PT, a 34 year old sales director, decided to consult with me following 14 miscarriages and poor outcomes with IVF over the past 7 years. PT and her husband MT did have a son in 2003, born prematurely who sadly passed away at 24 weeks. PT was also diagnosed with PCOS for which she was taking metformin, hypothyroid for which she was taking thyroxin, endometriosis and complained of IBS.
PT was under the care of a fertility consultant and was diagnosed with a condition where she had elevated natural killer cells that would attack the developing foetus, she also had heightened immune activity in her endometrium which made it difficult for implantation to take place. PT had undergone 6 laparoscopy operations to clear out her endometriosis and de-bride and clean her womb following unsuccessful pregnancies.
On initial consultation the things that stood out to me were the previously mentioned PCOS and endometriosis, and a number of symptoms related to the bowels such as bloating, cramping, flatulence, constipation and diarrhoea. There were other things that stood out including poor energy levels, the use of caffeine as a stimulant, symptoms of PMS and previous multiple uses of antibiotics.
A dietary analysis highlighted an over reliance on oats, dairy and wheat for nutrition, however she had consciously made some good nutrition choices such as reducing red meat and increasing fish as well as eating berries and vegetables. A typical breakfast was oatibix, berries and yoghurt, lunch was usually a sandwich and occasionally crisps and dinner would include pasta, poultry, fish and some vegetables. There were often no snacks or they consisted of an oat bar. PT did consciously try to drink 4-5 glasses of water a day and drank several cups of tea.
It was clear from this initial consultation that there was a problem with PT’s hormone balance, PCOS is a condition where insulin is poorly controlled, the low thyroid speaks for itself and the endometriosis and PMS suggested out of balance oestrogen and poor oestrogen metabolism. There was also a big problem with the bowels causing immune dysfunction, I believed the over reliance on oats, wheat and dairy and the multiple exposures to antibiotics had created food intolerances and dysbiosis.
My plan to help PT was to balance her blood sugar to control insulin, heal and repair the gut, improve oestrogen metabolism and boost the immune system.
I suggested going wheat and dairy free and that PT swapped the oatibix and yoghurt at breakfast for eggs, homemade muesli and soymilk, fish, nuts and berries. These types of breakfasts have a good serving of protein and healthy fats that will help stabilise blood sugar but also provide essential nutrients such as antioxidants, vitamins and minerals. I suggested having a mid morning and mid afternoon snack of nuts, fruits, seeds or hummus with crudités to further control blood sugar and control insulin. My final nutrition advice for the initial session was to switch to “free from” bread for her sandwiches at lunch and to include more fish such as mackerel and sardines in her sandwiches.
To work on digestion I suggested PT do the HCL test, this is a functional medicine test that is explained in my book “The little book of nutrition tips”. Mechanical digestion begins in the mouth, but the real work starts in the stomach where the parietal cells of the stomach release HCL. HCL is essential for protein breakdown, mineral absorption, the release of digestive enzymes and bile and for killing parasites and bacteria. Both the immune system and the liver require the breakdown products of protein – amino acids to function properly, and establishing HCL levels was fundamental to my strategy of boosting the immune system and improving the metabolism of oestrogen through the liver. I suggested that PT continue with her Sanatogen Mum to be multi vitamin, as she needed the folic acid and B12 that the drug metformin depletes, but I would want to change this for a better brand in the following sessions.
I spoke with PT over the phone 2 weeks later and she had successfully cut out wheat and dairy and had “radically changed her eating habits” with good results, she also reported sleeping better. However she raised a concern about her homocysteine levels because of the metformin depleting B12 and folic acid. I assured her that eating meat and fish and by including more green leafy vegetables as well as taking her multi vitamin she would be getting adequate B12 and folic acid.
Another month later, on our second consultation, PT reported feeling much better and that many of her problems had cleared up. She reported her IBS had gone, and she had no cramps or diarrhoea. She also had lost about half a stone, dropped a dress size and her energy levels were much better. She reported that her fertility consultant had put her on heparin and progesterone and she was going to attempt a further course of IVF. PT indicated she had been following the suggestions made to her and was eating a lot of vegetables and had cut coffee out.
PT had successfully controlled her blood sugar and insulin levels, so now I wanted to focus on the bowels and liver. About 60% of the immune system is located around the bowels and by cleaning up the bowels I felt that we could lessen the demand on her immune system and reduce the NK cell count. I suggested that we work though what Jeffrey Bland calls the 4 R’s – remove, replace, reinoculate and repair.
PT had successfully removed the offending foods from her diet and we had replaced HCL and digestive enzymes in her stomach. The next step was to initiate a dose of probiotics to rebalance the gut micro flora which I believe was out of balance due to taking antibiotics and to take a small dose of glutamine to help heal the gut lining.
The next piece of advice was centred on supporting the liver not only detoxify some of the drugs PT took, but also to improve oestrogen metabolism. PT was advised to eat more onions, leeks, garlic and broccoli in evening meals and to get more seeds and berries into her snacks. Finally I suggested that PT take BioCare adult multi vitamin and mineral.
After 3 months of following my nutrition plan PT attempted another course of IVF that lead to a successful pregnancy and the birth of baby Maya at 35 weeks. Both mother and baby are well.
PT says it best…
“I believe the success is totally down to the time and effort London nutritionist Steve Hines invested in my problems and the plan he created. I would recommend a consult for anyone planning motherhood!”
