S1 E21: Preparing for Conception with Loren De La Cruz


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Amanda: In this episode, I’m joined by Loren De La Cruz, or you may know her as @innatefunctionalnutrition on Instagram, to share knowledge on how to prepare your body for conception. Loren is a Functional Nutritional Therapy Practitioner, Root Cause Protocol Consultant, and Functional Diagnostic Nutrition Practitioner that specializes in preconception nutrition. Her mission is to empower women with the tools and the knowledge they need to regulate their cycles, balance their hormones, heal their metabolism, optimize their fertility, and have a thriving pregnancy.

So the goal today is to talk about that preconception time. I feel like as soon as you get into preconception pregnancy, prenatal nutrition, it starts to get confusing. I get a lot of questions around this stuff like what do I follow, what’s correct what’s not, what’s up to date based on research. So the goal is to just kind of go through what’s the most essential for people to dig into during this time when they’re preparing to conceive? And then hopefully, like, dispel a few myths, because I feel like we get really bad advice on conception from doctors. So thank you for being here with me, Loren. 

Loren: Oh, thanks so much for having me, Amanda. I’m super excited to be here.

Amanda: So if you guys don’t follow Loren on Instagram, please do. I feel like I always look at your posts, like, it’s and, you know, when you look at someone’s stuff all the time, it comes up on top of your feed, it’s like always really good quality content. And, like, you even share resources and stuff, like above and beyond for sure. So if you’re interested in this stuff or even just like hormone health, because I personally feel like fertility is just health, you know, whether you want to have a baby or not. But I’m really curious to know, like, how did you get interested so specifically in conception, and then just like a little bit more about your own health story?

Loren: Yeah, thanks so much. So yeah, where to begin. I got interested in conception, because I was previously working with women helping them with metabolic issues, just feeling better in general, whether it was coming off the birth control pill, or, you know, working through menopausal symptoms. So the range was really large and wide. And more and more, I started to get into my own preconception journey. And that itself has been very, very interesting and fun. But the more I did research on, okay, fertility, pregnancy, and how all these things connect, the more I realized that there was a hugely missed opportunity to not only impact our children’s health, you know, in the womb, but also impact their children’s health and their children’s children’s health. But also this aspect of, you know, reducing complications during pregnancy and increasing our ability to recover postpartum. So, and that all starts with preconception prep. Because the moment you, you have a conception, it’s, it all starts, all the dominoes start to fall into place. And so the way that we can affect that the best is preconception prep. So I just view it as a really powerful, not only a beautiful time, but also a really powerful way to influence our health and our children’s health in a much deeper way.

Amanda: And with your own kind of health journey, I feel like it’s kind of natural, like as we get to those phases in your life, you’re like this is, it’s all your researching and like reading about and thinking about…I think a lot of women kind of naturally go through that whether they work in the field or not. Did you find that there’s anything specifically that you were curious about that with your own health that like you wanted to prevent within your kids?

Loren: Yeah, so that’s a great question. And, you know, I think definitely there’s one of the reasons I sort of pursued this after doing so much research, and I continue to do it is because I found that there was a lack of resources for women for this time period. There’s only like, you know, when you do the research, there’s a lot of pregnancy stuff, maybe a little postpartum stuff, but really nothing on preconception. So definitely self-motivated to sort of put some stops or, you know, change the outcomes of my future children’s health. My mother personally, she dealt with preeclampsia twice in two out of three children, and so that is really important to me. I do have a family history of diabetes on both sides of my family. And there’s another, I guess, personally, I had also grown up having to take steroid inhalers for asthma as well. And so that is also really important to me to not, you know, as much as possible. Of course, you can’t control every single aspect of your future children’s health. There are so many different and inputs, but it’s really all about putting your best foot forward to try to mitigate that as much as possible. I myself have been working on these, preconception with these things in mind. And it’s been, it’s so far it’s been going well, I mean, I’ve been able to heal my asthma, which has been awesome. And I no longer have to take daily steroid inhalers, which is excellent.

Amanda: So I actually grew up with asthma. I, as soon as I was born, I wasn’t breathing, and I always had breathing issues ever since. I used nebulizers, like the machines, oh my gosh, I hated doing those. Oh, it was like torture. And so I totally, I can definitely relate to that. Were you using inhalers up until somewhat recently? Or is that something you resolved a while ago?

Loren: I guess it depends on what you, you know, say recently is. I resolved my asthma about four to five years ago. And that was its own journey, because that’s really how I fell into nutrition in general. I had a really terrible experience on the birth control pill. I initially started taking it for adult acne that I developed after being on a vegan diet. So just hindsight 20/20, I was very malnourished, and my body was just telling me I needed more animal foods, animal products, specifically vitamin A retinol. You know, I was desperate though, and no one, you know, back then—and I’m not that old—but back then, we didn’t have resources available to us instantly. No, there were no blogs on this. And that was the length of online information available. And my doctors had no idea what to do. They were just like, people get adult acne sorry. I was offered the birth control pill. And I definitely was like, yes, let’s do this. All my other friends were on it. So I was like, this can’t be that bad.

So I dealt with a string of, you know, various issues. I had pre-diabetes, I was constantly cold. Oh, gosh, what else? Oh, I had Candida. I also developed an autoimmune skin condition called lichen planus, which is really just not fun. So you know, after, after that…these things were progressive, like it just got progressively worse and worse. And then my acne started coming back. And I was like, why am I even on this thing? And so I started doing research on how to come off. And that is when I realized how it actually works. I was like, are you kidding me? I had no idea it worked this way. My brain, but the connection between my brain and my ovaries had been shut off. I haven’t been producing progesterone, which is, you know, pro-thyroid. Like no wonder I feel bloated all the time. No wonder my gut is so messed up. And so I went to my doctor’s with, for some guidance, you know, hopefully I was on it for eight years. But um, I went to my doctor’s try, hoping that they would have some guidance for me. So they didn’t, they were just like, you can stop it at any time. And you know, do you. But then I did, and then my hair started falling out and my skin, my acne came back tenfold. I was like, what is going on? So I went back to them, none of them had any idea about how to help me. They were just completely clueless. And there, they offered me getting back on the pill or getting on a different pill, which is called spironolactone. So those were the two options I got, or just wait it out.

And I was like there has to be something else I can do here that doesn’t involve medication, but that doesn’t involve doing nothing. So I started researching and that’s when I found the work of Dr. Jolene Brighten. And it made me feel so validated and so much less crazy. And I started putting some of that research together, doing a little more research outside of her realm, and I started seeing results. And it was completely empowering to see those results and having taken things into my own hands. And that’s actually when I started feeling relief from asthma and started seeing progress in that too. And, you know, maybe a year after that I, I was really good to go, so…

Amanda: That’s amazing. Yeah, I think people don’t realize it. Like we don’t, we did not have Instagram, and like people weren’t doing what they’re doing now on Instagram. You know, like, we didn’t have all this information like at our fingertips. Now people are incredibly lucky. I feel like it’s a lot to sift through, and, to, it’s hard to know who to trust but there’s still so many resources. You know, even it’s like, you could go to either of our pages and learn at least a few things you could start doing right away, you know, to start easing symptoms. That’s really wild that you had, it’s such a crazy journey on the pill and had all those issues develop.

Loren: Yeah, it was. I mean, of course, hindsight is 20/20, too. I was constantly, you know, wondering, okay, why do I have pre-diabetes? I don’t do anything crazy. And like, that scared me too, because of my family history. So I was like, what can I do? And of course, you know, I ate low carb for a little while thinking, I’ve done vegan, low carb, all you could think…keto. So yeah, it’s definitely just a big learning experience. But as you start to put more, more and more dots together, it all starts to make sense. And definitely, I don’t know that if I hadn’t gone through what I went through on the pill, I would be in this position now what I’m doing, which I absolutely love. So I am also, in a sense, grateful for what it taught me.

Amanda: Same here, I’ve, very, very similar story. When I came off the pill, that’s really when all my research on this stuff started. So I was very focused on sports nutrition. So it like completely flipped everything. I feel like a lot of women, unfortunately, have stories with the pill, which is sad, but it’s also it’s important to share them. Some people do great on it, and I think that’s awesome for those people. But a lot of people can really struggle, and because it’s so normalized, like you said, all your friends were on it so you thought it can’t be that bad. It is so normalized, I would even forget to tell when I would go to doctor’s appointments. Like I’d forget to say I was even on it. And they would ask, like, oh, you’re on the pill? Oh, yeah, I forgot. Like, I forgot to even put that, in my mind. It almost wasn’t a prescription med is like how normal it was. So I can totally get that.

So as far as, I totally agree with you about the whole there’s not a lot of great info for preconception. When I think of it, I think of like when I went to, like, we’re, my husband’s in the military. And I went to our doctor like a year ago, and for one of my like, typical like pap smears. And you know, of course they freak out because I’m not taking any birth control. And they’re, like, you’re gonna get pregnant, and I was like, I’ve been doing this for four years and we haven’t gotten pregnant. So it does work. It’s very effective. I was like, we want to conceive probably in the next year. And they were just like, I’m like, as you know, that I just was sharing that, because I feel like my doctor should know, in case they saw anything like with my pap smear or anything. And they’re basically, they’re just like, yep, just like start taking a prenatal, you know, like, that’s literally their advice. And if you’re on the pill, the advice is, don’t stop taking the pill until you want to get pregnant and start a prenatal. And so what, what is wrong with that typical preconception advice?

Loren: Yeah, so you know, what I’m about to say, take it with a grain of salt, because it’s definitely not normal to hear this in the conventional medical space. And, you know, your doctor definitely has, usually has your best interests in mind, but they just might not be super educated on these aspects of them. And so I would say definitely do more research as well. Happy to also mention a few resources you can look at. But I think one of the main issues that I have with it is that it doesn’t address the concept of fetal programming. So earlier, I mentioned that we can affect our child, future child’s health, but also their child’s health and their children’s children’s health. So the concept of fetal programming is a well-researched, well-established concept. And it’s basically the idea that we imprint our health on our baby. So the issue here is that, one, the pill itself, there’s many functions in the body that it messes with. It dysregulates the adrenal glands, or the adrenal hormones, it dysregulates the thyroid, it also can increase the risk for autoimmune diseases, it affects the mental health of the, the woman, of the person taking it in in various ways, and that has a lot to do with the effect that it has on the hormones that it also suppresses.

So the way that the pill works is that it cuts off the you’re, you’re getting a supplemental synthetic dose of estrogen and progesterone. So the body, the way that it thinks is, okay, I’m getting all of these things, I don’t need to make any more. So it’ll stop producing those hormones or at least diminish the production of those, at least. And so whatever, how long we’ve been taking the pill, our bodies slow down the production of these important hormones—which are essential to, for fertility also, and to also successfully implant and to successfully carry a baby. So we’re not getting any of these hormones, or at least we’re getting a lot less of them. And the body, when you come off the pill, it has to re-establish that connection. So that’s the first issue. And what most doctors won’t tell you is that, you know, long-term birth control use is associated with subfertility, is what they call it, for at least a year to a year and a half post-pill. So it takes a lot longer for the body to get back online. Some women, maybe not for sure, some women, depending on how long they were on it, you know, it could be that it comes back within the first or second month. But if you’ve been taking the pill for two years or more, which most of us have, it could be 12-18 months.

And that’s exactly what happened to me. I got my period back when I came off the pill the second month, but I didn’t start ovulating until a year and a half later. And that’s one of the things that was really clear to me, when I started ovulating again, because a lot of my symptoms went away. And that was just a lightbulb moment. I was like oh my god, really. So there’s that issue. A lot of us are also estrogen dominant when we come off the pill because it’s while, it is a, some of the pills are called low, you know, low… 

Amanda: Lo Loestrin.

Loren: Yeah, it’s supposed to be a lower dose than the extremely high doses that they came out with when the pill was first introduced into the market, which caused a lot of problems. But even though it’s a lower dose, it’s still a pretty significantly high dose of estrogen. So we’re getting synthetic estrogen, progesterone that behaves like estrogen, looks molecularly similar to…sorry, testosterone actually, I believe. Is that correct? I…

Amanda: Progestins do look similar to androgens, yeah.

Loren: Okay, yeah. Having a little brain fart. But yeah, okay, so that can mess with things too. Really, it’s the estrogen, that’s really kind of the problem, because Dr. Ray Peat talks about this a lot, and he attributes estrogen to being the most potent anti-fertility factor. So, yes, we do need estrogen, but we don’t need a lot of it, like, or there’s a fine balance and a lot, you know, depends, it depends on of course, how you look at it, and the relevance, you know. There’s definitely a balance that the body needs to have and too much is not going to work in our favor. So we tend to have a lot of estrogen stored up post-pill also, because when we are not making progesterone, the body tends, tends to accumulate estrogen anyway, so we can’t really get rid of it. Progesterone is what balances estrogen in the body, and because we’re not making any, because we’re not ovulating—that’s what the pill stops us from doing—we end up pretty estrogen dominant postpartum.

Other aspects of sort of why this isn’t a great idea either is because it depletes us of nutrients. So really, really important nutrients for fertility, but also a healthy baby. These include things like vitamin A, which is really important for egg health and fertility; of vitamin E, which is also called the fertility factor x by the people who discovered it, the researchers who discovered it; vitamin C, super important for just overall structural function, but also the creation of skin in the baby, muscle in the baby, but also the stretching of your own skin; B vitamins like folate, which prevent neural tube defects; B12, which also prevents neural tube defects, really important for neurological function of baby too. Also, these two are really important for methylation. So really, really important stuff there. Zinc, selenium…what else? Just…

Amanda: Magnesium I think, right?

Loren: Yes, you’re right. And then it also messes with ceruloplasmin and copper. So I talk a lot about copper on my page, you do too. And that’s a result of, you know, the Root Cause Protocol Institute, which is one of my favorite schools I’ve ever done. So, you know that, that aspect is really important, and that’s a whole other can of worms, but it can increase…a lot of women that go on the birth control pill find that they have high copper levels. And also the Paragard, which is non-hormonal, but it can still affect hormones in that way. Because when we have high unbound copper—and that’s what the pill is increasing—copper needs to be bound to a protein called ceruloplasmin, and that’s how it exerts its antioxidant effects, it’s amazing effects on iron regulation and all these other enzymatic functions. But the pill and the hormones that it has in it really kind of separates copper from ceruloplasmin, so we have an excess of this metal copper, which is not necessarily terrible, but it really should be bound to this protein to do its job well. And so a lot of women have “copper toxicity” coming off the pill and need to rebind all of this copper to support metabolic function, fertility, etc.

So there’s so many aspects of that. I could go on, but again, you know, I guess, in short, the idea, having, knowing the and understanding the idea of fetal programming and understanding that your body is probably not in the best state post-pill that to, you know, not only support proper development of maybe an optimal fertility of your body. But also, we want to put our best foot forward or at least, you know, some, most of us do to impact our how our pregnancy goes, because nutrient deficiencies can lead to complications during pregnancy for you, postpartum, there’s so much that, you know, happens postpartum, and that we can affect by making sure we’re replenishing really well, like PMDD. Even thyroid issues postpartum, which I see so often, and then you know, the aspect of not only our babies, but our future generations, too.

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Amanda: Yeah, and I feel like that’s, it’s like, there’s so much there. But when you simplify it and think about it, it’s like, you’re just, when you’re just coming off the pill and starting a prenatal, trying to conceive, it’s like you don’t, you’re not even taking into account all those different deficiencies that your body has in the different systems. And it’s, I did a postpartum episode with my friend Kim, and we were talking about obviously postpartum depletion. And she was just emphasizing how, she’s like, I mean, that depletion is really starting preconception, you know, like, you can definitely be, obviously, like, you get depleted after pregnancy, but it also depends on how depleted are you going into pregnancy?

Loren: Exactly, and most women statistically are nutrient deficient in their childbearing years. So we’re already entering pregnancy in nutrient debt and other kinds of health debt. And so that’s why more and more, we’re seeing a lot of issues not only in pregnancy, like, so things like preeclampsia, gestational diabetes, other issues, but postpartum—a lot of thyroid issues or autoimmune conditions that just crop up, and it doesn’t have to be that way. So you know, just keeping that in mind too, that I probably just, statistically I’m not, not as nourished as I maybe should be to support myself and baby throughout these phases. And taking that time to really work on it is invaluable.

Amanda: And like, and like everyone’s different, you know, like you had mentioned, like, you’ve tried all the different diets. And at one point you were vegan. How long were you vegan for?

Loren: About two years. 

Amanda: I can’t even picture you being vegan.

Loren: I was very malnourished, actually, I was probably like, oh my gosh, 70 pounds.

Amanda: That’s crazy, just because of all the foods that you share, and like the meat and stuff, like, and, and it’s, it’s like, you know how to cook it all so well. I just like can’t picture that extreme. But I feel like we’ve all kind of been there like, especially if you’re interested in health, like, you tend to like try the different things that are popular, which I don’t think is bad. But it’s like if, even if you didn’t take the pill, if you’re coming from that history of like, maybe restrictive diets or more extreme diets and stuff, or even undereating, you’re going to be entering, you would be entering pregnancy in a more depleted state. And I don’t, I, like, I’m very cautious with labs. Like, I love using labs and I recommend them, but I do, I do find like around that preconception time people can get obsessive and they like, when is it okay to conceive? Um, like, we can’t just be going for perfect lab numbers.

Loren: Oh yeah, yeah, for sure. It’s, it’s what you said is so it makes so much sense. I remember when I was vegan I was using, like, hydrogenated vegetable oil to cook because that’s what my vegan cookbook said. And now I look back on it, I’m like, oh, my gosh, what was I doing? But yeah, that, you make a really, really great point. And that’s something that I go through in the courses, like how to build your timeline, things to consider. And definitely your previous diet or your current lifestyle, nutrition strategy is definitely one of them. Because if you’re on a plant-based diet, you’re going to be missing a lot of really important fat-soluble nutrients that you can really only get from animal foods. And those are extremely important for fertility, but also, baby’s health and development.

And you also mentioned, you know, the lab aspect, and I do find this too. I’m very cautious in the way that I approach labs as well, because I think that a lot of women, you know, there’s a fine balance between like being ready to go, and I think that’s important, trusting your body to be ready to go—that’s super important. That’s really the first thing that I ask people when they are on their preconception journey. How do you feel today, right now in this moment? Because that will tell you a lot. If you’re not sleeping well, eating well, if you’re not getting sunlight, if your digestion is really bad, if your hair is falling out already, if your skin has issues, how your mood, how is your mood, how are your energy levels throughout the day…these are all pieces of information that you can use to say, okay, maybe I need to work on these things first before I go into pregnancy. Because these things may only manifest as, or are becoming sad… exacerbated, excuse me. So there’s, there’s that aspect, and we definitely need to trust our body and get in tune with it to understand where it’s at. But it’s never that we’re chasing perfection here either. And that’s really important. Because if we are chasing perfection, we’re never going to be ready, ever. You have to find, while progress, one, is really important, but finding the right place for you as an individual and your unique situation in history is also super important. There is definitely a fine balance, and I think that’s important to figure out.

Amanda: So for, I feel like you get this question all the time, I see you do prenatal reviews all the time, which is great. And I feel like it’s really helpful for people. This is probably the hardest concept for the women that I, that are in my community that I work with to accept is that most prenatal vitamins are not going to meet 100% of your needs, right? We kind of we were told this like, we’re like, oh, just start taking prenatal and it’ll be fine. But most prenatals, and we kind of think it’s like, oh, I’m fine, I’m taking a prenatal, right. What are some of the concerns with current prenatals on the market that you have? And like any advice for women as far as kind of like, how to, how to, like, tease that out and find out what’s gonna work best for them?

Loren: Yeah, that’s a great question and there’s a lot to unpack there. Prenatals, you know, I definitely think there’s a time and a place for them. But I think what’s important to remember is that they’re a one size fits all solution, and you are not a, I guess, or I should say, everybody is so different. And usually one size fits all solutions, like diets themselves—there are so many concepts we can apply to that sort of concept itself, too—one size fits all solutions are bound to, you know, fail. So you’re a unique individual with different metabolic needs, and, you know, different deficiencies, different accesses. So right there, there’s a potential to create more imbalance, just you know, because the prenatals don’t take your unique individual needs and imbalances into account. So that’s important.

Supplements, prenatal supplements are also not regulated by the FDA. So just keep that in mind that just because it says a prenatal doesn’t necessarily mean it’s safe to consume. And this will even be on prenatal vitamin labels, like it says, disclaimer, discuss with your doctor, or you know, do not start taking without discussing with your doctor. That’s because they’re just, they’re not FDA-regulated. Other issues that I have with prenatals…the supplement company is releasing supplements to make money, and with that said, if there are multiple nutrients in a supplement, the more expensive it’s going to be. So the way that they cut costs, and the way that they increase their bottom line—because they’re not going to be just doing this from the bottom of their heart—is they will swap out good forms of vitamins for cheaper ones, which usually means they’re going to work less well. So they’ll pick maybe, you know, a couple of good forms of the vitamins, but the rest will be really cheap forms like magnesium oxide or beta carotene for vitamin A, ascorbic acid for vitamin C, although you’ll be, be hard-pressed to find, like zinc oxide, or citrate or whatever. So take that into account, you know, not everything in there is going to work optimally in your body.

Another aspect of that too, in another angle is that a lot of these forms of vitamins are synthetic, so they’re not going to work optimally in your body anyway, even if they are in great, you know, forms or whatever. Some synthetic vitamins will work very, very similarly, I will say that, but there’s a lot of them that won’t. And so you have this synthetic form of vitamin, sure it looks molecularly similar to the sort of natural form that it comes in, but it won’t function or, you know, promote the same functions in the body that the natural form would. So the issue here is that it takes up receptor space, especially if we’re getting a lot of it, and so it’ll keep the natural form from doing its job properly. And so you’re getting a bunch of synthetic stuff that’s not allowing your natural forms that you’re intaking through food, say, to do, to work optimally.

Another issue is that I think going back to sort of how unregulated it is, I’m pretty sure that a supplement company can call anything a prenatal. There’s not necessarily like a standard requirement for what a prenatal contains or the levels that they contain. It also doesn’t take into account nutrient interactions. So some do, well, some do kind of. So you might see like iron-free prenatals, which makes sense because calcium and iron compete for absorption, but so do other nutrients. So it’s not just calcium, it’s zinc as well, and others. So you know, you’re taking all these things together, and they’re going to compete, so you’re not going to benefit from all of them anyway—the body has to prioritize one or the other. And if you’re taking them, again, together, it’s gonna be a problem and you’re not gonna be able to benefit from it. It also, you know, because these are not regulated and, you know, they don’t, you can call anything a prenatal, even the ones that do have, like, seem really comprehensive, they’re still missing key nutrients. One, you need macronutrients—you need fat, carbs, and protein. So definitely, and I see this problem a lot, like, a lot of women will say, oh, I don’t feel like you know, eating, just going to eat this cake for dinner. And like,

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

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