583: Dr. Robin Rose on the Gut Microbiome Link to Fertility With Staggering Results

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Katie: Hello, and welcome to “The Wellness Mama Podcast.” I’m Katie from wellnessmama.com. And this episode goes deep on the link between gut health and fertility and in a new way you’ve probably not heard and some incredible staggering results that are happening, but these results are also very valid for anyone who may not be struggling with infertility but just wants to improve some of these outcomes we talk about, whether it be pregnancy related or not.

I’m here with Dr. Robin Rose who is a board certified specialist in gastroenterology and internal medicine. She is a mom herself and she has been doing a deep dive in this research area of gut health through her practice called Terrain Health. And we go deep on this today really, really fascinating research on a lot of new gut testing they’re doing and the emerging role of things like metabolites. We talk about why gut health is even more important than we thought especially when it comes to fertility. This link wasn’t that clearly established before.

We talk about the things that affect our gut bacteria in a negative and a positive way, why we know that 95% of disease begins in the gut, but the really clear results on how that includes fertility now. She talks about the advanced testing that they’re now doing that looks at vaginal and gut microbiome for fertility. And they have helped in their clinical studies 75% plus of women who were struggling with infertility were able to get pregnant, including women who had been through on average 4.2 cycles of IVF.

So those results are extremely staggering. Even the first round of IVF is often only 29% effective. And so to go from rates like that to 75% in a very short period of time, women are conceiving within 90 days of finishing this relatively short protocol. And she walks us through all of the science behind that. It’s super fascinating. I’ve known about the gut microbiome connection in pregnancy and passing that on to baby during the birth process through my work as a doula and student midwife.

But she talks about how this goes even as far back as fertility and conception with some really, really fascinating implications. So if you are considering being pregnant, trying to get pregnant, struggling with infertility in any way, this could be extremely relevant information to you. But even if you’re not, we talk a lot about some really fascinating new studies related to the gut. So without further ado, let’s join Dr. Robin Rose. Robin, welcome to the podcast. Thanks for being here.

Dr. Robin: Thanks for having me. I really appreciate it.

Katie: I’m excited to learn from you today. And I think we’re talking about a topic that is very relevant to all humans, but especially to moms. And we’re gonna get to go deep on topics like gut health and fertility, and the link between the two. And I feel like I have so much I can learn from you. Let’s start broad. I feel like most of my listeners are pretty well versed in understanding that gut health affects the health of the whole body. And there’s obviously been so much emerging research in this area, as well as ancient knowledge from all of these different traditions that have always known that. But give us a broad overview of what we need to know about the gut microbiome and why it’s so important for our health.

Dr. Robin: Yeah. So, really, you know, this is so quickly evolving, you know, at lightning speed, the gut microbiome and what we’re learning on a daily basis, you know, how we’ve evolved, right? From being when we were hunter-gatherers to now how deforestation, urbanization, industrialization, all these things have really played such a huge impact on our overall gut microbiome health, how we are missing so many organisms and species that we used to be inhabited with that we no longer are, that are no longer in our gut, likely definitely contributing to many of the chronic disease conditions that we suffer from.

But in general, the overall health of the gut microbiome is really compromised, and probably to some degree in everyone. You know, I always say unless you live in a bubble and you’re a cow and you eat grass all day, you’re going to have…you’re gonna have some element of what we call leaky gut or intestinal permeability because the bottom line is, is that everything from drinking your tap water to taking Advil, to having alcoholic beverages, refined sugars, and I can name about 20 other things in this list, on my list, destroy the health the gut microbiome on a daily basis, even the air we breathe in.

So, you know, that constant onslaught of this, you know, of that microbiome, the health is extremely dynamic, right? On even a minute-to-minute, day-to-day basis. Oh, and I failed to mention antibiotics. Everybody takes antibiotics. And so, that’s a really big, you know, obviously culprit. But, you know, there’s trillions, 100 trillion organisms, including bacteria, viruses, protozoa, archaea, these other species called methanogens which produce methane, fungi, so on and so forth, but mostly bacteria that compose the makeup of the gut microbiome. And, you know, those bacteria, we really wanna have what’s called these good keystone commensal organisms. They’re super important for creating and making and synthesizing the metabolites that are so important for our overall health, for our metabolic health, for our immune health, for providing the nutrients that the other bacteria need, and that the cells that line our gut need.

And so, when there is a breakdown there and we have an imbalance and we have a lot more of the unfriendly or pathogens versus the friendly, or we don’t have enough of the friendly, you know, that’s called dysbiosis, an imbalance of the gut microbiome. And then, as a result, you know, because of that shift in real estate, then you have… you know, you get intestinal permeability, or you get, you know, basically, the lining, which is only a hair-inch thick of the intestinal, you know, mucosa, that intestinal lining, that barrier rather, it’s compromised very easily, and then things start to leak out that aren’t supposed to leave our gut because they’re supposed to either be assimilated, or absorbed, or eliminated. And especially those things that are supposed to leave our body and be eliminated, they’re then getting into our bloodstream. And then that’s stimulating the immune system in a specific way that shouldn’t be happening.

And those constant hits of, like, stimulation, stimulation, stimulation, everyone’s different, but it’s sort of, like, whatever your bucket is at, right? It’s like the bucket theory and when your last drop drops, right, it spills over and then you manifest whatever underlying, you know, disease process you were maybe meant to underlie. You know, that’s the 10% to 15% of the genetics part versus the 85% epigenetics, you know? Epigenetics being how we interact and adapt to the world around us affects our genes and that we can either amplify our good genes, right? Or amplify our bad genes or tone our bad genes down or tone our good genes down. And that’s based on us and how we decide to live our lives. So, basically, that gut microbiome has evolved with us and really controls the majority of our health. And so, we have to be super conscientious about giving that gut microbiome and feeding it what it needs and trying to take away the things that are destroying it on a daily basis. So, sorry if I…my little tirade about the gut microbiome.

Katie: No, that’s such a helpful overview. And I think you’re right. We know that rates of all kinds of chronic disease and more acute things are all on the rise right now. And it makes sense that the microbiome would play a huge role in this, especially because we know things like our food supply has changed and the positive things that would’ve been in our food supply are declining and there’s a lot more things that we’re having to deal with that we didn’t use to. But I love how you talked about it all as far as being in balance and reframing that idea. I think often we get in that mindset of bacteria are bad, and especially the last few years, there’s been this, you know, mass, like, let’s wipe out the bacteria and use hand sanitizer all the time. And that has negative consequences as well. And, you know, we used to get a lot more dirt and we used to get a lot more outside time and interact with animals more. And those all impact along with, of course, what we eat, our gut health. And like you said, this touches every aspect of health. But one thing I wanted to make sure we really get to go deep on today is the link with infertility, because I feel like this is pretty cutting edge and not being talked about very much, but could be really, really relevant to a lot of people listening.

Dr. Robin: Yeah. So, just how we know that all chronic… We really know that 95% of all disease begins in the gut. And so, you know, what is infertility, right? Why are some women not able to get pregnant? What does that mean? And so, the evidence that I’m going to share with you in a few minutes, it wasn’t shocking to me that infertility is just another manifestation of chronic disease. And probably just the first clue that that woman is going to manifest something at either very shortly or down the road. And so, by restoring health and balance of the gut microbiome, you can markedly increase the chances of a woman conceiving.

So, let me back this up. So, basically, I partnered, you know, with two amazing unbelievable women who have spent 15 years in the lab trying to figure all this out for all you women out there. Okay. So, they really get all the credit. They’ve done a ton, you know, a bench research that has culminated in basically… they’ve solved the mystery in a lot of ways as to what infertility is or why infertility happens. And it all stems from the gut microbiome.

So, they have been able to show that there’s specific bacteria that are missing from the gut microbiome or specific bacteria that are then overgrowing, right? And through these little sort of substances called micro RNAs, micro RNAs are basically…they’re secreted by macrophages in our gut. Okay? And they’re non-coding DNA molecules, but they travel distances and they communicate with the other biomes in our body. So, we have a vaginal biome, we have a lung biome, we have a skin biome, we have… Even men have a microbiome in their sperm. Okay? And so, through the technology that they’ve discovered, what’s basically…in the best way that I can explain it, it’s very complex, is that whatever’s happening in the gut microbiome, there’s a mirror image of that in the vaginal biome. Does that make sense?

So, they’re able to see through specific testing, and I’ll get into the diagnostic testing, but, you know, through a combination of doing a vaginal swab, right? And seeing what organisms are living in your vaginal biome plus some blood testing of specific inflammatory biomarkers and then also getting a saliva collection to look at this substance called secretory IGA, which is extremely important in the health of the gut microbiome and our immune system, the combination of those three things in women that they’ve studied in over 3,000, at this point, they’ve been able to come up with their 64 different variations or phenotypes for expressions of the gut microbiome in women that have infertility, 64 different. Okay? And depending on what each woman is manifesting, there’s a specific treatment that will go with that phenotype or that expression. Just tell me to slow down. Or if you need me to elaborate, I will.

Katie: That’s super fascinating. And this is definitely new research because I’ve only heard little bits of this, but I know from my work in the midwifery world and as a doula, that this is also really important much beyond just fertility and conception in that the mom passes her microbiome onto the baby during birth. So, not only is this gonna help women get pregnant, it’s also gonna optimize their baby’s gut health.

Dr. Robin: Right. And so, what I am so super passionate about too, is that I get as a woman and, you know, I never experienced infertility myself, but I had many friends that did. But I really can empathize, obviously not to the level of going through it myself, but it’s really just so devastating on an emotional, physical, mental level, all of those levels. And women that have to start doing hormones, IUI, and then they go on to IVF, I mean, not only just the emotional, but, God, even the financial stress of it all and tens and tens, even hundreds of thousands of dollars that go into the treatment, right? Here’s where I’m going with this. No one’s ever saying, “Well, what’s going on with mom? What is the root cause of why she can’t get pregnant?” Right?

And so, here with this testing, we’re understanding what the root cause is. We’re understanding what mom is smoldering, what illness is… Like, so this is like the first, like, if you were a detective, mom’s infertility is her first manifestation of that some…she’s going to express something. Whether it’s an autoimmune disease, Hashimotos, PCOS, endometriosis, insulin resistant, like, the list goes on. Okay? And so, by addressing this, and this is why I’m so passionate… And I guess I digress, but I was saying, I get that a woman will do anything. They don’t care about their health even. They just want to get pregnant, right? And I fully understand that, but guess what? Now you’re able to change the trajectory of your health as well. You’re changing the trajectory of your… That, to me, is so powerful, right? And so, I didn’t get to the best part. I’ll tell you what the results are.

So, their first clinical studies were done in women, and they’ve studied over 3,000 women to date, which is a really fan… That’s a lot of people, okay? And it’s also, remember, a noninvasive way of treating. So, we’re not talking about giving people invasive things either, you know? So, they studied women from Latin America and from Spain, and these women were actually IVF refractory. So, on average, they had already gone through 4.2 cycles of IVF. And some of them had been trying for 10 years.

And the studies are all published and they’re out there, so you can, you know, look at what I’m quoting, but they had pretty much just 75% success rate in conception in these women. So, staggering. I mean, we’re not… I mean, just unbelievable.

And this is an abstract form, and it’s pre-publication. It’s about to be published, I think in another month or so. They replicated the study in American women. And these women in America were… They didn’t study women that had gotten to IVF yet. They actually had either done nothing or they had started dabbling in maybe IUI or some hormone therapy. There was a little bit of a mixed population. And these women, on average, had been struggling to get pregnant for three years. And the results, again, they had a 75% success rate in conception.

The other interesting thing when you tease through the data is that, you know, women that get pregnant through IVF or these other means, they have a very high miscarriage rate, you know, very high. And the miscarriage with the women that went through the microgenesis program was significantly, statistically significantly lower. So, moms were able to carry to term much more successfully as well. So, I thought that was a really big deal, obviously.

And I don’t know if most women know the statistics, but even women in an optimal age, and I’m talking about like young 30s, like, 30s and below, like mid… You know, either 35 or 32 and below…I forget the exact number, but their first IVF attempt on average is 29.5% successful. So, to go from 29.5% to 75%, that’s like a huge jump. And remember, you’re treating the underlying cause. So, you are healthier, like you said before so beautifully, baby’s healthier, pregnancy’s healthier. Right? So, to me, I was like, why would you not even go through this? It’s a lot less inexpensive than IVF and hormone therapy. It really is. And you’re, again, going after the root cause and correcting what’s going on.

And we believe that the numbers will be higher because the way we’ve restructured programming, because when they did the studies, the women, it was more through like AI, like, artificial… Like, we’re gonna be…we’re touching them now weekly, you know, registered dieticians or like working with, you know, so there’s was a compliance issue with the women that didn’t succeed, you know? So, we think if we can increase our compliance, we’ll have much better results.

Katie: Those results are really staggering. And I spend a lot of time in PubMed reading studies, and to see that big of a jump is almost unheard of in scientific studies. So, that’s incredible. And it makes me also excited for the day that even women who aren’t having fertility issues have the ability to test and optimize these things ahead of time. I’ve done more research into the nutrition and genetic side and experimented with that, even in my own pregnancies of realizing, okay, if I know I have genetic potential weaknesses in these areas, we know, for instance, when babies in utero, they’re using a lot of fat-soluble vitamins, you want your methylation in order. Even just improving those things preconception makes a big difference for the baby and for the mom. And I feel like this is even a step beyond, like, how can we give baby and mom both the best outcomes in the future? I’m sure a lot of people are gonna be curious, what kind of testing? What does it look like? How is it done? And then what is the follow-up? Like, what do they change to get these amazing results?

Dr. Robin: Yeah. So, it’s really not difficult at all. It’s pretty easy. We have some women in America now through us going through the program, and they’re doing great. The way it works is, so basically you already touched on there’s like three buckets of patients that I think of, it’s sort of like women that have already embarked on IVF. Because even if you have to do embryo transfer and you’re still needing to do the IVF, by doing this, it’s optimizing your chances by, like, two and a half fold. And again, going to the root cause. And then you have women that haven’t gotten to IVF but are struggling for several months or a few years and they’re starting to think about IUI or hormone, but they might just be able to get away just doing this, never having even touched that stuff. And then you have the third bucket that you just touched on so eloquently is like just optimizing health, right? Like, understanding the health of your gut microbiome, what’s going on from an inflammation standpoint, correcting all those underlying reasons so that when you are ready to get pregnant, you really have gotten your health into a very optimal place.

So, the way it works is, is that there’s a kit sent home to you, and in the kit… So, it’s amazing because it’s all at home, which I think is unbelievable. There’s a swab to just do a little vaginal swab. There’s a blood spot. So, like, you know, just like a diabetic does a finger prick, you just do a little finger prick and then you…the blood goes on these little cards. And that’s to look at specific inflammatory biomarkers like insulin levels, LDL, vitamin…you know, some other biomarkers, vitamin D, things like that. And then the third part is just a little tube to collect saliva for that secretory IGA. And then that all goes off to the lab, those results then through all these algorithms that have been developed will basically spew out one of these 64 genotypes usually. Sometimes every once in a blue moon, a woman doesn’t have a genotype, right? But for the most part, any woman that’s struggling with pregnancy, that’s had the full workup and they’ve ruled out that Dad’s an issue, they’ve ruled out anything anatomical, the vast, vast majority have one of these expressions or phenotypes, right?

And then once they get the results, we go over the results in detail, we explain, you know, well, you know, what’s going on, what they’re lacking, and then they basically get a treatment kit sent to them. And this is like precision medicine at its best because each phenotype gets its own treatment. So, nobody’s treatment is really the same, which is really so fascinating. So, what they get is specific probiotics, and the amount depends on which phenotype they have. So, they take specific probiotics because they have to reinoculate their gut with the strains that they’re missing. Okay? And then that indirectly impacts the health of the vaginal biome like I was saying through this micro RNA that we talked about earlier. So, those probiotics are then matched to a specific meal plan, like nutrition plan. Because the ideas is whatever probiotics they’re missing, we’re giving them the nutrition that those probiotics need to thrive and survive and to continue to grow. Does that make sense? So, easy peasy.

Then the other part is they get specific supplements based on those inflammatory biomarkers I was talking about. So, again, all different, depending on what that phenotype is, they can take anywhere from two vitamins to maybe six, you know, depending on what they’re lacking, what is elevated as far as biomarkers go, and then that’s paired to a specific movement program. Like, we’re not asking anyone to go run a marathon or do, like, crazy workouts. It’s a specific movement exercise program that’s there to boost the efficacy of the nutraceuticals, of those supplements they’re taking. And it’s literally 75 days. It’s two and a half months, that’s it. Which, to me, in the scheme of, like, what you go through and the rounds and rounds of, like, hormone and, you know, the hormones or the IVF and, you know, to do… And then once you’re through, like, literally at day 60 actually, we tell mom to start her pregnancy planning because all of these women in the studies conceived within 90 days of finishing.

So, they’re, like, ready. It’s great. And I get it because that’s what’s so great about how we designed this program because mom wants to go, she wants to go and get pregnant, right? So, we’re not holding that up. So, at day 60, even though there’s still 15 more days left of the program, pregnancy planning begins, everything starts and conception occurs within 90 days of completion.

Katie: Wow. And I’m sure this will get follow-up questions, like can women do this in combination with other things they might already be doing? And, of course, in working with maybe their fertility specialist, are there any things they need to be aware of that might conflict there, or is this something that’s very complimentary with other existing protocols?

Dr. Robin: So, it’s very complimentary with other existing protocols. Like I said, if they have to still do IVF or if they’re planning IVF, embryo transfer, any of those things, this will optimize the chances. It will take those chances, like I said, from that under 30% to over 70%. Okay? And then the other women that are in that category of, like, maybe, you know, figuring out if they are gonna do hormones or figuring out they’re gonna…they actually could probably just do this because the success rate was very high for those women that never even started that, right? And then if they still need to do that afterwards, but it is complimentary, we can work together. There’s just a few things that we have to be very cognizant of is, first, we really don’t want any of the women to be on antibiotics during the treatment because that will basically negate all the positive effects that we’re trying to gain. So, that’s just one of them. And then, like, obviously everything’s personal, so we personalize everything to each, you know, to each individual patient or person that’s going through this. So, if there’s little things here or there that we have to tweak, we can. But it’s very complimentary too, it doesn’t have to just be a standalone.

Katie: And it’s also amazing how rapidly women see changes. Because I know even in the nutrition world, it sometimes can take a while to see things change. And this seems like it goes extremely fast, and I put it in the category of things I wish I had known before I had kids. Even though I never had fertility issues, it seems like a thing that could really help optimize. And I look back even my third was my only C-section and I didn’t know then about the microbiome transfer during the birth process, I didn’t know to swab him or any of that. And he was my only one who had allergies, which we thankfully resolved, but it’s like those things I wish I could go back and tell my younger self, but it makes me glad that this is now available and that my daughters will have access to stuff like this. I’m sure it’s really exciting. Are you guys… What are the plans for expanding this? You said it can all be done at home. Do women even need a doctor’s oversight, or can they do this on their own?

Dr. Robin: Yeah. I mean, that was a thing. They do need oversight for sure. So, that’s why… And the way we’ve developed it because we felt that in the initial stages, like I was saying, the compliance, we think that the compliance can be… The success rate will be even higher. So, we do recommend, I mean, listen, they can totally…women can do it on their own. We do recommend them being touched and followed frequently through the 75-day process for sure. And being, you know, followed up with the doctor or the healthcare provider, that’s the women’s health expert because a lot of things do come up. I’ll give you examples. Even in some of the women that we’ve been seeing, because their diet’s changing so drastically too, you don’t want women losing weight. They’re losing weight, let’s say. Like, there’s just a lot of things that happen that we feel like by the constant touching is super important and will make this even more successful. And like I said, for what it is, it’s nominal compared to what you’re doing through IVF and the multiple attempts in the end and all those doctor visits. So…

Katie: That makes sense. And it also makes me wonder because I feel like fertility is a great marker of some aspects of health in general. Like, if the body isn’t feeling optimal, it would make sense it might not wanna carry a baby at that time. So, it makes me wonder, like, what are the other implications of testing like this, even for potentially in the future, you know, women who aren’t trying to conceive or for other conditions, are you guys looking into other implications?

Dr. Robin: Yeah. So, we get a lot of calls. We’ve done some testing already on women that say they’re on the autism spectrum. They have a lot of gut issues, they think they have PCOS, and this is all picked up in the testing. For example, I mean, even they’ve identified two different forms of PCOS. There’s the insulin-resistant form, you know, metabolic, versus the one that really stems from your gut microbiome or your overall gut health. I mean, both are stemming from that, but they’re very specific. And so, the treatments are completely different for, you know, even those two different types of PCOS. So, we’re able to, like, identify exactly Hashimotos, early Hashimoto… Like I said, we talked about the beginning, the infertility aspect, if they’re at that point, is a manifestation of something that’s smoldering or that’s going on that’s not being picked up or that they have already but is also not being treated the right way through the gut.

Katie: That makes sense because I’m not currently trying to get pregnant or have any more babies right now, but it makes me so curious just to see the data, like, this is fascinating new world. And early on, you mentioned the word metabolites, which I feel like are also a new frontier in understanding aspects of gut health. For people who may not be familiar with that term, can you just explain what it means? Because I know there’s implications here far beyond even just fertility. This is widespread.

Dr. Robin: Sure. So, when I say metabolites, I’m talking about the postbiotics. So, the metabolites are what the bacteria, those good, what we call Keystone commensal organisms, what they’re supposed to be secreting and synthesizing in our gut. So, anything… So let’s talk first. So, people are gonna be like, “What’s that?” But we’ll explain it. So, first thing is these compounds called short-chain fatty acids. So short-chain fatty acids, there’s three of them. They’re super important. And these short-chain fatty acids control everything from immune regulation, to metabolic functioning, to brain health, cardiovascular health, hormone health, all of these different things. So they’re super-duper important. And when we don’t have the right bacteria growing in our gut, we don’t make these short-chain fatty acids. And I can tell you from experience, and I run next-generation sequencing of the gut microbiome and every patient that walks through my office, that 9 out of 10 people don’t make short-chain fatty acids, or at least are missing two out of three from the testing that we do.

So, that’s, you know, extremely problematic, clearly. And that’s because the standard American diet isn’t getting enough…we’re not getting enough fiber. We’re not getting enough, like, of those resistance starches, high fiber foods, complex carbohydrates, which is what the good bacteria need to thrive and survive. And that’s why many of us are missing those good bacteria that make these metabolites or postbiotics. And so, if you don’t have the bacteria there, you’re not gonna have these metabolites. Other metabolites, neurotransmitters, actually, your gut makes more neurotransmitters than your brain does. And we know that there’s a huge gut-brain connection. And actually, the gut speaks to the brain significantly amount more than the brain speaks to the gut. Mostly through the vagus nerve, other ways as well, but very important. All of your B vitamins, everything from B1 through B12 plus vitamin K2, all of that is produced in the gut. And there’s tons of other metabolites too, and they all have specific crucial roles in our health. And so, again, if we don’t have those right bacteria there, we’re not making those metabolites or postbiotics that are so super important for our health.

Katie: I’m really excited to keep following the research on metabolites as we learn more because it seems, like to your point, they are linked to everything from maintaining a healthy weight or not, to autoimmunity, to, like, you said, mental health. And I think we’re finally able to test and understand these things in a way that we never have been before. I’m sure there are people listening who are also wanting, and I’ll make sure we link in the show notes to know where they can get this testing, how they can get this testing. Is it available to the general public now?

Dr. Robin: Yeah. So, yes, they can. And I always say to everybody, get the test done because knowledge is power, right? So, even women that are sort of like, not sure, and they don’t know and they’re like, “Should I do this? Should I do the IVF stuff? Or should I do the hormone stuff?” You know, do the test because if you have the test results, then you’re gonna know what’s going on with you. And I think that that then really makes a lot of women stop and think and say, “You know what, I should really correct these underlying issues first before I go ahead.” And then they wind up having, like, again, a much more successful pregnancy, and healthier baby, and again, correct their underlying health. So, they can get the kit through us. You know, they just call us… We actually also do free complimentary discovery calls. So, if anyone wants to talk more about this and understand the process, we’re more than happy to talk them through this. We just think this is so important to get help there to women. It’s just so cutting-edge, like, natural, like, noninvasive. I mean, just think about it, women with IVF, they have to go every week, they have to get their blood taken, they have to get ultrasounds. Like, it’s just so much pricking, and prodding and, you know. And if they can just do this, it’s just so much better for, again, your mental, physical, emotional health.

So, they can get the kit through us and then the treatment as well, they would get both. And like I said, we do the consult with them, we go over all of the results. The treatment could get sent home, we arrange all of that for all of our patients. And, you know, at that point, again, like after the first visit and going over the results, they can decide if they want to, you know, move on to treatment and do the treatment. The vast majority of women do. And then we bring them through that process.

Katie: And I would guess with the amount of data that you have, you guys are probably seeing some trends, and I’m curious if anything emerges that’s helpful just for the general public as far as gut knowledge of things that should almost universally be avoided or things that are almost universally beneficial. Are there any kind of dos or don’t that you think are, like, almost universal or can be recommended across the board?

Dr. Robin: Yeah. Again, there’s so… Like I said, they’re so, so different. But, you know, let’s again like really trying to… Yes. I will say one thing, food first. Food first. Really shifting away from that standard American diet and really flooding your body with a whole foods, more plant-centric diet. You know, I’m not against eating meat, grass-fed, grass-finish, regenerative, farmed meat is so amazing, you know, and having that, you know, in moderation. But I always say to my patients, like, building your plate and having that plate be like the animal protein be the smaller part and the rest of your plate being the salads and all the vegetables. And maybe if you have some grain…you know, and you can have grains and all that stuff, but really just whole foods, plant-centric, getting those simple refined sugars and carbs out, you are going to build such a healthier gut microbiome. You know, studies show, like studies show shifting from the standard American diet to a whole foods even within three days changes your genomic expression. Like food is code for your genes. So, just doing that, like, look how powerful that is. And that’s having a direct impact on your gut microbiome.

Katie: Yeah. And thankfully, the gut is an area of the body that does, it’s very active like you said, and it regenerates very rapidly. So, whereas, like, if you have an injury or to muscle or tissue, it can take much longer to regenerate all of those cells. The gut is so adaptable and does this so quickly. And I learned early in my health journey, as you do this, your taste buds adapt, you begin to actually want these foods. And the process gets even easier and easier over time. But I think as a general rule, that’s when I always point to as well, like there’s not…almost nothing I say universally, like, it’s all very personalized and we have the ability to personalize more and more. But I would say, like, to echo you, removing those standard American foods, especially the processed oils, processed sugars, processed grains, all the things that make up, unfortunately, 80% of most people’s diets, like, that alone can be life-changing.

Dr. Robin: And that’s why the nutrition is such an important part of the program. But people are like, “Oh, my God, I’m not gonna be able to eat.” No, you can eat. Nobody’s restricting your calories. No one’s, you know… I just think like I was anecdotally telling you about one of our patients, you know, she never ate so clean before, you know? And so, eating cleaner, you know, but also, I think she wasn’t eating enough. And once we got her eating…because no one’s restricting your calories here. We’re just shifting you to eat more whole food so we can support that gut microbiome and lower your inflammation and, you know, get your body to a place where it wants to hold a baby and carry a baby.

Katie: Yeah. And diet is so key with that.

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Like you said, and I’ve noticed this trend among women, a lot of women that I’ve talked to, especially that women tend to be under-eating or at least undernourishing themselves really drastically. So even if it’s possible to get enough calories just from these kind of nutrient-devoid foods, women are like… And the entire population are very malnourished essentially at this point with the standard American diet. And I’ve seen so many women, myself included, who actually had to start eating more and more nutrient-dense foods and actually upping the volume of food to achieve certain health results. Because when you’re under-eating, your body’s in a state of stress and you’re also sending the message to your body, like it’s not safe to grow a baby right now because obviously there’s a famine. I’m not getting enough nutrients

Dr. Robin: That’s right. That was beautifully said, I love it.

Katie: Well, I am super excited about this research. I’m excited to keep reading about the results you guys continue to have. And I think this can be an absolute life-changing treatment for a lot of people who are in that infertility space and who are really trying to work through it. A couple of questions I love to ask toward the end of interviews, the first being, if there is a book or number of books that have profoundly influenced your life, and if so, what they are, and why.

Dr. Robin: I’m thinking. I will say… This is sort of dorky, but when I was shifting from conventional medicine into the functional space, I had a lot of, sort of mentors, not that they really knew me, that I looked up to, to really understand nutritional science. So, one of the books that really changed my life was the “Wahls Protocol” by Terry Wahls. Because it just taught me so much and opened my mind up too so much. It was really unbelievable. And then another one that really has stuck with me during this journey, I guess I’m just not going further back but… Is “Radical Remission” by Kelly Turner. And she’s basically a Ph.D. So, anyone that I know who has a family member going through cancer or personally going through cancer, I have them read this book. It is one of the best books in the world. And this woman did her Ph.D. basically studying radical remissions all over the world. And, you know, it was her dissertation. There were, you know, statistical analysis involved, and yeah, she was able to show there was 160-something variables that took place in people that achieved radical remission, meaning people that were in stage four cancer were gonna die any minute and they’re living 30 years later. But there were nine common variables between each person that went into radical remission. And she writes about each one of these nine factors. And it’s just unbelievable. It’s such a great read. It’s just such food for thought, no pun intended. It was just a great, great read, and it really had a profound impact on me and how I practice medicine.

Katie: I love that. Terry Wahls has been on this podcast, and I’m a huge fan of her work as well. I got to hear her story.

Dr. Robin: You’re, like, really famous. You had Terry Wahls. Now, that’s unbelievable. She’s a super human being. Unbelievable.

Katie: Yeah. I love her story. Definitely echo your recommendation. And “Radical Remission” is a new recommendation on this podcast that I’m excited to check out. That sounds incredible.

Dr. Robin: It’s great. It’s such an amazing book. It’s such a beautiful story. Even her story and how she wound up doing this, it’s… You have to read it. It’s unbelievable. It’s a great story.

Katie: Adding it to my list. And lastly, I wonder if you have any parting advice for mostly women who are listening to this episode today. Could be related to everything we talked about or entirely unrelated.

Dr. Robin: Okay. Can I say two things? Okay. Something that I learned and I really am so conscientious about it, and it’s really helped me, I think, as a person, as a physician, as a mom, is that I stop at least once a day for at least 20 seconds and show gratitude. It was life-changing for me. It’s something I learned through my coursework at the IFM, at the Institute of Functional Medicine, you know, some of our beautiful mentors that give us lectures on this part about it, like, right of the mindfulness piece. But it really, I just feel so blessed that I can work with people in this capacity. I never thought, or at least years ago in my career, I was just practicing medicine, seeing 30 people a day, burnt out, stressed out. But to be able to do this, I’m just blessed. And I really just stop and give gratitude for this, for having healthy children, for my family, for my friend, you know, and that, to me, is like very powerful. And, you know, that has…even that 20 seconds has significant impact on your health on a daily basis. And there’s studies on this.

And the other thing is, and I’ve been working on this myself a lot, is sleep. Especially women, you know, that already have kids or women that don’t have kids but have high-stress jobs, like, they’re never putting themselves first. Right? And sleep, when you talk about the four pillars of health, you know, nutrition, exercise, you know, stress management or mindfulness and sleep, sleep is your foundational pillar because that’s when your body regenerates, repairs, restores itself. And if you are not sleeping, you can’t heal. So, I can throw whatever I want at you, but you’re not going to get better if you’re not sleeping and getting good quality deep sleep where you can do those things that I just spoke about. So, really try to do a little self-care, try to get yourself in bed a decent time, try to stay asleep for a decent amount of hours. And I think that that will…that could be one of the greatest gifts you give to yourself. Because I can tell you, 9 out of 10 people walking through our doors have sleep issues and poor sleep hygiene.

Katie: Yeah. So important. And that carries over into every other aspect of health, which, in turn, makes sleep even harder. And I think of all the things you can say, but you can’t out-supplement a poor diet. You can’t out-exercise a poor diet. You can’t out anything lack of sleep

Dr. Robin: Nope!

Katie: So, I think that’s super relevant advice. And this has been a really fun conversation. I’m super impressed with the work that you’re doing. And I think it sounds like you’re hoping so many women and many more to come. Thank you for sharing today. This has been awesome.

Dr. Robin: Thank you so much for having me. It was great. It was great talking to you, and, yeah, I hope that we can get the word out about this and help as many women as we can.

Katie: And thanks, as always, to all of you for listening and sharing your most valuable resources, your time, your energy, and your attention with us today. We’re both so grateful that you did, and I hope that you will join me again on the next episode of “The Wellness Mama Podcast.”

If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.