This is going to be a long post, but I really hope you’ll bear with me and read through it. I hope that the information I share will be helpful to at least one person.
Full disclaimer: I am not saying that lowering your carbohydrates is going to magically make you fertile. I’m also not saying that this is the be-all end-all for wellness. What I am saying is that getting your blood sugar under control is the first step that you can take in improving your fertility. To get your blood sugar under control, going low-carb has been proven time and time again to be effective. Nothing in your body can be healed if there are underlying metabolic (i.e. blood sugar) issues. That is a fact. Some people are going to struggle with blood sugar issues for the rest of their lives. In order to control those, they might have to remain low carb. Find what works for you and your body and stick with it. But, don’t kid yourself and think that you have nothing to worry about on the blood sugar front. I’d venture to say that almost everyone walking around today has some sort of blood sugar imbalance.
Also, I am just sharing my experiences, because I truly believe that by sharing our stories with one another, we can learn and heal.
OK. Read on.
Let’s Talk About Blood Sugar
So, like I mentioned a couple weeks ago, the reason I have decided to put my health in the front seat is because I am concerned about my fertility. My husband and I would like to start a family in a couple years and I honestly have fears that I won’t be able to conceive. Now that I have received all of my blood work, we know where we stand and can start making a road map for healing. I’ll discuss more of my diagnosis in a different post.
First and foremost. If you don’t know how your blood sugar works, then please read this post: “How Does Your Blood Sugar Work?” Please note that: “Blood sugar balance (or blood glucose level) is one of the 2 most tightly regulated systems in the body, with the other being blood pH.” So yeah. It’s kind of important. I don’t want to go into the basics of blood sugar in this post, in an effort to save time, so read the one above to get the overview of how it works and what normal numbers are.
The more blog posts and comments and Facebook posts that I read from people around the Web, the more and more clear it becomes that people simply do not understand how the blood sugar system works and why it is CRITICAL that it is managed well.
Blood sugar has to be managed before ANYTHING else can be addressed.
I cannot stress the importance of this enough, and I think many other people, people who are much more educated and popular than me, would agree.
You cannot sit there and tell me that you’re eating all these carbs and that it is having no effect on your blood sugar and insulin. If you continuously dump excess carbs (even “good” carbs like soaked and sprouted grains, legumes, breads, etc.) into your system, sooner or later, you will have blood sugar issues. Note, I said excess. Some carbohydrate intake is necessary. Grains, pasta, potato chips, ice cream, bread, cakes, cookies, etc., at every meal, or even a few times a week, are not necessary.
But, I digress.
The first thing that one must do to improve their fertility is get their blood sugar under control.
Now, before you say (and boy, have I heard this 1,000 times in the last couple weeks), “I get my blood sugar checked every year and it’s normal“, let me just tell you that even if that lab comes back normal, there is still a chance that there are still underlying issues that you’re not aware of. That is simply because doctors don’t do anything but the bare basics when it comes to checking blood sugar metabolism. As long as the standard lab comes back “normal”, that’s good enough from them. Believe me, because it happened to me.
The standard lab that most of us have received is the Fasting Blood Glucose test (FBG). According to Chris Kresser, “It only tells us how blood sugar behaves in a fasting state. It tells us very little about how your blood sugar responds to the food you eat.”
Before we proceed, let me just say that I am speaking from personal experience here. In all the years that I have been getting my yearly physicals (about 14 years total), I have never had my standard blood sugar test come back abnormal (the FBG is the only one I’ve ever had). Scratch that, it came back abnormal one time, when I was in college and eating loads of crap. I stopped eating crap, had it re-tested in 3 months and I was normal again. That was a good lesson for me that if you eat crap, you get crappy results.
Fast forward 14 years of normal blood sugar tests to today. Last week, I got my blood sugar tests back. And they were not what we expected.
First, I had the C-Peptide test, which is used to monitor insulin production and to help determine the cause of low blood sugar. That came back in the normal range.
Second, I had the FBG, I also had my Hemoglobin A1c test done, which came back in the normal range, but it was on the higher end of the range.
Lastly, I had to have a 2-hour monitored blood glucose test done. This is called the Oral Glucose Tolerance Test (OGTT). For this test (if you’ve never had one of them) they prick your finger and take your fasting blood sugar. Then, they give you this DISGUSTING, fake orange flavored, glucose-laden, nasty drink and have you chug it (ewwwwwwwwwwwww!). Then, they test your blood sugar at hour 1 and then hour 2. You get three blood sugar readings in all.
According to the OGTT, I am diabetic.
Now, before you ask why I’m not freaking out, let me tell you why I’m not.
1. My doctor didn’t freak out about it.
2. My other numbers are “normal”.
3. I have been, and will continue eating, low-carb, because I know it works, and my doctor knows it works, and has had countless success stories with this form of eating.
4. I don’t really think that the OGTT is the best test in the world. According to Chris Kresser, “The other problem with the OGTT is that it’s completely artificial. I don’t know anyone who drinks a pure solution of 75 grams of glucose. A 32-oz Big Gulp from 7-11 has 96 grams of sugar, but 55% of that is fructose, which produces a different effect on blood sugar. The OGTT can be a brutal test for someone with impaired glucose tolerance, producing intense blood sugar swings far greater than what one would experience from eating carbohydrates.”
When we got the labs back, I was so pleased with my doctor’s reactions. He never once mentioned medication. He never once gave me a diagnosis of being diabetic. He just said, “Interesting” and then proceeded to discuss diet and nutrition with me (which included him advocating that I eat lots of coconut oil. NICE!).
This is totally fixable. And, for the record, I don’t think that I am diabetic. I think that there is definitely something out of whack in my body and it could be a combination of various things, including my thyroid and adrenal health (which I will discuss in a different post). I know that with a continued low-carb diet, exercise, and some weight loss, things will correct themselves.
Now, I want to state something right here and now.
Prior to this test, I was not gorging on lots of heavy-carb filled meals, lots of sweets, and tons of sugar and soda. I was eating a real food diet (think Nourishing Traditions), with lots of protein, fats, fruits, and some grains. I was by no means eating a your Standard American Diet (SAD).
<begin pity party>
To be brutally honest, when I saw these numbers I was shocked, because it seemed unfair. Here I was, doing what I thought was best, and it wasn’t enough. It’s unfair that I try to live a healthy life, and this is what I get. Look at all the people walking around eating Big Macs and chugging down Big Gulps, and here I am eating, grass-fed dairy, grass-fed meats, properly prepared grains, etc., and I am the one with problems? Dammit.
<end pity party>
That said, I am really glad I got all of these additional labs done, because now I know where I stand. I didn’t feel any different than I usually do. I had no idea that something was amiss with my blood sugar. I didn’t have any diabetic symptoms. It hadn’t even crossed my mind that I was having blood sugar issues. So, I was actually quite shocked at my results.
The last time I had blood work, which wasn’t that long ago, the doctor said everything was “normal”. But, then again, that doctor only ran what was considered standard (the FBG test). They didn’t think about doing all of the additional testing that my new doctor has done. It makes me wonder if there were underlying issues for quite some time, but because I was always “normal” no one thought anything different.
Hmmm … food for thought there if you’ve always had normal labs … Just because you don’t think you have blood sugar issues does not mean that you really are in the clear. I had no clue about mine.
If you want more great reading about blood sugar, I strongly encourage you to check out these two posts from Chris Kresser:
OK, Let’s Talk About Babies
Imbalanced blood sugar, insulin resistance, and diabetes WILL have negative effects on your fertility.
A simple Google search will yield millions of results that will back that statement up.
So, put down the potato chips, set down the bowl of properly prepared rice, and lay down the sandwich made on sprouted wheat bread, and let’s get down to business.
In just a sampling of the literature I have read on this subject of blood sugar imbalance and infertility, Dr. John Briffa says that carbohydrates are linked to infertility in women:
Sometimes, problems with ovulation can relate to a condition known as polycystic ovarian syndrome or ‘PCOS’. Individuals with this condition often have problems with sugar and insulin regulation in the body. A mainstay of medical treatment for PCOS are drugs designed primarily for diabetes. Treating women with PCOS with these drugs has been found to improve ovulatory function.
Other evidence has linked higher levels of HbA1c (a measure of blood sugar control over the last 2-3 months) and reduced fertility.
These lines of evidence suggest that, generally speaking, high levels of blood sugar-disruptive carbohydrates in the diet might be bad news for female fertility.
Dr. Briffa goes on to say,
…The results of this study found that compared to women eating diets of lower GL values, those eating diets with the highest GL were 92 per cent more likely to suffer from ovulatory infertility. Total carbohydrate intake was also associated with risk of ovulatory fertility, with highest intakes associated with a 91 per cent increased risk compared to the lowest intakes.
As a disclaimer, I don’t know if I have PCOS. That is an area that I have not looked into, but at the rate things are going, I wouldn’t be surprised.
So, simply put (because it is a little more complex than this), eating excess carbohydrates –> leads to blood sugar imbalances –> leads to issues with fertility.
Note that I say excess. Again, some carbs are needed in our diet, however, that intake is way less than you would think. We do not need to eat bread with breakfast, grains with lunch, and pasta with dinner, in order to be healthy. It’s time that we start changing our perceptions of what is considered healthy. Just because your grains have been soaked and sprouted, your cakes are made with coconut flour and honey, and your ice cream is homemade, doesn’t mean those things are healthy! And, please, spare me the “everything in moderation” excuse. Do you eat arsinic in moderation? How about smoking? Is that OK in moderation?
On August 1st, I started Lydia’s (from Divine Health) Blood Sugar Control Challenge. I have also transitioned my style of eating from a traditional foods (aka. Nourishing Traditions) style, to a more Paleo/Primal style. I have received countless comments about how that will do more harm than good, but frankly, I don’t buy it. I have been moderate/high carb up until this point, but I am going to become more strictly low-carb, at least for awhile. Perhaps once my blood sugar issues are stabilized, I can start adding more carbs in. But, I know that I will never go back to grains, because frankly, I feel SO much better without them in my diet. And, even when I do start adding more carbs in, I can’t see going over 100 grams per day. Now that I am accustomed to this style of eating, I don’t crave carbs. I don’t want sweets. I don’t even miss my favorite sourdough bread. I feel full and satiated and pleased with the foods I am eating.
Coincidentally, I just found this article from Liz at Paleo Pregnancy Guide:
A Paleo diet isn’t necessarily a low-carb diet, but sometimes reducing your carbohydrate intake can be beneficial. This has proven to be the case when it comes to improving fertility. Specialist Dr. Michael D. Fox from the Jacksonville Center for Reproductive Medicine says that nutrition plays an important role in fertility, and ovulation disorders are often the result of elevated insulin levels caused by excess carbohydrate in the diet.
Polycystic ovary syndrome (PCOS) is frequently found in those who have trouble conceiving. It is now the number-one cause of infertility. This hormonal disturbance is closely related to metabolic syndrome and is often found in women who struggle with their weight.
According to Dr. Fox, women at his clinic who follow a low-carb diet double their chances of conception. Those who stick to a diet as close to zero carbs as possible rarely need aggressive therapies and become pregnant in one or two cycles with simple oral fertility drugs.
Let’s Talk Carbs
So, how many carbs should you be eating? According to this article from Mark’s Daily Apple, the amount of carbs that we need to survive is much less than you would think.
0-50 carbs per day for a ketosis state and accelerated fat burning (it’s wise to be under the care of a physician, if you’re going to drop this low). I am personally in the 40-50 carbs per day range, per the request of my doctor.
50-100 grams per day is the “primal sweet spot for effortless weight loss”, because it minimizes insulin production.
100-150 grams per day is the optimal maintenance range.
150-300 per day is going to equate steady weight gain.
300+ carbs per day puts you in the danger zone!
For all you people who may have skipped reading the “How Does Your Blood Sugar Work” post above, you might not be getting the full effects of what I am writing. Try reading this one instead: “The Definitive Guide to Insulin, Blood Sugar & Type 2 Diabetes (and you’ll understand it)“.
For optimal health, the 100-150 range is a good range, provided you have no blood sugar issues and that fact has been established through proper testing. If you are able to consume that many carbs, it is a lot easier to reach that 100-150 mark than you would think. Just take a look at these numbers — and these are just basic foods, not even full meals. Also, it doesn’t matter if these are homemade or store bought. Carbs are carbs are carbs. Our bodies treat them the same way.
- 1 cup brown rice = 45 grams carbs
- 1 cup white rice = 37 carbs
- 1 slice wheat bread = 15 carbs
- 1 slice sourdough bread = 19 carbs
- 1 whole wheat pancake (6″) = 38 carbs
- 1/2 cup dry rolled oats = 32 carbs
- 2oz (approx. 3/4 cup cooked) whole grain spaghetti = 42 carbs
- 1 small Russet potato = 30 grams carbs
- 1 cup hashbrowns = 55 carbs
- 1 cup sweet potato = 41 carbs
- 1 cup quinoa = 39 carbs
- 1 cup black beans = 41 carbs
- 1 cup pinto beans = 45 carbs
- 1 cup whole milk = 13 carbs
So, the fact is: If your blood sugar is messed up, your fertility is messed up. Simple as that.
So, if you are at all serious about (a) conceiving, (b) living a long, healthy life, (c) losing weight and feeling better, (d) avoiding disease later in life, or (e) any or all of the above, this is what I recommend:
1. Get serious about this. Realize that blood sugar regulation is delicate and can easily be messed up. This is serious. I cannot stress that enough. Even if you’ve never had your FBG come back abnormal, there could still be underlying issues.
2. Get your doctor to do some additional blood sugar testing and see what your results are. Get your normal FBG lab, but also request the C-Peptide, the Hemoglobin A1c, and, if you are really curious, the Oral Glucose Tolerance Test, but let me warn you, it is nasty, nasty stuff.
3. Get a blood sugar monitor and start testing at home. This is going to be the easiest and most efficient way to see what is really going on with your blood sugar levels.
4. Reduce your stress. Stress interferes with proper blood glucose levels. Stress also makes you fat and diabetic.
5. Exercise. Exercise plays an important role in blood sugar control. Plus, you get all the awesome other benefits from it like, a healthier heart, less jiggle in the belly, and a nicer butt.
6. Lose that extra weight. Understand that extra weight has detrimental effects on your blood sugar. Now, I don’t believe that we all fall into the “ideal” weight ranges that the medical community sets forth, however, even 20 or 30 extra pounds can have a major effect on your overall health, including your blood sugar. I don’t think the “experts” would disagree with me on this either. There is no good reason for women to carry around an extra 20, 30, 40 pounds. Women should be curvy, but curves don’t weigh that much.
7. Get lots and lots of sleep. Get less than 6 hours on most nights and you’re 3 times more likely to have elevated blood sugar levels.
8. Say goodbye to excess carbs. This doesn’t mean that you can never have a cup of kefired ice cream or a homemade brownie ever again (two of my favorite indulgences – I can’t help but stare at the photos and shed a small tear). But, you can’t have them until you get your blood sugar issues resolved. And, even then, they should be reserved for very special occasions and do not need to be eaten daily, or even weekly. Think birthdays and anniversaries.
I could go on and on and on. This is such a huge topic with so much information. I have barely scratched the surface, but my recent fascination with this subject has been brought on by conversations with my doctor, medical industry experts, my nutritional therapist, and many friends who are also facing similar challenges right now. The information I share above is true. It’s just up to you to choose what you believe.
Oh, and P.S. There is WAAAAAAAAAAAAAAAY more that goes into your fertility and thyroid health than just checking your temperature. That is NOT a good gauge of whether or not you are fertile and healthy. Get your blood sugar sorted out and then let’s talk about temperature.
Talk to me. I want to hear your feedback! Let’s start the discussion below!