Dear Infertility _Season 5_Ep4_Macy Coleman: Audio automatically transcribed by Sonix

Dear Infertility _Season 5_Ep4_Macy Coleman: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Kristyn Hodgdon:
Hi, I'm Kristyn Hodgdon, an IVF mom, proud women's health advocate, and co-founder of Rescripted. Welcome to Dear (In)fertility. This season join me along with a variety of women's health experts as we explore holistic approaches to our reproductive, hormonal, sexual, mental, and overall health and wellness. From the practice of cycle syncing to the importance of pelvic floor therapy. We'll address some of the many questions women have about their bodies and share practical tips for improving your day-to-day life. Now, let's dive in and work towards ending the shame and stigma surrounding women's bodies once and for all, from first period to last period.

Kristyn Hodgdon:
Hi, everyone, and welcome back to Dear Infertility. I'm your host, Kristyn, and I'm here today with Macy Coleman. Hi, Macy.

Macy Coleman:
Hi!

Kristyn Hodgdon:
So happy to have you. Macy Coleman is a registered dietitian specializing in women's health and the founder of Well Women Nutrition, a virtual private practice focusing on fertility, hormone health imbalance, pre-pregnancy, and postpartum nutrition. Macy also happens to be my nutritionist. So excited to talk to you, to bring your wisdom to our community.

Macy Coleman:
I'm so excited. Thank you for having me.

Kristyn Hodgdon:
Of course, I think we all know to some extent that we need to be eating healthy just for general women's health, but obviously for fertility. But going back to the basics, what role does nutrition play when it comes to women's health specifically? And what does like healthy mean to you or healthy eating?

Macy Coleman:
Yeah, that's a good question. So when I think of women's health and fertility in general, I think of nutrients. So we have our macronutrients, carbs, fat, and protein, but then we have our micronutrients, which are our vitamins and minerals, and they're really the building blocks to every single function in the human body. And when it comes to women and when it comes to fertility, we're preparing to create another human from those building blocks. So we know that nutrition is the star of the show there because it is the building blocks for making a second being. And there are some certain micronutrients like antioxidants that are incredibly important to fertility and overall egg quality, and macronutrients, all of them, but definitely, like fat and protein, are so important for women. They're essential for our sex hormone production and balance, and we know that, like sex hormones are really important for fertility, but not only that, they make us feel good, they give us energy. So it's all about foundational health for women as well. And when I think about what does healthy mean, what does healthy eating mean, healthy nutrition, I really teach in my practice that we focus on a healthy plate distribution of all the macronutrients. So for fertility specifically, I like to focus on about 50% of the meal containing non-starchy veggies with lots and lots of color and variety there, that's a huge key because that's where we get our antioxidants. 5% percent high-quality protein, 25% high fiber carbs, and then I also teach that we want to have intentional fat at every single meal, which is deliberate consumption of fat versus just passively like spraying it in a pan with a little bit of avocado oil before you cook something; it's really just not enough fat in a meal to support fertility and women's health and also blood sugar and hormone production, all the things that come with nutrition. But also, on the flip side, really understanding that healthy eating, healthy nutrition doesn't always look like this, and it isn't strict, and it's not perfect. Healthy eating includes indulgences. You can still enjoy some ice cream or a cupcake, but understand that there's just a better way to have that when it comes to like balance and moderation and supporting blood sugar. So the long-winded answer to, what is health and nutrition, and it's all of those things.

Kristyn Hodgdon:
Yeah, no, and I love that about working with you too, as I think, I was nervous that I was going to come to my first session and be told that I need to go dairy-free and gluten-free and all the fad things that you hear when you think of PCOS, and it wasn't bad at all. It was actually like I wasn't eating enough and that, and then I've been making like these small changes, and it hasn't felt overwhelming. So thank you for that. And I love, the biggest thing that I've been thinking about is like always pairing my carbs with a protein and/or a fat and a snack, only you have to; you can't just have carbs by themselves, or not that you can't, but you shouldn't for blood sugar, right? Can you explain a little bit?

Macy Coleman:
Yeah, so blood sugar is also foundational to health and fertility because it impacts stress hormones and sex hormones, but when it comes to carbohydrates, I always just say that they operate on a buddy system, so always pairing with a fat or a protein, because if we're absorbing and our body is digesting something, if things get in the way, it kind of stalls and takes more time to digest. And time is on our side when it comes to blood sugar; we don't want that big rise and then the cliff dive fall after, and that's what happens when we're having carbohydrates by themselves, especially like simple carbohydrates. We know how important fruit is. Fruit is delicious, and that tends to be one of the go-to snacks for people, but it is a quick carbohydrate that's going to spike our blood sugar and cause it to crash. So if we can anchor that by giving our body and our GI tract something to digest, to keep it busy in the meantime, and spread time out, that's going to be where we see the benefit of a less, like not a big spike, and a little bit more stability in that blood sugar.

Kristyn Hodgdon:
Love it, and that's just one of the small changes I've been making. But what are some other just small lifestyle changes, so it doesn't feel overwhelming for people? But, whether it's like eating breakfast, which is something I'm working on. What are some other small changes that women can make?

Macy Coleman:
Yeah, so there are so many lifestyle changes that you can make, big or small, that have a huge impact and really just significantly influence our adrenal hormones, aka our stress hormones like cortisol, which we know have a lot to do with our sex hormones, they all overlap and intertwine. One big thing that I really like to prioritize for clients is getting exposure to bright light first thing in the morning. So what this does is we hear about cortisol as the bad guy, I just mentioned it's a stress hormone; it is when it's too high for too long, but we actually require a bit of a cortisol spike first thing in the morning, it's called our cortisol awakening response, and we need that so that we can get out of bed so that we have energy throughout the day, but it's a controlled situation. We hopefully can control that situation. One really good way to do that is exposing ourselves to natural, bright light. Whether that's going on a walk outside, that would be ideal, but if you can't get outside first thing in the morning, get ready by a big window in your house. Or if it's dark when you wake up, utilizing like a full spectrum light box can be helpful. So there's a lot of hacks for that, but that's a good way to start your day and get your hormones settled and pumping, giving you energy and just setting up for success for the rest of the day, especially for energy. So that's a big one, and then avoiding coffee first thing in the morning, we know that it spikes cortisol and it can raise blood sugar levels, and those can go hand in hand. So if we get a big cortisol response, a big spike past what that control is, and we can also spike blood sugar because of that, because it's like alarm bells sounding, it can also cause anxious energy if we're having coffee by itself, it's also naturally dehydrating, and we're waking up from likely not drinking water or at least much during the night. So if we start with dehydrating, not a good place to start our morning, and it can also suppress our appetite. So there are so many people that come to me, and they're like, oh, I have coffee, and I don't need breakfast because I don't feel like I need it, but coffee is an appetite suppressant, so we can definitely see that too. So that can be a hard change for a lot of people because that can be their go-to, but we can just adjust a couple of things. It doesn't mean you can't have coffee, just adjusting when you have it. And then, yeah, on the flip side, making sure you're trying to eat breakfast within that first like 60-minute window of waking, and the non-negotiable there is to include a protein source; so that can help with blood sugar management, it can give you more sustained energy throughout the day, and it also revs up your metabolism, supports a healthy metabolism through the day. So those are some biggies that I focus on.

Kristyn Hodgdon:
And I love that they're not necessarily restrictive. It's just like ... breakfast. What about exercise? I love exercising. And because there's no real measure for cortisol or, correct me if I'm wrong, but I never know if the amount of exercise I'm doing is spiking that response.

Macy Coleman:
Yeah, so exercise is a Goldilocks scenario for sure because there's too much and there's too little when it comes to fertility, but also overall health. It really also depends on all the other stressors, because we have to understand that exercise, so many people always say, like growing up, I heard everyone say, oh, exercise is a stress, but it's a good stress, right? Everyone says it. That is only true sometimes, it can actually be a bad stress. If our stress buckets overflowing from mental stress, from emotional stress, from under-eating, like a million other things, it can just be the one thing that kind of tips the scale in the wrong direction. So it's highly individualized per person, if exercise is going to be a good or a bad thing for you and what type. So we know that walking and doing more like restorative exercise is really good for hormones. Weight training is good for hormones. The things that get in the gray area is like HIIT training, if we're doing so much high-intensity cardio that we can't handle. There is a marker on the Dutch test, we can measure cortisol in two different ways on a Dutch test, one to see metabolized, it's 24 hours, and then we also can see free cortisol that's measured at different points of your day. Anytime we're exercising, we're making cortisol. So we can honestly see from a Dutch test like what's been going on over the last few months or a few years, can your body really handle this exercise, or is it pushing you in the wrong direction? So I encourage people to exercise for fertility, but it's just so individualized per person.

Kristyn Hodgdon:
Yeah. Can you tell us more about the Dutch test?

Macy Coleman:
Yeah, I love the Dutch test. The Dutch test is my favorite hormone test, just because it tells us way more than we can get from any other test. I also sometimes use like blood markers, serum markers for hormones for certain situations, but that tells us, like at that exact moment in time, what's going through your blood. But when we see a Dutch hormone test, it's a dried urine hormone test that you take at home, and you do it between 5 to 7 days after you ovulate so that we can see your progesterone production, which is the star of the show. In the luteal phase after we ovulate, we want to see that nice and high. We tend to see peak, we hopefully see peak progesterone right at that point in time, so that's what we really want to catch. And then, we understand what, where estrogen should also be during that time. So we get to see fun things like testosterone, estrogen, and progesterone, but not only that, we get to see how your unique body's metabolizing these hormones, and that's what we don't see on really anything else. So we can see what pathways your DHEA is going down, which is really imperative to fertility DHEA, but comes a lot from your adrenal glands, so then we also get to see a whole picture of your adrenals, so that's the stress piece that's connected. It's highly connected to sex hormones, but also fertility as well. So we get to see that kind of play out. And I do find, oftentimes, that when people have, when women have symptoms, they come to me and they're like, I think I have high estrogen because I have heavy clotting periods and tender breasts. And I'm like, what I've learned over the years is that you can never assume without testing because there are so many symptoms that have way different results as root causes. So I love to test for that reason. And then we might find actually your estrogen is normal, but you're just pumping it down this pathway that's not very supportive to you or conducive to you, and it's actually giving you all these symptoms. So the problems in the pathway and that has to do with, again, that unique person. So I've never seen the same Dutch test twice. I've never given the same supplement regimen twice. It's just, again, highly unique and individualized, and it's just a really cool snapshot that we can see how women are metabolizing their hormones and what's going on behind the scenes because we're always looking for root causes there.

Kristyn Hodgdon:
Yeah, that's so cool. I'm so excited to do mine. Yeah, and what other markers are you looking for? So you mentioned adrenals; I've been seeing so much about like adrenal cocktails on TikTok and like, adrenal fatigue and, can you explain that a little bit? Because I feel like it's a mystery to me.

Macy Coleman:
Yeah, adrenal fatigue is such a trendy phrase. To me, it honestly makes sense, but just to go in-depth with what that is and like adrenals and adrenal recovery and things we're talking about when we see Dutch results, for one, adrenal fatigue has gotten, the term, has gotten so much backlash because our adrenal glands don't actually get fatigued and quit making cortisol. It actually has to do with the pulsation of a hormone called ACTH, which we see on a Dutch test, it's actually a brain hormone. So the problem is further up, but this is like a technicality, it's actually referred to as the HPA axis dysfunction, which is a mouthful, and adrenal fatigue sounds better. So what we're really talking about here is burnout. So when we feel burnout, we can see that on the Dutch test, it oftentimes is just so very validating to people. I'm like, hey, at this point in time, do you feel like this, and this is this how you feel overall? Is this how you feel when you wake up, and they're like, That's literally me to a T. So we can see that on a Dutch, and then, in my practice, we focus on the root cause, and this is really no different. So when we're seeing a problem with stress resilience and adrenal hormones, again, we have to follow that upstream, and when you follow it upstream, you get to the brain. So it's really about what is the brain perceiving, aka stress, in one way or another, because we know there's so many different types of stress. So the best way to support your adrenals is to support the brain, and some good supportive modalities for that whole picture, aka nervous system support, are things like adrenal cocktails. They can be really helpful, they can be really nourishing, they can provide us with the spark plug of all cells in our body, aka electrolytes, aka minerals, like those things are just so important and so foundational. Another one, and probably the biggest, is routine. So our nervous system, our brain loves to know what to expect. It doesn't like surprises. It wants the same meal times, it wants the same bedtimes. It just wants to know when we're winding down. Okay, when we do this wind-down routine, we know we fall asleep after, so it gets us there a little quicker. Sunlight, so spending time outside during the day is really conducive, really helpful for the brain, for the nervous system, for the adrenals, but equally spending time in darkness. I feel like this is a big one that not a lot of people talk about, but it's so imperative in modern times because we don't spend time in darkness, right? We have a phone in front of us, we have the TV on, we go to bed with the TV on or a nightlight on, or scrolling through our phones. We're just not spending enough time in darkness, and we need, not to get into the science weeds here, but we need to make melatonin, right? We know melatonin is our sleep hormone, but what we also know is that melatonin and cortisol directly oppose each other. So when cortisol spiked, we can't make melatonin, and we have to be in darkness to make melatonin. So we have to consider, too, the balance between cortisol and melatonin. A couple other things like fish oils, anti-inflammatory diets, really supportive to the nervous system, to the brain, and then daily stress management techniques. So a lot of times when we're super stressed out, when we're really feeling it, we're feeling some neck tension, we're feeling some eye twitching, whatever it is that tells you, okay, you're past your stress limit, then we take some deep breaths, and then we do some things. But it's really about what you do in between. What about the days you're feeling good? Are we doing things that are still going to be supportive to that stress resilience? Like meditation or going on walks, spending time in nature, whatever that is to you, so that's huge. There's a lot more, but honestly, to make it really super simple, if someone is okay, this is me, I'm burnt out, and I want to know what to do and where to start, all these things sound great, but now I'm even more overwhelmed; honestly, the first place to start is write down what you do for the first 30 minutes of your day and what you're doing for the last 30 minutes of your day. Analyze that; if it's not conducive to supporting stress or supporting energy levels throughout the day, that's where you need to start, first 30 minutes in the last 30 minutes. How can we make routines there that are really supportive?

Kristyn Hodgdon:
That's so helpful. I love that tip. Yeah, I'm just thinking about how, I don't know, as a woman with a complex body as it is, but then add on like PCOS or endometriosis or Hashimoto's or any of these things. And then, yet to the outside world, it's like invisible, right? And it's like only, like on the outside I look like a healthy, functioning human, but I'm dealing with fatigue or this or that. And sometimes it doesn't always show on like traditional blood tests or traditional anything. I'm getting my East and West, except Eastern medicine doctors, right? Well, no, sorry, Western medicine doctors will say like, not that anything's wrong because it's like, oh, your TSH looks fine, but maybe there is something underlying. Like I hit a point where I had gone through five IVF transfers, and none of them worked, and with genetically normal embryos, and I had to take a step back and say, okay, maybe it's something with my body. Like maybe my body is just not in a place that it's ready to accept embryos right now. And like, how are we getting to the root cause instead of just like putting a Band-Aid on it or trying more IVF meds and more transfers and, at some point, I just hit a point where it was like, I really want to get to the bottom of this so that I don't have to go back on birth control forever, or I don't have to just always be like, why am I always so tired? If you've hit that point where you have symptoms, but doctors might be telling you that you're fine, and it's just really frustrating. So I just wanted to, like, speak that out loud because I know so many people feel that.

Macy Coleman:
Yeah, and honestly, I'll give you an example. One of my clients that I'm working with now, I talked to her yesterday, and she came to me, and they have done multiple IVF cycles, and she kept being told by her doctor the very first retrieval they did, they got 20-some eggs, and like everything looked perfect. They were like, your labs are awesome, you're the perfect candidate for IVF, you're for sure going to get pregnant. And telling her all these things that she's that's awesome, that's going to be a walk in the park, here we are years later, and nothing has ever happened, she's never had a successful transfer and has had so many transfers. And she came to me, and she was just like, I'm at the end of the road for conventional medicine. They keep telling me everything's normal, but I'm not getting pregnant. Everything can't be normal, so what can you do? So we actually ran, we ran a lot of tests, but the first two that came back that we have are a vaginal microbiome swab and a GI map. So those are very similar ideals to look at the microbiome of each space, and we found for her she has multiple parasites, she's had recurrent yeast infections, she has like so much dysbiosis and issues with her gut, and then we also found from her vaginal microbiome that she only has two types of bacteria and none of them are lactobacillus, which is what we want. So they're actually pathogens that are causing recurrent BV and yeast infections, which we have literature to say that it impacts IVF transfers, and it's a low rate of success of conception and success when you have these microbes in your vaginal tract. So already, we've done two tests, and we found like massive red flags, and she's, I just feel so relieved that you found something. Even though it's a bummer, I'm just glad we found something.

Kristyn Hodgdon:
Oh, 100%. It's so frustrating. I was just talking to my GP about this today. It's, oh, hysteroscopy, normal. Your uterus looks great. Your tubes are clear. You're like, your embryos look perfect. It's, and I only have two embryos left frozen, and not wanting to just continue to throw things against the wall and seeing what sticks. And then, you can validate whether that's true or not, but I read or listened to something that said how you take care of your hormones in your 30s can have a lot to do with how you experience menopause later on.

Macy Coleman:
100%.

Kristyn Hodgdon:
I said to myself, okay, even if I don't end up having another baby, which I hope I can, but if even if we don't, this is lifestyle; these are lifestyle changes that can benefit me throughout the rest of my entire life. And we know that PCOS and Hashimoto's can put you at risk for other things down the road, and I don't want to, I don't want that to be the case. So it's not just about my fertility anymore, it's about my just overall well-being. And when you shift that perspective too, it kind of changes, it changes things for me, I think.

Macy Coleman:
Yeah, and that's a, it's such an important conversation that I have with clients. When I start working with them, I say, okay, what I can't guarantee you is that you'll have a baby. That's what the goal is, but what I can promise you that when you're done working with me, that your health will be in a better place than when we started, like that's a guarantee. You're going to get improvements of overall health, and then we know with overall health comes more optimized fertility. So even if people think that's a good distinction too, it's not either/or, it's not black or white, it's not holistic medicine or conventional, you can do both. I work with people going through IVF, and what can we do to optimize your fertility so that this IVF works this time? Because we can manipulate that, right? Like, it's not a perfect science, but we can improve the odds, and so those two things can absolutely be blended.

Kristyn Hodgdon:
Absolutely. Yeah, no, I've been saying, like, I haven't closed the door completely. I just need to be in a place where I feel like my body is ready to receive whatever that means.

Macy Coleman:
Yes, I love that.

Kristyn Hodgdon:
So supplements. I feel like there's so many on the market, so many different types. Are there any specific ones that you often recommend to your clients just like off the bat, or is it really dependent on each individual?

Macy Coleman:
Yeah, so I, it's dependent on each individual, but there's still some basics. So I think supplements are really supportive to a full regimen when it comes to fertility or just health in general, but they aren't going to take you very far for one if you're skipping the basics. So basics would be like good nutrition, nervous system management, sleep, etc. So if you have those squared away or at least you're working on supporting them, it's never going to be perfect for anyone, it's always a work in progress, then you're going to see more benefits from supplements, that's for sure. And again, I've never recommended the same supplement regimen twice that I'm aware of, so it's really highly individualized. But the one things that I do almost always for fertility is starting with a high-quality prenatal. There are two main ones that I like to recommend, I don't know if you guys have any sponsors or anything that you recommend on this podcast, but I have two quality prenatals that I really, really depend on for my clients and respect and recommend the brand, and then fish oil, for sure. I have seen so many fatty acid profiles in the years, and I've honestly yet to see one person that has optimal omega three levels on any of these, just because the Western diet, it's just the way it is really. It's just, there's so many processed foods and seed oils, you just can't escape it. You could literally go to the most fancy restaurant possible, and they're probably still going to use inflammatory oils. So we know that omega threes lower inflammation, they boost ovulation, it supports hormone production, and impacts the growth of oocytes and ovaries. There's a lot of benefit there, so the balance between omega three anti-inflammatory omegas and then inflammatory omegas, like omega six is really important. So fish oil can just help tip the scale in the right direction. So those are two that I'm always doing. After those, it gets a little more individualized when it comes to things like does someone need vitamin DK2, for their vitamin D level. Do they need NAC? It's honestly one I do all the time too. I love NAC. Inositol. Is blood sugar an issue? Is egg quality an issue? Is the, is our cycle gone? Do we have PCOS? And then antioxidants and beyond, so those are things that I'm also choosing, but it always is based on that person, and also whatever data we have from testing.

Kristyn Hodgdon:
Absolutely. I love my omega three and NAC, and my inositol. That is the one supplement I've been taking for probably five years now.

Macy Coleman:
It's impressive.

Kristyn Hodgdon:
... yeah, and that was the only supplement that my first fertility clinic recommended. I got like a brochure about PCOS and was ... inositol, that was about it.

Macy Coleman:
They do go hand in hand, and that is one a lot of people, or one thing I do say to people is a lot of the supplement regimens that we do in my practice are based off of testing, but they're, so a lot of them fall off after 3 to 6 months. It's trying to push us into the right direction, and then we take off the training wheels and use diet and lifestyle to keep us there. But there are some that just hang on a little more longer term, like the prenatals or the fish oils or the inositol. That's one that hangs on for kind of the long-term ride.

Kristyn Hodgdon:
Yeah, absolutely. So what did I miss? ... Sleep, we should be sleeping eight hours a night, or? I don't have an issue with sleep. That's what my one issue that I don't have.

Macy Coleman:
I love that for you. Oh, gosh, sleep is everything. So it's when our cells and tissues recover, and they regenerate. And there's actually research to show us that women with lower quality sleep, they mention eight hours, eight hours is great, but it's all about quality over quantity. So those with lower quality sleep had lower rates of fertility than those that got higher amounts of sleep or more adequate sleep. And then poor sleep also predicted higher cortisol levels or stress hormone. And we know that when cortisol spikes at night, melatonin levels decrease again because they oppose each other. And I don't know if you've talked on the podcast before, but melatonin is so vital to fertility and to egg quality, it's a major antioxidant. So we make melatonin when we're sleeping and right before sleep as well, so that's really important. So it's, really comes down to that sleep quality, like how much deep sleep are we getting tonight, and do we wake up ...

Kristyn Hodgdon:
How much deep sleep should we be getting because I've been wearing a wearable, and I was surprised because I thought I slept really deeply, and it says I'm only deep REM sleep like 50% of the time.

Macy Coleman:
That's a lot.

Kristyn Hodgdon:
Oh, okay.

Macy Coleman:
Yeah, I don't know the number off the top of my head, but it should, I'm pretty sure is less than half is optimal. Yeah, so we go like we rotate, we go in sleep cycles, and only part of that is our deep sleep, which we should see multiple times a night. So when I look at people's wearable data, sometimes I'll just see it like once, and I'm like, okay, we need to work on getting you in deep sleep more than one time every night.

Kristyn Hodgdon:
Yeah, for sure. I have one more question, which is, I feel like as someone who has gone through fertility, and I have a PCOS diagnosis, Hashimoto's diagnosis. I'm very in tune with my body, but for someone, and being through going through IVF, every twinge you recognize, but for someone who might not be in touch with their body as a woman, like what are some things to look out for if you may not be feeling your best, and how, what are the next steps that you should take?

Macy Coleman:
Yeah, good question. So first and foremost, try not to normalize everything. Understand that what is common is most of the time not normal. So really, taking a look at your cycle, we call it the fifth vital sign, right? Our cycle tells us something. It tells us red flags. It's the way that our body communicates that something deeper is wrong. So understanding learning about your cycle and what a normal cycle should be, and like how far off are you and what parts of your cycle are off? Are you having a typical like 3 to 5-day bleed or is it shorter or longer? Are you having clotty, like really heavy clotty periods? Not normal. Are you having super light periods? Not normal. Are you spotting before periods? Not normal. All those things are common, we hear about them, but again, not normalizing them. So really it's about the education surrounding what we should be aiming for and what's going on with us, because it also allows us to communicate with our body, increases body literacy when we see, okay, what's normal, what is optimal, and what is going on with me and where can I pinpoint my issues, and that can tell you something. But also if you're confused and you're like, I don't actually know, or I don't feel good, I feel fatigued all the time, or I can't get pregnant, or my labs keep coming back normal but I just know there's something inherently wrong because we know our bodies better than any lab test or any provider. Look for help, look for someone that matches your goals and what your ideal scenario is when it comes to treatment. It's hard to find. That's an easy statement to say, but it's actually really hard to find someone that treats us how we deserve to be treated honestly. But taking time to look, asking people for recommendations, and then utilizing experts to guide you into the direction that you want to go.

Kristyn Hodgdon:
Absolutely, and I like what you said about, it can be a combination of traditional medicine and holistic medicine, too. It doesn't have to be one or the other. I always like to ask, what would you rescript about the way people think about, basically, like what they put into their bodies, how they handle their stress, like any of what we spoke about today?

Macy Coleman:
Yeah, so when I think of what we put into our bodies, of course, being a dietician, I think of food. So I think one big thing to rescript is what we talked a little bit about at the beginning, is that when we eat for fertility, the first thought is what can we take away? Understanding that none of this is a black-and-white mentality, so there's no perfect fertility diet or perfect way of eating. There is balance and moderation and focusing on what you can add to our fertility-friendly diet versus what we take away. So many of my clients come to me confused about what you mentioned earlier. Should they cut out gluten or dairy or nightshades or coffee? Because that's what all the fertility bloggers are telling them to do. But in fact, they're actually not even eating enough calories or fat and protein to begin with, so that's where we have to start. So think about what are we putting into our bodies that's going to nourish us. Are we putting in enough fuel to fuel our body but also create the building blocks to add a second human to grow a second human? That's huge, so that's always the starting point, and then understanding that all foods fit. And when it comes to, what was the second part you asked about stress?

Kristyn Hodgdon:
Yeah, like nervous system, stress. I know that's such a big factor when people are trying to conceive.

Macy Coleman:
Yeah, I think when it comes to that, also understanding that those things aren't sexy, those things aren't fun to do. They're not fun. Brand new supplements to take. It's okay, what's, where's your nervous system? What's your body doing? Are you spending time in fight or flight mode all the time when we should be in rest and digest? How can we get there? And also meeting you where you're at. So one of the first things I even mentioned earlier, meditation, deep breathing. Those are first things that come to our mind, but what if you're not a person that likes to meditate? What have you tried that you're like, that doesn't work, I know I should meditate, but I just don't want to. There's a million other things. So just understanding, one, that those foundations are truly key to overall health and fertility, and like, how can you make it exciting and comfortable and connected to you? Like, what things can we pick? Because there's a million things to pick from. It doesn't have to be the basics, and you don't have to force yourself to do something that you don't want to do or that you don't enjoy doing. So those are things I would really think about is that those foundations do really matter. They're probably more important than anything else, and you can find something that you really connect with.

Kristyn Hodgdon:
Love it. Thank you so much, Macy. This was so informative and I think is going to help a lot of people, so I appreciate your time.

Macy Coleman:
Of course, thanks for having me.

Kristyn Hodgdon:
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