Causes of Miscarriage Before 12 Weeks: What Most Doctors Miss

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TRANSCRIPT

[00:00:00] We're holding space for anyone who's experienced early pregnancy loss miscarriage in the first trimester, something that affects up to 15, to 20% of known pregnancies. If this is your story, please know you're not alone and there are powerful ways to support your healing and nurture hope for the future.

In this episode, we're talking about conventional and functional medicine, functional nutrition perspectives, including testing. Causes practical lifestyle and diet strategies that can help. So whether you're just beginning your journey or have faced multiple losses, this episode is for you.

If you want to learn more about later losses and pregnancy, I invite you to listen to our episode on late term pregnancy loss. For additional insights, let's go.

Welcome back. I'm Sarah Clark, founder of Fab Fertile. For over a decade, my team and I have helped hundreds of couples improve their chances of pregnancy success, whether naturally or through IVF. We specialize in supporting those with low AMH, high FSH, diminished ovarian reserve, premature ovarian sufficiency, and recurrent pregnancy loss through [00:01:00] functional testing and personalized fertility strategies.

Today we're diving into early pregnancy loss and what you can do to improve pregnancy success. This episode is for you if you've experienced a miscarriage before 12 to 14 weeks of pregnancy and want to understand what may might be behind it. You're seeking both conventional and functional insights to improve healing and improve your chances of future pregnancies.

And you want actionable lifestyle, diet and testing strategies to help prepare your body for a healthy pregnancy. Thanks so much for listening. I'm so thankful that you're here. Make sure you hit subscribe or follow, and if you know someone else who's on the fertility journey, please share this podcast with them.

So we're talking about early pregnancy loss. So we'll start first with the conventional versus the functional medicine functional nutrition approach. So first is for progesterone. So the conventional approach is usually they want to measure it in the mid luteal phase or early pregnancy to confirm.

They may suggest progesterone supplementation, oral or vaginal. Typically it's synthetic progesterone and often it's only tested after recurrent pregnancy [00:02:00] loss or bleeding. So from a functional nutrition, functional medicine standpoint, we're looking at why is the progesterone low to begin with?

Are there issues with the adrenals, the thyroid? Are there nutrient deficiencies? We can look at your basal body temperature and ovulation patterns. If you have an iPhone, we like Inito. And I'll have the link there for you at the end of the episode where you can save 15% on the Inito and that'll track ovulation and look at your FSH and your LH with urine, being able to track that.

And you don't want to get too obsessive about it. If you find yourself being triggered by this. Especially if your cycle is very irregular, we need to be mindful of that, but being able to track is key. And then we also look at the basal body temperature and the cervical mucus in conjunction with the inito.

We also can use Mira . We're going to manage stress with mindfulness and looking at potential adaptogens cortisol manager Ashwagandha. need to make sure that's personalized, supporting your nutrients. We see a lot of people with magnesium deficiency, zinc deficiency, vitamin B6.

A theme we see with couples we work with that [00:03:00] have low AMH, poor egg quality, pregnancy loss is methylation issues. Maybe you need more support with your B vitamins. And then we can discuss a bioidentical progesterone with your provider if necessary.

A lot of times they're taking some of the hormones and you're just throwing a bandaid on it. You're not digging deeper. Why is it off? So sometimes the hormones can be there to support making sure you're not using synthetic, always bioidenticals. Sometimes we're looking at a progesterone cream.

But if you had a pregnancy loss, that might not be enough. Chromosomal causes, from a conventional standpoint, they'll probably want to do some testing. Fetal tissue testing. To check for chromosomal abnormalities. want to do some parental karyotyping. They usually don't do that until after three losses, which can be devastating if

you're going through these losses and you've had two. They want to wait to dig deeper. From a functional medicine, nutrition standpoint, we're looking at everything we can do to support the egg and the sperm quality, to reduce oxidative stress and improve methylation, reduce inflammation.

So having an [00:04:00] anti-inflammatory diet. Avoiding environmental toxins, so plastics and pesticides. Definitely supplementing, making sure your prenatal is methylfolate. Then maybe we need additional supplementation. We see a lot of people that have low B12.

We like that between eight, 800 to 900. Maybe yours is elevated, but it's falsely elevated. You're not absorbing it. Or maybe it is low and we need to look at that methylation standpoint. Looking at some omega threes, looking at some NAC, optimize that thyroid and the metabolic health. So it's not just doing the testing and think there's nothing we can do that it's a, genetic issue going on.

And really with that karyotyping, that only affects about 10% of couples. Obviously, we want to be aware something is happening and things we can do to support, but a lot of the times epigenetics has been missed. What are the diet and lifestyle and supplement recommendations you can use to then prevent preeclampsia, prevent gestational diabetes, and prevent pregnancy loss?

Clotting disorders, the conventional approach, they're going to be testing for the antiphospholipid [00:05:00] syndrome, the factor V leiden, the prothrombin gene mutation, the protein CS deficiencies. Those are usually done after multiple losses. And then they may recommend a low dose aspirin or heparin if diagnosed.

So that's something you work with your practitioner on. From a functional standpoint, looking at inflammation. Done a whole podcast on inflammation, looking at homocysteine levels. Done a whole podcast on homocysteine levels. Why that's important. Looking at your methylation. I've done a whole podcast episode on our genetic test that we have, so we can support methylation.

That could be contributing to clot risk. To support anti-coagulation via diet and supplements. So looking at homocysteine and adding in some more B vitamins and methylfolate to making sure you're having an anti-inflammatory diet.

With Omega-3 supplementation, so anti-inflammatory. So just send me a message at hello@fabfertile.ca. Subject line 10 DAY, and I'll send you our elimination diet. So you take out the top allergens [00:06:00] systematically reintroduce over the course of 30 days. All anti-inflammatory foods.

Obviously we know we need to avoid smoking and caffeine and alcohol. You don't want to be drinking alcohol when you're trying to conceive. You don't want to be smoking or smoking weed. You and your partner. Caffeine, we need to be mindful about if we're doing an elimination diet and then taking out caffeine, we don't want to do that all together because you could have die off reactions.

You definitely do want to consider taking out caffeine later. So we have people do, regular caffeine down to decaf, down to green tea, down to herbal over the course of 10 days, adding lots of water because otherwise you'll have potential headaches. And then liver support for detoxification.

So castor oil packs and milk thistle and dandelion tea and rebounding and lots of water. And those castor oil packs that we just talked about. I've got episodes on those, and a whole episode on detoxification. Placental issues, the conventional side of things.

You want to do an ultrasound to monitor for placental abnormalities. Testing for placental insufficiency is usually later in pregnancy. [00:07:00] From a functional standpoint, we want to support the placental blood flow that's going to reduce inflammation proactively. So consider that anti-inflammatory diet, reducing stress.

Looking at your blood sugar. Consider a continuous glucose monitor. If your blood sugar is spiking, that can cause inflammation in your body. Maintaining a healthy weight looking at your blood pressure before conception, so looking at all your lipid levels and seeing, making sure all those are in the right range.

Immune dysfunction. So ANA and NK cells have done a whole podcast episode on ANA and why that's important. But the conventional approach, they're going to measure the ANA, look at the antiphospholipid antibodies, look at the lupus anti coagulant testing after recurrent pregnancy loss.

So in the conventional approach, you're going to, they're going to test ANA, they're going to look at your antiphospholipid and antibodies. The lupus anticoagulant is going to be tested after recurrent pregnancy loss. They're going to look, potentially look at the NK cell activity. This can be controversial and it's not [00:08:00] routinely recommended.

Everything we're doing is reducing inflammation and some of these tests we can get the testing to to know. 'because it's good to know, test not guess. In conjunction still making all these changes here. So looking at the health of your gut microbiome, addressing infections, eating that anti-inflammatory diet, addressing food sensitivities.

And these can all be immune triggers. And healing the gut microbiome. If you got infections, we need to address it. Starting to repair and heal with probiotics or with l-glutamine. and you can test and address those chronic infections, parasites, bacterial infections, fungal infections.

That could be why you're having pregnancy loss or it's not implanting. Eliminate some of those reactive foods. we have people do a five day food diary. We do a 10 day elimination diet, taking out the top allergens and systematically reintroduce them. We have the female do the food sensitivity testing. I got people intolerant to lettuce or avocados, some of your favorite foods that you're eating. Maybe your body mounts an immune response to it because you have leaky gut. And the body [00:09:00] identifies that as a foreign invader.

As you repair the gut you can bring most of your foods back in, sometimes people are on this very restrictive diet because they've got infections and the body just starts mounting immune response to everything. And so supplementing with vitamin D, we see a lot of people with low AMH and low vitamin D, the omegas and the curcumin can be really good for the immune system.

Vaginal microbiome, done many episodes of the vaginal microbiome. Definitely check that out. Conventional testing they're testing is limited to bacterial vaginosis or candida with a culture or PCR testing. And it's often overlooked in miscarriage evaluation, functional standpoint. Doing vaginal microbiome testing getting the good bacteria back into the vaginal area. The lactobacillus

crispatus. Avoiding the overuse of antibiotics and harsh hygiene products. We have a whole vaginal microbiome protocol. We work on the health of the gut microbiome, and then we work on the health of the vaginal microbiome.

There's supplements and we can use to get the vaginal microbiome in the best shape. When [00:10:00] we test it, we know exactly what we're doing, what's low. What's the invader and how do we then address it. Then when we support gut health, that benefits the vaginal flora.

The conventional side of things, there could be infections. Looking at the TORCH panel. So toxoplasmosis, rubella, CMV, herpes. These may be ordered after pregnancy loss and sometimes they're not. From a functional standpoint, we're looking at chronic and hidden infections so we're doing the stool and the blood testing.

Looking at viruses, bacterial infections, parasites fungal infections. We address that with supplement protocols. Sometimes you do need to work with your practitioner, PCP on this. If it is a very strong infection, sometimes you need to bring in the antimicrobials or the

antifungal or antiparasitic, but most of the time we want to be able to use a low and slow approach to be able to maintain the good bacteria. Sometimes we go in really strong and then it kicks out the bad bacteria as well, and we still need to work on the other side of it to repair [00:11:00] it.

You want immune support. So with your vitamin C you can do medicinal mushrooms can be helpful. Zinc. You want to be careful just doing that yourself. Obviously with immune support, vitamin C or adaptogens, things like that can be helpful. But just be careful on DIYing.

Cortisol and stress. So the conventional side of things it's rarely tested in pregnancy loss unless they're suspected adrenal disorders. From a functional standpoint. We regularly are looking at your cortisol rhythms and stress. Our whole thesis on this. Is it early menopause or is it your adrenals that impact your AMH, your FSH and your follicle count and implantation.

Chronic stress you've been under. We can look at that in serum, in blood as well as in urine. Sometimes we see it in black and white. Daily stress management, meditation, yoga, breath work. Pick something. If you're getting outside, whatever feels right for you, working on your sleep you need to have seven to nine hours of sleep.

And if your sleep is off, that can then be causing inflammation in your body. And so we need to work on [00:12:00] sleep. I did a whole episode where we talk about you could be waking up 'because you have blood sugar issues, liver issues. You're not detoxifying properly. Maybe you're having cortisol spikes and that's why you're waking up.

You want to be able to have a restful sleep seven to nine hours. And we need to be able to address it. And then you want to limit some stimulants like caffeine and sugar. Looking at some of the GI issues or dysbiosis, conventional side of things, rarely are they going to look at the DNA of your stool.

And that's from a functional standpoint, this part of our testing. We do, food sensitivity testing using blood. Stool testing, looking at the DNA of the stool, and then also genetic testing. We also look at your blood chemistry and then look at semen analysis as well.

And so the gut is central to the health of the immune system. Your nutrient absorption. We like the GI MAP test. I caution just doing one. We need to do conjunction with other changes. Developing a protocol based on that, we can add in probiotics, prebiotics, do the elimination diet in conjunction, on just about doing a stool test.

And then we haven't made [00:13:00] any dietary changes. Nutrients for gut repair. We want to be able to then address what's happening in the gut and repair and then potentially consider adding in some fermented foods. If we have a fungal issue, we don't want to be doing that.

We need to take a very personalized approach. Food sensitivities. I just talked a little bit about that. That's rarely tested in conventional approach. Maybe they'll send you off to an allergist and say, you've got allergies to mold and dust, but, or you've got a strawberry allergy.

But that's an immediate reaction, which is hives or you need an EpiPen, but we're looking at delayed reaction and all this inflammation. So on a regular basis, these foods are coming in and causing inflammation in your body and driving immune activation. And we've had people have pregnancy loss like over and over again, and we had them do an elimination diet and then an AIP diet.

Lo and behold, the pregnancy holds. So it is conjunction all of these things. It's hard to pinpoint exactly what it is, but we need to be able to, in a targeted manner, be able [00:14:00] to dig into this and recording this. And it is like super hot where we are my air conditioning is starting to falter.

So I'm sweating. We do food sensitivity testing. The gold standard is the elimination diet. So we do the gold standard and we do the food sensitivity testing. We're removing the common allergens, dairy, gluten, soy, corn, peanuts, eggs, processed sugars. Consider an AIP diet so you take out nightshades and legumes and grains. We do the elimination diet first, and then we can consider doing an AIP little bit later. The idea is to slowly bring these foods back, not being on this restrictive diet forever. And so you want to make sure they're all anti-inflammatory nutrient dense. Iodine deficiency.

It's not routinely tested in conventional medicine. It's not done unless there's thyroid issues are present. And then so in the functional side of things iodine's rule in thyroid production and is really important. You can consider a urinary iodine test.

If you're deficient, we need to, be careful on this here so we can support the thyroid with selenium and zinc. I've done a whole podcast episode on the [00:15:00] thyroid, so we need to look at the full thyroid plan, including antibodies. We can support with iodine.

You need to be very careful on this. Not having too much. I would not DIY, that with the iodine. And then if you have gut infections or autoimmune thyroid issues, that could be, impacting your iodine intake, toxins and detoxification. Most conventional practitioners are not going to look at environmental toxins unless you're an occupation such as a firefighter, or you're exposed to

a lot of toxins. They're not going to look at heavy metals. We do hair tissue mineral analysis test. They're not going to look at that. Maybe if there's neurological symptoms they might look at it. And they're not going to look at the BPAs the pesticides, the parabens, the phthalates that you're exposed to in conventional medicine.

The detox pathways, they're going to do the basic liver function, your ALT, your AST but not typically in the context of pregnancy loss, functional side of things. The toxic burden can really impact your hormone balance, your immune [00:16:00] function. And pregnancy maintenance. So we are going to look at toxins .

We want you to reduce all of those and that can impact your estrogen and your progesterone. The heavy metals such as lead, mercury can be linked to increased risk of pregnancy loss . Organic pollutants. So it could be stored in fat and they can disrupt your endocrine and your immune function.

We do genetic testing so you can then support your methylation pathways. We do heavy metal testing and nutrient absorption testing. We can dig deeper and do some other toxin screens. Testing if you know that you're exposed to mold.

There's a lot of low hanging fruit here where we can we can dig deeper with some of these tests. And we start with the food stool and genetics. Then we can bring in the vaginal microbiome, bring in the heavy metals or nutrient deficiencies bring in the adrenals. And if we need to look at an environmental toxin screen, we can do that as well.

It's just not about throwing all these tests at you. If we can reduce our exposure to plastics and parabens and phthalates and making sure your skincare is non-toxic, that [00:17:00] your cleaning products are non to toxic and making small steps.

So you want to choose the fragrance free and choose fragrance free non-toxic personal care. Eat organic as much as possible. You can refer to the Dirty Dozen or the Clean 15. Dirty Dozen, the ones that are most highly sprayed, clean 15

you can consider eating those non-organic. But we always recommend organic, using water and air filters to reduce your exposure. Eating cruciferous vegetables that can support your liver and detoxification pathways. Making sure you're eliminating daily. You want to go one to three times a day, having a bowel movement.

So getting those toxins outta there. If you're not, all those toxins are circulating in your body. That can be why it's not working. Staying well hydrated is key. Getting enough fiber and then doing some supplements under practitioner guidance. So you can do milk thistle or DIM for estrogen metabolism.

And you can do the methylated B vitamins if you already know you have that MTHFR gene variant. Which we do see a lot. You can do dry blushing brushing or sauna therapy. Just be careful in the [00:18:00] sauna, during certain parts of your cycle, and you don't want to be going in there for hours.

We need to be very mindful on that side of things. Check out the detox episode I did. Gentle exercise, sleep hygiene that can allow nighttime detoxification. So you want to support your circadian rhythms. Many conventional providers, they're only going to test after three or more losses.

This is devastating. I've just reeled off a whole bunch of information here. If you've gone through pregnancy loss, my heart goes out to you. I haven't experienced it myself. When I had my daughter and then we had some embryos left over.

We had another transfer that didn't work. It didn't implant. But going through a pregnancy loss, it's hard. We don't want to blame yourself. You want to be able to test, make some targeted changes, be your own advocate. Don't take no for an answer and include your conventional team, but also look at this from a functional standpoint too.

And so you can really start to know the biomarkers, the testing, the mental emotional side of things. And there's a whole, range of tools available to improve pregnancy outcomes. That genetic test that we do it's designed to [00:19:00] help improve pregnancy outcomes. There's 10 different pathways we can personalize that diet.

Lifestyle and supplement recommendations. because a lot of times we're just throwing spaghetti at the wall and reading a bunch of books and blogs and taking all these supplements and making a couple changes. But we've got to do this in a very targeted manner. Definitely check out our episode coming up on late term.

Or second trimester pregnancy loss. And we'll be talking about some strategies to help with that. Hopefully this has been helpful for you. If you're ready to get pregnant this year and improve pregnancy success, send me a message at hello@fabfertile.ca. Subject line FERTILE, and we'll give some options to help. Take care.