Leave No Stone Unturned: Fertility Functional Medicine Testing with Dr. Kali MacIsaac ND

If you’re struggling to get pregnant, you may feel like you’ve tried everything and are running out of options. But have you considered doing a deeper dive into looking for the underlying causes of your infertility?

In this episode, Lorne speaks with Acubalance’s clinical director of naturopathic medicine, Dr. Kali MacIsaac ND, about the importance of fertility functional medicine testing. Naturopathic doctors like Dr. MacIsaac don’t just look for results within the “normal” range – they aim for optimal or functional ranges that give you the best chance of success. As she puts it, “Would you rather be in the bottom 10% percentile or the top 10% percentile? When it comes to fertility and creating a healthy baby, we want you to be in the top percentile of ranges for most tests.”

Dr. MacIsaac will explain how comprehensive naturopathic fertility testing looks beyond just the surface-level symptoms of infertility and digs deeper to identify the root causes. By leaving no stone unturned, you can take targeted action to improve your fertility and increase your chances of success.

Dr. MacIsaac will also share how simple lifestyle changes can make a big difference in fertility, and why adding fertility functional medicine testing to your conventional fertility workup can be beneficial.

“Starting a family is a dream for many, and it’s understandable to feel discouraged if you’re having trouble getting pregnant. With functional medicine fertility testing, you can take a proactive approach to understanding your  current fertility status and identify any underlying issues that may be impacting your ability to get pregnant. Don’t let your dreams of parenthood slip away – take control and pursue them with confidence.”

fertility functional medicine testing, podcasts on fertility

Listen to this Podcast

Key Topics/Takeaways:

  • An introduction to naturopathic medicine [3:10]
  • How naturopathic medicine approaches a patient [5:17]
  • Issues that impact fertility [10:27]
  • The functional range of testing [14:15]
  • Ways a naturopathic thyroid test is different [17:45]
  • A case story about PCOS [21:38]
  • Lifestyle changes you can make to boost your fertility [36:24]
  • The negative impacts of consuming trans fats [40:35]
  • Chronological age vs. biological age [42:29]
  • A patient’s story of how she turned back her biological clock after a failed IVF cycle to a different outcome, having a baby girl [47:19]
Dr. Kali MacIsaac

Dr. Kali MacIsaac is a registered Naturopathic Doctor (ND) with the College of Naturopathic Physicians of British Columbia. She is a member of the BC Naturopathic Association (BCNA) and the Canadian Association of Naturopathic Doctors (CAND). Prior to medical school, Kali earned an Honours Bachelor of Science degree in Biomedical Science from the University of Waterloo where her passion for healthcare developed. Following this, she attended the Canadian College of Naturopathic Medicine (CCNM) in Toronto, Ontario, for a 4-year accredited naturopathic medicine program.

Dr. MacIsaac works as a general practitioner and has a clinical focus on digestive health, reproduction and fertility, endocrinology, and hormonal balance. She has completed the full curriculum of Biological Medicine certification with the Paracelsus Klinik Lustmuhle, as instructed by Dr. Thomas Rau MD, as well as a full curriculum in microscope technology from BiomedX. She believes in the power of an empowered patient and develops individual treatment protocols to inspire patients to take an active role in their health.

Dr. MacIsaac is also actively involved in educating the public about health and naturopathic medicine through speaking engagements and media appearances.

Watch The Full Interview

Lorne Brown:

By listening to the Conscious Fertility Podcast, you agree to not use this podcast as medical advice to treat any medical condition in either yourself or others. Consult your own physician or healthcare provider for any medical issues that you may be having. This entire disclaimer also applies to any guest or contributors to the podcast. Welcome to Conscious Fertility, the show that listens to all of your fertility questions so that you can move from fear and suffering to peace of mind and joy. My name is Lorne Brown. I’m a doctor of traditional Chinese medicine and a clinical hypnotherapist. I’m on a mission to explore all the paths to peak fertility and joyful living. It’s time to learn how to be and receive so that you can create life on purpose. Today on our episode, I have my colleague and friend from Acubalance, Dr. Kali MacIsaac. She is a naturopathic physician and she has an honors and bachelor of science. Kali, I have to introduce the group, kind of how we met. I don’t know if you remember exactly how, we may have two versions of the story. No?

Kali MacIsaac:

Yeah, we might. We definitely might.

Lorne Brown:

So I’m going to just have our listeners share with you that first of all, Kali is brilliant and she’s the clinical director of naturopathy at our clinic in Acubalance. I met Kali years ago in Florida. I went to attend a conference living in Vancouver, practicing in Vancouver. Kali, you were in Toronto and what year was that?

Kali MacIsaac:

Gosh, that would’ve been in probably 2012.

Lorne Brown:

Okay. So it was a while ago and it’s an intensive conference. We’re there for several days in Florida and Kali and I get matched up in a group and I’m aware that this physician to be because you were in your last year of naturopathic school, was brilliant. I wanted to have somebody brilliant on my team. At that time, I was referring out my patients to one or two naturopathic physicians in Vancouver that I liked because we saw so many sub-clinical hypothyroid issues and vitamin D issues and we needed that testing. So I begged you to come to Vancouver. I told you Vancouver would be a great place to live and practice. You said you’d think about it and I called you on a regular basis, right? For one year.

Kali MacIsaac:

That’s right.

Lorne Brown:

I recruited you and I basically wore you down. Then with dog and yourself, you came out to Vancouver and started your practice with Acubalance and now you’re such a crucial part of our integrative team. So I want to welcome you, Kali to the Conscious Fertility Podcast and I’m so glad that you accepted my invitation and joined Acubalance way back when.

Kali MacIsaac:

Thanks so much, Lorne. I’m really super excited to be here and also would say that the feeling is mutual and reciprocal because I am really glad that I took you up on that offer and landed at Acubalance. We have an awesome practice here, we have an awesome team and I’m just super excited to be a part of it.

Lorne Brown:

I want us today to introduce some of our listeners to how naturopathic care can optimize fertility and then we’ll talk a little bit about what we’re doing as well. So maybe give a little introduction to naturopathic medicine, maybe some of your tenants, your principles. Then let’s dive into how you’re helping men and women optimize their fertility and share some stories to help empower, inspire these women and men as well that are listening

Kali MacIsaac:

For sure. So I think it’s really important to start with kind of an understanding of what naturopathic medicine is because a lot of the time, patients come into my practice and they’re like, “I know I’m here to try and find something different, but I don’t really know what it is that we’re about to do.” So they kind of enroll before they even find out what naturopathic medicine is. So to even just sort of start with a general idea of what our system of medicine is, naturopathic medicine is an entire system of medicine that combines natural therapeutics with modern medical science. I think that’s really important to understand because we do have this very broad scope of practice in naturopathic medicine, meaning we have all these modalities in our toolkit like dietary counseling, nutritional therapy, we can use botanical medicine, we can use homeopathy.

We have all of these tools in our toolkit. What we’re doing with those tools is using the research that we have for modern medical science, we’re using these ancient tools like botanical herbal medicine and we’re kind of combining the two in individual ways for each patient to make it fit. So when it’s really most well indicated, we reach for a particular tool in our kit. So naturopathic approach often combines kind of that functional nutrition piece and botanical medicine and we may use pharmaceuticals when they’re indicated and we use mind body medicine, but we’re really tailoring each of those therapies to the person that’s sitting in front of us.

Lorne Brown:

I have found that the women and men that come to our practice that are drawn to us in the naturopathic side of it is the testing because they really want to leave no stone unturned. So can you share a bit about when somebody comes in, kind of how you do your deep dive in your investigation and compare that to what’s standard and what you’re doing that adds to it, that gives it a deeper dive?

Kali MacIsaac:

So I think a good place to start with that is sort of the philosophy behind how naturopathic medicine approaches a patient that might be a little bit different from in the conventional system. One of the ways that I like to explain how I’m going to do things with patients is to explain that our approach understands that fertility and definitely also your general health exists on a spectrum. So on one end of that spectrum you might be struggling to conceive. In the middle of that spectrum, is kind of like this gray zone. So maybe you’re a fertility patient, you’ve been having trouble getting pregnant and you’ve had a standard fertility workup and we can talk about what that is. So maybe you’ve had some lab work done, you’ve looked at a semen analysis if there’s a male partner and in this middle gray zone on the spectrum, maybe all of your lab tests are normal, but your body’s still not doing the thing that you’re hoping that it would do, which is be able to bring home a healthy baby.

Then on the other end of that spectrum is what we call vitality. So that is where someone’s peak fertility potential lies and where the body is performing and behaving in the way that we really wish that it would. So you have lots of energy and you sleep well and you’re really feeling vital. So when a patient comes in, what I always like to say is that wherever you are at on this spectrum is like a snapshot in time. So we’re looking at you today, you’re probably here-ish on the spectrum. We have all of these tools in our toolkit as naturopathic doctors and also with the integrative care with TCM and acupuncture as well, to really push you toward that vital end of the spectrum. That is where someone’s peak fertility potential really lies. The way that we go about trying to figure out where you are at on the spectrum always starts with that sort of standard initial fertility workup.

So depending on how long someone’s been trying to conceive, if the female partners under the age of 35 and they’ve been trying over a year, typically that’s when you would get to see a fertility doctor and they would do a standard conventional fertility workup. Over the age of 35, if it’s been six months, you qualify to have that workup done. So there’s some blood tests that gets done on the female partner. They also will do some imaging to take a look and see if her fallopian tubes are open and maybe take a peak at how many follicles are getting activated every single cycle. Then they may do a semen analysis on a male partner if there’s a male partner, that sort of standard workup might find something and then it also might not find something. That scenario where your lab tests are normal, that’s probably the most common patient that I see in my office because we’re like, “All right, we’ve had the workup done, there’s no explanation for why we’re still not able to bring home this baby. So then, what?”

Lorne Brown:

Their diagnosis that you see is if they’re in their early to mid-thirties, they’ll say it’s unexplained because their labs are normal. If they’re in their late thirties to early forties, then they say it’s age related and your labs are normal.

Kali MacIsaac:

That’s right.

Lorne Brown:

You take it another step then

Kali MacIsaac:

That’s right.

Lorne Brown:

The testing.

Kali MacIsaac:

That’s right. So what we say is that we want to leave sort of no stone unturned. So we want to look at an individual patient’s circumstances. I kind of think of it like this puzzle. When I’m working with someone, I’m really trying to take a look at what’s standing in their way of making a healthy baby. Because one of the tenants that our medicine stands on is that we really honor the body’s ability to heal itself the body’s natural sort of innate ability to heal itself. I would argue also to procreate because that’s one of the reasons that we’ve been put on this earth is our ability to sort of reproduce and make the next generation. So there’s something standing like a block to conception is what I call it. We then take a bit of a deeper dive with our testing to try and find out where this block lies.

What we often say to patients is our goal is to nourish the soil before we plant the seed. So this is an analogy that we talk about all the time, I’m sure you’ve probably already talked about it on the podcast, but I think it’s a good reminder for listeners to think about our fertility as if we are tending to a garden and if we take a seed, so let’s call that seed like the embryo. If we take a seed and we plant it in not very well-nourished soil. So let’s say we plant it in a sandbox where there’s not a lot of nutrition available, there’s not a lot of water available and maybe there’s not a lot of sunlight either. The chances that seed are going to turn into a really, really robust healthy plant that can bear fruits and flowers is pretty minimal. That’s because we’ve taken a seed and we’ve put it into soil that’s not a great quality.

If we were to change the soil. So maybe we add some fertilizer, maybe we add some water, maybe we make sure it’s getting the right amount of sunlight and then we plant the seed, the likelihood that that’s going to turn into a healthy plant is much, much higher. So I think of our fertility in that way. What we’re doing with our functional medicine testing that is outside of that standard fertility workup is trying to figure out for a patient what’s the block or what is out of balance in their soil and how can we change that soil up so that when we plant the seed, it’s more likely to become a healthy baby.

Lorne Brown:

I like this analogy because we do this so often about nourishing the soil before you plant the seed. What are some of the things that you are seeing that impacts the soil? So this plant can’t reach its peak fertility potential or in this case for the listeners, the egg and sperm cell can’t reach their peak fertility potential. What are the issues that are causing the soil to be suboptimal? Then do you test for any of this?

Kali MacIsaac:

Definitely. So there are lots of things that could be out of balance in the soil. Many of them are environmental factors and then a few of them are outside of our control. So we know that age is technically a factor that’s outside of our control. I can’t control how many birthdays somebody’s had it before they come into Acubalance and want to work on their fertility. We will in a minute I think, talk about the difference between someone’s chronological age and their biological age, but your chronological age we can’t change. But there are a ton of factors that could be creating an imbalance in the soil or the terrain of a patient’s body that we want to take a look for. So I’ll just give you sort of a short list or some examples of those things. So someone is dealing with excessive stress, whether that’s physical or mental, that can create a shift in the hormonal system that would put that soil out of balance.

Nutritional deficiencies are a really common one that we see in our practice. So for example, vitamin D deficiency or not having the right form or usable type of folate or folic acid in their system. Issues with the immune system is another really common way that that soil could be out of balance. That could mean a number of different things like for example, excessive inflammation that also could mean autoimmunity, that could mean infection. Each of those things makes the body less hospitable to a pregnancy and might damage the quality of the egg cells in the sperm cells.

Lorne Brown:

I have a question for you actually, because you said something about folate and folic acid because you said there based on the type so that can impact the health of the cell. When we say soil, just in case, because we know you guys aren’t plants. Soil is our metaphor for the cellular environment that your egg and sperm mature in.

Kali MacIsaac:

Yeah, so folate is obviously an important nutrient. It’s like of all of the nutrients that exist, vitamins and minerals and antioxidants, almost everyone who’s trying to make a baby knows they’re supposed to be taking folic acid or some version of folate. But there are genetic differences in the way that people process and are able to utilize synthetic folic acid, which is what’s founded probably 90% of the prenatal vitamins that are on the market. The synthetic version of vitamin B9 that’s called folic acid. So depending on your genetics, you might really easily use folic acid and turn it into the actual activated version of that vitamin, which is called methylated folate or MTHF.

You may also have genetics that would mean that you don’t process synthetic folic acid very easily and you can’t make that usable form of folate. Folate is a critical nutrient because it’s what’s called a methyl donor. It takes part in the process of cellular replication and DNA expression in the body. It helps to turn on and turn off genes and a lot of that’s happening in early pregnancy. So we want to make sure that someone has a sufficient level of the active version of that nutrient.

Lorne Brown:

In our demographics in the Pacific, Northwestern in Vancouver, we have many people that are from Asia, East Asia, India, and they’re more predisposed to having these genetic issues of metabolizing these, this B9. Correct?

Kali MacIsaac:

That’s right. Yeah.

Lorne Brown:

This is what I love about the naturopathic approach because I think the standard of care is we have the synthetic form of folic acid, cheaper, it’s in the bottle and you guys look at these subtle differences that can make a huge difference in some individuals.

Kali MacIsaac:

Yeah.

Lorne Brown:

The other thing when you’re doing your testing, which I’m also become fascinated with in working with you over these years is the functional range. Because when people get their labs back, there’s a range and you like a functional range. Just to put into perspective for our listeners, and I want to talk about vitamin D for an example, it’s like you have a range when you go to school and the pass is 50. So 50 to a hundred is your range. If you’re getting 50 or 51, are you super excited? You did pass, you want to get closer to a hundred.

When you talk about the spectrum of fertility and fertility is in that, you can have absence of disease where your labs are normal but you got constipation, you’re cold, you have headaches, you’ve got spotting, you got terrible period pain, miscarriages, that’s like in the 50% range or you can take your range up to a hundred percent where you’re in that vitality range. So when you as a naturopathic physician look at the labs that you get, you’re not satisfied just with it being within the range. I like the vitamin D1 because the range in Canada was 75 to 150.

Kali MacIsaac:

Yes. Now to 250, 75 to 250 is their range.

Lorne Brown:

For years, you would tell our patients you would like it or closer to 125, right? With our Canadian metric units and sometimes our doctors would give pushback, right? Because it’s fine, you’re at 74, you’re close, right?

Kali MacIsaac:

You’re normal, yeah.

Lorne Brown:

75 and you’re like … But you look at all the vitamin D deficiencies that they get symptoms of vitamin D deficiencies and you would say yeah, although you’re within the range, you’re on the low end and you’re showing subclinical symptoms of people that would have vitamin D deficiency and so you’d help them build it up. What’s really nice is, it was just recently that in British Columbia they changed the range from 75 to 150 to now to 75 to 250, right?

Kali MacIsaac:

Yeah.

Lorne Brown:

So now that 125 doesn’t seem so crazy but that’s your sweet spot for a lot of the patients we see, right?

Kali MacIsaac:

Yeah, it’s similar with vitamin D. It’s also a very common conversation we have around iron status and iron numbers. What’s your ferritin value? A lot of the time patients are told their ferritin is normal and a ferritin of until it’s below 10 it’s going to look normal on the lab results. But below 50 people are fatigued, their hair is falling out. But it’s not a really good place to come at a pregnancy from because we use a ton of iron and early pregnancy. So we prefer to have it middle to upper end of the range. Like you said, I’m not satisfied, I am very picky about where these numbers are. So when someone comes in and they say that, “Oh, I had that test done and it was normal.” I’m like, “Okay, yeah. But I want to know what the number was because normal is one thing and then optimal is another.”

Lorne Brown:

Yeah, we’ve normalized and normalized and not a good way and so normal doesn’t always mean healthy. It’s kind of like it’s normal for women to have PMS and menstrual pain and cramps. We’ve normalized it. That doesn’t mean that’s a good thing because it’s not necessary to have pain with your cycles for example. I love your holistic approach that you look at the labs but you’re also looking at their symptoms because if the labs say they’re normal but they’re showing all those signs and symptoms, you are not treating the labs, you’re treating the individual and the thyroid also you do a deeper dive in the thyroid panel rather than in BC they just look at TSH. You really look at the thyroid because … We’re going to get back to the soil. I know we went on a tangent, but our listeners want to hear this stuff. I know this is the stuff they come into your treatment room for.

Kali MacIsaac:

Right.

Lorne Brown:

Can you talk a little bit about how you do a thyroid test as an naturopathic physician different than the standard care here in BC and why you care so much about the thyroid health and the adrenal health?

Kali MacIsaac:

That’s right. Thyroid’s another very common thing that I test a little bit more deeply than what’s allowable through MSP. So when you go through the MSP system to test a thyroid, what’s going to be requested as a TSH and if that TSH is within range, meaning it’s somewhere between 0.3 and I think it’s 5.08 now. So somewhere between basically a little bit less than one and a little bit over five, everything’s considered to be normal. If that TSH is normal, there will be no other testing done. What TSH is actually just a brain hormone. So it comes from the pituitary gland, it’s the brain hormone that asks for the thyroid to make thyroid hormone. When you test TSH, you are looking for really full-blown hypo or hyperthyroidism, but you’re not getting a really good idea or really good handle on the functionality of the thyroid hormone system.

So what I find often happens is the TSH looks really normal, but the patient might have some clinical signs of having what we would call subclinical hypothyroidism or like a slightly underperforming thyroid hormone gland. So that might look like cold body temperature, constipation, they might have sort of sluggish energy, kind of low energy throughout the day. They might have diffuse hair loss or brittle fingernails. There’s lots of signs that we can see in the way that the body is presenting. That could mean that yes, your TSH is normal but maybe your thyroid’s not doing the best job of manufacturing hormones. That becomes really important in pregnancy because in your first trimester, your body has to up-regulate thyroid hormone production by about 50%. So we need more thyroid hormone in early pregnancy. If we’re going into a pregnancy with a sluggish thyroid production, my concern is that we’re not going to have that ability to really up-regulate thyroid hormone in order to maintain a healthy pregnancy.

So what we do is we run what’s called a full thyroid panel that’s going to look at not just TSH but also the actual thyroid hormones themselves. So T4, which is the precursor hormone. T3, which is the active hormone, we also screen for thyroid antibodies. There’s a little bit of research that shows that even if your TSH is normal, if you have positive thyroid antibodies or autoimmunity within the thyroid system, it can lead to a delayed time to conception. It may also contribute to miscarriages. So we take a deeper dive to at least rule out that there’s nothing going on with the thyroid or if we find something, support that thyroid before the woman gets pregnant.

Lorne Brown:

We have multiple cases in our practice where they’ve come diagnosed as unexplained infertility and you do the vitamin D testing and the thyroid testing and you see those ranges aren’t optimal, they get addressed and then we see those natural conceptions.

Kali MacIsaac:

That’s right. Yeah.

Lorne Brown:

It’s one of the most common things for even our PCOS patients. So many of our polycystical variant syndrome, patients that have ovulatory disorders, a quality disorders, often you’ve seen a lot of vitamin D and thyroid issues with them, right?

Kali MacIsaac:

Yeah. Slightly higher risk of both of those things. We have decent evidence that shows that being deficient in vitamin D can affect ovulatory function. So even just bringing your vitamin D up into the optimal range for someone with PCOS can allow them to start ovulating regularly, which we definitely need you to do if we want you to get pregnant.

Lorne Brown:

I want to go back to the soil, but first, I just was curious if you have a story you want to share, just kind of putting the picture of the naturopathic approach together and then we’ll go back and start to talk more about some of the things that you said that I’m interested in getting more information from you for our listeners.

Kali MacIsaac:

For sure. Well we’re speaking about PCOS, so I’ll share this case about PCOS that I love because it really just shows the power of natural medicine. So this patient, when she first started coming to see us at Acubalance, I think she was 32 and she wasn’t having regular periods, so she was maybe bleeding two or three times a year and she knew that she wanted to get pregnant and she was coming in because she was like, “Look, we haven’t started trying yet because really I’m not ovulating but I know that I want to get pregnant in the next couple of years. So what can we do?” This is kind of a best case scenario. We love when people come in for preconception care when they’re like, “I want to get pregnant in a year, what can we do now?”

So we started working with her and really our main goal in the very beginning was to just get her ovulating. She wasn’t ovulating so she wasn’t releasing an egg cell, but there was just kind of very few chances during the year that she could actually get pregnant. So what we started doing is really regular acupuncture with her. In the beginning she was doing weekly acupuncture. We used some of our very basic naturopathic interventions to help with ovulatory function. So I do believe we tested her vitamin D status. We did things like we gave her N-acetyl cysteine, we gave her some myo-inositol, both of which can help with ovulatory function. NAC is a really nice antioxidant and it helps with blood sugar stabilization, which is an important goal in PCOS management for many patients, not all but many patients.Myo-inositol is one of our most well researched nutrients for helping to improve egg quality in PCOS. It also does have some blood sugar stabilizing effect as well.

So she did a few basic supplements with us. She started doing really regular acupuncture and we did use some herbal therapies with her. We didn’t actually even get to the step of using any pharmaceuticals. In naturopathic medicine, we always kind of say that we want to use the most effective but least invasive less likely to have side effects interventions first. So we started with herbs and nutrients and acupuncture and our plan was to eventually use cyclical progesterone with her.

But after about, I think it was three or four months, she had a period and we were like, “Okay, good. This is a good starting place. We’ve got a cycle day one, let’s see if we can help to work on ovulation in the next few weeks.” What happened was she didn’t even get her next period and we were like, “Ah, dang it, you didn’t get your next period but let’s just test for pregnancy and see.” She was pregnant. So what had happened was she had been very infrequently ovulating. She started working with us for about three cycles, had a period, ovulated a couple weeks later and that ovulation actually turned out to be a pregnancy.

Lorne Brown:

So there you go, doing the preconception care and addressing the imbalances in a non-invasive way and without needing to use ovulation drugs or something as invasive as IVF, which is a strategy that can work. It’s just the diet, the lifestyle, the supplements and this kind of testing usually starts first, so. Many of the women don’t have to go on to more invasive approaches. Let’s go back to the soil. So sorry guys, I know I’ve jumped us over place, but that’s what we do here, right?

Kali MacIsaac:

That’s right.

Lorne Brown:

So we were talking about the soil and how the soil’s a cellular environment and how this impacts the maturation process of the sperm and egg cell because we’re looking for them to reach their peak fertility potential at the time of conception In the story Kali shared or if you’re doing IVF at the time of the egg retrieval and you had shared that you can have excessive stress, physical emotional that impacts the body, you can have nutritional deficiencies. I think you’re talking about inflammation in the body and that’s where I think I interrupted you. So please continue.

Kali MacIsaac:

That’s all good. Yeah, so those are sort of three things that can throw the soil out of balance. Additional things that we look for are excessive levels of oxidative stress. You can kind of think of oxidative stress like body rust, like it is the type of cellular stress that can cause a lot of damage to our cells, both their membranes and also to the nucleus and the DNA that’s inside of our cells. So it can be really damaging to egg cells and sperm cells which are very vulnerable, tiny little cells in our body, but really crucial gamuts obviously to conception and we have lots of oxidative stress, it can hinder their quality. So we look for that in our testing. We of course look for hormonal imbalances. So we’ve already talked a little bit about how we might assess for thyroid. We would also be looking for example for things like low progesterone or stress hormones like we talked about earlier and excessive toxic loads.

So if someone’s had a lot of chemical exposures, for example, occupational exposures like through painting or working in a lab or exposure to solvents, that would be something to consider. We also know that even just in our every regular everyday lives, we are all exposed to environmental toxins. So even just plastics. So working on reducing our exposures in our everyday life, we look for markers of excessive toxic flow with patients. Poor blood flow is another consideration. If we’ve got poor blood flow, that also means that we’re not circulating the nutrients and the oxygen to the ovaries or to the testes to the cells that really need it.

PH imbalance is something that I look for in my practice. What we want is for that soil or that cellular environment to be well-balanced from a pH perspective that has a role to play in regulating inflammation. Microbiome disturbances is another way that the soil can be out of balance. This is a really exciting sort of emerging area of research in regards to fertility. We are starting to see really interesting papers come out about the status of the uterine microbiome and the ability for an embryo to stick. So that’s a really interesting thing to take a peak at.

Lorne Brown:

This is why I notice in our practice we’re doing a lot more of the gut microbiome testing that you guys are looking at. That’s because of the gut has so much impact on our overall health including our fertility. Now you’re sharing also just a uterine receptivity for implantation.

Kali MacIsaac:

Yeah. Then it’s really funny because naturopaths have been saying this since the dawn of time, which is that all disease starts in the gut or the vast majority of disease starts in the gut. How we think of it is that the gut is like ground zero for the microbiome. It’s like our major microbiome. If there are major disturbances in the healthy levels of bacteria in the gut that concede and affect the healthy levels in the vagina or the cervix or in the uterus or in the testes as well.

Lorne Brown:

Our environment is so important as in they’ve even … The latest studies that have come out that I know at our team we had that little look at with C-sections versus vaginal births, how that is affecting the health of the child, their immune system. So everything is connected and for fertility, immunity is a big thing. So can you share a little bit about in general the … You’re talking about things that can affect the soil. So what kind of testing are you doing then again that’s different than just the conventional test? You are recommending the conventional standard test so that everybody gets that.

Kali MacIsaac:

Definitely.

Lorne Brown:

Then what are some of the things that you as a naturopathic physician are doing more functional medicine testing that patients may not be aware of? They’re listening today.

Kali MacIsaac:

So some of those functional tests might even just be run through life labs. Like I can check your vitamin D by sending you for a blood draw at local lab and we can look more closely at your thyroid that way as well. Beyond that, we use some private labs. Some of them are Canadian, some of them are from the US to do things like look at your amino metabolic picture, for example. We can look for nutritional deficiencies more closely through some of these private labs. We might also do stool testing to look at the gut microbiome. That’s a very common one that we will run with our fertility patients.

We have one of my favorite tests that looks at sort of what we would call maybe the five pillars of fertility, which it gives us a really great idea of the vitamin mineral essential fatty acid antioxidant status. So that would be sort of pillar number one, nutritional status. Pillar number two would be mitochondrial function. Pillar number three, state of the immune system. So inflammation or markers of excessive immune activity. Pillar number four would be oxidative stress. Pillar number five is toxic load. So it kind of gives a broad overview of a number of these different areas where the soil can be out of balance. That’s just actually a urine test that patients take home and they do in the comfort of their own homes.

Lorne Brown:

So this testing I find interesting, fascinated, excited about because when you think of the soil, things that can go to balance if you don’t have the right nutritional status in the soil, we have issues with our plants. So same thing with our cells, our egg and sperm cell. You mentioned the mitochondrial health mitochondria from the egg cell is so important for that early embryo development. The dividing and implantation. Toxicity, we know about endocrine disruptors, how they can impact our fertility. Immune system that has to be regulated in balance and in communication. So it allows this beautiful embryo to implant and just the microbiome of the soil. So this is why I love that analogy that we use about the soil and just how you’re testing for the soil to see what is going on in the soil that could be impacting the egg and sperm cells environment when it’s maturing. So thanks for sharing that. Anything else you want to add? Because I’m love interrupting you, Kali because you make me think of stuff. But did I catch you in mid thought or did you finish your thought about testing there? I apologize.

Kali MacIsaac:

That’s great. It’s all good. This is why we do these things. The only thing that I would add to that is to really highlight the importance of mitochondrial function. It is really one of, I think the most important targets when it comes to optimizing both egg cell and sperm cell quality. But definitely giving the embryo its best chance. Mitochondria are the powerhouses of our cells. So they are what make cellular energy and oocytes or egg cells are the most concentrated source of mitochondria in the body for the reason that the egg cell provides all of the mitochondria to the embryo. That is what sustains that very early part of cellular division. So there’s obviously a lot of cellular energy required for those several first divisions that happen within the embryo. As we age, our mitochondria function less well, that results in, of course that cell not having enough energy.

But another important factor that not everybody knows is that the ATP that come from the mitochondria in the egg cell are what is responsible for what’s called spindle formation when cells divide. So the ability for the chromosomes to line up properly along the midline and separate like one chromosome, one into one cell and one chromosome one into the other cell for them to separate properly and evenly requires really robust mitochondrial function and ATP. So what this means is that the better the mitochondria function and the more available ATP we have for that embryo, the more likely it is that that embryo is going to be euploid or it’s going to have the right number of chromosomes.

Lorne Brown:

That’s why in Acubalance, we’ve been pioneering using low-level laser therapy photobiomodulation for fertility because of the ability when you have the right wavelength and the right power and dosage that you have the opportunity to impact the mitochondria of the cells. This is another good segue then to say, “Okay, you figured out where people are out of balance.” Can you share our approach then, what we’re doing when we see patients? What kind of things are you recommending, offering and focus a lot on the naturopathic side as well, but I know it’s very integrative. So tell us what you see your patients doing.

Kali MacIsaac:

So we almost always start with the basics, the pillars, the foundations of health, which are our free therapies. We talk about that all the time at Acubalance. I think people often will discount changing their diet or sleeping a little bit longer or maybe exercising a bit more or with maybe even more moderate intensity than they already are. But the foundations of health are foundational for a reason because if someone comes into my practice with a poor diet, they’re not sleeping properly, they’re not exercising at all. I can give them all the supplements in the world and you could poke them with a million acupuncture needles. But nothing that we can do in our practice can make up for the missing fundamentals. So we almost always start by talking about diet and subtle shifts in dietary patterns actually are really quite powerful when it comes to improving egg quality, sperm quality and your ability to nourish a healthy pregnancy too.

Lorne Brown:

Can I share about our fertility diet book recipe recipes?

Kali MacIsaac:

For sure, yeah.

Lorne Brown:

So cute, funny story guys, many moons ago I wrote a book called the Acubalance Fertility Diet that has the pillars of eating for fertility. I got a lot of recipes in there as well that I found. Kali, you liked the theory, you thought it was pretty dead on and you approved on it and you cook. I don’t.

Kali MacIsaac:

That’s right.

Lorne Brown:

I can cook, I don’t cook well let me put it that way. It’s not that I don’t cook, it’s not my skillset. You were making some of those recipes and you gave me some feedback. What’d you tell me?

Kali MacIsaac:

Yeah, they were gross. I didn’t enjoy them. I was like, “Nobody’s making these things for pleasure, no one’s enjoying these.”

Lorne Brown:

So you took the Acubalance Fertility Diet and you gave it a rewrite and I had pages and pages and pages of theory and you simplified it down to a few pages so it was just really digestible, excuse the pun. Then you found recipes that are aligned with the Acubalance Fertility Diet principles that will optimize fertility. You put those recipes together and that is available on the Acubalance website, so people can get a download of that for free if they go to Acubalance.ca. I just want to let people know that there is a really good diet book out there for fertility that Kali and I put together, and a recipe approved by Kali and tested and tasted by Kali.

Kali MacIsaac:

That’s right. They actually fair things that I eat in my everyday life and you will enjoy them too.

Lorne Brown:

All right, again, so you’re talking about the pillars of what we do, the free therapies, you talked about diet.

Kali MacIsaac:

So you diet first, then we talk all about lifestyle. So it is actually really important to get a good, we say minimum of seven, but seven to nine hours of sleep every night. We know that melatonin for example, is an important nutrient for egg quality and you have the ability to make lots of your own melatonin yourself. If we can go to bed on time and sleep when it’s dark out and get you sleeping deeply for a good seven to nine hours. We talk about exercise, we talk about mind body techniques, these are all of the pillars. Then on top of that, once we get the pillars in place, we would use thing … I would use things like botanical medicine, so herbal medicine, which might be an encapsulated herb, it might also be a tincture version of a herb. Lorne, in your practice you might use Chinese medicine herbs.

We use a lot of supplements, so nutraceuticals, many of which have very good research behind them for supporting various factors regarding fertility, we almost always pair the naturopathic approach with acupuncture and often laser therapy too. So we enroll patients in regular acupuncture and laser sessions and then we do something called nutritional IV therapy in Acubalance as well, which is where we can sort of bypass the digestive system and give patients blend specific sort of specifically blended formulas for them of vitamins and minerals and antioxidants. We give it directly into the venous system to really boost nutritional status more quickly.

Lorne Brown:

Yeah. That’s something that I like because I just had one the other day with you, so thank you for that. Patients I see hanging out and doing this together and liking it as well with the drip 45 minutes approximately to have that. Those that have gut health issues where they’re eating well and they’re taking their vitamins but they just can’t absorb it, this is a great way to deal with that and get the cells healthy so then they can start to absorb and you can start to absorb your food because you’ve gotten the key nutrients to those cells in the intestinal tract for example. So the gut can heal and then people can start to take their supplements and diet get absorbed.

Kali MacIsaac:

That’s right. We often say you are what you eat, but I always argue you’re not what you eat, you actually are what you absorb and absorptive issues. So for example, that could be your ability to break down proteins into their individual amino acids and actually derive the amino acids into the cells where they’re actually needed. That can be hindered in a lot of scenarios. You may have gut symptoms associated with that. There might be digestive trouble, gas and bloating and diarrhea, but it might also just be low stomach acid and we don’t maybe have a huge number of signs of that. So when we go in with nutritional IV therapy, we fully bypass the gut and like you said, we are able to deliver the nutrients that we want directly to the cells and often in higher or more therapeutic levels than you could even absorb through a healthy gut.

Lorne Brown:

I see people’s feedback, comments. Some say, “I get so energized after my IV therapy.” Some say, “I feel so calm after my IV therapy.”

Kali MacIsaac:

Yeah. Yeah, we see a number of different responses. After a single session of IV therapy. I tell people the most likely thing you’re going to notice is not much of anything, but many people will notice that they do get an energy boost, especially if they’ve had a few of these in a row. As those cellular effects start to compound. So you may come away from an IV session feeling like you get this really great brush of stable energy for the next couple of days. Then there is a small percentage of people who will say, “I feel sort of calm or almost even kind of like, I want to go take a nap after my IV therapy.” It’s like we’ve just given the body a whole bunch of stuff to do and it just wants to go and hibernate and put all those nutrients away.

Lorne Brown:

I think because there’s some good dose of magnesium in there. So that can be calming. I know people that have neck tension headaches say that they found that beneficial. All right, so acupuncture and laser, your IV therapy, diet. Just one more thing on diet because I remember you said something once, you said earlier here that people dismiss it because it’s so basic. But you said something, even something small change in trans fats can have a dramatic effect. Can you share that with us?

Kali MacIsaac:

Yeah, that’s right. We actually have research that shows that a difference in just 5%. So if your diet contains out of everything that you eat in the day, 5% trans fats as opposed to 0% trans fats where you don’t eat any process or commercially produced oils, a 5% intake of trans fats in the diet more than doubles the risk of having an ovulatory fertility disorder. So simply cutting back on the processed foods and not eating of any of those cheaper, a more inflammatory versions of oils that would contain trans fats can really improve ovulatory function for some patients.

Lorne Brown:

Again, I’ll give the Acubalance fertility diet a shout-out. If you go to the website acubalance.ca, you can download that for free with all this advice in a simple form with recipes. So the integrative approach that we’re having here at Acubalance with you being the naturopathic medicine, such a key component of this integrative approach, they get this standard workup and either we can requisition those or they do it through reproductive endocrinologist. Then you have your deeper dive once you kind of see what’s going on. The approach, the therapies used. So diet, lifestyle. So exercise, sleep, rest, mind body stress reduction, you talked about some of the interventions we like to use. So IV therapy. Botanical, so supplements and herbs, and then there’s the acupuncture, laser, Chinese herbs. So it’s kind of our approach in the mind body approach. Really cool integrative approach. That’s kind of … I got it down, right? I’m remembering?

Kali MacIsaac:

That’s right.

Lorne Brown:

I’m remembering correctly today?

Kali MacIsaac:

You got them all. Yeah.

Lorne Brown:

We’re close to the end of the time you were able to spend with me today. Before you go over and do some transfers over at the IVF clinics, I know you’re doing some support over there. You did say something that I thought it’d be nice if you can kind of touch on you. Earlier, were talking about chronological age versus biological age. I just thought if we could revisit that. I know we were talking off camera before we started to some of the fun cases that we’ve seen that kind of show that example of chronological versus biological age. You can share those too.

Kali MacIsaac:

Thanks for bringing that back up because I forgot that we said that at the top. It is a really, really important concept. So we know within fertility that age is a hugely important factor and by age I mean chronological age. So when we are over the age of 35 for women and we are starting to see more and more research that male age matters as well for fertility, fertility rates decline. That’s because as we age, the systems perform less well. We make less cellular energy, we tend to have more oxidative stress, we have poor quality gamuts to work with, so that can really affect the likelihood that someone falls pregnant. What we understand in naturopathic and functional medicine, and really what Chinese medicine has been telling us for a very long time is that there’s a difference between somebody’s chronological age, which is how many birthdays they’ve had and their biological age, which is the age at which their cells are operating.

So meaning we could have two chronologically 40-year-old women sitting in front of us, one of those women with a healthy diet and lifestyle and doing lots of things to support her system might be operating a biologically 40 and biologically 40-year-old women should absolutely be able to fall pregnant and carry healthy babies to term. The other chronologically 40-year-old women might have some lifestyle factors. There may be genetics involved here as well, but poor dietary habits, poor sleep patterns that might be causing what we call accelerated biological aging. Her cells might be performing as if they’re 45 or maybe even 50. At 50 the likelihood that her cells are going to be able to create a healthy baby is much lower than someone who would be operating at biologically 40. So we know there is this reproductive clock, fertility declines with age, and what we are trying to do at Acubalance is reduce that accelerated biological aging so that your cells are performing at the chronological age that you are.

An important distinction there is that I cannot have somebody come in at chronologically 40 and turn back the reproductive clock to the point where her cells are operating like they were when she was 20. I wish we could do that, but we can’t turn back the clock that far. What we can do is make sure that they match up. There was a really interesting study, and this was way back in 2009, a study came out talking about the fact that there may be a difference in the chronological and biological ovarian age. What it came out at the end of the study was their conclusion was that chronological and biological ovarian age are not always equivalent. Furthermore, the biological age is a more important indicator of predicting the outcome of ART or Assisted Reproductive Technologies than the chronological age. So it is really important to focus on these lifestyle factors that can reduce the biological age.

We now have a growing body of research that shows that lifestyle of interventions are actually extremely effective at reversing the biological age. So you and I have talked about this research quite a lot and we’ve read the book and we share with patients. Dr. Kara Fitzgerald, who is also a naturopath, she’s a functional medicine doctor, she’s just written a book called Younger You that outlines a pilot study that she did, trying to clock, trying to show the reversal of biological age with simply diet and lifestyle changes. So she took a group of people, they did diet and lifestyle interventions for only eight weeks and she was able to track a change in the markers of biological age. They saw a two to three year reduction in their biological age in just eight weeks.

Lorne Brown:

See. So that’s why the emphasis on the lifestyle therapies are so important. You are talking about the microbiome and about hormone imbalances and inflammation and it seems like chronic systemic inflammation, which can come from infections, poor microbiome from stress or diet, lifestyle, sleep, all that creates chronic systemic inflammation. There’s a term where they call inflammaging, which you’re calling accelerated biological aging, which is what it is, and diet lifestyle. Then we use acupuncture, laser, mind body techniques, the nutritional supplements, IVs, all these things are about creating that balance, calming that inflammation to help reverse that accelerated biological aging.

Kali MacIsaac:

Yeah.

Lorne Brown:

Did you story you wanted to share and then we’ll wrap it up?

Kali MacIsaac:

I definitely do. Yeah. So one of my favorite examples of sort of turning back this biological clock is a patient who came in and the reason that she was coming to our clinic, she was 38 and she had just had a failed IVF cycle. So they had just done a retrieval, fertilization, they were watching actually five embryos. So it actually seemed that she had responded quite well to the IVF protocol. They watched those five embryos grow, they biopsied them for genetic testing, which I believe you talked about before on the podcast, there is the testing now available called PGTA where they can tell you how many of your embryos are chromosomally normal. Unfortunately for this woman, five of five of her embryos were aneuploid or abnormal. So they weren’t actually even able to use any of those embryos for a transfer to try and make a baby.

So she came to us because she was feeling kind of dejected. She had just done this really invasive thing. They just spent all this time and money and emotional investment in the process of IVF and they weren’t even able to get to a transfer. So what we did was the thing that we talk about doing with all of our patients. So we looked at her standard fertility workup, we did a bit of a deeper dive and what we found for her were a significant number of nutritional deficiencies that could affect mitochondrial function and just generally embryo quality. So that means things like the B complex vitamins. We actually saw that even though she was taking antioxidants, she had really low levels of antioxidants in her system. So possibly that absorptive thing we were talking about earlier. What we decided to do together with the patient was to take a little break from IVF retrieval and work from this preconception perspective for a good three months prior to her considering going into another IVF cycle.

So we did acupuncture and laser therapy with her. We did all of the dietary lifestyle stuff we’ve talked about. We also used IV therapy, we did weekly IV therapy with her for three months and then they went into a subsequent IVF cycle. What’s really cool is this patient was chronologically three or four months older than she had been. The first time she did the IVF cycle, she responded actually quite similarly to the medications, meaning they actually did have another five embryos to watch and to test and screen with PGTA. But this time when her results came back, she had four euploid embryos and just one aneuploid. So from five of five abnormal to four of five normal embryos that they were then able to use for transfers. Her first transfer luckily actually did stick and they now have a healthy baby girl who’s about 18 months old and then they still have three euploid embryos on ice should they want to try and have another baby.

Lorne Brown:

Again, this is that idea of she was chronologically older when she did her second IVF, but just those subtle differences, and this is where the integration comes in, we see we would wish, we see people before the IVF so they only have to do hopefully IVF once or maybe nans, maybe they get pregnant naturally, but it’s to prepare the body, the egg, and the sperm cell in the uterine environment before they even go into the IVF. Really what we see often is they’ve gone through one or two cycles and so then they come to us as, “What else can I do? Because I’ve done what I think is the most I can do.” I think what we do our best with education is integration. So doing it all as much as you can, it can be a difficult journey and a long journey.

So there are things that women can do and the diet and lifestyle, there’s a lot of things that people can do to help with their health and I hope this podcast and what you shared lets them know that they can also look at naturopathic medicine as another modality that they can look into to support them on their journey. Kali, I know you got to go running and do some IVF acupuncture over at the local fertility clinic. Thanks for taking the time today to talk about what you’re doing over at Acubalance and enjoy the rest of your afternoon.

Kali MacIsaac:

Thank You so much for having me. Have a great day.

Lorne Brown:

Thank you so much for tuning into another episode of Conscious Fertility, the show that helps you receive life on purpose. Please take a moment to subscribe to the show, and join the community of women and men on their path to peak fertility and choosing to live consciously on purpose. I would love to continue this conversation with you, so please direct message me on Instagram at Lorne Brown Official. That’s Instagram, Lorne Brown Official, or you can visit my websites, lornebrown.com and acubalance.ca. Until the next episode, stay curious and for a few moments, bring your awareness to your heart center and breathe.

Where to Find Dr. Kali MacIsaac

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Instagram: @drkalimacisaac

How to connect to Lorne Brown Online and In Person (Vancouver, BC)

Acubalance.ca

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