• Gabrielle – Missing Georgia Eight Years Later

    Beth Heller, MS, RYT

    I have two of the most amazing little boys on the planet.  Every day they give me joy beyond words.

    But my first baby  was a little girl, Georgia, who was stillborn at 38 weeks.  I thought she was going to be a boy.  That first pregnancy we wanted to be surprised but I was almost certain.   When I traveled to France in my 7th month of pregnancy all the little French shop keeper ladies said “c’est un garcon!”  When she was stillborn and I held her I was shocked and surprised to learn that all those months I’d been carrying a little girl.  That surprise did not have a chance to linger, though.  It was too painful to switch the gears in my head to pink or too imagine life as the mom of a little girl.   I was too focused on strapping on my “fertility Rambo” gear and trying again that I didn’t stop much to think.  Of course I grieved the loss of a baby but at that point I was more focused on having a live child than on gender.  I went on to have Jackson and then Calvin – immersing myself in the life and identity of a “boy mom.”

    Until Gabrielle.

    Last summer my boys went to day camp with a little girl named Gabrielle.  I didn’t meet her then – just heard about her.  Each day when they would come home they would tell me a new story about something funny Gabrielle had done.

    This year I finally met Gabrielle.   She’s eight.  She has a short brown tom-boy bob and tons of scrapes, mosquito bites and scabs on her legs that show she’s not afraid to play in the mud.  She’s bossy and confident.  She likes me.  Whenever I come in to pick up Calvin she tells me where he is, where his backpack is and what he ate for snack.  She probably does that for all the moms (she’s that kind of girl) but it felt special when she would do it for me.

    My husband noticed my attachment before I did.

    “Wow,” he said one night when we were cuddled up talking, “aren’t you Miss Gabrielle-breath!”

    I asked what he meant.  He said that I’d updated him on Gabrielle almost every day that week.  It was true.  I had asked her what subject she liked best, if she played any sports, if she had siblings.  I had mentioned how much I loved the plaid uniform skirts and how cute Gabrielle looked in hers.  I loved her new haircut.

    Before I could answer him I realized there were tears in my eyes.  Gabrielle was the same age Georgia would have been had she lived.

    I had a good cry that night in Matt’s arms.  I cried for my little girl, for never putting hair ribbons in my child’s hair, for the lack of dolls in my house.  I cried that I would never get to tell a daughter about her period or do any of those very special rites of passage.

    When I was done, though, my heart felt light again.  I know I am blessed with two amazing little boys and wouldn’t change a single thing that has brought me to this point.  When something like this happens, I tend to think it is Georgia coming to me to make me pay attention to life.  I think this time she just wanted me to take notice of how my boys are getting older, to remind me that just because I am the mom I am not cut off from their important rites of passage.  To honor this message I made a commitment to myself to take each of my boys out on their own special “date” with me and to really learn who they are.

    This whole experience got me thinking about the very important role these “lost children” play in our lives.  Do you have a story of loss that has opened your eyes in some way?  If so, we’d love to hear it.

  • Supplements to Improve Egg Quality?

    Beth Heller, MS, RYT

    At the Moon we are constantly striving to increase our E.Q.I.Q. (Egg Quality I.Q.) and for years we have believed that nutrition can play a role in eqq quality. However, until recently there were few studies to support this claim so we needed to temper our recommendations with the phrase “but there isn’t any clinical evidence for this yet.” Now, several new investigations have shown that, yes, certain nutritional supplements may make a difference in egg quality. The goal of this blog is to summarize the latest clinical news, discuss the substances that are now showing potential benefits for women with poor egg quality and help you make choices about which supplements may be right for you. As with any supplement protocol, you should always consult your physician before starting.

    1. Myo-inositol (MI)

    Very recently two clinical trials were published that clarified a lot of the unknowns about myo-inositol, a product we use at PDtM under the name of FlowPro. Myo-inositol (MI) is a part of the B vitamin complex and is a known insulin-sensitizer. It has also been shown to improve both physical (hirsutism and acne) and reproductive (anovulation and amenorrhea) manifestations of Polycystic Ovarian Syndrome (PCOS). In addition, myo-inositol plays a role in cell growth and early studies indicated that higher levels of MI in the follicular fluid was associated with better egg quality.

    Several exciting new studies have emerged that have shed new light on MI and its role in fertility, particularly Assisted Reproductive Technology. The latest study of interest demonstrated that treatment with 4 g per day of MI for three months prior to IVF improved egg quality in women who had failed a previous IVF due to poor egg quality. In this study the treatment also included 3mg per day of melatonin, which I will talk about next.

    But first, a note about inositol. For some time there has been a debate as to the efficacy of d-chiro vs. myo-inositol for fertility. We have chosen to use MI in our products because a) this is the form that has been used in all the clinical research we have seen to date on PCOS, egg and embryo quality and b) it is less expensive than the d- form. Now, a new study confirms that myo-inositol seems to be more effective than d-chiro for egg and embryo-quality. On another happy note, MI has also been shown to have a positive therapeutic effect on mood disorders that are responsive to SSRI’s (serotonin selective reuptake inhibitors) including depression, panic and OCD – a potential plus for the anxious, depressed fertility patient!

    2. Melatonin

    Melatonin is a hormone that is secreted by the pineal gland. It regulates our sleep/wake cycle as well as other hormones, in particular the hormones of the female reproductive cycle. New studies like the one above suggest that melatonin supplementation at a level of 3 mg per day may help to improve egg quality when taken with MI for several months prior to IVF.

    There are caveats to the use of melatonin. Side-effects may include exacerbation of depression symptoms and patients who struggle with depression should make sure to discuss this side-effect with their physician. Melatonin should not be used with patients using thyroid medication as it can impact thyroid hormone levels. It can also suppress ovulation at high doses so in general we only recommend this supplement for women who will be using ART and a trigger shot to stimulate ovulation and/or retrieval.

    Finally, melatonin should NOT be taken while pregnant or nursing. In general we do not recommend melatonin use for longer than 3 months without taking a break. It can also cause marked drowsiness and is best taken just before bedtime.

    3. DHEA

    DHEA ( not to be confused with the omega-3 fatty acid DHA ) is a hormone that serves as a precursor of steroid hormones testosterone and estrogen. Research indicates it may also stimulate follicular development. Several studies have shown supplementation with 75 mg of DHEA daily to improve egg quality and pregnancy outcome in women who were “poor responders” to IVF stimulation medication. Another study suggests that DHEA supplementation may reduce the risk of aneupoloidy.

    DHEA should be used with caution as it is a pretty powerful hormone and when used at high levels and over a long term it may damage the liver. Women who are pregnant or nursing should not take DHEA, nor should women with PCOS as this could exacerbate the condition. Like melatonin, we recommend a three month treatment period.

    4. CoQ10

    CoQ10 is a naturally occurring fat-soluble nutrient that is essential for energy production. CoQ10 has potent antioxidant properties and cell membrane stabilizing effects that make it beneficial for egg and sperm quality, specifically sperm motility. CoQ10 works within the mitochondria (the cellular power stations) in the cells and is essential for energy production. Until recently, CoQ10 was not thought to be a nutrient that required supplementation, as all normal tissue manufactures its own CoQ10; however, this production decreases naturally with age and is also lowered by certain drugs, including statins. When CoQ10 levels in the cells are low, energy production may be reduced and oxidative stress increased as a result.

    CoQ10 has been shown to improve sperm quality and is now under investigation for potential use with women of advanced reproductive age undergoing ART to improve egg/embryo quality. The oocyte has among the highest concentrations of mitochondria of all body cells and uses immense amounts of energy in the process of maturation and ovulation. Researchers hypothesize that supporting the oocyte with CoQ10 may improve egg quality (Bentov et al. 2010).

    The recommended dosage for overall health is 100-300 mg/day, or as directed by a nutritionist. The dosage under investigation in studies looking at egg quality is higher: 600 mg/day. CoQ10 appears to be a safe supplement: Studies have used supplementation of CoQ10 up to levels of 3,000 mg per day without adverse side effects. At present, the only risk to taking CoQ is the cost, as this supplement can be pricy, and no data currently exists on its usage in high doses during pregnancy.

    5. Omega-3 Fatty Acid (EPA/DHA)

    There is still no direct clinical evidence that omega-3 fatty acids improve egg quality but we are convinced they are a good bet and include them in our Egg Quality Protocol. Eicosapentaenoic acid (EPA) forms the backbone of many of the chemicals that halt inflammation in our body and also serves to support the health of our cell membranes. Docosahexaenoic acid (DHA) (not to be confused with DHEA above) is important for brain health and adequate stores of DHA are thought to be beneficial for the early cognitive development of the fetus. DHA may also be helpful for depression. Look for purity-tested products.

    This is exciting news indeed but you should always speak with your physician before beginning a supplementation regimen of any kind. Of course, we would also be remiss if we didn’t mention that providing your body with the highest quality diet is also important for fertility. If you are specifically seeking to improve your egg quality you should also consider re-thinking your diet to limit inflammation, achieve good blood sugar control and get ample antioxidant nutrients from food sources. Our nutritionists at Pulling Down the Moon are specialists and will tailor their recommendations to your fertility diagnosis.

    For more information about any of the supplements or info in this blog, please feel free to contact me at beth@pullingdownthemoon.com. These supplements and other fertility-related products are available at our online store.

  • The Earth Element in Chinese Medicine

    by Anna Pyne LAc FABORM

    One aspect of medical theory in Traditional Chinese Medicine (TCM) includes the system of the five elements; wood, fire, earth, metal, and water. They can be used to differentiate TCM physiology, pathology, and treatment plan.  Each element corresponds to a specific emotion and an individual TCM organ.  The Earth element is affiliated with the worry or rumination emotion.  When our minds are busy over-thinking it hinders us from being grounded and impairs harmony between the mind-body connection.  The earth element is also associated with the spleen (not the same as Western medical spleen), which has to do in part with the digestive system.  A person with a poor digestive system usually cannot think clearly, hence the importance of a well functioning spleen.   When the spleen is working properly it means the earth element is being sufficiently nourished so that the mind can remain grounded.   This enables us to reduce stress, keep life in perspective when it gets tough, and can help maintain optimal physical health.

    At Pulling Down the Moon we have numerous treatment modalities to ensure that the earth element comes into and stays in balance.  The therapies offered are acupuncture, herbal therapy, yoga, meditation, diaphragmatic breathing exercises, reiki, massage, and nutrition all of which can be used either individually or in combination.  If you have any questions regarding the earth element according to TCM, feel free to contact me via email ( anna@pullingdownthemoon.com ) or make an appointment for acupuncture/herbal therapy by calling the office.

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