MTHFR, have you heard about it? What's the big deal anyway?

Warning! I'm going to get a bit geek squad on this weeks post. There will be big words...bear with me. I hate it too :) 

Have you ever heard of MTHFR Mutation? It seems to be getting a bit of attention lately in the Paleo/real food sphere and it inspired me to write a little bit about this very common genetic mutation. If you've been following a real food diet, reduced your stress, are getting good quality exercise and sleep lots but are still feeling blah, learning you have this mutation might just be the missing piece that you've been searching for. 

MTHFR AKA Methyl-tetrahydrofolate reductase mutation is a relatively common group of mutations that effect many major systems in the body. There are a few different types of MTHFR mutations. MTHFR C677T and A1298C are the most common and are responsible for breaking down the amino acid homocysteine.

Homocysteine is a sulfur containing amino acid that lives in your blood plasma. It must be broken down in the presence of B-vitamins (B6, B12 and B9/Folate).  High levels of homocysteine (aka that isn't broken down) causes scaring and possible damage to vessels, which can lead to a host of inflammatory diseases including cardiovascular disease, stroke, Alzheimer's disease ect ect.  

In normal folks, active folate, known as 5-MTHF or 5-methyltetrahydrofolate, works in concert with vitamin B12 as a methyl-group donor to convert homocysteine to methionine. When homocysteine is broken down into methionine, it's used by the body to help metabolize fats, make proteins, utilize antioxidants, reduce the risk of depression caused by sam-e deficiency. Methionine also helps to reduce systemic inflammation and convert estradiol into estriol (a pretty rad form of estrogen). 

About 50% of homocysteine is remethylated with the remaining 50% trans-sulfurated into cysteine which then uses Vit B6 to make glutathione.Glutathione is a key antioxidant and detoxifier in the body. In fact, some may even call it a master controller. The less glutathione you have the more you are susceptible to stress and toxic build up. Glutathione is a key element of may processes in the body including:

  • Cell mediated immunity (aka immune function)
  • Bile production
  • Liver detoxification
  • Removal of heavy metals
  • Cellular growth, proliferation and death

When you have an MTHFR mutation one or more of these pathways becomes less efficient or disrupted (depending on the particular mutation) resulting in diminished levels of glutathione or methionine. Low levels of these amino acids cause a host of generic symptoms such as fatigue, anemia, low B12, hypothyroidism...the list can go on and on. 

 MTHFR is most common amongst Mediterranean and Hispanic populations (~22%) but is also found in white European populations in about 5-15%, Japanese/Chinese 8-18% and only in about 2% of African populations. That's a lot of people when you think about it! 

How do you find out if you have MTHFR mutation?

If you suspect you may have this mutation or, like me, are just super curious you can find out a few different ways:

Exhibit A- My spit...ready for processing. I'll share my results in 4-6 weeks.

Exhibit A- My spit...ready for processing. I'll share my results in 4-6 weeks.

  1. Submit your saliva sample to a company such as 23andme. I just did this last week and am waiting for my results. I'm pretty curious to find out about my ancestry and my genetic make-up, not to mention my MTHFR status.
  2. Have your blood tested by your functional medicine physician. These tests are a bit hard to find in standard labs but ask to see what's available in your area. 

 

 

 

 RECENTLY DIAGNOSED WITH MTHFR? 

Saunas can be great detoxifiers when you are preparing to become pregnant. 

Saunas can be great detoxifiers when you are preparing to become pregnant. 

  • Consider a period of supportive detoxification 
    • Because MTHFR mutations can make it more difficult for your body to detoxify itself, consider a 3-6 month period of gentle supportive detoxification. Castor oil packs, saunas/sweating and gentle activity all support detox.
      • Eliminate all food sensitivities and allergies. You're body's detoxification system is overburdened and stressing it out by consuming foods you are sensitive too will only further contribute to poor health. Consider some allergy testing or follow an elimination diet for a period of time.

      • Avoid toxins: choose natural skin & household cleaning products. Consider removing any mercury fillings.

      • Drink clean filtered water

      • Lay off the booze and Fructose: (agave, honey, high fructose fruits): These substances get processed through the liver and can stress out an already stressed out organ. 

      • Eat a clean paleo diet and avoid any packaged foods that may be fortified with folic acid. Folic acid and unmethylated B-vitamins commonly found in fortified processed foods can be potentially very harmful to you. 

      • Eat proboitic foods which will help your body absorb nutrients from your foods by optimizing gut function. 

  • Practice Intelligent Supplementation:

    • I'm never a big fan of just throwing a heap of generic supplements at a problem. Warning...I'm about to rant! Supplement recommendations are based on averages not individuals. Having a genetic mutations does not mean that an individual will have every deficiency that may be associated with a specific each condition. It depends on the expression of each unique gene by each unique individual (think epigenetics). See your ND or Functional Medicine MD and have some testing done. This may include checking levels of essential fatty acids, vit D, Vit B12, folate, iron, iodine, ferritin, calcium and more. Supplement based on your individual deficiencies. Trust me, the money you save in useless and even potentially harmful supplements will more than cover the cost of additional testing. 

 pregnant or trying? 

Trying to become pregnant with an MTHFR mutation can create a few special challenges. Not to worry however, there are things you can do to support your body's special needs. Many women who are diagnosed with the MTHFR mutation and have healthy pregnancies. Here are a few things to consider.

Newly Pregnant? 

  • I don't mean to freak you out but you are at increased risk for blood clotting and preeclampsia. Your care provider may recommend taking an anticoagulant or low dose aspirin to prevent blood clotting and reduce the risk of these complications.
  • Your baby may also be at risk for for neural tube defects such has spina bifida which are caused by folate deficiency. Ensuring you have adequate folate levels in very early pregnancy (ideally beforehand) is critical to prevent this serious birth defect. If a supplement is required (quite likely) always choose folate rather than folic acid.
  • Elevated homocysteine has been associated with low birth weight babies and increase the risk of preterm birth. Continue to support your body's natural detoxification systems by not overburdening it with toxins or allergens. Follow the guidelines in the above section but stay away from saunas, which are not recommended during pregnancy.

Struggling to become pregnant? See my recommendations above and try waiting a few months. You just may need a bit of time to detoxify and nourish yourself. A body that is toxic and undernourished (despite a clean diet) may not be ready for a baby just yet.

  • See a health care practitioner such as a Naturopath or Functional Medicine physician to get your hormones in balance. In particular, estrogen and thyroid hormones may be all out of whack. These can play key roles in becoming fabulous and fertile. 
  • Does your partner have a MTHFR mutation? New research shows that spermatogenesis (told ya I'd be using big word ) aka sperm production is effected in Dads with this mutation. Read all about it here.
  • Supplement wisely according to your bodies own needs. Choose folate from whole food baed supplements and ensure you have adequate B12, iron, ferritin and Vitamin D levels. 
  • Stress less: chillax....a mellow body functions at it's best and is supportive to our detoxification process. Practice daily meditation, relaxation, hug the ones that love you and for heaven sakes...laugh a little everyday. 

Laugh a little every day. As seen here, my friend Laurie thinks her hat is rather hilarious. Quite frankly, so do I. 

Laugh a little every day. As seen here, my friend Laurie thinks her hat is rather hilarious. Quite frankly, so do I. 


Take a chill pill....The importance of stress reduction for fertility

Squeaky clean paleo diet- check

Engage in daily gentle movement- check

Take all your supplements- check

Are a healthy weight- check

Why on earth are you still struggling to get pregnant? Well, the answer may be the one thing that is the hardest to truly change.....stress and how we manage it.  

Stress can be a good thing in moderation. A little burst of cortisol (stress hormone) helps to fire up our engines so we can run away from a lion or wildebeest (my personal fav). But, when this sort of stress and resulting cortisol release becomes chronic, unrelenting, day in and day out stress, our bodies don't cope quite so well. When this happens we start producing a hormone called alpha- amylase. Alpha-amylase has recently be discovered as a bio-marker for chronic sympathetic nervous system activation. AKA a signal that you're mind and/or body are chronically stressed out. AA has been formerly used as a way to diagnose pancreatitis or pancreatic inflammation. The geek in me finds this fascinating because when we are stressed and living in a chronic sympathetic dominant state our pancreas has to work overtime producing insulin in response to elevated blood glucose levels. When we are stressed and exerting a high level of cortisol our bodies naturally increase our blood sugars in order to mobilize energy in our skeletal muscles so we can make that mad dash away from the wildebeest. 

Recent studies have confirmed the link between stress and infertility. A few different studies measured these two hormones, cortisol and alpha-amylase. They demonstrated that while cortisol has no effect on infertility, women with high alpha-amylase had nearly double the risk of infertility. This makes perfect sense if you think about it from an ancestral perspective. Fertile women need to be able to run away from possible dangers every once in a while. A healthy cortisol response signals a fit and thriving individual. What we DON'T want is a woman who is chronically stressed. Chronic stress sends signals to our body that our world is a really dangerous place out there and isn't a safe space to raise a new little baby. The body is smart and wants to survive....so, it shuts down your ability to conceive. 

What can you do if you're feeling chronically stressed out? Here are a few tips:

Erin Urton...practicing what she preaches...and looking simply beautiful in the process  

Erin Urton...practicing what she preaches...and looking simply beautiful in the process

 

  1. Try to sleep or rest more. Sleep is how we tell our bodies it's safe to recover. Try to get more.
  2. Practice yoga or meditation. Even 5 mins a day will make a difference in terms of your response to stress. Need a launching pad? These short guided meditations will help you on your way and feature the beautiful Erin Urton who is an expert in fertility, pregnancy and postpartum meditation and yoga practice. 
  3. Lighten up on the caffeine. Did you know that just 200 mg of caffeine (one 12 oz mug of coffee) increases blood cortisol levels by 30% in one hour! Switch to herbal tea or decaf while your body resets and recharges.
  4. Move gently everyday. I don't mean hard stress inducing crossfit WODS. I mean walking outdoors, cross country skiing, hiking and gentle weight lifting. These things are all proven to lower your body's stress response and help you chill out. 
  5. LAUGH. Surround yourself with people who love and support you and lighten up. Have a good time
  6. Give. The process of giving back helps to elevate your mood and support the body's natural ability to heal. The holiday season is a perfect time to get started on this one! 
Gently moving in nature has remarkably restorative properties. 

Gently moving in nature has remarkably restorative properties. 



Tasty Living Amaze Bars....Meg the Midwife Approved!

These hempy happy chips are my regular nutrient dense stand- in for standard corn chips

These hempy happy chips are my regular nutrient dense stand- in for standard corn chips

My friend, former Midwifery client and fellow nutrition enthusiast Lindsey Williams has done it again! She first hit the nutrition scene with her company Tasty Living which brings raw whole food goodies straight from her kitchen to your tummy. Over the past few years, I've grown addicted to her line of paleo friendly crackers, "granolas" and cookies. It's so nice to be able to go to the grocery store and find treats that are local, well sourced, healthy and nutrient dense. 

My spelendid samples of Tasty Living's new Paleo Amaze bars

This week I had the honour and privilege to sample her NEW product the AMAZE bar. Let me tell you, these bars are just that..... AMAZEing. I sampled the Crunchy Hemp-Cacao Fudge Bar and the Green Goddess Bar. The Cacao bar is loaded with cacao nibs giving this chocolatey treat a splendid bit of texture and crunch. It was the Green Goddess bar really surprised me...I wasn't expecting to like it but the sea salt paired beautifully with the matcha and spirulina, making this healthy treat my favourite among the bunch. These bars are nutrient dense, locally sourced and PALEO friendly. They will be available across Western Canada to start but it wouldn't surprise me if we see her line of products hitting store shelves nation wide and even internationally in the future. 

Lindsey has launched a new kickstarter campaign to help launch her new products. I'm more than happy to support this new adventure of hers. She needs our help so please support REAL FOOD and join me in showing her some love with a small donation. 

Is Kombucha Safe? The great Alcohol Debate

If you're a listener to the most amazing Balanced Bites Podcast, you may have heard Liz Wolfe teasing a new fertility program/site, Baby Making and Beyond, that we are hard at work on. I'm SOOO excited to share this comprehensive information source for everything from fertility, pregnancy, trimester by trimester real food nutrition and popular postpartum topics. We want to have answers to all your questions so if you have something you'd like us to include, please send me a message! This program hopes to launch mid-2015 and will be kicked off with a fantastic 28 day Baby Makin' Bootcamp. Stay tuned for more info on that. 

One of the topics covered on the podcast last week was a question regarding the safety of Kombucha during pregnancy. I wrote about this topic a while back. Here's the link to the Kombucha Saved My Life Post.  Our Baby Makin' and Beyond program will answer questions just like this but until it's launched here's a brief rundown on the safety of Kombucha consumption in pregnancy.

Let's start by breaking down just what's in commercially made Kombucha. As I wrote about in my previous post, I ONLY recommend commercially made Kombucha during pregnancy. 

Kombucha Composition in a Nutshell

Tea (green, black, white): contains caffeine ~ 8-14mg/ 8oz

Sugar:~ 2-6g/8oz

  • This isn't much sugar at all. Kombucha's low sugar content is considered safe for women with blood sugar regulation issues and one serving of Kombucha is even considered acceptable on many Paleo 30 day challenges or while on the 21-day Sugar Detox Program.

Scoby: good bacteria to feed your gut flora

  • Optimizing gut flora is a great idea for both fertility and during your pregnancy. Kombucha was originally used as a digestive aid because the bacteria helps you optimize your gut flora and thus digest your food more efficiently. This can help to maximize the nutrient absorption from your diet. Adding a new probiotic into your regime can sometimes cause a "cleansing effect". If you are newly pregnant and aren't already a long time Kombucha drinker, I would recommend starting with very small doses (2-3oz/day) or just avoid it entirely just to be on the safe side. Once your system has gotten used to the bacteria, it is theoretically safe to continue during pregnancy and many of my pregnant friends happily enjoy 8-16oz/day with no side effects. In fact, a number of friends use GT's Gingerade as a pretty effective remedy for first trimester nausea. 

Alcohol: ~0.5%

  • This is the big concern for most women. While we don't know if there is ANY safe amount of alcohol consumption in pregnancy, we do know that 0.5% is a very small amount. In Canada and the US, non- alcoholic beer and wine are defined as anything 0.5% or less. I know many physicians who have told friends that it's okay to enjoy a non-alcoholic beer (0.5% alcohol content) a day with no evidence of harmful effects. One study even indicated that upwards of 40% of physicians tell their patients that even the occasional glass of wine (11-14%) is safe after the first trimester.  If drinking the occasional glass of 13% wine a week is considered by some to be safe and a bottle of 0.5% O'Dooles beer a day is safe can we say the same for Kombucha?

Some of GT's Classic Synergy products in the United States are labeled a must be "21 or over" with contents at or above 0.5%, while the Enlightened and Classic Kombucha versions have lower amounts of alcohol and do not require special labels. In Canada, there are no such label regulations or warnings on any GT products.

But is it really safe? Well, we don't totally know. Obviously it is unethical to run randomized clinical trials on pregnant women, but, there have been some studies that analyze long term data from pregnant women that we can use to make our assumptions. Once study of over 7600 women measured levels of behavioural problems among 2-year olds. The results were similar between women who reported zero drinking (11%) vs < 1 drink/wk (13.7%) vs light drinking 2-3 drinks/ wk (9%). Multiple studies seem to conclude that very light alcohol consumption may be safe during pregnancy. 

Studies indcate that it isn't the occasional small amounts of alcohol that put our babies at risk for Fetal Alcohol Disorder but it is the BINGE type drinking that is most dangerous. This makes perfect sense when we consider the science behind alcohol metabolism. 

Alcohol is metabolized in the body by a variety of enzymes including alcohol dehydrogenase (ADH), cytochrome P450 (CYP2E1) and catalase. ADH is the powerhouse of the metabolizers and is found in our liver. It's a supply and demand system. The more you drink, the more dehydrogenase you produce. This is why midwives, who live a life on call, are classically cheap dates :) This enzyme is also present in variable amounts depending on your ethnicity. Aboriginal and people of East Asian decent tend to have less and metabolize alcohol at a much slower rate. When you overwhelm this system with LARGE amounts of alcohol in one sitting, like when you binge drink, your body can't keep up with the demand for the ADH enzyme and your blood alcohol content goes up dramatically, crossing the placenta and potentially causing great harm to your developing baby. Bottom line...NEVER binge drink during pregnancy.

So what happens when we consume small amounts of alcohol like what's found in Kombucha or even baking extracts (like vanilla)? While we have no proof that this level of consumption is 100% safe, I feel like it's pretty fair to say that it's likely fine. While I'm not advocating going out and drinking a glass of wine every night, I am suggesting that perhaps the 0.5% we find in our daily 8oz of GT's may be totally safe. What do you think? Send me you're thoughts. 

It's raining babies

This is more or less my life right now! Happily and steadily catching little cavebabies. Some at home, some in hospital and one due any-day now in the birth center.  It's a busy but lovely time.

Stay tuned for a new post and be sure to check me out on Instagram. I'm still cooking up a storm to fuel my adventures and hope to share some new paleo pregnancy and fertility friendly recipes just in time for the holidays really soon. After all, it can't rain babies forever! 


It's my B-day Ya'll and there are some big things on the horizion

Fancy Fall days in the US and A

Hi Ya'll ! I feel like it's appropriate to say "ya'll" because I've just spent the past 8 days in the USA. Here's how it all went down:

After a long summer away from clinical care, I’ve returned to my lovely midwifery practice and had the pleasure of welcoming in several beautiful little babies into the world. It’s been busy, but a total joy to come back to baby catching.

After all the craziness that September brought, I decided to take a week off for my birthday and do some travelling! Well, it turns out that taking a week off is harder than it may seem!

 If you follow me on Instagram you may know that I just spent the first half of the week visiting fellow blogger and best selling Eat the Yolks author, Liz Wolfe at her homestead in Middle America. I’ve had tons of respect for Liz over the years and we’ve been in casual contact ever since I wrote a guest post for the Balanced Bites site last summer. Liz and I are in the beginning stages of a new AMAZING project! 

We also enjoyed some fantastic Kansas City Farm-to-Table

We worked our butts off and generally had a blast both getting creative and starting to lay the fertile groundwork for this lady focused paleo, primal and real-food friendly fertility, pregnancy and breastfeeding site. Thanks to Chameleon Cold brew and Pete’s Paleo for keeping us well fed and watered during the whirlwind visit! Stay posted for more updates about this amazing new adventure on The Modern Paleo Midwife as well as over at Liz’s site, Real Food Liz and on the Balanced Bites Podcast.

Earthy Fall day in Boulder Co

From Liz’s happy abode, I flew to Denver and went straight from the airport to Inspyre Boutique! Juli over at Paleomg blogs about this place all the time and man, did I find some cool stuff.  Everything is under $100! Dangerous. Very dangerous. From Denver, I headed North to Boulder to visit friends, eat my face off, hike and trail run in the beautiful foothills of the Colorado Rockies. The weather was chilly but we got some great days in outside. I spent my birthday feeling pretty blessed and well loved.

In short.....Happy Birthday to me 



The Real Deal on Vitamin A

Last week was all about pumpkin! Man, there is something so magical about that precious veggie. I've been eating my pumpkin gelatin recipe I posted almost every night. #obsessed! Pumpkin is a great nutrient dense starch that is loaded with all sorts of good things, including vitamin A...but did you know, there are two types of vitamin A? Yup, it's true...hang tight, let's explore the wonders of this over achieving vitamin. 

The Scoop on Vitamin A 

Vitamin A is important for many key functions in the body. These include: 

  • Eyesight
  • Hormone Balance and Fertility  
  • Thyroid function
  • Bone growth and skin health
  • Cell differentiation and multiplication
  • Immune Function (viruses and bacteria seem to retreat in the presence of high vit A)
  • Specifically for pregnancy, vitamin A is important development of the neural pathways between the brain and sensory organs and in the development of the nephrons in the kidney. Vitamin A deficiency is also associated with pregnancy loss...needless to say, it's an important part of a healthy diet. 

Two Types of Vitamin A

This blooger has her diet down! Eggs and liver on one plate! 

Retinoids (Reteinol Esters): Derived from animal sources. Retinoids are found in the liver of any animal and in smaller quantities in egg yolks,  butter and cream from grass fed cows. 

Kabocha squash...amongst my fav! 

Kabocha squash...amongst my fav! 

 

 

 

Carotenoids:  AKA Beta-carotene. Vitamin A derived from plant sources. Think carrots, PUMPKIN, sweet potatoes, cantaloupe. If it has an orange hue, it's probably rich in carotenoids. Carotenoids must be converted by the body into retinol in order to be used by the body. This is kind of tricky for the body to do and is a pretty inefficient process. This process can be even trickier if you suffer from a hormone imbalance, thyroid condition, don't have enough fat in your diet or if you have digestive problems. Babies also don't convert well (another reason to feed your infants over 6months liver).  

Vit A in a Nutshell

  • Fat soluble Vitamin. This means it must be consumed with a fat to be properly absorbed.
  • Both Retinol Esters from animals and Beta Carotene from plants must be converted by the body into Retinoids. Once converted they are stored in the liver as Retinol Esters. This  is why liver is such a rad source of Vit A .
  • Traditional cultures around the world seem to instinctively know the the benefits of proper vitamin A consumption. In fact, liver is found in the diets of almost every tribal group around the world, from the Canadian Inuit to the Maori in New Zealand. Many cultures even make special efforts to ensure pregnant women consume liver regularly. They instinctively know that vitamin A is critical for the health and wellbeing of our growing babies and is an KEY part of there development. Weston A Price has a great article that goes into the details about why Vitamin A is so critical for fetal development. Take home message....CONSUME LIVER! 

Vitamin A Toxicity in Pregnancy

The fear about Vitamin A toxicity in pregnancy over the past 20 years is something that commonly worries women whenever I suggest regular  dietary liver consumption. Here's the deal.....In 1995, a small study based in Boston found that high does of vitamin A could cause neural tube defects. The issue with this study is that it only looked at higher does (25,000 IU+) Vitamin A consumption from SYNTHETIC sources (retinol & retinol esters).  Follow up studies from several sites in Europe concluded that doses up to 30-50,000 IU in pregnancy from REAL FOOD sources were very safe, in fact, potentially beneficial to pregnant women. Sadly however the FDA did not change it's message and the public was once again misinformed.

Retinol Sources and Levels

I like this cod liver/butter oil blend. A natural, real food based source of vit A.

I like this cod liver/butter oil blend. A natural, real food based source of vit A.

  • High-vitamin cod liver oil 230,000/100g
  • Regular cod liver oil 100,000/100g
  • Duck liver 40,000/100g
  • Beef liver 35,000/100g
  • Goose liver 31,000/100g
  • Liverwurst sausage (pork) 28,000/100g
  • Lamb liver 25,000/100g
  • Egg Yolk 1,442/100g
  • Pasture Raised Butter 2,500 /100g (this level varies greatly depending on diet of cows)

The US  and Canada currently recommend 5,000 IU per day . From the work of Weston Price, we can assume that the amount in primitive diets was about 50,000 IU per day. Current Weston A Price recommendations include 20,000 IU-35,000IU  from  a modern diet of  butter and eggs from pastured animals; beef or duck liver several times per week; and 1 tablespoon regular cod liver oil or 1/2 tablespoon high-vitamin cod liver oil per day.

What's a Pregnant Paleo Mama to do?

Lambs liver...one of the milder livers. It makes great meatballs and pate spreads.

  1. Always enjoy your vitamin A sources with a fat. Vitamin A is fat soluble and needs fat to be properly absorbed.

  2. Enjoy liberal amounts of butter from grass fed cows and egg yolks. 

  3. Enjoy liver from grass fed animals once or twice a week to ensure you have a good supply of retinoids. Unless you are consuming Polar Bear or walrus liver, a serving or two of liver per week is not likely to cause any trouble. 

  4. Consume beta-carotene rich foods to your hearts content. This includes PUMPKIN! 

    • Always consume vitamin A rich food with a FAT. This helps you absorb to absorb the nutrient. This gives you full permission to slather your pumpkin or kabocha squash liberally with grass fed butter or coconut oil. 

  5. Make sure you are getting enough Vitamin E in your diet

    • Vitamin E is necessary for the absorption of Vitamin A. Vitamin E can be found in: spinach, turnip, chard, sunflower seeds, almonds, bell peppers, asparagus, collard greens, broccoli, kale and brussels sprouts.