Appropriate nutrition can enhance fertility. Specifically, vitamin A has a critical role to play in reproductive health. Its presence in the body can improve the chances of conception. And its absence can impede the process.
Pam Schoenfeld, a registered dietician with a specialty on family and reproductive nutrition, today shares her experience and research for improving fertility simply by increasing vitamin A intake, as a starting point. She goes over how to recognize the signs of deficiency and how to incorporate foods that offer the best sources of vitamin A, like eggs, liver, raw milk, and fish eggs. She also gets specific about what vitamin A does for the reproductive system of both men and women and how it facilitates conception.
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Within the below transcript the bolded text is Hilda.
What can vitamin A do to enhance fertility and what can its absence do to impede the process? This is episode 413, a special bonus episode with no interruptions or ads. Our guest has a specialty in her practice of family and reproductive nutrition. She shares her experience and research that has helped numerous people improve their fertility simply by increasing their vitamin A intake as a starting point.
She goes over how to recognize the signs of deficiency and how to incorporate foods that offer the best sources of vitamin A like eggs, liver, raw milk, and fish eggs. She also gets specific about what vitamin A does for the reproductive system of both men and women, and how it facilitates conception. Our guest in this episode is Pam Schoenfeld, a registered dietician.
Also, a quick reminder to stay on to the very end. We tacked on a mini-episode where Pam reveals a lot of resources that may be of help to those who want to enhance their fertility. Remember that minisodes are short episodes with our guests that we are posting in a space on our website for Weston A. Price Foundation members. It is that extra little touch to let you know that we appreciate your support of the work here. If you want to become a member, go to Weston A. Price, and click on the Become a Member Button. Membership is only $30 a year using the code, POD10, and you can enjoy all the perks including these minisodes.
Welcome to the show, Pam.
Hilda, it’s so good to see you. It’s been a long time. I missed the last conference. I couldn’t make it. I know I’m going to see you this year in 2023. I can’t wait.
I’m looking forward to it as well. The last time we had you on, we talked about Vitamin A-mazing, which it is. Vitamin A is amazing, and in this episode, we want to do a deeper dive in terms of how it relates to fertility. I know you work with a lot of different clients. Talk to us about a patient who has struggled with fertility and some changes they saw through including more vitamin A-rich foods in their diet.
A little bit of background, probably 2/3 of the women I see come in for either trying to get their periods regulated or 1/2 of them are trying to get pregnant. There are clear signs of vitamin A deficiency. It’s so easy to see. They have problems with their vision, especially at night. They have bumps on the back of their arms. I see this over and over again. For this one patient I’m working with, I’m not as fresh in the memory of some of the other ones because I can think of a couple offhand, but I didn’t review the details. I’d rather them review a case.
This lady is 32. For a medical reason on her husband’s end, they had to go with the IVF route, which is In Vitro Fertilization. She had twice already gone through the process where they stimulate the body to produce more eggs with the goal of retrieving the eggs, which they do with minor surgical procedures. They retrieve the mature eggs out of the follicles.
The first time she had a retrieval, she had two eggs. One was usable as far as maturity after becoming fertilized with her husband who had banked sperm. That mature egg was then fertilized and they transferred it and it did not implant. That was the first time. In the second cycle, she only got one mature embryo, and she was very concerned that the same thing could happen. The embryo was pretty good quality, but it wasn’t the top quality.
She was like, “I’ve got one embryo left. What if this doesn’t work?” She had talked to her doctor and they decided to do another egg retrieval. In December when she called me, I was going on vacation and I was like, “Wait a minute.” I talked to her on the phone while I was waiting for my husband at a medical appointment because that was the only time I had. I immediately said, “If you are planning on doing this in mid-February, you need to get started right now. We’re not going to wait.”
Technically, it takes three months to improve egg quality. I gave her various recommendations after discovering that two-thirds of my other patients had signs of vitamin a deficiency. I asked her. I said, “Do you have bumps on your arms?” “Yes.” “Do you have trouble with night vision? How do you feel about driving at night?” “I never drive at night.” They always tell me that, “I hate to drive at night.” That’s a big telltale sign.
I said, “You’re vitamin A deficient.” With diet and with appropriate supplements, I corrected the vitamin A deficiency. It does take a little time to correct the vitamin A deficiency, but certain tissues in your body respond quickly like your eyes. In the diet, it’s hard to know because it depends on the quality of the eggs and the dairy she was eating, and she was not going to eat liver. She never ate liver. It’s very hard to get women to eat liver. I have to be super careful too. I have to know the amounts of vitamin A that people are getting so I don’t go over the upper limit of 10,000 total from the diet and any nutritional supplement.
She did everything I asked. She was gung-ho. I love this field that I’m in because women are gung-ho. They want to do it. She had her most recent retrieval and fertilization. She got four very high-grade embryos. The fertility specialist or the doctor said, “This is night and day,” the difference. She was ecstatic. She put exclamation points after everything, “I’m so happy! This is a miracle!”
The embryos have not been transferred. She is meeting with me to refine all the recommendations and make sure her body’s ready to receive and the embryos will implant properly because that’s the next stage. Since I’ve been getting a few more women going through assisted rep technology, which wasn’t my focus in the initial into reproductive nutrition, especially for women. It was more like, “Can I support a woman’s pregnancy?” was my initial goal.
I understand you’ve dove into this area that you weren’t planning on going into, but I wanted to go back to what you said. You said that vitamin A deficiency is very prevalent among women of reproductive age and that you’re not surprised. You can see the telltale signs. You’ve mentioned issues with driving and vision at night. Also, issues with the bumps on the back of my arm, which I remember having back in the day myself. What other things give the indicators or the indicators that we’re vitamin A deficient?
It’s interesting you asked that question because there are probably twenty different indicators. The classic ones are night vision problems, diminished night vision, and skin problems that usually would happen at a higher degree of vitamin A deficiency where you might see acne, bumps, hyperkeratosis on the back of the arms, sometimes eczema, and often, dry skin and dandruff. They don’t all have to present together, but they can be combinations of these. Also, a history of severe acne when they were young, especially.
You’ve also got your eye problems, your inability to see well at night or sensitivity to glare from bright light. On top of that, which is interesting, there’s not a lot of data on this, but sensitivity to sunlight is a big one. I asked these women, “How do you feel about going out in the sunlight? Do you need to wear sunglasses or do you find it difficult?” “Yes. I always have to wear sunglasses.” I had the same thing.
If any of your readers had seen my presentation at the Wise Traditions Conference in 2019, I talked about my own personal history of vitamin A deficiency. I didn’t know it until I discovered the Weston Price Foundation. That’s what I had. We all walk around in life thinking we’re doing the right thing but we have the wrong information.
We think, “All our friends are struggling with the same thing. It’s normal.” It may be common, but that doesn’t mean it’s normal.
It’s not normal physiology necessarily to have excessive bumps on the back of your arm or to be very sensitive to bright sunlight and if a woman has dry eyes. What’s interesting is that there are some more of this. There are allergies, asthma, and frequent respiratory infections. There’s a lot. The other thing that was interesting and I’ve been digging into old research articles. In the 1920s when they first started noticing if you are an animal vitamin A efficient, a female and a male couldn’t reproduce but usually, it was the females that they were working with.
There are a lot of rat studies. There was a researcher and I’m writing a pretty extensive article for the summer journal. All this will be detailed in there. I’m going to hit on the highlights but this one researcher noticed that when they change their animals, the experimental rats were the ones that included inexpensive foods, which was awful that they collected from slaughterhouses. The number of offspring went up like crazy.
I was thinking about a friend of mine who’s mad at the Weston Price Foundation because I keep having babies. They were saying it tongue-in-cheek, but this woman had four kids, which by the way I did too. She’s can’t believe how fertile I am when I eat the nutrient-dense diet. I want to get to that, Pam, but first I want to ask you. I know you’re going to touch on this in the article, but why does vitamin A deficiency affect our ability to reproduce or affect our fertility, in other words?
That’s got about fifteen answers to it, but I want to finish what I was saying before because this researcher called it a delicate sign of vitamin A deficiency because, in all other aspects, the animals appeared normal. I haven’t been able to get the full paper yet. I have to see if I can get it at the university library. What I took that to mean is that the inability to reproduce is one of the first signs of vitamin A deficiency.
The inability to reproduce is one of the first signs of vitamin A deficiency.
If you think about it, that makes perfect sense. Why does the body want to reproduce and try to make a new living being, in our case, a human baby, if it can’t even take care of itself? You asked a very good question. What is going on? What is the mechanism of action? Why is vitamin A so important? I will tell you that in one second. This is what I’ve been working on because I keep refining that I have books and papers. There is a lot of stuff in old books. It doesn’t even get noticed anymore. It’s lost information.
They keep having to read what they used to think and see if they followed up on these studies because a lot of this stuff gets dropped because there’s no money in the research. Vitamins are not money-makers. Corporations or even the government that funds the research, there’s nothing to be patented there, especially food. We all know the story. Nobody wants anybody to eat these nourishing foods. Nobody in the government does because they think we’re all going to peel over from coronary heart disease or something.
In the meantime, we’re all running around malnourished unless we’ve learned better like I did when I was 40. Vitamin A is now getting some attention as needed during pregnancy. That tide is starting to turn, which is interesting. I listened to a podcast by another dietician. She’s being interviewed and she was talking about the need for vitamin A in pregnancy, but the fertility thing, there’s not a lot of stuff that tells women you can turn your fertility around through nutrition.
The last vitamin that anybody would ever think of is poor little vitamin A, which is probably the most important vitamin in our bodies. It’s this forgotten story. The other part of it is that, at the same time, animal studies are forgotten because you know how many studies were done on humans. You can do an observation and I’ll tell you some other things that they’ve observed in humans. You asked me about the signs and symptoms. One of the other signs is very little cervical mucus.
This is something I hear over and over in women. I’m like, “You’re only 30. You think when you are old, it’s going to happen.” They have no clue why this is happening to them. In early animal studies, one of the earliest signs is the quantification of the vaginal tract, the vaginal epithelium. In fact, the same thing happens to the oviducts, which are the fallopian tubes. They became hard and they lack moisture. That’s what quantification is.
The cells become flattened and hardened. That’s what our skin is. Our skin is keratinized or quantified. It’s normal, but in our mucus-containing tissues, that’s abnormal. That’s why we see dry eyes, sometimes dry mouth, and certainly for some women, dry vaginal. This is not a conducive environment for the sperm to travel and flourish. The sperm has to make it to the fallopian tubes in most cases to get together with the egg and create a fertilized embryo.
It’s like it’s hitting a pothole because it’s being impeded.
These little cilia are supposed to be in the fallopian tubes. I’m sure they exist to some extent, but just as the lung loses functional cilia, when we don’t have enough vitamin A, those cilia are the same morphology. It means they’re the same type of cells that are in the fallopian tubes as they are in the lungs. It’s recognized that in the lungs you can get this flattened cilia or a reduction of cilia and less mucus. It’s the right kind of mucus or the mucus that protects the surfaces and provides in the lungs and the vaginal tract an antimicrobial action.
I see women once they get vitamin A back into their diets, whether it’s their diet or a supplement. It depends on the woman. They have to be very flexible or have the right prenatal vitamin. All of a sudden, she’s getting cervical mucus. All of a sudden, she’s ovulating. Usually, the first thing I see is women saying they feel more energy. They say, “I feel more energy.” It’s because it’s also needed for your mitochondria. They say, “My eyes aren’t dry anymore. I got a period. Now, I can monitor my ovulation signs.”
I’m seeing these true signs of ovulation when I’m using the s urine testing sticks. I call it my secret sauce because it’s not the only thing that I have to tend to by the way but it’s so prevalent. It’s almost like, “How can the medical community be missing this? How can they be so blind that this is happening?” As you said, it’s because it’s so common to see these signs and you think of the commercials for Restasis or for skin bumps. You see those ads for those products now and it’s almost as if this is normal.
They’ve got a solution for vaginal dryness. They’ve got the products that women use for lubrication. There’s always a product to be sold to correct these things when probably 50% more of them stem from a vitamin A deficiency, which could also be made by zinc deficiency, fat deficiency, or iron deficiency. When we’re talking about women that are doing these “healthy plant-based diets,” we know that there’s not only vitamin A can be a problem, but also zinc and even iron and protein intakes.
Can you explore that a little bit more? I think you’re right. Young women in their childbearing years are often going plant-based. They’re influenced by a concern for their environment or maybe their own health. They think, “This has got to be healthier. I don’t feel energetic.” What foods do they turn to and how are those missing this critical vitamin A?
It’s interesting now. If you don’t eat liver, that right there is going to make me suspicious that you could be vitamin A deficient. I didn’t forget you wanted to know what happens when you’re vitamin A deficient or why you can’t reproduce. I want to leave that to the end because it is so interesting. I’m only going to be able to touch on the fifteen different things that happened. It’s that big, but the more I dive into the literature, the more I’m going, “Why are people not seeing this?”
We’ll talk about at the end how exactly this affects our reproductive health. Talk right now about what people are missing in their diet, especially if they go plant-based.
If they do not eat liver, I have to right away go and 1 out of 50 women that I see have never ever eaten liver because it’s not the food they were raised on. I get it because it’s a strong flavor and it’s difficult for them to even think of preparing it because the texture is very odd. The other thing is a lot of people are very concerned that liver is toxic and it’s hard to find good quality liver. There are a number of things that work against that.
The other thing is there still is a lot of messaging on the internet and other sources that liver is bad for you in general and specifically bad during pregnancy. It used to be the other way around. By the way, people used to say, “Eat liver when you’re pregnant.” That all goes back to the ’90s, especially with the Rothman study. Your readers can read those details when the paper comes out in the Wise Traditions Journal. That’s number one.
A lot of women don’t eat eggs or they don’t eat high-quality eggs, which I think is the most biologically available source of real vitamin A in the diet for those who don’t eat liver. If you get a really good orange egg yolk and I know the Weston A. Price Foundation has information on this. I haven’t talked to Sally about sharing it with me, but I probably will. True vitamin A is in the egg yolks of these pastured animals. I have a feeling it’s pretty significant.
Number two is a lot of women are either too busy or don’t understand the importance of eggs. On rare occasions, they don’t like eggs. Very rarely do I see a woman with an egg allergy. That happens though. That’s the second food I consider fundamental for vitamin A. The third one would be full-fat dairy and quality full-fat dairy. It’s because the quality of the animal’s diet is going to influence the amount of retinol or true vitamin A in the product because the carotenoids in the grass and pasture convert very well in the animal.
They do that well to make vitamin A into that milk or the egg yolk. Unfortunately, most of us are not as good as animals at converting the carotenoids in plants into true vitamin A or retinol. That is even more prevalent in women of European ancestry. I’m one of those bad people. It can be the point that you can only convert 10% of the carotenoids that you eat to retinol.
That’s why you said we want bioavailable sources of vitamin A because sometimes people say, “This carrot has vitamin A,” but it’s a precursor. Your body needs the ability to change it into something useful and not everybody can do that well.
Carotenoids serve their own purpose as antioxidants. There is some data showing an excess of beta carotene. That’s the main carotenoids in carrots. It’s difficult to get it from the diet, but it’s not possible. There are women that I see that eat sweet potatoes all the time. That can interfere with the action of true vitamin A in the body. There’s not a lot of research on that. There’s very little, but I did see 1 or 2 papers on and I thought, “That’s interesting.”
There was a study years ago that showed that high doses of beta-carotene from supplements were very bad for your body and specifically for smokers. Every time we try to think we know better than our ancestors, we mess up. That’s what nutrition has been doing for the past many years. They think they know better than the people that came before us. The other part of the equation is that most of the prenatal vitamins that women take do not have any preformed vitamin A in them and that they only have beta-carotene.
I didn’t know that when I was popping those prenatal pills.
Yours might have been different. They’ve changed that a lot since 2000 because there’s a big scare on vitamin A that came up in the mid-’90s and everybody started turning the products and reducing the amount of vitamin A and even taking it out and only using beta-carotene. This whole thing has come together and created this problem that a few educated and informed people do know but the majority of healthcare practitioners in the system in general still tell women to avoid sources of vitamin A during pregnancy.
One other thing there is this widespread misconception that Westernized populations, industrialized, or more modern populations don’t have a vitamin A problem. Every scientist who studies vitamin A knows that developing nations have a vitamin A deficiency problem. That’s widespread, but in the United States, Europe, and any of these more developed countries, nobody thinks it’s a problem. At the same time, our Federal government knows that 80% of women don’t consume an adequate amount of vitamin A from their diet, even counting sources of beta-carotene. I don’t get the disconnect.
What’s the incentive to make the connection? What’s the incentive to correct this? In my opinion, fertility specialists have very little incentive to fix their patients’ nutrition.
It’s because their revenue stream depends on people having trouble with their fertility. What I was going to ask you next was, do you have an idea of what the statistics are for the rate of infertility in developed countries? I feel like it’s on the rise anecdotally from talking to my young friends who are of that age, who are like, “We’re hoping to have kids, but we don’t know.”
I’m going to go back to my paper, but the rates right now are between 8% and 12% in couples. I can tell you what the increase has been. It’s increased by 1% a year. It’s increased a lot in the past many years. I’ve got all that in my paper.
I understand there’s a resource you have to look at, but in the meantime, since you were talking about couples, I wanted to ask you the question about men. I know you work primarily with women, but I suspect that men also have low levels of vitamin A and that’s also causing a compounded issue when you go about wanting to have kids.
I can explain why the sperm is affected by vitamin A as well as the woman’s reproductive ability. It was more pervasive in a woman because there are more things that happen in the woman but the creation of sperm requires vitamin A. Also, it’s the same thing I mentioned before where you get that keratinized tissue. That happens to men, too, and their sperm also gets keratinized. In animal studies, the count, morphology, and motility of sperm can be affected by vitamin A deficiency.
This is another area which I think people don’t understand I believe that these highly damaged oxidized industrial seed oils are pervasive in our food environment, especially in fried foods and many eat a lot of fried foods. We know that these deplete vitamin A because they create excessive reactive oxygen species and vitamin A is needed along with some other things to quench reactive oxygen species.
That is the cause of infertility in both men and women is excessive reactive oxygen species because there’s a delicate balance between antioxidants and oxidation during the reproductive process. When that gets tilted too much to oxidation, you get damage to sperm and DNA. Vitamin A is so important in that whole process. There are some definite things that we know and there are things we can probably surmise are going on because you can look at the connections. Did you have another question before I start talking about what happens in men and women, starting with women?
I am grateful that you mentioned at least three vitamin A-rich foods like the liver, dairy products, and eggs.
They are commonly eaten. I don’t know what the levels are in things like shellfish. I imagine fish eggs are very good. Anything in the animal product, a young growing animal or organ meat would have more because first of all, vitamin A in the body is stored. They think about 90% of the vitamin A in the body is stored in the liver and that could be another problem as well because if people don’t have healthy livers, they either don’t store enough or they can’t release it.
I have this theory that a lot of women with PCOS get pregnant when they start to lose weight. There could be lots of reasons for that, but one of the reasons could be is their livers get healthy. They reduce the fat in their liver. Now, their liver is functioning and exporting vitamin A out of it or the adipose tissue can contain up to 20% of the body stores. As they lose weight, they can release that vitamin A into their bloodstream if they extort it there.
It’s a good possibility. It’s not a bad theory.
It’s a theory but when I see a woman that’s told me, “I’ve been diagnosed with PCOS.” I’m like, “Let’s see if you have PCOS.” I don’t say that to her. It is in my mind because 30% to 50% of women I see don’t even have PCOS. They have nutrition problems. PCOS is Polycystic Ovary Syndrome. It’s considered one of the major causes of infertility or subfertility in women. It gets diagnosed so easily. Women are not cycling regularly or they have cysts in their ovaries.
Those two can be the results of nutritional problems. Again, I don’t want to just say vitamin A because it’s not just vitamin A. There are a number of things. The third thing is the excessive amount of testosterone, which I don’t know. I have a feeling that’s in utero exposure in a lot of women and/or it’s from excessive stress and/or obesity can cause it too.
In a woman that’s not significantly overweight, they tell me they have PCOS, and they don’t have any problems with hair growth on their face, I’m like, “I don’t know about that.” I tell them, “You might have PCOS, but that’s not my assumption. I’m going to look for everything else that could be wrong nutritionally or lifestyle.” Mostly, it’s nutritional, but sometimes it’s stress that could cause these symptoms and we’re going to clear those up.
If I assume that you have PCOS and go down that trail, I may be missing things. It’s interesting to consider everything. The second aspect of that is there are a lot of dieticians, nutritionists, and alternative practitioners that are now doing what I do. You’ve probably seen it. I cannot tell you that they do the same. If they’re Weston A. Price Foundation-trained, yes probably.
The beautiful thing is they’re not accepting a label or diagnosis as a stamp of, “This is the patient’s destiny,” but rather they’re working with the individual. Whether or not they’re Weston A. Price-trained, they’re looking for other ways to shore up their overall health, and as their overall health improves through diet, movement, and all the things, their chances of having a baby increase.
Those are the root causes they’re looking for which is interesting because I’ve worked with an alternative OB-GYN group and they identified the root causes as this thyroid function progesterone deficiency. In some cases, DHEA was low. They have a bunch of tests they run and they consider those root causes. The methodology is called restorative reproductive nutrition but I don’t consider those root causes in many cases.
Those are not root causes. Why does someone have low progesterone? Why is their thyroid not functioning well? You can get to levels of root causes and I’m not saying I can fix everyone’s thyroid problems. That could be also related to environmental toxins, stress, and stuff like that but never stop until you get looked down on and say, “What?” You need to know the biochemistry but more than that, you need to know where they’re getting their nutrients from and what signs and symptoms of nutrient shortfalls they have.
They’re not hard to find if you know what you’re looking for. You look at their diets and you can start making some assumptions. In some cases, I will ask for zinc levels and iron levels. I will ask for Vitamin D because I want to make sure it’s not too high or too low because both of those to me is a problem vitamin A is tough because the blood levels don’t reflect the body levels but you can’t use that necessarily reliably.
Let’s go ahead and get to those fifteen issues that the woman’s body can have because of a vitamin A deficiency and maybe those of the men. I have one more question before we wrap up.
Vitamin A deficiency affects reproduction at almost every stage, right from preconception to the end of pregnancy. I’m going to speak more about the things that happened early. In the preconception time, women’s eggs go through the first stage of myosis while the female baby is in utero.
Vitamin A deficiency affects reproduction at almost every stage, right from preconception to the end of pregnancy.
In other words, a young woman’s vitamin A stores are affected by how her mother and maybe even her grandmother ate or lived.
Yeah. For example, my daughter’s eggs were created when I was pregnant and they go through the first stage of what they call myosis, which is an important part of cell division and maturation. That happens in utero at around twelve weeks. It is partially dependent on adequate vitamin A. I don’t know if that’s affected because if your vitamin A levels were so low, the mother would have a miscarriage. I don’t know but they see this in animals and both they do know that there’s a reduced number of eggs in the animals where the mother of the animal had low vitamin A levels.
It could reduce the number of eggs and the number that ever make it to that first stage that has to happen in utero. That’s one. That is, again, a little bit of theory, but it could explain why some women I try to help, I can’t even help because maybe stuff has been going on too long and too early to even change or I haven’t found it. The next thing that happens is there’s an interruption with the creation of the sex hormones because estrogen made necessarily, there’s not enough progesterone made.
Also, thyroid hormone can be affected because it works together in the cell. Vitamin A is considered a hormone, and the thyroid hormone and vitamin A work together. All these steroid hormones work together with vitamin A in the cells. Vitamin A has a regulatory function on the body as far as it works in its genetic effects because there are some other effects of vitamin A like antioxidants and a couple of other things.
In the nucleus of the cell, it controls how cells express their DNA. It turns on and turns off certain genes to regulate things. That’s why it’s very important in early development as soon as conception occurs. Before conception, it’s important for the hormones. The other thing is to let me go back to the papers. I want to make sure I get these in order.
It seems to be required for the selection of the dominant follicle which is the follicle that releases the mature egg at ovulation. Do you know how many women I see that do not create dominant follicles and what does that mean? That means they have cysts. If you don’t have dominant follicles, you have multiple cysts and what is that thought to be? It’s polycystic ovary syndrome.
Correcting the diet could help prevent some of the situations you’re describing.
I see it all the time. I see it in at least 2/3 of the women I see. It’s hard because I have not done a review of all the cases. I’m starting to go back and look as I write this article, but I am half-retired. I do other things for fun. I love helping women but sometimes I’m like, “If I look at another paper or something, I’m going to blow up because there’s so much data that I’m looking at but nobody’s doing these studies.
However, I do have one study that I’m going to tell you about. We talked about myosis in utero. We talked already about the cervical mucus, the healthy vaginal tract, and even the uterine tissues depending on vitamin A and certainly, the fallopian tubes do as well. If you don’t have healthy tissues that usher the eggs and sperm together or allow the egg to implant, that’s right there. It’s fertility problems.
You may be ovulating but if you have low vitamin A or a higher need for it, then maybe some women do because it’s all very generic. We’ve talked about it before. Not all of it, but 50% of women have an inability or 50% of people have the inability to make enough vitamin A from the carotenoids. For some reason, vitamin A deficiency doesn’t look the same in everybody even if all things were equal. They only know this probably from animal studies because what they’ve seen in animals is that given the same diet which was a vitamin A-deficient diet, there was a range of outcomes that they saw.
Some were able to have litters that survived term and then they just didn’t have fully developed eyes. That was the best outcome. The worst outcome is they couldn’t even get their estrus, which is a cycle like women’s. In between, some would get pregnant but then had a resorption of the fetus, which is similar to an early miscarriage. All the animals were given the same vitamin A-deficient diet for the same amount of time, which was 5 months before they were bred, and then 1 month after that they were bred.
If they got pregnant, they didn’t lose the fetus because they finally put the vitamin A in. If you didn’t have any vitamin A for the whole pregnancy, there would be no way that pregnancy could go to term. For some reason, whether they saved enough from their previous diet or were able to mobilize it better, some of these animals didn’t have the outcomes that others did. They’re all bad outcomes and humans don’t want babies that don’t have full eye development.
I have a feeling that with humans, it does happen. There are some birth defects that we or some people suspect that I’ve been reading are attributable to low vitamin A during pregnancy but the very low vitamin A will interrupt ovulation, fertilization, and implantation at one of those stages. It’s hard to know in some cases, but a lot of women that I see do start to ovulate regularly when they have vitamin A and they haven’t ovulated in a year.
Also, if you don’t have enough progesterone, that’s another thing. Vitamin A is needed to create it. You cannot maintain your pregnancy. That’s another one. That’s thought to be partly from a reduced conversion of that very important molecule cholesterol to pregnenolone, which is the next step in the synthesis of steroids. As we know, cholesterols are one of our friends when we want to reproduce. The egg is a great vehicle for both cholesterol and vitamin A. That’s why I always tell women, “What is an egg? Do you want to get fertile? It’s something that has the ability to be fertile.”
The egg, the fish roe, and all these things are precursors and symbols of what we should be ingesting. I’m glad you mentioned that bit, Pam, about how some of the animals still were able to hold onto their pregnancy or seem to still have babies or litters that looked healthy because of their own previous inputs from their own parents.
Whatever the differences were, I read briefly the synopsis, the study in a book, and I’m like, “That’s interesting that they all were treated the same and yet some of them had entirely different outcomes.”
It comes to my mind because I live in the city and I see some folks of lower economic class. Somehow, they’re fertile like crazy and I’m like, “I know they don’t have the best diet but maybe their parents or grandparents had a more solid base of real food.” I don’t know everybody’s history and some of the immigrants, too. They might have a better base and that’s why they were able to carry the term and see kids that relatively are well.
We don’t know maybe they were eating a lot of eggs because eggs used to be pretty cheap. Also, fortified cereals in some cases. They used to fortify cereals with a lot of vitamin A. They’ve taken that out but I also want to mention, African-Americans or people of color, in general, are much less likely to have difficulty converting beta-carotene to vitamin A.
Did you touch on how vitamin A deficiency affects men? Were you going to touch on that as well?
I haven’t finished women yet though. There are a couple more things. Lack of vitamin A can cause chromosomal defects. That can cause a miscarriage, especially an early miscarriage. When they gave low-income women vitamin A supplementations, there was an increase in the amount of progesterone that was produced by their placenta. I’m not saying that has anything to do with what you said, but there is this thing where you need vitamin A to make progesterone.
I forgot to mention this, but vitamin A is an antioxidant for both sperm and egg. We talked about that before. It can quench the reactive oxygen species. Finally, this is the most acknowledged role of vitamin A during pregnancy. It’s needed for differentiation. As the embryo goes through growth and into the fetus, all the different cell types have to be created from stem cells. You cannot do that without vitamin A or it’s not done properly. That’s why we can see birth defects like heart problems.
A very common one now is called congenital diaphragmatic hernia, which has gone up in incidents since the 1990s. It’s interesting because that could relate to vitamin A deficiency. Finally, mitochondrial energy. Vitamin A is needed for mitochondria energy and that’s needed for both egg and sperm quality and function. I am touching on the male role here.
Finally, I want to talk about the IVF role. Most of these processes should be occurring during IVF except for the fallopian tubes. IVF, In Vitro Fertilization where they implant the eight-cell blastocyst into the woman’s uterus and that’s where the conception starts in utero. That’s where it’s transferred into the uterus. There have been some studies and I’m particularly going to mention one where they looked at the levels of fat-soluble vitamins in follicular fluid. That’s the fluid that surrounds the eggs that’s within the follicles that hold the egg.
What they found is the vitamin A, D, and E contents of the follicular fluid very much matched the levels of the serum. What was even more important and interesting is that vitamin A levels and also, to some extent, vitamin E levels predicted the fertilization success of each individual egg in the IVF process. The higher the vitamin A and the follicular fluid, the more likely the eggs were to be fertilized and go through that process.
Embryo scores were better. They do these scoring systems. I have to research that and figure out exactly how they do this but there are all these numbers and letters and there are high-scoring ones and lower-scoring ones. They were better with vitamin A and in fact, there was a negative association between higher vitamin D levels in the blood and the day-five embryo scores.
With vitamin D, there was no correlation with fertilization success. There are other researchers that found that vitamin D is helpful and I think it is helpful, but what you are seeing now is women being prescribed 2,000 to 5,000 IUs of vitamin D. Everyone seems to be getting their vitamin D levels tested and I’m not against that. It’s good to get it tested. Is it reflective of what’s going on in the body? Not really but if you know it’s in the 20s, that’s not good. If you start seeing it much above 50, you start saying, “We don’t need to be taking that level for that long.”
I’ve had women come into me with 5,000 IU vitamin D for like years and I’m like, “Why are you taking that?” “My doctor said to take it.” I’m like, “You just can’t take that indefinitely.” We know from what Dr. Chris Masterjohn has written, it uses up vitamin A in the body. Vitamin A and vitamin D have to be partnered. If you wanted to do it the old-fashioned way, the cod liver oil is a great match. I don’t think cod liver oil has enough vitamin D for the winter but if you did in the summer, the spring, and the fall, if you have an access to sun, if you want to do it that way, that’s the best way to get your vitamin D.
The other thing is, at least this is what I’ve heard from the foundation testing of different foods. Lard is a pretty good source of vitamin D and so is so egg yolks. Also, wild fish and fish eggs. For those of your readers who don’t want to do any supplements other than food-based supplements, those are alternatives but I would encourage some sun exposure as well to keep those vitamin D levels up.
It makes me so happy that some of these most effective foods as vehicles of vitamin A are also so delicious. I’m just chiming in on that bit.
I’m in a retirement community mostly because I like to play tennis and other sports with people. I enjoy it. My husband and I have more energy and we stay healthier than almost anybody we know. I have to attribute most of that to vitamin A. It’s crazy because I must not like this when I was younger before the Weston A. Price Foundation came into my life.
It’s great for all ages, but the need for it during pregnancy and pre-pregnancy, it’s not only so a woman and a man can have a baby. It’s so that the baby is healthy. That’s a whole other story about why it’s so important for the baby in every stage of life and including during lactation. It’s irresponsible to force couples to reproduce using all these high-tech methods.
I was thinking about Principle number 11 of the Wise Traditions Dietary Principles. It’s that couples would prepare for pregnancy beforehand. They were eating their most nutrient-dense diet. They were getting that sunshine. They were outside so they weren’t just doing it when they wanted to conceive. They were doing it ahead of time so that their bodies were most optimally ready to bear children and to give them a great head start. They were preparing for future generations even before they came together.
They did not have an alternative in those days. We have decided that we have alternatives to nature and sometimes it’s needed. I do see women like the woman I told you about that need to use that procedure. She cannot get around that but unfortunately, she had to go through a couple of bad experiences so, “Maybe I need to prepare.” She was so motivated by those bad experiences but what we don’t want is there are a lot of women that are having say mediocre experiences that could have much better experiences.
Mediocre is a weird word, but that’s one of the regrets I had because I felt I could have done better. Now, thank God our children are healthy and then my daughters have been able to have children but when you look back and realize that this information wasn’t available to you, you become a warrior for others. That’s what you are.
I’m thinking of the phrase that is attributed to Dr. Price. “Life in all its fullness is Mother Nature obeyed.” What does that mean? It means living according to these natural principles. It flows. Also, you don’t need to go through all these backbend experiences that embrace modern technology, “Forget the past because the past has clues for us.” Some people call what we’re doing now, Pam, as part of the remembering. It’s drawing us back to principles that were the bedrock of healthy living in the past.
Also, for centuries, for millennia. We decide now that when we started with the first test tube baby in the 1970s, this was science. I don’t want to say it’s run amok. They start with this experiment and now it’s become what they call the reproscape. It’s this huge industry and it does not care where the couple is starting off from. There probably are situations that happen in utero in early life that may prevent a woman from normally reproducing or a man and I get it.
There are things about me that I’d be like, “I bet that would be different. I bet I wouldn’t have to wear glasses for distance vision if I had enough vitamin A in utero when I was young because I have those genetics that I need real vitamin A.” I always wonder, “Could I have been better? Could I have been different?” With that said, do I blame anybody? If anybody is to blame, it’s modern medicine. It’s not my parents because I was lucky I ate liver when I was growing up. I don’t think my mother ate liver when she was pregnant with me.
We, as women, and men can’t blame ourselves if we didn’t do everything right because it’s hard to find this information. It’s getting easier all the time, but the internet and all the media and all the social media’s cluttered with stuff and to get this stuff to stand out is getting harder because of the forces outside of us pushing this plant-based diet agenda and also, the money to be made in the modern medical system with this reproductive technology.
The internet and social media are cluttered with stuff. To get the right information to stand out is getting harder because of the forces pushing this plant-based diet agenda and the money to be made in the modern medical system with this reproductive technology.
I don’t get referrals from reproductive specialists. Although, I’m thinking of reaching out to this doctor because her patient, the one that I told you about at the beginning, had asked her, “What can I do?” She said maybe you can do something with nutrition. She gave her a list of a couple of supplements, and CoQ10 was one of the things she was taking but she was like, “There’s got to be more.”
You wanted to know about how it affects men and the male reproductive system. As I said before, they get the keratinized things in the reproductive tract. It’s the epididymis, the prostate, and the seminal vesicles. They can become keratinized. Again, that’s going to be hard for them to produce the right type and number of sperm because everything that happens in the body, metabolically biochemistry happens in a fluid solution. Nothing happens to any great extent.
In fact, a keratinized cell is a dead cell. We know that the skin on the surface of our body is dead cells. There’s no biochemistry going on here. It doesn’t happen underneath where there’s moisture. That’s what we need. We need a fluid medium to do everything biochemically in our bodies. If you think of that in and of itself, that’s enough right there to stop everything.
They don’t put the egg in the sperm together in a dry jar. They put it in a Petri dish with a medium. We need to make sure our medium and our body are full of the nutrients that we need and we have plenty of it. Also with men, that could be problems with the DNA. It’s an early miscarriage. It has too many genetic defects to survive.
Medically, it’s called a spontaneous abortion. I never use that word. With women, I use it but everybody thinks those things are so common now. They say 50% of pregnancies end in spontaneous abortion. Sometimes women don’t know they’re happening. Sometimes they’re so early that women don’t know. There’s this thing called a chemical pregnancy, which is probably a very early spontaneous abortion where the HCG goes up, and then all of a sudden it drops but there’s nothing you can see in the uterus. It’s probably reabsorbed.
Pam, I feel like you’ve given us so much information. It’s amazing. I will put a link to our previous conversations so they can even find more sources of vitamin A to rectify vitamin A deficiency for fertility and for a healthier, more energetic life, whether it’s a man listening or a woman. I also wanted to wrap up now with the question I like to pose at the end. If the reader could do one thing to improve their health, it might be related to fertility, or it might not. It might be related to vitamin A or it might not but if they could just do one thing to improve their health, what would you recommend that they do?
As a dietician and a Weston A. Price number for many years, there are so many things, but I would have to say eat liver.
There are ways to go about it so it’s not unpalatable. You can have pâté.
Look up the liver files on the Weston Price website and there are other resources, but certainly, there are 1 million things that contribute to our well-being that is what I would have to leave your readers with because that is a turnkey, in my opinion, to much better health if you’re not already doing so.
Thank you, Pam, so much for this conversation. It has been a delight.
Me, too. Anytime, Hilda. I look forward to seeing you and everyone else. I’m supposed to be giving a talk on this and look out for my article. I always look forward to lots of interaction with people because I learn more when people ask me questions and tell me things that they’ve experienced.
If someone is having fertility issues, obviously they might seek out a health professional near them, but do you have any quick words of advice or resources, Pam, for that person?
It’s interesting because there are a lot of so-called professionals trying to do what I do and maybe doing it better but I noticed that there’s a tremendous amount of interventions that they’re using just by reading their blogs and following some of the things they say or and looking at the cost of their services. There’s got to be a lot of things that they’re testing and they’re intervening on.
For some people, I have a feeling that’s helpful but I know one of the reasons I do what I do, and I don’t charge probably as much. I know I don’t because I charge insurance rates to serve couples because first of all, this is partly a labor of love. I want this information to be accessible but then the other reason is sometimes it’s not that hard to fix. Sometimes it’s working with someone who knows how to identify nutrient shortfalls and then if not, there may be some genetic things going on.
What I would say for those who are looking to start with the fundamentals. Lily Nichols has written a great book called Real Food for Pregnancy. I’m coming out with this article. Sally Fallon Morell has wonderful articles on this. There are more articles on vitamin A on the Weston Price website. There are also some other nutrients. I’m always trying to find the simplest answer to something before you go on because you can get sucked into these alternative practitioners that want to do everything.
They want to have you spend $3,000 to $4,000 right off the bat, and they’re going to do tons of testing. A lot of this testing can be helpful, but you should work with a practitioner who knows how to first look at the most obvious and correct that. Unless you’re in this tremendous hurry and you want to get pregnant ASAP and you want to make sure you haven’t overlooked anything. I noticed that it takes about 2 to 3 months to see a woman start to ovulate and maybe 6 months to get pregnant if everything else works well.
With that said, I do have some patients that have not been able to get pregnant. I don’t necessarily work with their partners though and that is super important. A woman should not take on this as if she has the only responsibility because about a third of known causes of infertility or subfertility they think are women-related problems. A third are men’s problems and a third that they know of, they’re not sure about. It could be either or both.
However, there is 50% of unexplained infertility and that’s what we’re seeing with nutritional problems, the unexplained fertility. Even explained fertility such as block tubes, that could be a sign of vitamin A deficiency in the past. That’s all I’m trying to say. You don’t have to spend $5,000 to get answers in many cases. Don’t assume that because that is a financial burden on a lot of young couples.
You mentioned Lily Nichols’ book, and Sally Fallon Morell has resources on Weston A. Price website and her own NourishingTraditions blog. You’ve got this article coming out in the journal. You’ve mentioned foods in the show, but are there any foundational supplements that are your go-tos?
I don’t do that a lot because a lot of women get nervous unless their doctors tell them to. In fact, some women will stop taking vitamin A as soon as they’re pregnant or right before they think they’re going to be pregnant. They will stop it because they believe it’s not good. A lot of times they’ll say, “Replete it yourself.” I can assume that they’re doing a certain amount of vitamin A in their diet, etc., like 5,000 IUs for six months.
They probably built their liver stores up but I’ll always tell them right before the pregnancy, like the last month, to take something with vitamin A or eat something with vitamin A because it’s going to make your lactation better. One woman didn’t do that. “I’m having trouble making enough milk.” I asked her and she says, “I forgot.” I hadn’t beat her up or anything, but she was one of the ones that stopped doing what I asked her to do during pregnancy. I’m like, “I can’t do anything about that. I’m not going to tell her to do something she’s uncomfortable with.”
You were asking, if you have low levels of CoQ10 in your body, that’s usually a result of, I believe, too much ox oxidative stress in your body and that you can take CoQ10 and that’s great, but get rid of those fried foods. Get rid of vegetable oils. Get rid of any processed foods to try to get stress out of your life. Do not over-exercise. That’s a big source of oxidative stress in your body.
Another one would be melatonin. A lot of time, melatonin can be helpful. Melatonin as we know, your body would be best able to make it if you go to bed close to when it gets dark and wake up when it gets light, get outside in the morning, and make sure everything’s dark in your bedroom. If you have to wear a face shield or an eye mask, do it, but try to make your room dark.
Myo-inositol is a big one for women with insulin resistance. It also is known to improve egg quality. The interesting about myo-inositol, it is made by the body and it is in some foods. It’s considered the second messenger for glucose, and they believe that some people genetically don’t make enough. That’s something that with women with PCOS if they take myo-inositol or a combination of that in D-chiro-inositol.
Pam, that is great. This is helpful. This is a handful of resources for folks who could check out this minisode. I’m grateful that you spent an extra five minutes.
If you don’t like liver, get desiccated liver or get the organ meat blend now that companies sell. You can do that too.
Some people can tolerate either frozen bits of liver, desiccated liver, or capsules.
You can do that too. It’s a very good idea.
It’s a way to get it into the diet without having to taste it if you struggle with it. Thank you so much for this extra time and your insights. We appreciate you, Pam.
Thank you and the Weston Price Foundation for changing my life. You
Our guest was Pam Schoenfeld. Visit her website, Women And Family Nutrition for more information on this topic. Be sure to be on the lookout for her article in an upcoming Wise Traditions Journal. The quarterly journal goes to all members four times a year. Become a member now so that you can get it as well. Go to Weston A Price and click on the Become a Member button. Membership is only $30 a year using the code, POD10.
You can find me at Holistic Hilda. Now, for a review from Apple Podcasts. Jennifer Potts had this to say, “This is the most important show I’ve ever listened to. Our world needs to hear this message.” Jennifer, thank you so much. We are so grateful that you’ve enjoyed it and that you want to get the word out. You can get the word out too by subscribing, first and foremost, following the show, and sharing the links. Sharing these episodes with people is a wonderful way to get the word out. Thank you once again for reading. Stay well, my friend, and remember to keep your feet on the ground and your face to the sun.
About Pam Schoenfeld
Pamela Schoenfeld, RD, LDN, is a registered dietitian who practices in Raleigh, North Carolina, focusing on family and reproductive nutrition. She handles Governmental Relations as a member of the Board of Directors for the Weston A. Price Foundation.
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