In this episode of the root cause medicine podcast, we will be discussing infertility with Dr. Daniel. Okay. What's happening now is that women are getting female hormone issues at younger and younger ages. We routinely now run labs on women in their twenties whose hormones look like my 85 year old patients. That is truly frightening. The root cause medicine podcast, each episode focuses on giving you the information. You need to understand the root cause symptoms and treatments available for specific medical conditions. In each episode, we'll meet renowned medical experts, specialists, and pioneers who have influenced the way certain conditions and diseases are understood and treated. I'm your host, Dr. Anthony Fauci on today's episode. The root cause medicine podcast. My guest is Dr. Daniel Kalish. Dr. Kayla is the founder of the Kailash Institute, an online training program dedicated to building functional medicine practices. Since 2006, the Kailash Institute has helped grow practice models for more than 1000 practitioners worldwide. Dr. Kayla is a highly sought after speaker and presenter in the integrative and functional medicine spaces and is a current presenter for the Institute of functional medicine. Dr. Kaitlin proudly served as an advisor to the honorable Patrick Kennedy and is also the author of numerous books. One of which is titled your guide to healthy hormones, among many other things. Dr. Carlos has co-published a research study on the evaluation and management of women's. Among many other things that Dr. Kayla has done, you can find more about him at Kayla's wellness, as well [email protected] Dr. Kayla, welcome to the show. It's great to see you. I'm so thrilled to have you here. Thanks for having me. I appreciate it. You know, a tremendous amount has happened this past year, Dr. Keller and I was actually recently reading through the journal of the American medical association and they actually released a review on July 6th, 2021 this very year, which discussed the diagnosis and management of infertility. And it actually reported that approximately 12.7% of reproductive age women seek treatment for infertility each. That's a lot. So this comes out to about one in eight women. So this is a heavy topic, you know, when many people hear that can't have kids it's can be pretty saddening. So in your experience, what are some of the most common root issues you see with women and men when it comes to this? When I just think it speaks to the whole global epidemic of everything that we see right. With diabetes on the increased metabolic syndrome problems on the increase cancer on the increase. So people are just becoming less healthy overall. And I think women's, and men's fertility just get swept up in that, but this goes back to like early 1990s, 1992, when I was first studying this. And my first teacher was a man named Dr. John or Lee wrote a really famous book back in those days called what your Dr. May not tell you about progesterone. And in the nineties, they were sounding the alarm bells about reproductive problems with fish, with frogs that humans were starting to get caught up in this. But that was 30 years ago. And there were, again, 30 years ago, there were whole categories of fish that were no longer viable. They couldn't reproduce anymore. And so it turns out that our hormonal systems for all animals, it's not just humans. Right? All animals, their reproductive systems are very sensitive to environmental toxins to changes that we are sort of invoking upon this planet. And I think we're just seeing the long-term effects of that. It's starting to get noticed. So true. I absolutely resonate with that. This has been going on for years and years and years, just as our grandparents do not have issues now with eating certain foods, it's now becoming a problem as it has for a while. So, absolutely so true. I mean, how do you identify some of these other root issues though, aside from doing a, maybe an intake with your patients or helping out with practitioners? Yeah. I mean, there's some big picture issues, right? Like one is I just chronic malnutrition. The person has had a poor diet for their whole life. They just don't have the vitamins minerals. They need fatty acids that they need to make all the hormones and to make the hormones work, you know, and then there's digestive problems often see, almost always see accompanying female hormone issues. So infections in the gut leaky gut damage to the gut lining damage to the immune system. The gut, those kinds of problems usually are going to lead to a hormone and bad. Heavy metals chemicals. And now that's another thing that, you know, I think about hormone production, what regulates the amount of hormone circulating in the body is how they're cleared, right? So it's not just that sometimes you can't make enough hormones or don't make hormones at the right times, but then the liver is ability to clear hormones can get disturbed, which means that as the same net effect is making the wrong amount of hormone. You know, if you're not clearing the right amount of the hormone, because what ends up circulating in your bloodstream is, is not right either. And so you can have liver toxicity issues that can lead to these kinds of problems as well. And then I guess you could overlay on top of that intense emotional stress kind of economic and political instability that sweeping through the world. I mean, people are just kind of worried now and, you know, maybe they don't feel as sexual or have sex as often, or just not as sexually vibrant when we're for men and women, both. Right. When we're under that kind of intense stress, because the stress hormones shoot. And when the human being, the human body prioritizes survival over reproduction, right? So when stress, hormone, surge, and catecholamine surge and the thyroid gets a little walked out, then the sex hormones often take a hit in response. So very true. And you brought up some really good points there. If you can. Dr. Carlos, can you really dive into the different links between fertility and reproductive hormones and then some of these other organ systems like the thyroid and the gut systems? Because I really don't think many people realize how everything is truly connected in the body and how a lot of these root issues are impacting each. Yeah, I know what I've been telling patients this for 30 years, which is that I've never had a case where the ovaries spontaneously malfunctioned in complete isolation from the rest of the body. I'm sure that's possible. I've just never seen it. I've never heard of it either. In any of the cases that I've seen in the training programs. No. I teach doctors every week. We have five hours of class a week. We have hundreds of cases a week that I review. And so you think I would have seen it by now. That was a common part. In other words, the ovaries are responding to their response team. And so I think about it, like if you were an alien looking down on this planet and you saw these fires breaking out in cities periodically, and then you always would see these red trucks there, you know, you'd be like, Hmm, these guys driving around in red trucks, setting fires. No, that's the fire department, right. They're trying to put the fire out. So we don't want to blame the response team. For what's going on. And what's often going on is come kind of internal fire, right? Some kind of internal inflammatory process in the body. That's generating this. And so if it's inflammation in the gut, if it's inflammation in the liver, if it's inflammation, cause you're stressed. If it's inflammation, cause you're eating inflammatory foods, whatever that source is, right. Then all the hormones sort of jump on. So the thyroid hormone conversion gets thrown off from that inflammation. The ability to make cortisol and DHA and the adrenal glands gets dysregulated. The brain's not doing so well telling the adrenal glands what to do. And then somewhere in the midst of all that dopamine gets thrown off brain chemicals, catacholamines start to surge, epinephrin norepinephrine and adrenaline, all that stuff, surgery. And then somewhere in the middle of all that stuff, progesterone and estrogen start to falter, but it's always contextual, right? It's always in response to this. What should be a hormone symphony of coordinate? Beautiful things happening just gets a wrench. Then things start to get through. Absolutely. And you talked a lot about inflammation and some of these other things that can ruin the body then leading to these conditions or diagnoses that people are often labeled with. Right. And so when we separate the body systems, like that can be very difficult then. Without identifying the root issues. Those people are then stuck with being on a specific medication or something further and further getting away from the root issue. So it sounds like it's kind of safe to say that a lot of these root issues can be an infertility in particular. It can be mixed in and mistaken for conditions like PCOS or endometriosis or even other symptoms like heavy menstrual cycles or irregular menstrual cycles. Is that. Yeah, absolutely. And in fact, you know, I think that most women that have fertility problems, if you had get their history done well enough have had hormone problems 5, 10, 15 years prior, if you can go back enough to your point, you know, like, oh yeah. When I was 18, I was diagnosed with PCO S or when I was 15, I got put on birth control because I was having migraine headaches related to my menstrual cycle. So again, it's rare that the fertility problem is the first sign that there is an imbalance in the hormones. It's usually. The one that is bad enough that they want to go see a bunch of doctors for it because it's a pretty serious. Okay. Yeah. I mean, that, that makes sense. There's a lot of people suffering clearly from infertility, if it's one in eight women. So what about women who have been diagnosed with conditions like uterine or fallopian tube issues? How does, how do you differentiate those problems from some of these other root issues? Yeah. Well, you know, what's interesting is that there are these month-long female hormone labs that are available, right? And so you can just do these month long panels and see if it's a timing problem or production problem, or oscillation timing problem with the hormones or not. And it's, those are rarely done in fertility cases. And so most of the time doctors are immediately looking for more complex potential problems, or they'll give this diagnosis that the woman's have. And obviously cycles or she's sort of not ovulating at all. Right? Like she's infertile, cause you're not ovulating. And then you'll run a month long lab. This I've seen this hundreds of times, then you run the month-long lab and you're like, oh, well, yeah, you're oscillating, but it's on day seven. It's a little early. So they didn't see it. Or it's not, we just had one in class last week. She was obviously getting back on day 23 or something. So like a week late, right. Eight days late. It's very rare to see women that don't ovulate. Usually when they're diagnosed with some kind of more dramatic condition, like they're not ovulating it's because the timing of the cycle is off. And you can capture that if you do a simple test and again, I'm sure there are people that exist that really do have these more serious medical issues, but the vast majority of women that have her fertility problem, you can see it on these blood tests and you can see the underlying causes for it on the other functional medicine tests that we do. Well, that's great news. So the one in eight women who are suffering with this who are listening might not be able to, might not necessarily have to continue to deal with this. If they get some of the proper testing. Is that correct on no. Absolutely. If you see someone who's experienced has done a bunch of fertility cases, the odds are in your favor that you could have it solved. I mean, it's certainly not a hundred percent, but I'd say the vast majority of people can be held traumatic. It takes some commitment, though, right? Obviously you have to stop drinking coffee and you have to, you know, eat a really healthy breakfast and there's things that you have to do to participate, to make it happen. But most of the time when women want to have a baby, they're all too happy to make these changes where perhaps it may be, it'd be harder to do if you didn't have that kind of pressure that you want to have a child on you. Absolutely. I think the birth of a child definitely can make people jump into action a little quicker than most. You talked a little bit about potential risk factors. Like you're saying us, we have too much maybe coffee consumption or some of these other things. Can you dive a little bit into maybe some of these other risk factors? And then again, how do you test? And you mentioned some of these tests as well. Can you elaborate. Yeah. So by risk factors, you mean like lifestyle stuff that people do? Yeah. Like lifestyle respecters. And again, just whether that's weight management, whether that is again, types of food that they're eating, whether that is the chemicals, they might be exposed to all these different things. Stress. Okay. Yeah. So, I mean, I try to look at it in a systems basis, right. So we think of these three body systems. So the first one would be related to the hormones themselves, including stress work. So if there's a lot of emotional stress, dietary stress, and planetary stress, anything like that, going on, that's significant kind of have to figure that out. The second system is the microbiome and it's amazing. Like we did this years ago when I used to work in one of these labs, maybe 25 years ago, but we took like a hundred of the cases that had the most severe female hormone imbalances, like fertility and other kinds of problems. And then we lined up next to the. All the GI testing that we had and the gluten intolerance testing that we do. And you could just see it on this wall. We did this, we must've been bored. I didn't know there was a lot going on. The phones were ringing or whatever this day, but you can literally see this on a wall where as these hundreds of patients of labs got worse in terms of hormone imbalances, their digestive problems just parallel that in exact accordance. Right. And when I saw that, I was like, oh, maybe this is a thing. Maybe if you're not digesting, well, you're not eating well. You've got parasites, bacteria, yeast, overgrowth. Uh, you know, this whole like suppressed immune system in the gut lining and you're not absorbing nutrients. Well, maybe that makes it really hard to get pregnant. Right? Because that in and of itself is the origin of a lot of hormone imbalances. And so the corollary of that is that you can fix the gut, right. And you can fix the diet. And then that in of itself often corrects the hormones, not by itself. And you still have to test the hormones with correct. And then the other system that we see with a lot of problems or all these liver detox issues, because it's such a toxic environment now. And a lot of the environmental toxins chemicals and heavy metals act as endocrine disruptors specifically. Right? So when they get into the body tissues, they just, you just buzz line, right. For the hormone receptors and interfere with them. In fact, there's this whole class of chemicals that are. Xeno estrogens, which means that they're just similar enough to estrogen to get into the estrogen receptors. Right. And to act like an estrogen, but in a really evil kind of way. And so that's from plastics. You can even get that from like microwaving your food in a plastic container and then eating it. I mean, there's lots of ways that people get Xenos. You don't have to be working around pesticides and that kind of thing to get the exposure anymore. And so, yeah, the list kind of continues on and on. And the other really big one is insulin resistance. I mean that, one's pretty hard to overcome. That's going to almost always cause other hormone imbalances, obviously insulin is a hormone itself, but that's going to often kind of bleed over to causing female hormone issues. Absolutely. That's really, really important points. And so for all of these types of issues that you're explaining and health concerns, how do you test for a lot of this? Yeah. So this is the fun part, right? Is that you can do labs for this. So your test thyroid, obviously there's some really standard thyroid panels. You can do this and more advanced thyroid panels. You can do they'll look at things like the antibodies and the free thyroid hormones, as well as the regular TSA. So they do so usually one of those and then a complete adrenal panel. Cause the stress hormones can have a really big impact looking at cortisol and DHA. And then if it's a fertility case, we always do these month-long female hormone panels. So they look at estrogen and progesterone production over the course of a whole monthly cycle and they map out what your production is. So you do a saliva. About every other day for a month. And those give you the most information you can imagine, because you can see when estrogen is spiking. If it's spiking earlier late, that would lead to a problem with ovulation timing because he, how much progesterone is being produced. And it's common to see not enough progesterone being. And there's really straightforward protocols for correcting those monthly female hormone panels. And then the testing that I'm really into now in the last five, six years is like a comprehensive metabolic assessment. Right? So for those, we look at fatty acids, amino acids, and organic acids, all the vitamin and nutrient levels. And you can tell so much from that, right? So for example, fatty acids are used to make hormones, amino acids are required for all the enzymes that we're talking about. They make all these conversions. That part is beyond the organic acids. Look at all the detox pathways in the liver. So those more advanced metabolic panels really kind of shed a deeper light. Oh, and then the big one I forgot about is oxidative stress, right? So if women are under oxidative stress and men too, that's going to lead to some pretty severe hormone issues. And when I think about it from the biggest picture, I think of like four big problems. Oxidative stress. I call them the four horsemen, oxidative stress, insulin resistance. Are you catabolic or not? Catalog physiology kind of blog means that you're breaking things down. That's kind of the adrenals and the whole stress response part. And then they say oxidative stress or the Australia's catabolic physiology, insulin resistance. And forgetting the fourth horseman and blocking it out. Now it'll come to me. This that's okay. Yeah. 30 horsemen for today, but I think we have a good understanding of what you're explaining. That's so fascinating for those of you who are listening to what is really the difference between testing a lot of these things that you just explained and getting to the root issues versus the traditional testing for infertility. And what does that treatment look a little bit different? How does that. Yeah. So the conventional treatments, I'm not against these, why don't women have success with these, but the conventional treatments really look at it as an isolated problem. Like the ovaries are spontaneously malfunctioning as if they are unrelated to the entire rest of the body, the emotions, spiritual life of the person. Right. We're just going to take control over this cycle. We're going to force you to ovulate. If you're not ovulating, if that doesn't work, then we're going to just grab an egg and fertilize it and force you to hold onto the pregnancy. And I find in general, those treatments can be well, if they work great, I don't ever talk to those women. Right. They wouldn't come in, but when they don't work and they come to see a practitioner like myself, usually the woman has been kind of a little bit traumatized by it. You know, her obviously they've been manipulating her hormones for awhile and forcing various things to happen. And there has an emotional toll. It's sort of like a chemically induced PMs type problem. Oh, there's pretty severe. And then usually then her cycles kind of struggles to get back to any sense of normalcy. And I think he can be a very frustrating and expensive experience for a lot of people. I would say the majority of fertility cases I've had have already gone through IVF or some kind of fertility treatment and that didn't work after a few rounds. So they'll come to see. And if you're listening to this and you have a fertility issue, it makes sensitive the other way to try the natural treatments first that are a little less invasive and easier to get you through without all the drama and trauma. And then if that doesn't work, then you could escalate to the more conventional approach that would be a more logical way that sequencing thing to do in my world. Sound. It makes sense to always start with a conservative route. First begin, before beginning, further internal and more in depth procedures and treatments and stuff like that. In Decker case, you know, genetic testing is now become very, very popular all over, not just the United States, but the world. And so do you believe that you think that genetics are also playing a role in some of these risk factors that you discussed with the insulin dysfunction and oxidation and environmental chemical? As a whole for infertility. Yeah. I mean, we look at that a lot now. So I do these complex tests that are, you know, look at the genetics of all these metabolic issues that I was talking about earlier. And I don't know what percentage, I never really thought about it that way, but it's common. I'd say, you know, every week in my practice, I have a couple patients where the origins of what we're talking about are really genetically based. And there is some kind of defective enzyme in their system that they just don't make properly or some kind of B vitamin that they don't handle very well. And that leads to all these different problems that we're talking about. And in those situations, there's always like a disconnect in that the, the woman's lifestyle factors and how well she's taken care of herself, don't really match what the labs show. Right. And so you can, there's a variety of kind of, sort of mathematical techniques you can use kind of number crunchy. To look at the lab markers and see if there's a genetic basis to the problem or not. That doesn't mean that you're in a lot of trouble. You know, it means that to me, this is not your fault kind of, I guess, and you can still treat the person. And usually if there's a genetic variable, then the treatment dosages have to go quite a bit higher. So instead of 50 milligrams of B6, you might need 200 something like that. And then the treatments obviously need to go on for a little bit longer if there's a genetic basis of the problem, because if you can't really fix the genes necessarily you need to more work around. So that you're getting a solution, even though there is a genetic flaw in the system. That's very interesting. Dr. Kellis, you know, one of the other things that it sounds like commonly is blamed for potential fertility or infertility issues is age, right. And as a woman becomes older and, and don't worry for all the males listening, we're going to get to you guys here. But as a woman ages, you know, the ovaries produce less eggs, but it's not necessarily uncommon for women to become pregnant at age 35 or older. So for all the women who are listening that are getting to that age, can you explain that how that's possible and any associations with that kind of old, you know, I've been doing this 30 years and so I have. Patients that come in now that are the kids of my first round of patients, which is a little freaky. So this happened a couple of years ago, this woman came in and she's just, I'll make up a name. It was, her name was Mary and it's not her name, but Mary came in and I'm like, okay. And she's like, Susie is my mom. I'm like your mom. And the last time I saw it as women, she was like, literally five years old. And now she's like 30 to do the math on that. Okay. So I've had the privilege of being able to see this sort of spectrum happened. Right. And for sure, for sure, for sure what's happening now is that women are getting female hormone issues at younger and younger ages. So like we routinely now run labs on women in their twenties. Who's hormones look like my 85 year old patients. Okay. And that's Friday. That is truly frightening. And that is, I think, an impact of changing times, right? How the planet has changed, how the soils have changed. Quality-wise how environmental toxins have changed, but whatever the changes are that are happening, that are driving this. And so I think that there are plenty of younger women that say teens and twenties who have hormone problems. That are like a middle-aged woman, whether it's diet related or whatever it may be. Right. And so the corollary of that is that if you take really good care of yourself and you're physically fit and you eat extremely well, and you do all the right things in terms of supplementing and taking care of yourself, Go through your twenties and thirties, you can be incredibly healthy in your mid to late thirties and easily have a baby. Whereas a woman could be in her early twenties and struggling because maybe she grew up in a socioeconomic situation where she couldn't get good food or whatever it may be. That'd be driving some of these problems in really young women. So it, it does seem that, you know, especially in the circles that I often, most of my practice years were in Del Mar California is you're pretty well to do clientele. And everybody had the time and money to buy organic food. Do all that kind of stuff. And so I think that crowd does quite well, but people that don't have access to those kinds of resources, no definitely are going to have fertility problems at a higher rate. They're going to be more significant to try to fit. Interesting. Well, that's a, both a pro and a con at least the good news is we know that it's capable and there's not potentially many issues with kissy being older. As you get older, as long as the overall host health sounds like it is in good shape. So that's a great, that's good news. All right. Mails for all the guys that are listening, it's your turn to carry the torture. Fertility is such a vast topic, but it's true that this area of health is often labeled as just a female issue. For those of males who are listening, Dr. Killers, can you explain all of this, really this condition is affecting and is affected towards males and how this is diagnosed and treated. Yeah. So for men you can have sperm count and mobility and motility, all these things. And the SMN will do that. Hopefully they will. Cause, you know, it's oftentimes I don't know the last statistics I saw and this was almost half of the time. It's really the fault of the man, not the woman. So that at least has to be checked in any couple. That's serious about this stuff. And then sometimes we get men that come in on their own. Sometimes we get men that are dragged in by their partner. Who's like, he's got to get tested too. And there's some kind of off the shelf nutrition. Solutions and the ones that you see the most often on the labs that I do is you'll see nutrients related to sperm. That are compromised. And the two key ones are zinc and Argentine. And so if the couple, for example, maybe they can't afford to do all the testing for the management. Then I usually will recommend men take 3000 milligrams of Argentine a day and at least 30, maybe 50 milligrams of zinc a day, and a really potent multivitamin and those things together can get sperm counts and spur mobility, motility, and all that stuff back up. If they can do the testing, it's even better because then you can get more specific with additional support for the body. But those are the, like the fundamental basics that should be covered by anybody. Interesting. What would be some other things that a man can do to optimize his body? So that is his body and his sperm are very healthy. Even outside of some of these supplements you recommended. Oh yeah. In terms of lifestyle lifestyle-wise, I mean, it just comes down to such basic things. Again, almost gets embarrassing to just keep saying it over and over again, but, you know, The basis of your health comes down to how much fruit and vegetables you eat. There's very few people that are protein malnourished. I mean, that's really rare. So, but almost everybody that I work with is dehydrated. They don't drink enough water. We'll have another sip here. My water add very important. Buy a good water filter. Yeah, I get a good filter. It costs 200 bucks, but then. So dehydration number one, nutritional deficit that we see and then just not eating enough fruits and vegetables. And that leads to things like zinc, deficiencies, and magnesium deficiencies, calcium deficiencies, copper deficiencies, and you'd be amazed how important all these minerals are. And then of course, the antioxidants that are present in vegetables and fruit have this massive anti-inflammatory restorative effect on the. And if you don't eat those every meal, then you're going to run a deficit and then everything's going to not work that well. Right. It's so true. I mean, as you're saying though, this trend. Getting to the root issue and really addressing it. A lot of it comes down to the lifestyle choices that people make leading to things like infertility in both men and women and all these other conditions that plague play, not just the United States, but all of the world. So it sounds like there's obviously that trend of take care of your health as much as you can eat, right. Get, stay active. So really, really important. Dr. Kayla, you were talking a little bit about medications and conventional treatments in fertility just a bit ago. And when people are commonly using that, if it's couples that are using these medications to conceive, we often know that there's sometimes unwanted, maybe side effects or byproducts with some of these medications. Can you kind of go down that road a little bit and explain this and will this really affect the baby? And a lot of these questions that people may have, I'd say one thing. I guess there's two different scenarios. One scenario is that the troubles trying to conceive and they do some kind of fertility treatment or IVF, and then it works right. In which case, again, I don't really see those people because they're not. But what I often see, I've seen more times than I would want to remember as a couple that's been through six months or a year or two of fertility treatments, and now they've given up because it didn't work. And now they're trying to figure out what to happen. So I've tested a lot of people in that situation. And what we often see is that the monthly cycle is highly dysregulated, you know, and we have to reset it. They pretty much always have insulin resistance or some kind of blood sugar instability, right. Their hormones are off in that regard. And we have to get that reset, get the diet working and get their blood sugar regulated and all those kinds of things. And then do everything to get the GI tract back working again, there's usually like some kind of yeast or fungal overgrowth or something dysbiotic type situation in the gut. And I think some of that are the effects of the drugs that they are throwing off the healthy microbiome and the throwing off the monthly rhythm of hormones. And they're throwing off a blood sugar in a whole variety of. So I was just trying to restore that. Basically it's a doable project though. I mean, it's not like there's any point where it's too late, but I think it just takes a lot more work on the woman's part in terms of lifestyle changes. If she's gone through fertility treatment and it didn't work and now she wants to have a baby naturally, I think it's just kind of twice as much work probably to get things cleaned up, but that. Absolutely. I mean, affecting what about how, the way it affects the baby? Do you think that again, that these, uh, the women that go through that route through the treatments, fertility, treatments and medications, does that affect the baby in a different way than if you were to address it naturally and succeed in that route? No, I don't think it does really not in comparison with other factors. Like, I really don't think it does. I think the things that really affect babies are just the basics. Who their parents are as people. And what they're like in terms of Natchez when they're in an, in utero, but what they're like in their first year or two of life and how much your parents love them. Basically, that seems to overcome just about any of these other challenges that couples face earlier on. I think, but I think because where we see permanent damage in human beings is if in that first couple of years of. There's physical or sexual abuse or they're abandoned in some profound way. People you can even see on MRIs, the brain changes from those experiences. And I think that really leads to permanent problems, but I think the, if the couples loving, no matter how they can see if I think things generally work out for the baby in a good way, that's so true. The nurture versus nature debate is a, I believe is a very valid, valid debate in that respect. So very important to know. So Dr. Killers, what would you say would be the most important tests that you would run and that any female or male listening should be performing or getting when it comes to identifying these issues with fertility or infertility and, and are not really looking to conceive? Well, the month-long female hormone panel, you kind of have to do that. 'cause that'll tell you right away how to actually reset the cycle. Cause if she's having, for example, ovulation on day seven, then there's not enough time. Meaning none of time for the uterine lining to get thicker. The estrogen. If she's operating on date 22, then there's not enough time at the other half of the cycle. Sometimes if ovulation is just weak and there's not enough progesterone output after ovulation, then you need to supplement with progesterone. So I think that's the fundamental question. To get the actual female hormone levels filed in a central one. And it's not done that often. You know why? Cause it's really hard to interpret. It's hard and you get it back and you're looking at your very well, I don't know what any of this means. And it's like this 28 days of data and there's two hormones and they're going up one way and down the other way. And so a lot of doctors kind of shy away from it, even in my mentorship, classmates. I've been teaching this class since 2006, I've been teaching how to interpret the monthly female hormone panels for over 20 years. It's the one that doctors avoid the most, like seriously, a lot of people take my whole year long mentorship and they skip that whole section. I know they do because we can track them. I shouldn't be saying this on a recording, but we can track their behavior and like which modules they open and look at and you know, how much time they spend in there. And they, cause it's hard, it's hard to learn how to interpret them. And so it's intimidating. K. I'm not trying to poke fun at doctors. They just, yeah. And so I really try to encourage practitioners to learn how to interpret those months on panels, because then it's like, once you learn how to do it, you got it the whole rest of your career. You know, they do that and help a lot of women. That's so important. It's the difficult things that get us further along in life though. Right? So for those practitioners are listening as well. It's helpful. You can help a lot of people by learning how to interpret these month-long hormonal. Dr killers. What about for males? What would you think is the best or what would you recommend for men in terms of the best tests to, yeah. Basic metabolic profile with all the nutrients. Right? So that's where we look at amino acids, fatty acids, the vitamins minerals, all that, because that's what you want to know in terms of the health of the sperm. I mean, it'd be nice to see the male hormones in the male microbiome and all that, but that's actually kind of extra because if you just get the guy on the right nutrients, whether it's the zinc or the origin Nene, or maybe they're low. Who knows what magnesium or whatever, then that's kind of the key for them. And it's easier in a sense, cause you don't really have to fix their hormones and fix their gut. If you can just isolate it to those basic nutritional programs, then you can get them back on track. Interesting. Thank you so much for that insight. You know, Dr. Keller's just has been in such an amazing conversation with you today. Always apply. What do you think the future of fertility treatment looks like? Is it along the lines of the functional medicine testing and specialty testing, or is it along the lines of the infertility treatments and medications or a combination of both, but yeah, I mean, I've seen the future of this. It's a very famous acupuncturist named Lauren Brown and he has this acupuncturist clinic in Vancouver. And what does he have? He has natural paths on. He has acupuncture has done staff. Obviously he's an acupuncturist. He has functional medicine, doctors on staff that do all the testing that I've been talking about since we've been doing this call and he's got medical doctors on staff. So he's got this whole, truly integrative clinic and they get referrals from all over the U S and Canada. They are just cranking busy and their programs really, really work well. And so I think that integrated approach is really where it's at and it's way. I mean, like not just more emotional. Healthier and spiritually better, but it's just more, I think, effective in terms of the odds on it. When we getting pregnant, then the more conventional treatments would be. But, and I also think it's hard to, to kind of do this as a solo practitioner. So like whenever I get a fertility case, I always pretty much require in a nice way that the patient also see an acupuncturist who specializes in hormones because you do have to have this interdisciplinary approach to really make this work because there's a lot of different pressures going on for women. And you want to. The body, the mind, the soul, the spirit, the energy, all the different things, you know, that are included in something like acupuncture or Chinese medicine, as well as the functional medicine. That's very, very insightful. Thank you for that. And I think there's many people out there who understand what you're saying. As many people now are seeing multiple different doctors for different types of conditions, where that collaboration and integration of all different positions and types of practitioners is really important to truly not only heal and improve fertility or infertility, but many, many other conditions in the world. Thank you so much for that, Dr. Killer. So again, amazing to have you here, Dr. Kailash for everyone listening, you can find Dr. Kayla shed Kailash wellness.com. It's K a L I S H wellness.com as well as Kayla institute.com. So for everybody listening today, healthy, and until next time, thanks for tuning in the root cause. 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