera, more commonly known as ashwagandha, is a short and unassuming woody shrub with surprising benefits. It has been used for more than 5000 years in Ayurvedic medicine for its health promoting properties, and as such is extensively grown and cultivated across the drier parts of India. ¹ 

 

The stem, leaves, and roots are thought to be filled with naturally occurring bio actives, known as phytochemicals, many of which support relaxation and mental and physical well-being. Of particular interest are the roots, which contain numerous phytochemicals and give ashwagandha its distinctive name. ^2,3  The word ashwagandha originates from an ancient Indian language known as Sanskrit and literally translates as “horse smell”, owing to the roots displaying the distinctive odour of wet horse. Thankfully though, modern supplements have managed to overcome this, and more palatable versions are now available.  

 

Researchers nowadays are keen to give ashwagandha an evidence base to what the Ancients knew centuries ago, and they are uncovering some exciting things. This article reviews some of this research and provides an overview on the use of ashwagandha to support health and wellness.  

 

 

Ashwagandha as an Adaptogen 

 

Recent studies have driven researchers to find ways to support the body during times where emotional support is needed, and it has now classified a group of herbs as adaptogens. These herbs promote relaxation and hormonal balance, and support the body during times of occasional stress, with little or no side effects. ⁴ Examples include ashwagandha, eleuthero, and Panax ginseng. ^5-7  

 

There are over 140 naturally occurring chemical compounds in ashwagandha, but it is thought that its adaptogenic properties are due to a group of phytochemicals known as withanolides. There are at least 70 of these found in the leaves and roots, with higher concentrations in the latter. ^8,9 Withanolides may be key to ashwagandha supporting immune system and hormonal balance. ^10,11 

 

 

Supporting Emotional Well-Being 

 

The hypothalamic-pituitary-adrenal axis (HPA) plays a central role in the stress response in the body. It is a complex hormonal feedback loop, in which cortisol has a major role. Alongside daily cyclical fluctuations, cortisol is a hormone that is released as part of the fight or flight response when we experience stress. This aids survival when facing a threat or danger.  

 

Withanolides in ashwagandha are rapidly absorbed, and researchers have found that once inside the body they work in various ways to support positive mood and emotional balance. One study has shown that ashwagandha supplementation optimised morning cortisol levels, and the HPA. ¹² A second study has also shown that amongst adults with symptoms of occasional stress, two months of ashwagandha supplementation rebalanced the HPA and serotonergic systems and promoted emotional well-being and relaxation. ¹³ 

 

Supporting Sleep: What’s in a Name? 

 

The species name, Somnifera, literally translates from Latin as “sleep-inducing” indicating another potential effect of this botanical. Although stress and sleep are intertwined, and the use of Ashwagandha has been shown to support sleep and relaxation its effects appear to go beyond that. ¹⁴ One six-week study found that amongst non-stressed adults with poor sleep, ashwagandha promoted sleep quality compared to placebo. ¹⁵ A second study analysing five different trials reported similar results, with pronounced effects amongst individuals with sleep disruptions. ¹⁶ 

 

The Science Behind Safety 

 

The definition of an adaptogen requires it to be a safe herb, and ashwagandha has been reported in several research papers to be largely safe and well-tolerated. ^17,18 However, it is still an herb containing potent bio actives and mild and transient side effects have been reported in a small number of people. ^19,20 It is important to consult a healthcare professional before supplementing Ashwagandha, especially if you are on any medications.  

 

 

Ashwagandha: The Natural Way to Balance the Body 

 

The ancients knew that ashwagandha had therapeutic properties and it appears that the science agrees. Ashwagandha is an adaptogen that is worth more than just its nutritional value. The withanolides it contains may balance hormonal systems and support mood. Always make sure to consult your healthcare practitioner if you are considering incorporating ashwagandha into your daily routine.  

 

Chloe Steele, MSc Nutrition, mBANT - Transforming Complex Nutrition Research into Clear, Actionable Advice for Health and Wellness Chloe, based in Australia, gained her MSc in Personalised Nutrition from the University of Middlesex, and has worked for British Association for Nutrition and Lifestyle Medicine (BANT) since 2020.  

 

⁺The views expressed in this article are those of the authors. They do not reflect the opinions or views of Pure Encapsulations®.   

 

 

References: 

 

1. Mandlik DS, Namdeo AG. Pharmacological evaluation of Ashwagandha highlighting its healthcare claims, safety, and toxicity aspects. J Diet Suppl. 2021;18(2):183-226. doi:10.1080/19390211.2020.1741484 

    

2. Tetali SD, Acharya S, Ankari AB, Nanakram V, Raghavendra AS. Metabolomics of Withania somnifera (L.) Dunal: Advances and applications. J Ethnopharmacol. 2021;267:113469. doi:10.1016/j.jep.2020.113469 

    

3. Paul S, Chakraborty S, Anand U, et al. Withania somnifera (L.) Dunal (Ashwagandha): A comprehensive review on ethnopharmacology, pharmacotherapeutics, biomedicinal and toxicological aspects. Biomed Pharmacother. 2021;143(June). doi:10.1016/j.biopha.2021.112175 

    

4. Wu C, Mulakaluri A, Chaurasia P, et al. J Ayurveda Integr Med. 2024;15(1):100879. doi:10.1016/j.jaim.2023.100879 

    

5. Speers AB, Cabey KA, Soumyanath A, Wright KM.. Curr Neuropharmacol. 2021;19(9):1468-1495. doi:10.2174/1570159x19666210712151556 

    

6. Bleakney TL. Deconstructing an adaptogen: Eleutherococcus senticosus. Holist Nurs Pract. 2008;22(4):220-224. doi:10.1097/01.HNP.0000326005.65310.7c 

    

7. Todorova V, Ivanov K, Delattre C, Nalbantova V, Karcheva-Bahchevanska D, Ivanova S. Plant adaptogens—history and future perspectives. Nutrients. 2021;13(8):1-21. doi:10.3390/nu13082861 

    

8. Chatterjee S, Srivastava S, Khalid A, et al. Comprehensive metabolic fingerprinting of Withania somnifera leaf and root extracts. Phytochemistry. 2010;71(10):1085-1094. doi:10.1016/j.phytochem.2010.04.001 

    

9. Trivedi MK, Panda P, Sethi KK, Jana S. Metabolite Profiling in Withania somnifera Roots Hydroalcoholic Extract Using LC/MS, GC/MS and NMR Spectroscopy. Chem Biodivers. 2017;14(3). doi:10.1002/cbdv.201600280 

    

10. White PT, Subramanian C, Motiwala HF, Cohen MS. Vol 928.; 2016. doi:10.1007/978-3-319-41334-1_14 

     

11. Gómez Afonso A, Fernandez-Lazaro D, Adams DP, Monserdà-Vilaró A, Fernandez-Lazaro CI. Effects of Withania somnifera (Ashwagandha) on Hematological and Biochemical Markers, Hormonal Behavior, and Oxidant Response in Healthy Adults: A Systematic Review. Curr Nutr Rep. 2023;12(3):465-477. doi:10.1007/s13668-023-00481-0 

     

12. Lopresti AL, Smith SJ, Drummond PD. Modulation of the hypothalamic–pituitary–adrenal (HPA) axis by plants and phytonutrients: a systematic review of human trials. Nutr Neurosci. 2022;25(8):1704-1730. doi:10.1080/1028415X.2021.1892253 

     

13. Majeed M, Nagabhushanam K, Mundkur L. Medicine (Baltimore). 2023 Oct 13;102(41):e35521. doi: 10.1097/MD.0000000000035521. PMID: 37832082; PMCID: PMC10578737. 

     

14. Majeed M, Nagabhushanam K, Murali A, Vishwanathan DT, Mamidala RV, Mundkur L. J Integr Complement Med. 2023 Oct 25. doi: 10.1089/jicm.2023.0279. Epub ahead of print. PMID: 37878284. 

     

15. Deshpande A, Irani N, Balkrishnan R, Benny IR. A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults. Sleep Med. 2020;72:28-36. doi:10.1016/j.sleep.2020.03.012 

     

16. Cheah KL, Norhayati MN, Yaacob LH, Rahman RA. Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. PLoS One. 2021;16(9 September):1-22. doi:10.1371/journal.pone.0257843 

     

17. Langade D, Kanchi S, Salve J, Debnath K, Ambegaokar D. Cureus. 2019;00(9). doi:10.7759/cureus.5797 

     

18. Gopukumar K, Thanawala S, Somepalli V, Rao TSS, Thamatam VB, Chauhan S. Evidence-based Complement Altern Med. 2021;2021. doi:10.1155/2021/8254344 

     

19. Raut AA, Rege NN, Tadvi FM, et al. Exploratory study to evaluate tolerability, safety, and activity of Ashwagandha (Withania somnifera) in healthy volunteers. J Ayurveda Integr Med. 2012;3(3):111-114. doi:10.4103/0975-9476.100168 

     

20. Tandon N, Yadav SS. J Ethnopharmacol. 2020;255(March):112768. doi:10.1016/j.jep.2020.112768