Knocked Up Podcast - Could Your Gut Hold the Key to Fertility?
We are joined by gastroenterologist Dr. Lindy Jackson to uncover the surprising connection between gut health and fertility.
What if the secret to boosting your fertility isn't just about tracking ovulation or taking prenatal vitamins, but actually lies in your digestive system? We are joined by gastroenterologist Dr. Lindy Jackson to uncover the surprising connection between gut health and fertility.
Discover how the trillions of bacteria living in your bowel can influence your hormone levels, why stress might be sabotaging both your digestion and your chances of conception and how inflammatory bowel conditions can directly impact egg and sperm quality, and what those trendy microbiome tests actually mean for your reproductive health.
TRANSCRIPT
Jordi Morrison: Hello and welcome to Knocked Up, the podcast about fertility and women's health. You are joined, as always, by me, Jordi Morrison, and Dr. Raelia Lew, CREI Fertility Specialist. Today, we're also welcoming Dr. Lindy Jackson. Welcome, Lindy.
Dr. Lindy Jackson: Thank you, Jordi. Thank you, Raelia.
Jordi Morrison: Lindy, you're a gastroenterologist at Women's Health Melbourne. We haven't had a gastroenterologist on our podcast before. Could you tell us a little bit about your qualification and why a patient might see you?
Dr. Lindy Jackson: Sure. So gastroenterologists specialize in the gastrointestinal tract. So to make that simple, any problems from your swallowing to your stomach, so after you consume or ingest food, to your bowel, so small bowel, large bowel, and we're also specialists in the liver. Why? We get people come and see us about all sorts of problems. So anything to do with liver function tests, abnormalities. Anything to do with abdominal pain, swallowing issues, bloating, bowel issues. And anyone that needs an investigation, such as looking into the gastrointestinal tract.
Jordi Morrison: Colonoscopies.
Dr. Lindy Jackson: And gastroscopies, that's right. Which some people confuse with endoscopy, but endoscopy is the broad term for gastroscopies and colonoscopies. And there's also other procedures that we can do looking into the small bowel, which is called an enteroscopy.
Jordi Morrison: All the oscopies. We're having you on today to talk to us about gut health and how it might be affecting fertility. Gut's a very trendy word. Do you want to tell us a little bit about the term gut health?
Dr. Lindy Jackson: Gastroenterologists don't tend to use the term gut health, mainly because we like to talk more about symptoms. So if someone comes to us and talks about their gut health or their digestion, it's really important to clarify what they actually mean. The term gut health really refers to the overall wellbeing of the digestive system or the gastrointestinal system and the interplay between the gut's anatomy, how it functions and the microorganisms or bugs that live there. Include a lot of bugs that live there without causing any problems. We know that maintaining a healthy gut is crucial for good digestion. And when I talk about digestion, I mean breaking down food and then absorbing the nutrients.
Jordi Morrison: So, Lindy, when you were talking about gut health, another term that I think of quite a bit on this topic is the microbiome. Again, another trendy term. When we say the gut microbiome, what does this mean?
Dr. Lindy Jackson: We call it the sexy topic at the moment in gastroenterology, and that's because there's a lot of research on it. Everyone's talking about it. What it means is the community of bacteria, fungi, viruses, and other microorganisms living in your bowel. These microorganisms, they play a role in digestion, so we know that. We know that there are associations, and I'll go into this, with the immune system. So some of them will protect against harmful diseases or pathogens. Some of them regulate immune responses. Some of them protect against certain conditions. We know there is an association with some mental health conditions, some physical conditions. The disclaimer of the microbiome is that many studies have been done now. Studies are still being done. However, the studies are still limited and the conclusions are really up in the air regarding causation. We know that certain bacteria, and most of it, although there are other microorganisms in the gut, most of it is to do with bacteria. So we know certain conditions that are associated with increases in bacteria populations and specific bacteria populations. So that's an association. But we don't know what's causing what. We don't know if you change the microbiome, whether that condition will improve or resolve.
The only way at the moment to change it is you can change it by diet, but we don't exactly know how to specifically target certain bacteria. You can change it by having a fecal transplant. And so that's when you clear your bowel out through colonoscopy preparation so your bowels completely clear of any poo and then you put someone else's poo in. And someone else's poo, so there's a bank in Australia where you can put someone's poo into your bowel and you know what's in that microbiome. So you know what bacteria, fungi, viruses are in that. You've screened for hepatitis. You've made sure there's no infective viruses. And you can put that in. But at the moment, the studies have really only shown that it's definitely effective for Clostridium difficile, which is an infection, a recurrent infection that you can get in the large bowel. There's been studies looking at irritable bowel syndrome where you get some symptoms. There's been studies... looking at some other medical conditions and some mental health conditions and the conclusion is not 100% that it helps. So we know what's associated. We don't know how to clinically change it at the moment. It's all under research.
Jordi Morrison: Yeah, it's pretty early.
Dr. Lindy Jackson: I think so. It's pretty early days, I think.
Dr. Raelia Lew: I think when we were at medical school, you know, 25 years ago, it really wasn't spoken about at all, microbiome. I don't really remember it being particularly mentioned on our curriculum. Do you remember it, Lindy, being mentioned on your curriculum?
Dr. Lindy Jackson: No, not at all. They were just talking about the human micro, you know, looking at the genes that we have, but they know it's really only been talked about in the last five to 10 years. And as I said, lots of research, not really clinically applicable at the moment. You can pay for tests that test your microbiome and you get a report with all the things in your microbiome. We don't know what to do about it. So we can't interpret it.
Jordi Morrison: If you give probiotics to a patient, so bacteria in a pill, so to speak. Yes. Do that change somebody's microbiome in theory?
Dr. Lindy Jackson: In theory, it can. I like to talk about probiotics as resetting the bowel flora. So that's in a clinical situation. Yes, I'm sure they've done studies looking at someone's microbiome, giving some probiotics and then testing it again. But it doesn't do enough because what we're looking at is what are the symptoms they actually have. So it's all well and good to say, well, this is a bacteria, but what's the conclusion? So if you give probiotics... instance, and you know someone has an inflammatory bowel disease condition, which is Crohn's disease or ulcerative colitis, and we know there's certain populations of bacteria that are increased in those conditions, giving probiotics is not going to change the fact that they've got inflammation in their bowel. Although you may alter some parts of the microbiome, what's more relevant is... someone having some bloating or some diarrhea, not from an inflammatory condition, then that can actually change their system, which is more to do with the gas that's produced by these bacteria.
Dr. Raelia Lew: Yeah, that's interesting. And so, Lindy, a little bit kind of... to that. When I went recently to kind of a meeting looking at vaginal microbiome, so it's a little bit different to bowel microbiome, one thing I found really interesting that was presented was that different people from different countries and different ethnic group had their profiles done and it was all lined up on a slide looking at the microbiome and what it showed was that not only do different people from different racial and cultural origins have different microbiome profiles but also if you took somebody of a similar genetic ethnicity and put them in a different culture so say for example looking at someone of Vietnamese origin genetically, but who lived in the United States, their microbiome was different again. So I guess there's so many complexities that might influence the kind of bacteria that we have in our gut, our genes, our diet, and our general holistic cultural environment, potentially even things like whether we drink alcohol or whether we have other substances in our diet.
Dr. Lindy Jackson: Yeah, I think you're opening a bit of a can of worms here, but it is very similar to the gut microbe. And there are countries in Scandinavia is the main part of the world that does these amazing studies regarding what someone is consuming and doing and vaccination status from birth and they follow them into adult. Good, so some of those countries will have an opt-out system so unless you opt out you fill in some questionnaires and yes it doesn't follow you daily but it gives an idea of what is common to people who have a certain medical condition, mental health condition, microbiome, what is common to them? Is there something common that they all did when they were younger? And at the moment, we haven't really found anything. So there is good data, there's good epidemiological data in other parts of Europe that does the same thing. We don't have the answer, but as you said, it's fascinating that if you're born in one area, and the main one we like to talk about is Asia, because Asia... have a lot of gut conditions or we didn't know about it for a very long time. And now they do. Now they really mimic what we have in Western culture. And so if you think, well, what's changed in those cultures, and it's probably there is more of a Western diet, so the assumption is that it probably has a lot to do with what we're consuming. But yes, there is, there will be a genetic part, there will be an environmental part to it, but you look at people in Asian countries, what's happened over time, and so probably the diet in those countries has changed a little bit and the availability of certain foods has changed where the environment is the same and genetically they're the same. But you also look at the Asian cultures who then move to Western cultures and what happens with their microbiome. And that also seems to then change to a similar microbiome to the country that they move to.
Jordi Morrison: Fascinating. Fascinating.
Dr. Lindy Jackson: We don't know the answer, but if you ask most of it, it probably has a lot to do with what we're consuming.
Jordi Morrison: Completely fascinating. Thinking all about all these things we're talking about in terms of gut health, how can this influence, I guess, our hormonal balances and our... hormones and how does it impact fertility?
Dr. Lindy Jackson: So we know what is good bacteria, what bacteria can increase the risk of harmful conditions. We know that if you have an imbalance of the gut microbiome, so that term's called dysbiosis. So it means either a decrease in beneficial bacteria or an increase in harmful bacteria or a reduction in the diversity of the bugs in the gut. So we know that it's really important to have a variation. So even if you have a reduction in that variation, that can negatively affect hormone levels. So we do know that. We know if you have any of those, decrease in beneficial bacteria, increase in harmful bacteria, reduction in the diversity, it can influence the production and regulation of estrogen and progesterone and other hormones like cortisol and thyroid hormones, all which are important for fertility.
Jordi Morrison: A bit about microbiome but inflammation and gut inflammation is another buzzword we hear a lot about. Does gut inflammation affect fertility as well? Can it affect fertility?
Dr. Lindy Jackson: Definitely. So we know that people with inflammatory bowel disease, so that's Crohn's disease or ulcerative colitis as mentioned, we know that your fertility is either directly or indirectly affected if you have active inflammation in the bowel. So that's inflammation that comes up on a biopsy of the large bowel, which we call the colon, or if they've got, when we have a look with a colonoscopy, we can see it's clearly inflamed. So that's one part of inflammation. So we know that that can disrupt hormone balance, it can affect the egg and sperm quality, can interfere with implantation and the uterine lining, can interfere with menstrual cycles. What we also think is an inflammatory state in the body, so now we're not talking about inflammatory bowel disease but just inflammatory, this is something you can't see, may come up on a blood test. There is a marker called a C-reactive protein which is sometimes elevated in people who have a chronic inflammatory state. For instance, from inflammatory conditions but a high body mass index can also cause this. We know that all of those things can be affected. We know the gut microbiome can play a role in hormones like estrogen, progesterone, which I said. We know that in men, inflammation can impair sperm motility, production, morphology. And we know that inflammation, again inflammatory bowel disease and this may occur to non-inflammatory bowel disease, inflammation can increase the risk of miscarriage and other complications during pregnancy. And so yes, it probably does play a role. The question is, at the moment, you can't, other than the C-reactive protein, you can't measure this inflammation, inflammatory state, unless someone has a known inflammatory condition.
Dr. Raelia Lew: Yeah, but look, as Lindy mentioned, just being overweight is an inflammatory condition. If we are overweight and we carry more body fat, we are in a state of inflammation. And there's one in nine Australian women who have endometriosis. And if that is untreated, it's also a state of inflammation that is chronic. I think it's really important to just point out to our listeners that while medicine is often segregated, by necessity because it's impossible to be an expert in absolutely everything, to specialties and body systems, actually no body system is standalone. It's all happening together and there's also, we often see an interplay. You know, we're talking about the gut microbiome and associations between lots of conditions, but we see an interplay with the gut and other systems which results in symptoms.
Dr. Lindy Jackson: And we know that very well. The typical one is the gut. There's something called the gut-brain axis. The nerves to the gut affect the brain. And this is a subconscious part of your brain. And we can target that in some treatment. But there would be a connection, as you said, with lots of parts of the body.
Jordi Morrison: Do you notice any kind of pattern with patients who might have digestive issues and fertility challenges?
Dr. Lindy Jackson: Certainly. Patients that are overweight, the main one that I see. Patients who are stressed can have gut symptoms but also fertility issues. And stress is an interesting thing to measure because stress, you know, you can ask someone are you stressed, there's a population of people who are aware that they have some stress, some anxiety. There's another population of people that aren't aware of it, that's just their norm. They've been doing it for many years. They've run around all day. The fact that we live day to day, so you have to prepare your food, you have to pay your bills, you have to go to work, come home, you clean up, you go to sleep, you go to work, repeat. That is a stressful part of life and there's nothing you can do about that except if you go on a break and you go on a holiday and you lie on a beach or somewhere and you do nothing. We know that gut symptoms improve. But you know, we should all come and see you and get prescribed holidays.
Dr. Raelia Lew: Yeah.
Dr. Lindy Jackson: You know, if most patients, if I, I can usually tell them that if they have been away in the last year, their symptoms have probably resolved. And I'm not talking about going away to visit family. I'm not talking about traveling around Europe. I'm talking about a relaxing holiday. And that's the best thing you can do to de-stress, improve your gut symptoms and probably improve your fertility at that time, from in terms of the connection between the gut and fertility.
Jordi Morrison: Would you agree with that?
Dr. Raelia Lew: Yeah, look, I think you're right. Sometimes, I mean, obviously, there are many different pathologies that contribute to infertility and stress is probably an influencer rather than a cause. But certainly, I think it's important to recognise because in anybody suffering infertility, whether it is because of severe sperm problems or because of endometriosis or blocked fallopian tubes or advancing age and egg quality concerns, or an interaction or interplay between multiple factors. There's many of those factors that we can't change or control and some of our strategies to overcome infertility are really workarounds rather than cures for the problems causing patients to struggle to conceive. So there are things that we can change and there are things that we cannot, and I think managing factors like stress is one of the things that we can have some impact on.
And there's the perennial argument, does infertility cause stress? I think the answer to that question is definitely. Does stress cause infertility? Well, I don't think it can help. And I think anything that puts our body under additional burden can potentially make other factors work. And you certainly do hear anecdotally when patients are struggling to conceive that from time to time they go on something like a holiday, let their hair down and get pregnant. And I think that's really frustrating when it's recounted as an anecdote, you know, as advice to patients, like I think patients who for example have struggled for years or might be going through IVF and their well-intended, you know, kind of auntie says oh don't worry dear just you're too stressed just relax and you'll get pregnant, that can be like a red rag to a bull. But I also think that it does have some merit as well.
Dr. Lindy Jackson: I think it's probably also the worst thing you can say to someone is to stop stressing or in terms of stop thinking about it because you can't really.
Dr. Raelia Lew: Yeah, I agree.
Jordi Morrison: Yeah, totally. So if someone suspects that they might have gut issues, are there any red flags that they might notice?
Dr. Lindy Jackson: The red flags that we talk about, any bleeding from the bowel is a concern and should be investigated. Any unintentional weight loss should be investigated. Any new change in bowel habits. So that's anything such as new constipation, new diarrhea, a change in your bowel motion shape, should be looked at. And this is not, you know, a one or two days, this is ongoing. If your bowels have changed and it persists for more than several weeks, that should be looked at. New daily abdominal pain is also a concern. Any of those, you should really be going to your general practitioner who then may refer you to a gastroenterologist.
Jordi Morrison: That's really sort of great at a general level. These are all things we should be thinking about in terms of it affecting fatigue. If you're experiencing infertility and you go to your GP, I would think you would see a fertility specialist, but when would you get involved? When would you see a gastroenterologist? Raelia, would you be referring patients to gastroenterologists? Like how would the pathway be for someone?
Dr. Raelia Lew: Well, look, I think there's a lot of interaction with pelvic pain in gynaecology because a lot of people have pelvic pain or pelvic discomfort or abdominal pain. And the two main systems in young women that we kind of think might be involved are the gynae systems and the bowel. And so often we do work together to try and figure out what's going on by investigating those two systems in gynaecology. And in terms of fertility, I often do refer to a gastroenterologist if I pick up a concern, either a reported symptom or on screening bloods that I think about, maybe something like celiac disease. Another thing would be if, because inflammatory bowel disease is quite common, another thing would be if a patient is suffering a long-term diagnosis like Crohn's disease or another type of inflammatory bowel disease and you want to really say, particularly they're on medications, are those safe to conceive? Are there implications around fetal development and pregnancy? But we also want to make sure that their other conditions are well controlled and that they don't have necessarily flares while they're trying to conceive because trying to conceive can take a long time. We say it's quite normal to try for up to a year to get pregnant in the spectrum of natural fertility. So we're talking about a long time.
Dr. Lindy Jackson: Backing on to that, we gastroenterologists, anyone that has inflammatory bowel disease, would talk about fertility almost at first diagnosis if they are in the age of conceiving. So any premenopausal woman or mid-40s and less, I would always talk about at diagnosis what we know about medications, what we know about active disease and how that can affect fertility, pregnancy and the children that are born. And I think that's really important for someone to know at the outset because there used to be a lot of misinformation given. There were a lot of obstetricians who weren't educated about what's important preconception. And there's also a lot of data now. There's a lot more data. So we know what's safe. We know what increases your risk of complications. And we know what improves the chances of fertility in the bowel if there are no other pathology going on. So it is, as Raelia said, it's a really important discussion to be had by all specialists involved.
Jordi Morrison: Shout out to women in our audience who may have had a diagnosis in their 20s when they weren't thinking about having a baby. If you've forgotten advice that was given, or if you really just need an update on advice when you're thinking, you know, maybe a decade later, about having babies. So many new medications have developed in that time, treatment pathways and advice has changed. Come and see Lindy and, you know, you can have some really fertility-focused advice on how to manage these conditions. I think also what's interesting about that is we talk so often on this podcast about how things are changing and developing and what we're learning is evolving. And I think that's the same, Raelia, like you just said. If you were diagnosed with something 10 years ago, so much has changed in that time. And your quality of life and your fertility outcomes could be transformed.
Dr. Lindy Jackson: Well, yes, certainly lots has changed. The way we practice medicine today is not the way we practiced five years ago or 10 years ago, but some changes are really immense and others are subtle. But as a patient, I think it's good to have an update on information and entering a new phase of life when trying to conceive, especially if you've been on a kind of set and forget regimen that's kept you stable, but in another context. The other challenge at the moment is the internet and the availability of information and misinformation that's available. So if you don't know what sources you're looking at, you can get a lot of incorrect information. And I know that the medications that we use for some of our conditions are not up to date on the breastfeeding website in terms of what's safe for conception. So we don't like people looking on the internet because they're more likely to find some information that is not entirely correct. So it's much better to speak to a medical practitioner about what the latest data is rather than looking at a website that was written or has information from some data from 20 years ago.
Jordi Morrison: And also getting personalised advice to your situation.
Dr. Lindy Jackson: Yeah, absolutely.
Jordi Morrison: There are some different medical conditions that we know can have some negative effects on people trying to get pregnant. One that pops to mind is celiac disease. And sometimes we screen for that as fertility specialists because it can be a contributing factor. Patients who are having trouble getting pregnant, how a patient might be investigated for that condition and potentially what kinds of interventions would be recommended to improve fertility.
Dr. Lindy Jackson: Celiac disease in particular is a problem with the small bowel lining where the gluten destroys it. The person is unable to absorb nutrients because the gluten destroys the lining of the small bowel. With celiac disease, will generally be low in iron and be low in some other nutrients because it's just unable to be absorbed. The symptoms that they may have from this, so they may have no symptoms. And we actually think that one percent of people are diagnosed with celiac disease and ten percent of people have it. So there's a whole lot of people out there that probably have celiac disease that don't know it. Having celiac disease, other than the issues with nutrient malabsorption which then follows on to affect fertility. And that's how the connection plays a role. It can also increase the risk of some other conditions. So it's really important to identify that you have it. Avoid gluten so that your small bowel lining can regrow and start absorbing nutrients. But really, most of these conditions that result in a malabsorption of nutrients, that is how the fertility part gets affected.
Jordi Morrison: That's really interesting. So there's no thought from a gastro perspective that it's the activation of the immune system triggered by the gluten?
Dr. Lindy Jackson: Celiac disease is an autoimmune condition. It is part of the activation of the immune system that is destroying the gluten. It's part of the activation, the immune system that is playing a role in the gluten destroying the small bowel lining. But there's other things that play a role in the immune system, mainly with bacteria and gut that also then have a role. The other part of your question is how do we diagnose it? So the diagnosis at the moment is... gastroscopy with a small bowel biopsy. Now that's different in children and there's lots of research specifically from a gastroenterologist in Melbourne looking at how we can avoid a small bowel biopsy to formally diagnose it. There's also a lot of people who are unable to have a small bowel biopsy because the condition of having a small bowel biopsy and diagnosing celiac disease is you need to be having an equivalent of four pieces of bread per day. So a high gluten load to make sure that you're exposed to gluten. Now people who have severe symptoms from gluten absorption such as nausea, bloating, diarrhea, really feeling quite unwell, weight loss, some of those people can't actually consume that amount of gluten because the side effects are too severe. So in that case we would just look at the blood tests but really the diagnosis at the moment is the small bowel biopsy looking under the microscope and we look at these little projections of the small bowel called villi and if you have celiac disease, the villi are destroyed by the gluten.
Jordi Morrison: So then to treat it, all you need to do is avoid gluten. And how long, Lindy, does it take for the bowel to recover once someone with celiac disease eliminates gluten from their diet?
Dr. Lindy Jackson: It should recover pretty quickly. I don't think it's actually ever been recognised, the duration of recovery of villi, but what we do like to do is 12 months after being diagnosed is to have another look at the small bowel to see if the villi have regrown. Many years ago, it used to be recommended that this was done annually. Now it's recommended it's just done once after diagnosis and if the villi are regrown, you don't need to do further biopsies. There's a very small proportion of people that will still have active disease following avoiding gluten, but that's a very, very small proportion and then medications are required.
Jordi Morrison: If you think that this might be something that resonates with you because you have some symptoms and have been trying to get pregnant without success or have suffered miscarriages, the first step that we usually do is a blood test. See if you have any obvious risk factors, and Lindy, could you tell us what those blood tests are that we sometimes do?
Dr. Lindy Jackson: We do something called celiac serology. There's a few blood tests you can do. The main one is transglutaminase, that will always be elevated. There's one called gliadin which is to do with gluten that is not as specific as the transglutaminase. We always check part of the immune system, there's a blood test called IgA. And if you don't produce certain, they're called immunoglobulins, then you may not have a positive blood test. It's really important to do that in association with the other ones I was talking about. There's also gene testing. We know that to have celiac disease, you really need to have the gene to have celiac disease. You can test for the gene. If you don't have the gene, it's very unlikely that you will have celiac disease. If you do have the gene, you may or may not have celiac disease. It doesn't mean that you will. The other thing with celiac disease, you can be tested for celiac disease and be negative and have a normal small bowel biopsy. So you have negative blood tests and then years later, it comes up positive. So something's happening and we don't quite understand this, but at some stage in people's lives, you may suddenly react to gluten. We see the same with all autoimmune conditions. Most of them, you're not born with these conditions. They happen later in life. We don't understand why that happens.
Jordi Morrison: And one more question about blood tests. Sometimes we screen for antibodies, antigliadin antibodies. What's the current opinion on that?
Dr. Lindy Jackson: Yeah, so I wouldn't have a look at that alone. I'd need to have a look at it with the transglutaminase. If we write celiac blood tests, we use the term serology, both of them should be given to you. But the transglutaminase is a lot more specific. So some people would just report that or some people would just write that on a blood slip. Usually if that's elevated, the anti-gliadin will be elevated as well.
Jordi Morrison: And in terms of help with your diet, if you are given news that you are celiac, what kind of recommendations would be made?
Dr. Lindy Jackson: Just to avoid gluten, which these days is really easy. Once upon a time, it was quite difficult to buy non-gluten products from the supermarket and they were also very expensive. These days, almost every item can be bought gluten-free and they're really not too expensive. Gluten actually makes up the air in a lot of products. So if you talk about bread, bread's usually quite airy, is the best way to describe it. A gluten-free bread will be a lot denser. So it's really quite difficult to make these products that taste nice because it's missing this air feeling when you're consuming them.
Jordi Morrison: It's textural, isn't it? Gluten is very much sort of a textural agent. It's what makes things feel delicious in our mouth.
Dr. Lindy Jackson: Exactly. And it's improved a lot. I mean, gluten-free pasta almost tastes exactly like pasta with gluten. So it's, but that's, that's all you need to do. Just avoid gluten. There's cross-contamination with some other products so sometimes the reason that we do do this biopsy a year later is to make sure that you're not consuming gluten without realising it. So some people don't know what gluten is in, but you really need to check the ingredient list of the products that you're consuming to ensure that there is no gluten in them. And just like when you have an allergy to certain products, you just need to make sure that it's not near other products when you're making them. For most of us, that's fine. Most of us don't make bread ourself. Most of us don't make pasta ourself. So we rely on the product to be gluten free when it says it's gluten free.
Jordi Morrison: So Lindy, one last thing for our listeners, Lindy, what's the one takeaway about gut health and fertility that you think they should take from this episode?
Dr. Lindy Jackson: In someone that doesn't have an inflammatory condition, I think the best thing you can do for your gut to improve fertility is to eat well and avoid processed foods. So we know that processed foods increases the inflammatory state. Really, eat as well as possible and manage stress. And if possible, go on a relaxing holiday. Because if your bowel symptoms can be improved, stress can be improved, inflammation can be lowered, that will improve your fertility from the gut point of view.
Jordi Morrison: Thank you, Lindy. To support Knocked Up, leave us a review or recommend to a friend. Join us on Instagram @knockeduppodcast and join Raelia @drraelialew. And email us your questions to podcast@womenshealthmelbourne.com.au.
Hosted by Dr Raelia Lew and Jordi Morrison
Dr Raelia Lew is a RANZCOG Board Certified CREI Fertility specialist, Gynaecologist and the Director of Women’s Health Melbourne.
Find us on Instagram - @knockeduppodcast
Have a question about women's health? Is there a specific topic you'd like us to cover? Email podcast@womenshealthmelbourne.com.au. We keep all requests anonymous.