Unlocking Fertility: Understanding the Connection Between Blood Sugar and Pregnancy with Dr. Christine Maren

This episode is sponsored by Sweet Life Nutritionals. If you're looking for the absolute best supplements created by yours, Dr. Brian Moll, our products contain the highest quality ingredients and the formulas are evidence-based and backed by science. For blood sugar, metabolism, gut support, adrenal health, and detoxification, visit SweetLifeNutritionals.com and use the coupon code "podcast" to save 10% off your first order. Hey and welcome to the new Mastering Blood Sugar podcast. I'm your host, Dr. Brian Moll, and each and every week I bring you cutting-edge information, transformational stories, and exclusive interviews with the leading experts in the area of blood sugar, diabetes, and metabolism. My goal is to cut through the confusion by making complex concepts simple and to give you practical strategies to improve your blood sugar and optimize your metabolic health. Thanks for joining me and I hope you enjoy this next episode of the Mastering Blood Sugar podcast. All right, so Dr. Christine Marin, so glad to have you here with me today and welcome to the Mastering Blood Sugar podcast. Thank you. I'm so glad to be here. Yeah, so I'm talking about blood sugar. Yeah, yeah, we were just talking and you are going to be relocating your practice to Colorado soon and actually by the time this airs you'll probably be in Colorado, which is fantastic. Yep. Yeah, so that's great news and where are you right now? I'm in Michigan. I'm Birmingham, Michigan. We're here for a year. My husband's a physician also, so did his fellowship here. But yeah, so I'll be my practices here in Michigan, but relocating to Colorado and I'm licensed in Texas as well. So I have a lot of patients there. But I'm going back home to Colorado after a long time being gone and I'm super excited. My whole family lives there, so that would be good. Right outside of Boulder, which is my children. Yeah, exactly, exactly. Yeah, right outside of Boulder. So I want to talk to you about just stational diabetes today. Yes, yeah, and I don't think it's enough discussion around it because it's so important and it's for women suffering with just stational diabetes or dealing with it. It can be quite scary and not only scary, it can lead to type two diabetes down the road and other problems, potentially problems with the baby. So let's dive in and talk about this. The other thing is I think because of the nature pregnancy, it's easy for women to get intimidated and scared and just want to solve exactly what their doctor says. And so I want to bring your insight in here as a practicing physician and someone who's dealt with this. So could you maybe share your story first? So we get a little back. Yeah, yeah, absolutely. And I love what you said. I mean, exactly during pregnancy, it can be a very scary time for a lot of women in your pregnant and like who are you supposed to listen to? And you need to know now, right? You have this baby growing inside of you. And I understand that there is this, you know, a sense of urgency because I've been there. But my story, you know, as I was saying, like I grew up outside of Boulder, I was sort of like just used to this very natural approach to medicine and healthy living and you know, went to an acupuncture list when I had issues with my hormones or whatever. So I grew up with a very holistic sort of background, but I went to undergrad and Boulder and I went to medical school. I decided, you know, I was going to go to medical school, but be a holistic practitioner. And part of what brought me into functional medicine was really my experiences with pregnancies. I realized that acupuncture wasn't enough for me and that I really needed to delve deep and figure out what was really going on at this, you know, just root cause medicine. So it started really with gestational diabetes with my first pregnancy, with my daughter. I was diagnosed with gestational diabetes. I mean, I was a super normal way to have no risk factors you could think of. So it was pretty off the wall. I was surprised. And at that time I was resident in San Antonio. So like all of my patients had diabetes, but they were very different. They were, you know, they had a strong family history of it and they had all the risk factors. I didn't. And so that really caused me to sort of look deeper as to what was going on with my health and why I was having this reaction. But I also learned a lot about nutrition and I got really interested in foods and what those did your blood sugar. And so it was very empowering in a way and led me down a pretty specific path. But yeah, it was interesting because when I was diagnosed, you know, I received a lot of medical advice and had an appointment with a dietician. And luckily, I was equipped enough to know that the advice that I was given was not going to be to my benefit or to my baby's benefit. And I sort of went on my own path of figuring out like what I really need to do. What do I really need to be eating? What was some of that advice that you're given that that at that time even you realized was maybe not the best advice? Yeah. So a high carb whole grain diet. Of course, they recommend against eating sweets and cake and sugar, you know. But starting my day off with oatmeal was not the way to go. I mean, that was definitely something that would spike my blood sugar. I think the whole grain advice is very confusing for a lot of people because they think, oh, whole grains, okay, I'll eat whole wheat bread instead of white bread. But really, there's like, you know, no difference to your blood sugar. As you know, it's like totally negligible. So that was a big piece. I mean, essentially, the advice you get when you're pregnant has have about 50% carbs, but low fat. So what are you supposed to eat? Right? So like if you're not eating a lot of fat, you have to replace it with carbs. I mean, obviously, there's protein in there. But you know, I pulled up some recommendations. Actually, I want to read these because they're kind of scary. So one of the recommendations from family doctor org actually sadly, some of family physician, but it says if you get hungry between meals, eat foods that are healthy for you such as raisins or a piece of fruit, whole grain pasta, whole grain breads and rice are also good for both you and your baby. And that's in reference to gestational diabetes, right? So it's like, ah, no. I mean, that's not, you know, that's what spikes your blood sugar. So during my pregnancy, I learned, you know, I went to the pharmacy and got my glucose strips and my lancets and figured out what that was about. And monitored my blood sugar at least four times a day for like literally six months. So I watched it like a hawk, but I learned about exactly what those foods do. And I think, you know, self-monitoring blood sugar for pregnant females, specifically those with blood sugar issues is really empowering because you get this immediate feedback as to what certain foods are doing. So. So gestational diabetes is diagnosed with a oral glucose tolerance test, typically. Yes. Yeah. And if you have gestational diabetes, you're found to be intolerant to glucose. In other words, you don't tolerate glucose well. Yet the recommendations are to start your day with a ball of oatmeal, which has 70 grams of starch. Chains of glucose. And then if you get hungry between meals, you're supposed to eat more glucose and make at least half of your diet sugar, you know, which is, yeah, you know, glucose, but a lot of glucose in there. So for somebody who's tested and shown to be intolerant to glucose, why do you recommend is to eat a lot of glucose? I don't know. It's super weird, right? I mean, the other, if you look, you know, online or in medical literature, the other word for gestational diabetes is carbohydrate intolerance. But they're like, a lot of people say, but you need to eat a lot of carbohydrates. So I know one of the underlying reasons is because any pregnant female knows every time you go to the doctor, you get your urine checked. And when they check your urine, they're checking for ketones. Ketones would indicate not enough caloric or, you know, could potentially indicate caloric restriction. And ketosis for different reasons. Some of us go into ketosis purposefully, not during pregnancy generally, but, you know, a ketogenic diet, high fat, low carb, that sort of thing. So, I mean, there's definitely some arguments about that and testing urine strips for ketones, certainly don't correlate with serum ketones. But I think that most of that recommendation comes from from keto strips or from, you know, monitoring for ketones in pregnancy. And I don't know, honestly, I mean, I think, you know, look back at all of our dietary recommendations. I mean, I just, I think the gestational diabetes recommendations are even further behind the recommendations that we see for a normal population. Right. Because it's sort of, it's the ultra conservative. Yeah. Like, go back to the food pyramid and don't change it for several decades. And right. I think it just, it just archaic and nobody is caught up on those. Okay. So let's get back to your story then. And, and so you looked at all these recommendations and said, I know enough to not do this. So, yeah. What did you decide to do instead? Yeah. So what I did, I mean, I, I got out my calculator and looked at, you know, based on my weight and about a 2000 calorie diet, how that would divide out into percentages. So, you know, that recommended carbohydrate intake, it depends who you're looking at in terms of papers, but it's anywhere from 40 to 55%. At that time, I was told to eat 55% carbs, 25% protein, and 20% fat. So what I learned just, you know, by self-moded during my blood sugar, and obviously having been trained as a physician was that what I needed was more like 25% carbs if that. I mean, I dropped the lower at times, but then I would have ketones. So I had a pretty balanced approach, but I did 25% carbs, 25% protein, and 50% fat. So pretty high fat diet. And what type of carbs were you eating, and then where were you getting your fat? Yeah, great question. I mean, because obviously not all carbs are created equal. So my carbs were really plant-based. So like a sweet potato or spaghetti squash, things like that. I try, I mean, I still do that, right? Like I try not to eat processed things. And I think it's important when you talk about carbs and whole grains even for somebody who's eating whole grains, you know, maybe eating whole intact grains like quinoa is not going to spike the blood sugar as much as a not intact grain, like whole wheat bread. I mean, I don't think of whole wheat bread as a whole grain really, but most people do, right? But it's processed. It's highly processed. So really, it's like, I think intact grains is a better way to put it. I'm not, I don't do tons of grains myself, but I think, you know, some people would tolerate a little bit of quinoa, or maybe even like jasmine rice to a very small degree. So, but yeah, I mean, mostly if you have blood sugar issues, it's like plant-based carbs as much as you can. Yeah, well, that makes sense. And, and you know, the other unfortunate thing about, I think some of the recommendations, not just for people with gestational diabetes, but type two diabetes, pre-divities, even type one. Yeah. They don't really differentiate between the types of carbohydrate to them carbs or carbs. And that comes right from the ADA. Yeah, right. And it really doesn't make a difference according to them where you get your carbs. It's, you know, they, they will say maybe cut down on sugary drinks. Right. That's just to cut carbs in general to a allowable range. But where yet, it doesn't make that much of a difference. And of course, we know that food is way more than, you know, something you can calculate on a piece of paper. Absolutely. It's way more than macronutrients. There's so much more to food. Yeah, it's so much easier to think of things as black and white. But it's, it's never black and white I mean, our bodies are so complex and biochemistry is so complex. There's no black and white, you know, it's not calories and calories out, of course. But, but yeah, it's interesting to see, you know, how then food sensitivities play a role and different stressors play a role. And then, you know, I mean, we talk about carbs too. And then we get down this, this, um, rabbit hole of like, you know, food sensitivities. We'll talk about that later. I'm sure. And, you know, dairy, right? So like milk, milk's a carb. I mean, it's not, it's not I, some people think of milk as like a protein or something, but I mean, it's full of sugar. Hey, it's Dr. Brian Moll. I wanted to take just a second to thank you for listening to this episode of the Mastering Blood Sugar podcast. If you're enjoying the show and you want to support the creation of this content, then consider making a small contribution by buying me a coffee to show your support for the show. Just go to buymeacolfe.com/DrMoll. And you can buy me a cup of coffee or two there as a way of saying thanks for putting out this content and bringing you some of the leading experts in the field of blood sugar and metabolic health. Thanks for your support. And let's get back to the show. Yeah, for sure. Let's talk about food sensitivities because this is an area that I think is interesting. And we talk a lot on this program and in my other programs about stressors and going beyond the mental emotional stress and looking at logical stressors, which food sensitivities is one of those. It can trigger a stress response, which can have an effect on your blood sugar. And I think you said that's something you noticed when you were dealing with your blood sugar during your gestational diabetes period. Yeah, absolutely. I mean, what I've come to learn about myself is that I'm highly, highly gluten insensitive. So probably the most gluten sensitive person you've ever met. I mean, I won't even touch the stuff with like a four foot pole. So yeah, I mean, I think that was a huge part of my underlying blood sugar response. I mean, what I see in patients as I know you do is there's this population of patients where it's really it's not it's not really a insulin sensitivity issue. It's it's a stressor. It's this underlying stressor. And I like to how you said, like stressors are not always mental or psychological stressors are often very physical. So it's like this underlying physical stressor that's causing a blood sugar response. And you'll see these patients who now, you know, I work with so many patients who are like me and are a very normal weight and, you know, work out and eat healthy foods. And you would think they would never have a blood sugar issue. But underlying, you know, some of these things, they have these underlying health issues that just haven't been uncovered. And the symptom of that is a spiked blood sugar, you know, is a exaggerated blood sugar response. So yes, I absolutely realize like food sensitivities played a big role for me. Is that something you noticed? You talked about picking up a glucometer and some test strips and kind of monitoring yourself. Do you see a direct connection with certain foods and the foods? Oh boy, I don't know. It's a hard one to say because I've never I've never, I mean, if I gluten all like be vomiting. So I didn't really check my blood sugar, you know, like it's one of those responses. It's very easy to stay away from because I have a pretty violent response to it. But, but you know, as you know, until you eliminate that food completely, you often have no idea how sensitive you are to it until you really get it out of your diet. So yeah, I mean, at the time, I don't know, I don't know, I don't know that I could directly correlate it, although I'm sure. I mean, I think it was more sort of just like chronic, low grade underlying issue versus an acute response. Yeah. But, you know, I wonder because, you know, dealing with people with blood sugar problems, dating and now sometimes their blood sugar just jumps up and it's really hard to sometimes pinpoint what exactly did that and there's so many things that can affect it. Yeah. And, and I suspect that food sensitivities are one of them, but I've never been able to draw a real, you know, strong correlation there. It's interesting. I think what you said initially was perfect just that it's just like it is a stress on the body and these underlying stressors are the things that that spike blood sugar. Yeah, absolutely. I think so too. What do you think are some of the most common food sensitivities that you see in your practice? Yeah, I mean, definitely gluten and then dairy unfortunately is a big one for people. So I mean, there are so many people who are gluten intolerant. We've all seen this fad, but then yes, like dairy is is up there as well. So definitely those two unfortunately for some people it's eggs. I think eggs are great because, you know, there's a ton of coline in the yolk and nutrients and I love eggs, but unfortunately people have sensitivities to those. And sugar is a big one, just like white sugar. A lot of people are sensitive to that. So those would be like the first the top three are dairy gluten and unfortunately eggs. I don't take eggs out a lot unless there's pretty good evidence that it's a problem, but. Okay. And what do you think the best way of learning about your food sensitivities would be? Yeah. It's obviously not everybody vomits after the right. Yeah, obviously it's not so obvious and really that that reaction didn't come until I was, you know, completely off gluten for like at least a year. I mean, now, you know, now if I accidentally get exposed to it, that's the response, but that was not my initial response. I mean, I would accidentally slip up and like eat something with gluten and think like, oh, whoops, like did that give me like a GI issue? You know, I didn't I didn't really know for a while, but yeah. So testing for food sensitivities is a really interesting thing. I mean, I talked to my patients about this and and I offered food sensitivity testing through a couple different labs, but, you know, we have to remember food sensitivity testing isn't perfect. And so it's when do you do it? So for somebody who is already on an elimination diet and has taken out a lot of foods from their diet, it tends to be less helpful because if you're not eating foods and you test for them, they're not going to come up as positive. So you just have to interpret them with some degree of caution, but I do find them as a helpful guide. So it tends to be most helpful I found in the patients of mine who are really eating a variety of foods. I mean, they're eating a lot of foods. They have an eliminated things from their diet. And then you can sort of look at these categories and see if everything lights up in the dairy, but it's low grade. There's probably an issue of something lights up under egg or gluten. There's probably an issue. But you know, you just have to interpret it with caution in the case of egg, you know, that like, is it cooked egg or is it raw egg? I mean, those are different things that proteins change. And so just there are little details to pay attention to, but I do find that food sensitivity testing is a helpful guide. And then of course, an elimination diet. So I put a lot of my patients on something similar to like a whole 30 diet where you take out most of the offending foods. Of course, people are sensitive to things like legumes and alcohol and all of that. And so you take off all the foods and then slowly add them back one at a time and see if if you have a physical reaction to them. But really, I think it's important to take them out for at least four weeks. So let's say we do 30 days with no grains at all, no gluten, no dairy. Let's say we get rid of eggs as well. And then we do no beans and legumes. And maybe we get rid of, well, soy would be in there. We get rid of soy. We get rid of corn, which is a grain, but a lot of people forget it's a grains. We get rid of that one also, where we've covered, I think, you know, the most common food sensitivities there. And we do that for 30 days. And then we, we start to reintroduce these foods. What are some of the physical signs and symptoms that people should look for to, you know, as clues to whether they might be sensitive to a food? So I mean, most people think about gastrointestinal issues. So loose stools are even constipation, bloating, that kind of thing, vomiting. I mean, if it's pretty severe, but it goes way beyond that. Skin rashes, any histamine sort of issues, hives itching, that sort of thing. Also mental issues. I mean, I see people who have psychological issues with gluten. I mean, it makes them feel depressed or emotional. And some people who feel dizzy, I mean, it can affect your vestibular system for some people. What else? What else am I missing? What other kind of reactions do people have? Hed eggs is a big one. Stuff he knows is a big one to congestion and mucus production. That's another big one. Yeah. And sometimes it's like joint pain and swelling and just this overall inflammatory state. Yeah. Sometimes you can just see it in the mirror too. Totally. Yeah. A little puffy or those darks. Yeah. I talked to my patient yesterday and we had a video appointment. Like you look different. Like younger. I don't know. You look better, you know, because he's like taken out beer and bread and he looks good. And yes, it's hard to take that out of your life when it's part of your like social fabric, right? But there's some decent substitutes. And you know, you can see it. Yeah, you can absolutely see it in the mirror. I mean, I can see it in the mirror. If you look back at pictures of me from 15 years ago when I ate gluten and I had no idea that I was sensitive to it, I was just puffy. I mean, it was just puffy. Yeah. And so much of health is fairly subtle. I mean, you experience it. There's a huge difference between you know, feeling like a seven or a seven and a half or a nine, you know, 10 feeling, like truly like yourself. And sometimes it just feels like that veil gets lifted. And yeah, life just seems different. Yeah. Uh-huh. That's hard to describe. It's hard to measure. But yeah, it is. You go through that process. It's easy to see, right? Like you can totally see it on people, but it is such a good way to describe it as as like lifting the veil. Okay, great. You mentioned fats earlier. And I want to talk about fats because I think not only for adults, but for developing fetus and a baby, especially for moms, again, going back to gestational diabetes. A low fat diet is recommended by, but babies need healthy fats, right? Oh my gosh. Totally. Fats like one of my favorite things to talk about. Um, yeah. So it, having adequate fat in your diet is important for any pregnant female, uh, for baby, but also for mom. Um, so I have another quote. This one is from diabetes.org. It says, making healthy food choices. Follow simple daily guidelines, like eating a variety of foods, including fresh fruits and vegetables, limiting fat intake to 30% or less of daily calories and watching your portion size. Healthy eating habits can go a long way and preventing diabetes and other health problems. Um, and this isn't in their like section on gestational diabetes. So I mean, again, it's like back to the carbs thing. Like if you're not eating fat, what are you supposed to eat? I mean, you can only eat so much protein and we're trying to limit carbs. So like, what do you fill it with? Right? So, um, so yeah, like I said, I was eating at least 50% of my calories from fat, but looking back, that was a really good idea. Um, so some specific types of fat, particularly, uh, DHA and ALA. Um, those are especially important during pregnancy because they support the baby's brain and eye development. So we know that we know, you know, most good OB/GYNs are recommending patients take fish oil. That's another issue. You need to make sure your fish oil is pure and, you know, low mercury and all that. But, um, but those fats are really important for, for babies nervous system to develop. But, you know, fats are also helpful for the placenta and other tissue growth. Um, they're shown to prevent preterm birth and low birth weight. Uh, and then when you talk about mom and mom's mental health, um, fats are really associated with, with psychological well-being. And so I think they play a big role in preventing, uh, postpartum depression and issues with mom. I mean, during pregnancy, uh, as we know as mothers, it's like a very taxing time. I mean, all of our resources are going to baby and baby is, I mean, evolution is such that like baby pools the resources first and then we're left with nothing. So if you don't have enough fat on board, baby's getting what baby can get and then mom is going to be totally deficient, right? So, I mean, I think a lot of healthy fats are important. So the type of fat, I think, is important to talk about too. Um, so, you know, when we talk about DHA, that's a omega-3 fatty acid, which is a type of polyunsaturated fat. So that's going to come from cold water fish, another, you know, where do we get healthy cold water fish that is low in mercury? I mean, that's a whole other issue. Uh, for some people, they can convert flax and walnuts into omega-3s or into DHA specifically. Uh, that's the ALA, the alpha-lima. Right. Yeah. Yes. And that goes back to, you know, it's interesting if you look at genetics, and you look at something called nutrient genomics, which is the study of sort of how your genes react with nutrition. Or I'm sorry, react with food and what kind of nutrition would be optimal for a person, but, but looking at nutrient genomics during pregnancy or anytime is super interesting. So, you know, for some people, there's a genetic challenge with converting the alpha-lima-like acid to DHA. So, but for some people, they do that great. And so eating a lot of walnuts, you know, hopefully they convert to DHA down the line. And then what about, how do you feel about saturated fat, particularly, lamp-based saturated fats like that? Yeah. Okay. So, that's like a big thing, right? Saturated fats, again, back to nutrient genomics. Like, at one point, I sort of thought everybody did great on saturated fats, but I think there is a proportion or a population of people who don't do as well with a high saturated fat diet and are better with the polyunsaturated or the mono-unsaturated fats, but in general, you know, many people, most people do well with saturated fats and they make up close to like 50% of our human cell membranes. They're a really important energy source for a rapidly developing baby, right? So, like, what else if we're making a bunch of cell membranes, we need a lot of saturated fat. But I do feel like, like, as you said, eating them from plants is very different than eating them from animals and their metabolites differently. So, you know, optimally, if you're eating them from plants that's great. I mean, I think a lot of people do just fine with animal-based saturated fats as well. I mean, I particularly, I'm fine with those. I mean, but there definitely is a population that I see who are not. And it's interesting to look at their lineage too, like I have a patient who's Scandinavian and, you know, she really doesn't tolerate saturated fats very well. They really spike her blood sugar, looking at particle size and things like that. But, that's outside of pregnancy. I mean, I think, you know, inside of pregnancy, most pregnant females are, you know, young and very, we're not talking about cardiovascular risk factors. So, so yeah, I mean, I encourage a balance of preferentially plant-based saturated fats, polyunsaturated omega-3s. And then, of course, the monoinsaturated. I like to go pretty happy with monoinsaturated fats, like olive oil, avocado oil, olives, nuts, that sort of thing. Yeah, for sure. And if you look at breast milk, I mean, that's a totally, you would also, in breast milk, is obviously a high-fat food. And that's what babies are supposed to be, right? Yeah, have you ever seen express breast milk, like in the fridge? Yeah. Yeah, I mean, it's really interesting. You can see this layer of fat on top. And I will say just personal, you know, we're all sort of scientists on herself. But like, with my daughter, I was actually healthier with my first pregnancy than I was with my son, who was many pregnancies later, but my second-born child. And you could see it in my breast milk. Like, I had a lot of fat on the breast milk with my daughter. And then it was less obvious with him. And so, it's interesting, like, breast milk is a high-fat food. Babies need high fat. But it's also like looking at breast milk quality is reflective of mom's health. Wow, fascinating. Yeah. Well, if Gearson talk about pre-prinancy and fertility, because that's a huge issue as well. Yes. Blood sugar also plays a big role there. For sure. For sure. I mean, I think, you know, we have this underlying sort of health crisis. I feel like every, a lot of females I meet, moms, people who want to become moms have this underlying issue with their health. And they're just not able to pinpoint it. But so many people come to me, or send me text messages, or send me messages and say, like, I know something's wrong. Can you help me figure out what it is? And I think it's really important that we listen to that little inner voice that says something's wrong, because I think a lot of times what's happening is people look pretty good so their health gets dismissed because they're not having an acute issue. It's just this underlying chronic low grade thing that's happening. And so, anyways, I think this like underlying chronic low grade thing that's happening in our world is affecting our health and thus affecting our fertility. So it makes perfect sense. if you think about it, like if we're not in a good healthy state with our body, why would we want to procreate if you think of it from an evolutionary perspective? Like that just it doesn't make sense. So I think it's really important for women who are struggling with either recurrent pregnancy losses I did or infertility that they really look at underlying health issues and address those before they get pregnant. What would some of those be? Yeah, so I mean a big one is toxicity. You know if there's glyphosate or roundup in our food, on our plants, some people are spraying their homes with this stuff. That's just one of them. I mean we rub toxins on our body as makeup products and personal care products. We breathe toxic air a lot of times. I mean for some people with infertility issues or recurrent pregnancy loss it's mold and mycotoxins in a home. I mean there's so many different toxins in our world and there's only so much we can do to eliminate that but like you know it's a pretty it's a pretty big one and most people who are wanting to have a baby are thinking about those things a lot of them are eating organic foods and I think that's really important but sometimes you have to go further and really investigate what it is and and look at your environment. Water is another big one of course it's like air food and water right so what's going on with your air food and water is it clean? So toxins are a big one blood sugar. I mean blood sugar as you know is going to cause hormonal disruption. That ties me back into not only hormones but thyroid which is obviously another hormone. So I see so many people who are deficient with their thyroid hormone. They're just suboptimal and they're not like frankly hypothyroid but sometimes they are and I find a lot of women I check pretty much all my patients for thyroid antibodies and you know I unfortunately find a lot of people who have Hashimoto's and I had no idea they did right because their TSH is pretty normal ish like maybe it's three but it's certainly not something that most physicians address and so there's this underlying thyroid issue which you know it goes back to a lot of things if you're if you're one is autoimmunity but some people just have a low thyroid function for other reasons toxins infections dress. Another big issue I think with fertility is the gut you know if you don't have a healthy gut or you have intestinal permeability leaky gut issues that's going to affect fertility. There can be these underlying chronic low grade infections in the gut which are just perpetuated by foods on such activities and it's this like vicious cycle right and then you know micronutrient deficiencies. I think micronutrient deficiencies play a role in a lot of health issues if not any if not all of them I mean they're they're playing some role there and are only exacerbated by things like gut infections because absorption is an issue and then of course that goes back to what are we doing with our food supply and the nutrient density in our foods so those are just some I can pull off the top of my head but some that I focus on for sure I mean it's you know it depends on everybody in their environment and their risk factors and yeah well you can see how many people are dealing with these things and maybe why we have the problems we do right now. Yeah totally. Yeah. Excellent. Well this has been fantastic and I could probably talk to you all day but we're going to get close to wrapping up here so Kristine I want to give you an opportunity to let people know how to find you or to share kind of what you're doing right now so if people want to get more information about you and your practice or the information that you have available what's the best place for them to do that. Yeah the best way is just you know my website at StarkterChristineMarin.com so it's DR Kristine is with the CH and my last name is Marin and may our EN.com so if you go there there's plenty of information and lots of blog posts on there and pretty soon here I'll be publishing some more information about you know healthy pregnancies or supplements I take during pregnancy and that sort of thing. So yeah find me there or find me in Colorado. That's right. All right so I'd love to ask all my guests three questions here at the end and the first one has to do with your work and the impact you're trying to make on the world through medicine and through your practice. So if you had a quote or some sort of statement that best characterizes or represents your work the legacy sort of speak that you'd like to leave right now what would that be. You know I think a lot of it is just listening to your inner voice and trusting your intuition when it comes to your health. I think so many women I see and so many patients I see have been dismissed and told it's in your head go see a psychiatrist and I think that's a pretty offensive thing. So I think it's important that people really trust the inner inner intuition I had that once. I knew at a certain point in my life something's just not right and I had a lot of people trying to reassure me everything's fine you know but I just knew something's just not right and indeed something was not right so trust yourself. Powerful, powerful statement. If someone came to you let's say a friend or a family member newly diagnosed with type 2 diabetes or even gestational diabetes and it was coming to you for advice maybe not even as a doctor but just as a as you know a friend or a family member that has a lot of knowledge in this area in just a couple minutes what would you tell them to do. Check your blood sugar do a fasting blood sugar and then I wanted to our post-pranjoid blood sugar check and do it a lot I think it provides it empowers people and it provides like immediate feedback so you get this very individualized information on what certain foods are doing to your blood sugar because certain people you know people are different I tolerate potatoes fine some people don't you know. You know studies have shown that self-monitoring is the greatest key to success with the one many programs so I think self-monitoring is really important great advice. Lastly and this is kind of a bigger broader question but if you found yourself sitting around a large table in a boardroom with 20 of the world's leaders the industrialized world and they created this sort of summit of leaders to solve the diabetes epidemic and they brought you in as an expert to share advice what would you tell them to do. I would say go back and look at your nutrition recommendations right away I mean I think that's the biggest thing you know like even the broader audience people who are not who don't know to come find you and listen to your podcasts and read our blog posts and things like that I mean they need to hear that whole grains are you know not the key to health like things have changed we realize that's not what we're doing that's it's not the right thing for our body so this very simplistic approach is just like change the dietary guidelines so people have a better shot at it and if you could if you could have your influence over the dietary guidelines what's I would say liberalized fat especially monoinsaturated fat and omega-3 fatty acids from clean sources and you know eat clean protein and plant-based carbohydrates not all carbs are created equal like that would be my little snippet if I had 30 seconds. Awesome yeah. All right Dr. Christine Marin thank you so much for spending this time with us you know it's my pleasure yeah I just want to honor you for following that intervoice and you know being brave enough knowing what you knew at the time to to go into medicine and decide change it from the inside I think that's yeah it's it's not for the week of heart right I do have I can share a gift with your audience which is particularly relevant for for women who are you know pregnant or wanting to get pregnant but if you go to my website dr Christine Marin.com forward slash gift there is a free ebook on there in 12 ways to detox your home so it's you know basically the 12 sort of uh top ways to get the toxins out of your house and and sort of you know it's a good place to start especially for people who are sort of just going down this path and don't you know it's all very overwhelming and I did it in 12 ways because I consider it like you change one thing every month and within a year you'll have a pretty clean home. Nice I love that so dr Christine Marin.com forward slash gift that's it all right well Christine thank you so much for being on the Mastering Blood Sugar podcast and sharing this time with us. It was my pleasure thanks Brian and thanks to all of you for subscribing and for tuning in and listening to the Mastering Blood Sugar podcast this is Dr Brian Moll the diabetes coach and I will be back next week with another expert interview take care everybody. All right thanks again for joining the Mastering Blood Sugar podcast. Hey if you haven't already please do me a favor and subscribe to the podcast on iTunes or Google podcasts. If you want more helpful information check out my YouTube channel at youtube.com/DrBrianMoll and make sure you follow me on Instagram @DrMoll if you like this episode share it with a friend or family member who could really benefit and I'd love if you would leave me a five star review on iTunes or Google podcasts. Thanks again for listening this is Dr Brian Moll and I'll see you back on the next episode of Mastering Blood Sugar. [Music]