Consultation with Kerry Goodwin

Safety of Acupuncture in Pregnancy

Posted on by Kerry Goodwin in News

Are you a birth worker or healthcare provider working with antenatal and postnatal patients? Have you wondered if acupuncture can be a beneficial modality to safely recommend to your patients? With acupuncture, we have historical evidence in addition to well conducted studies and formal analysis to show its safe and effective use during pregnancy. Two systematic reviews show adverse reactions were described as minor, and were comparable to non-acupuncture therapies. Another key takeaway from a systematic review by Park et al assessing the safety states acupuncture during pregnancy is found to be safe when applied correctly. Education and training matters! It is imperative to find a provider that specializes in perinatal health with extensive training in providing maternity acupuncture.

Additional reassurance is found in statements from ACOG and RCOG (American and Royal College of Obstetrics and Gynecology) where acupuncture is listed in their clinical guidelines as a safe modality in a variety of conditions during pregnancy.

  1. Park, J., Sohn, Y., White, A. R., & Lee, H. (2014). The safety of acupuncture during pregnancy: a systematic review. Acupunct Med, 32(3), 257-266. doi:10.1136/acupmed-2013-010480
  2. Clarkson CE, O’Mahony D, Jones DE. Adverse event reporting in studies of penetrating acupuncture during pregnancy: a systematic review. Acta Obstet Gynecol Scand. 2015;94(5):453–464. doi:10.1111/aogs.12587

Thyroid and Your Health

Posted on by Kerry Goodwin in News

Your thyroid health, fertility, a healthy pregnancy, and postpartum are deeply intertwined. And unfortunately, the detailed care and information we receive as women around this matter is lacking. I see this nearly everyday in my practice and have experienced this discrepancy first hand at my last well woman care visit when I received my blood work results from routine lab work. (if you’re interested in knowing what thyroid tests to ask for consider working with a provider that specializes in thyroid support). My low functioning thyroid was not even addressed by my physician after my visit, and I know I am not the only one this is happening to. The awareness around this is changing slowly and more and more providers are paying closer attention, but when it comes to our thyroid health we need to know what to ask for and how to receive proper treatment.  This starts with educating ourselves.  

Women’s Health and Thyroid Function

Did you know that “1 in 8 women will develop a thyroid problem at some point in their lives” and “15 million more women have a thyroid condition and don’t know it.” A healthy thyroid has a big job, tasks involve managing our temperature, metabolism, and hormonal balance to name a few. The rise in thyroid conditions is linked to a huge increase in endocrine disruption, stress, poor digestion (gut dysbiosis) or micronutrient deficiencies. The “normal” levels for a functioning thyroid are between .5 and 4.5 mU/L, but most women feel best if they land between 1.5 and 2 mU/L. And while these levels are somewhat controversial in the medical community, that is a pretty big difference between normal range and ideal range. 

Understanding your Thyroid Health in the Childbearing Years

It is also very important to know that if you are not trying to conceive, pregnant, or in postpartum, this still completely applies! Many women are dismissed and undertreated if they aren’t trying to conceive. This is a problem, because we all deserve to feel good and deserve to get the best care possible! It is also a problem because un-addressed thyroid conditions can lead to many other medical problems including pulmonary, cardiovascular, neurological, autoimmune, and digestive conditions.  

Chinese Medicine and Your Thyroid

Chinese medicine is very helpful in supporting thyroid health in conjunction with support from a western medical provider. Making necessary dietary and lifestyle changes can have a dramatic effect as well. Treatment must be a multi faceted approach. Underfunctioning thyroids may need pharmaceutical medication. I am not a pharma pusher but sometimes medication is needed in order to bring our bodies back into balance. If you are interested in learning more about thyroid health, curious about what a comprehensive thyroid panel includes, have just been diagnosed or suspect you may be suffering from a thyroid condition, please contact me to set up an appointment. You can begin to heal and feel your very best.  When we feel our best, we are able to share our gifts with the world and be our best selves.

Resources

American Thyroid Association

Aviva Romm – Thyroid in Pregnancy: What you need to know

Foods to Optimize Fertility

Posted on by Kerry Goodwin in News

Foods to optimize fertility

Balanced blood sugar is the foundation of hormonal balance and the first step in optimizing fertility. It starts with what and how we eat – every single day. We also know that to optimize our fertility we need to minimize stress. By ‘stress’ we are not talking just about everyday stressors like driving in heavy traffic or running late to catch a flight; it is any perceived stress your body experiences (such as mismanaged blood sugar). Nowadays this can occur daily, sending our bodies into overdrive and keeping us in fight/flight/freeze mode. When we are under stress our body puts reproduction and digestion on the back burner in order to direct all resources toward survival.  

What foods best support your fertility? Ideally, most of the foods we consume should be organic as well as pesticide and chemical free and in their whole and unprocessed form. If all organic is cost prohibitive you can  focus on keeping the ‘dirty dozen’ organic, as well as 100% organic meat, eggs and full fat dairy. You can check the Environmental Working Group for an updated list of the Clean Fifteen and the Dirty Dozen. To support our body in making hormones we want to eat lots of omega rich foods such as avocados (the fertility superfood), wild-caught salmon, pastured organic eggs, walnuts, almonds, sunflower seeds, flax seeds, coconut, and olive oil.  Focus on foods rich in antioxidants and beta carotene like dark leafy greens, blueberries, raspberries, blackberries, red grapes, yellow and orange vegetables like carrots, squash, sweet potatoes. These will provide lots of nutrients our bodies need. Cruciferous vegetables are full of fiber and contain DIM to help with estrogen metabolism. They also protect our bodies from harmful chemicals. For men lycopene-rich foods like tomatoes help to support sperm count and eating a diet rich in antioxidants will help with sperm motility and morphology.

If you are trying to conceive it is helpful to eat as if you are pregnant. This means focusing on warm cooked foods, lots of broth such as bone broth soups and consuming warm or room temperature beverages. It is also important to stay hydrated. This also means ditch the caffeine, coffee can negatively impact fertility and studies have shown that if you’re undergoing IVF it can reduce your success rate by as much as 50%. Even though green tea seems like a healthy choice since it is high in antioxidants it can actually decrease blood flow to the uterus. That is something we definitely don’t want for conception!

For balanced blood sugar the Mediterranean diet has been found to be the most supportive.  This focuses on healthy fats, lean proteins, nuts, seeds, and lots of fresh veggies. Here the slow burning carbohydrates keep your blood sugar stable and prevent the crash and burn you can experience from sugar laden products.  

To ensure our microbiome is running smoothly focus on probiotic rich foods such as sauerkraut, kimchi, yogurt, or kefir. A healthy microbiome will ensure the estrobolome works well, helping your body metabolize and get rid of excess estrogen through phase 1 and 2 detoxification. Many studies have shown that if you’re trying to conceive, eating full fat dairy is beneficial.

If you want to take this a step further you may consider eating for each phase of your cycle to support hormones throughout your menstrual cycle. During menses you will want to eat more blood building foods such as dark berries, beets, mushrooms, black sesame seeds, kidney and black beans, and sea vegetables as well as lean proteins. During the follicular phase and ovulation phase focus will be on egg development and building a good endometrial lining to support a strong and successful implantation. This is the time to eat more raw vegetables to support estrogen metabolism. During the luteal phase you may notice you feel more hungry, this is because your body has a lower resting blood sugar rate.  Here the need for more slow burning carbohydrates increases and foods such as sweet potatoes, root vegetables, brown rice, and quinoa are optimal choices. These slow burning carbs will help to boost progesterone production which is necessary for a healthy pregnancy.

If you are looking for more support consider working with a fertility specialist!

Tracking Your Fertile Days

Posted on by Kerry Goodwin in News

A guide to basal body temperatures, ovulation predictor test kits, and cervical fluid.

I get asked a lot of questions in my practice when working with patients to optimize their fertility. For example:

“How come my basal body temperature chart does not line up with my increase in cervical fluid and a positive ovulation predictor test kit (OPK for short).”

 Or, “I don’t know when or if I’m ovulating so how can I possibly know when the right time to have intercourse is.”  

Or, “My cervical fluid changes and my temperature rises several days before I get a positive OPK.”  

You can see where I am going with this. It can be really tricky to determine when is the best time to conceive! The first step in the process is really getting to know your body. We are going to do a deep dive into how to properly read and assess your cervical fluid, basal body temperature chart, and your OPK and most importantly when is the best time to conceive.

What is an Ovulation Predictor Test Kit?

First it’s helpful to understand exactly what is an ovulation predictor test kit. This test will help determine when ovulation may be approaching. It measures the amount of luteinizing hormone, or LH, in the urine towards the end of the follicular phase. LH is is produced in the pituitary as the dominant follicle ripens, LH surges right before the egg is released. The OPK is best used between the hours of 10 a.m. and 8 p.m. and not using the first morning urine.  It’s also helpful to make sure you do not drink too much water beforehand as it will dilute the LH. Once you have a positive OPK you will likely ovulate within 12 to 48 hours. It is helpful to use the OPK in conjunction with the BBT (basal body temperature) especially if cervical mucus is not very strong.

What is your Basal Body Temperature or BBT?

Basal body temperature or BBT chart records the temperature of the body upon waking, a time when the body is deeply rested and metabolism and temperature is at its baseline. The temperature will begin to rise once a woman has ovulated and begins to produce progesterone. Historically, the BBT started in the Catholic religion in menstrual charting to detect the body’s rhythm. It’s helpful to have at least three months of temperature charts to see the consecutive changes in the temperature so you can see when the rise is occurring to track ovulation. All you need to take your BBT is a digital thermometer and a piece of paper, however now there are many great apps that you fill in your temp daily to see your monthly pattern. There are also trackers, like the Ava bracelet, that will do all the work for you. The temperature should be taken first thing in the morning before doing anything else. Note that temps are very sensitive to poor sleep, alcohol, and stress and will impact the temp each day. Temps will be most accurate when you have had three to four hours of consecutive sleep.

It’s important to note that BBT’s do not predict ovulation, they can only tell you that ovulation has already occurred. OPK’s will help you predict that ovulation will occur within the window of 12 to 48 hours. It is also helpful to know that hormone levels are constantly changing and LH can vary woman to woman in how long it remains at its peak. Some women experience mini-surges of LH prior to ovulation and some women don’t produce enough to be detected on the OPK but are still ovulating. Remember when I said to use the OPK it later in the day? This is because LH begins to rise in the morning so it will not be as strong as it is at 2 p.m., and the time your LH surges may vary. In some women it may last less than 24 hours.  if you’re only testing one time per day at 2 p.m. but the peak is occurring at 7 p.m., you will miss it. This is why it is important to test up to three times per day if you suspect you will be ovulating soon.

What is cervical mucus and how to I determine it’s quality?

Cervical mucus is another helpful sign to determine when ovulation is approaching.  Observing this will help you learn more about your body and when conception can take place.  There are four types of cervical mucus, G, L, S, and P. When estrogen peaks, it stimulates the production of cervical mucus, generally starting six days before ovulation. During the “dry” times of your cycle, when there is little moisture or fluid being produced from the vagina fertility is lower. This is when G type is present, it is impenetrable by sperm. As you approach ovulation, more liquid is produced moving from G to L type when the discharge will be more sticky and wet and finally to stretchy and slippery or egg white (S type). The S type mixes with the L type to make spinnbarkeit, or spinn. Next the mucus loses its stretch as the cervix produces P type that is very lubricative and slippery to aid the sperm during the most fertile day. It is helpful to recognize the changes in the fertile mucus because it precedes ovulation and can help you determine your most fertile days. The last day of cervical mucus is the peak day or best time for conceiving as it is the day of or day before the egg is released. Cervical fluids job is to help get the sperm inside the reproductive tract before the egg is released showing that the best time for intercourse is two days before ovulation.

A few final things to keep in mind. Previous birth control use may impair cervical mucus causing the body to only produce G type stopping the sperm from making it through the cervix despite ovulation occurring. Many medications can inhibit fertilization, this includes antibiotics, NSAIDs, antidepressants, antihistamines, and clomid.

How does Chinese Medicine fit in with tracking your fertility?

As an acupuncturist one of our greatest strengths is to see what is happening inside the body by watching or feeling what is happening on the outside of the body. This is done through taking pulse, looking at your tongue, a detailed intake, and palpation. In fertility, we look closely at the change in temperature throughout the whole cycle, not just during ovulation. We also discuss the cervical mucus, any symptoms that arise before menses and then what is happening during a woman’s bleed. All of these signs together can give us detailed information on how the body is performing and what may be happening hormonally. It is for this reason that the BBT will mean more to a Chinese medicine practitioner than to a Western specialist.  

Chinese medicine is also very beneficial to help encourage the body’s production of cervical mucus by nourishing blood and yin in the first half of the cycle (day 3 to 14) and by boosting yang in the second half (day 15 to the start of the period). If the cycles are irregular, it can also help to bring the cycle back to the optimal length of 26 to 33 days and can help regulate the temperature. When the temperature is too high or too low, it is a sign that something is out of balance. It will also detect what may be happening if either the follicular or luteal phase is to short or too long. If the follicular phase is too short, it is likely that the egg is unable to fully develop and if the luteal phase is too short it is likely there is insufficient progesterone to support a pregnancy. This can be treated by acupuncture and herbal medicine. Your practitioner will support you by treating you according to your cycle and recommending specific lifestyle and dietary changes as well as Chinese and western herbs to regulate the cycle and optimize fertility.  

I hope this guide helps you better determine how to track ovulation during your cycle!

Resource:

Lyttleton, Jane. Treatment of Infertility with Chinese Medicine. Churchill Livingstone/Elsevier, 2013.

 

Eat Your Way to a Better Menstrual Cycle

Posted on by Kerry Goodwin in News

We all know by now how much our diet and lifestyle impacts our physical, mental, and emotional health and well-being. This is especially true for women in terms of our hormonal body clocks. Just as we aren’t meant to eat the same food day after day, we are also not meant to exercise or live the same way each day. Our hormones are constantly changing in an intricate dance and when we take care of our bodies properly within the dance, all works magnificently. But when we don’t live by this model of syncing our diet and lifestyle it can be detrimental to our health and well being. This model of care was developed by the founder and creator of Flo Living, Alissa Vitti. This amazing practitioner is someone I recommend all my patients look to for dietary and lifestyle advice and recommendations around supporting hormonal balance. Many practitioners are now singing the praises of living a life that supports our hormones and fertility and it all starts with diet!  It is such an amazing compliment to Chinese medicine and more importantly, it works! I encourage you to check out Alissa Vitti’s website and blogs to learn more!

In Chinese medicine, we have a very similar view; the body is in a constant dynamic of change, never static. When we adopt healthy changes we can decrease the degree the pendulum will swing in each direction and therefore decrease the negative and pesky symptoms we experience. This is why acupuncture treatments vary, because your symptoms are never the same. By treating the body as a whole and selecting points that target each phase of your cycle, the hormones will be supported. But this work does not stop when you leave the treatment room. By integrating diet and lifestyle changes, you will see great changes in the health of your menstrual cycle. This means a decrease in cramps, less bloating, optimal digestion, decrease in breast swelling, decreasing PMS symptoms like anxiety, depression, and headaches before your cycle. The changes you make encourage healthy bleeding, showing a deep vibrant red colored blood, no spotting before or after, regular cycles, and removing stagnation that leads to clots. The changes boost your energy, stopping uterine and ovarian cysts and fibroids, as well as supporting weight management.  And my favorite – boosting your fertility and allowing for optimal ovulation for implantation and supporting a healthy full term pregnancy. This practice has also been proven to put certain conditions like PCOS (polycystic ovarian syndrome) and endometriosis into remission as well and a new research study shows that is can stave off early menopause by three years!

So what is cycle syncing and where do you begin? According to the research it all starts with regulating your blood sugar, then implementing exercising according to each phase, and eating different foods to support each phase. Research has also found that we can implement different times in our cycle to put our focus on making big decisions, prioritizing projects, or making plans. Research also shows that avoiding caffeine is necessary in the treatment of hormonal imbalance due to its impact on the breast tissue (leads to fibroids) and its negative effect on cortisol.


So what are the four phases and what exactly is a healthy cycle? Ideally a healthy menstrual cycle is 27 to 32 days, and menses or bleeding will last five to seven days that begins with moderate flow, not spotting, a deep rich red color that maintains a flow for three days, then begins to taper off slowly and ending by day seven. The first phase is the menses phase lasting 3 to 7 days, the second phase is the follicular phase lasting seven to 10 days, the ovulation phase lasting three to four days, then the follicular phase lasting 10 to 14 days.  

In the menses phase the hormones are at their lowest and as bleeding begins and estrogen drops, you will feel a sense of relaxation or relief. In Chinese medicine the menses phase is dominated by qi transformation, it is important to regulate qi and blood, promote the complete discharge of blood, allow a smooth transition of yin to yang and allow for the smooth flow of liver qi and blood. From a western perspective progesterone drops off, estrogen peaks and drops and the focus is on bleeding. This is the best time for self analysis and journaling.  Foods to focus on are nutrient dense, low glycemic, seafood and veggies to replenish and support the kidneys and blood. A good time for rest and recovery.

In the follicular phase the hypothalamus tells the pituitary to send follicle stimulating hormones to the ovaries to release the egg and estrogen will increase. In Chinese medicine the follicular phase is dominated by yin because we need yin and blood to fill the uterus. It is important to nourish kidney yin, blood, and support the spleen to fill the chong and ren with blood to promote optimal ovulation. This is the best time to tap into creativity and stimulating projects. It is also a good time for social interaction. Foods to focus on are fresh and light foods with high phytoestrogen content. This includes flax meal, raw veggies, beans, seeds, and lean proteins. This phase is a good time to try out new exercise classes and a great time for cardio workouts.

In the ovulation phase there is a sharp rise in follicle stimulating hormone and an increase in luteinizing hormone. The egg will release into the uterus and allows for estrogen and testosterone to rise. In Chinese medicine qi will need to transform yin into yang, or transitioning from the 1st half of the cycle to the 2nd. Here the goal is to course the qi and move blood, blood and yin are at their highest now and it is time to promote the movement of qi and blood. This is a good time to connect with your community since energy is high and communication is at its easiest. Foods to focus on are lighter grains, lots of fruits and veggies, and steamed or raw foods.

In the luteal phase the corpus luteum grows, progesterone rises, the pituitary stops follicle stimulating hormone, and estrogen continues to rise. In Chinese medicine the focus is on yang energy, its important to course the qi and move blood. Your acupuncturist will also focus on regulating the liver qi, calming the mind, and harmonizing the chong and ren meridians. It is important to maintain kidney yang to support implantation and pregnancy if that is the goal.  This is the time energy begins to decline and PMS may occur. It’s a good time to turn your energy inward and practice self care. Focus on foods that are rich in B vitamins, magnesium, and fiber to stabilize blood sugar and promote healthy elimination through the large intestine and liver. These foods include roasted veggies and grains like brown rice.

Now that you know a little more about each phase of your menstrual cycle from a Chinese medicine and Western perspective you can begin to incorporate some healthy changes and enjoy a happy and healthy period. To learn more check out Flo Living and give your acupuncturist a call!

{All images in this post are from Duvet Days.}

How Acupuncture can Support Mental Health in the Childbearing Years

Posted on by Kerry Goodwin in News

StressWomen are faced with many challenging decisions when deciding to start a family. One in particular is the decision regarding if and when to wean off certain types of medication. The most common and controversial pharmaceutical medication that women feel apprehensive about stopping is any type of antidepressant or anti-anxiety medication.  Pregnancy itself is fraught with heightened anxiety and the emotional roller coaster of fertility treatments and the additional hormones prescribed during that process may exacerbate the emotions and can leave a woman trying to conceive feeling frustrated and anxious.  Even the joyous news of learning you’re pregnant can cause feelings of ambivalence.  This is an incredibly exciting and wonderful journey, but the great changes on the horizon, whether it’s about your body or simply the attendant upheaval of lifestyle, can cause more than a little anxiety.

Many common medications that treat anxiety pose potential risks to your baby’s health because all medications cross the placenta and impact the growing baby.  While many studies have been done showing the risk is low, around 3 to 4%, drugs that treat mental health conditions still increase risks: congenital malformations, preterm birth, gestational hypertension, pre-eclampsia, stillbirth and increased risk of miscarriage are among some of the possibilities. Studies have also found that the timing of use of medication during pregnancy impacts the baby as well.

It is critically important to have a strong medical team to support you through the process of making these decisions.  Have you considered other options to support you through the process?  This can include activities like yoga, meditation, proper supplementation of Omega-3 fatty acids, light therapy, talk therapy, and acupuncture. Did you know acupuncture is incredibly helpful at relieving feelings of anxiety and depression?  By inserting needles into specific points along the body, your mind is calmed, your cortisol levels are lowered, and a release of dopamine and endorphins, the feel good chemicals in your body, flood your system, enhancing and lifting your mood.  Acupuncture, along with the use of Chinese herbal medicine, is a wonderful way to lower anxiety and stop heart palpitations associated with heightened anxiety or panic attacks.

It’s very important when making this decision to speak with both your care provider and the prescribing physician, as it may not be possible for some women to discontinue the use of medication supporting their mental health.  A strong support team can offer help with dosage, changing a medication, and access to other sources for support such as referrals to mental health therapists.

I hope that during this thrilling time of your life you consider the benefits of using acupuncture to support your mental health during your pregnancy!

Fertility Enhancement

Posted on by Kerry Goodwin in Interesting Articles, News

A few weeks ago during a summer evening around the pool with friends, I heard this story about bee’s and Shamans. The story spoke to my heart and my reverence for bees deepened. A new friend who’s a bee keeper shared a beautiful story that goes like this: The Shaman or the Medicine Man/Woman of the tribe would go out and pray to the bees. They would tell the bees all the problems of the tribe and the belief was the bees would then go out and pollenate holding the prayers and specific needs of the community as they buzzed around each flower doing their busy work, not only for their hive but for the tribe.

We use to be deeply interconnected with Mother Nature in a symbiotic relationship. As a collective whole we have gotten far away from this relationship. There are cultures around the world that still pray and give offerings to the earth, who they revere as Pachamama (the Andes goddess of the earth and fertility). As I write this it reminds me of women and their cycles being in sync with the moon… “The Red Tent”. A time when we use to sit close to the earth with other women, a place where wisdom would be passed down. Herbal medicine was the only medicine available to us; humanity was interwoven with the natural world.

There is a strong movement and desire pulling us back to the symbiotic relationship with Mother Nature. It’s happening! Our beloved Bees, I offer my gratitude and reverence to you and your medicine. One of the most profound gifts they offer us is their Royal Jelly. It is the potent medicine that only the Queen Bee and the Honey Bee larvae receive. The Queen receives it her entire life to keep her producing off spring. When taken with reverence, respect, and gratitude it will greatly enhance a women’s fertility. Here is an on-line article with more detailed information regarding Royal Jelly. It’s crucial to buy from a company with integrity, one that is not causing any harm to our bees. As we all know they are declining. They need our prayers now.