From a functional medicine perspective, postpartum cavities are not random. They are a predictable outcome of profound hormonal shifts, nutrient depletion, sleep disruption, and changes in oral and gut microbiomes that occur during pregnancy and the postpartum period. Understanding why postpartum cavities happen is the first step toward preventing and reversing them.

What Are Postpartum Cavities?

Postpartum cavities refer to tooth decay that develops during the months following childbirth. Some women notice sensitivity or pain shortly after delivery, while others discover postpartum cavities at their first dental visit after having a baby. In many cases, these cavities progress quickly and seem disproportionate to a woman’s oral hygiene habits.

This is often shocking, especially for women who brushed, flossed, and saw a dentist regularly before pregnancy. But postpartum cavities are usually less about hygiene and more about other aspects of biology.

Why Postpartum Cavities Are So Common

There is a perfect storm of factors that contribute to postpartum cavities, and they often overlap.

1. Hormonal Changes

Pregnancy and the postpartum period involve dramatic fluctuations in estrogen and progesterone. These hormones directly affect saliva production, blood flow to the gums, and the balance of bacteria in the mouth. Low estrogen postpartum can reduce saliva, and saliva is one of your primary defenses against cavities. Reduced saliva means acids linger longer on teeth, increasing the risk of postpartum cavities.

2. Mineral Depletion

Pregnancy places enormous demands on a woman’s mineral stores, particularly calcium, phosphorus, magnesium, and trace minerals. If these minerals are not adequately replenished postpartum, the body prioritizes survival and lactation over tooth remineralization. This creates a biological environment where postpartum cavities can form rapidly.

For several reasons, I usually recommend that my patients supplement with 1,000 mg of encapsulated calcium citrate beginning at 20 weeks gestation due to several studies indicating reduction in hypertension and pre-eclampsia risk in pregnant women. I recommend this practice continue for my patients who breastfeed their babies.

3. Changes in the Oral Microbiome

The oral microbiome shifts during pregnancy, often favoring more acid-producing bacteria. These changes don’t immediately reverse after delivery. When combined with lower saliva flow and mineral depletion, this microbial imbalance strongly contributes to postpartum cavities.

4. Increased Snacking and Nighttime Eating

Many new mothers eat more frequently (as well they should), often late at night (again, as well they should), to support breastfeeding and manage exhaustion. Unfortunately, frequent eating without immediate/adequate brushing increases acid exposure on teeth. This pattern is a significant driver of postpartum cavities, even when total sugar intake is not excessive.

Need an easy fix Pop a xylitol containing breath mint or chew a piece of xylitol-containing gum. Studies show that xylitol reduces the growth of cavity-forming oral bacteria. Xylitol consumption is considered safe during pregnancy (but check with your doctor) and studies even show that the children mothers who consume xylitol when pregnant themselves have lower risk of cavities.

Looking for an ultra-natural option? Underbrush Remineralizing Gum is a chewing gum made from natural tree sap with all natural ingredients and even nano-hydroxapatite which remineralizes teeth and stops decay.

5. Sleep Deprivation and Stress

Chronic stress and sleep deprivation elevate cortisol, impair immune function, and reduce the body’s ability to repair tissues. Teeth are living structures, and their ability to repair micro-damage is compromised in high-stress states. This is another underappreciated contributor to postpartum cavities.

I’ve said it before and I’ll say it again: sleep when your baby sleeps.

Why Traditional Dental Advice Falls Short

Most conventional explanations for postpartum cavities focus narrowly on brushing, flossing, and sugar intake. While these matter, they do not explain why so many women develop postpartum cavities despite good oral hygiene.

A functional medicine approach looks upstream. Postpartum cavities are a sign of systemic imbalance, not just local tooth decay. Addressing only the teeth without supporting the whole body often leads to recurring problems. Once again, a tooth problem is a gut problem, and we need to look inward to solve outward signs of toothe decay.

The Role of the Gut in Postpartum Cavities

It may surprise you to learn that postpartum cavities are closely tied to gut health. The gut microbiome influences mineral absorption, immune regulation, and inflammation throughout the body, including in the mouth.

Antibiotics during labor, C-sections, stress, and sleep deprivation all disrupt gut health postpartum. Poor mineral absorption and systemic inflammation increase susceptibility to postpartum cavities. Supporting gut healing is therefore a critical part of addressing postpartum cavities holistically.

Want to learn more about supporting your gut health Check out all the latest articles here.

Breastfeeding and Postpartum Cavities

Breastfeeding itself does not cause postpartum cavities, but it does increase nutritional demands. Producing breast milk requires significant amounts of calcium, magnesium, iodine, and fat-soluble vitamins. If intake does not meet demand, maternal stores are depleted, increasing the risk of postpartum cavities.

Based on his research in communities with little-to-no dental decay, Dr. Weston A Price (dentist) suggests a diet rich in whole foods, healthy fats, raw dairy and properly prepared (soaked, fresh-milled) grains. He also advocates for eating organ meats, bone broths, wild fish and fermented foods and avoiding processed foods. I will acknolwedge, postpartum is a time like no other to rely on prepared foods to support stress levels during the postpartum period. However, an ounce of prevention is worth a pound of cure. If you’re pregnant, check out this post about prepping nutritious meals for postpartum so that you are freed from so much reliance on food manufacturers to support your postpartum nutrition (seeing as they tend to be more concerned with their own profits than with your health, including your dental health.)

Nutrients That Protect Against Postpartum Cavities

One of the most powerful ways to prevent and heal postpartum cavities is by replenishing key nutrients.

• Calcium and phosphorus are foundational for tooth structure.
• Magnesium supports proper calcium utilization.
• Vitamin D regulates mineral absorption.
• Vitamin K2 directs calcium into teeth and bones rather than soft tissues.
• Vitamin A supports enamel integrity and immune defense.

Many women with postpartum cavities are deficient in one or more of these nutrients, even if they eat a generally healthy diet. All of these nutrients can be found in quality animal foods, like slow cooked meat on the bone. (And what postpartum mama doesn’t love a good crockpot meal?)

Blood Sugar Balance and Postpartum Cavities

Blood sugar instability is another overlooked contributor to postpartum cavities. Postpartum insulin resistance, sleep deprivation, and stress can all lead to blood sugar swings. Elevated blood sugar feeds acid-producing oral bacteria, increasing the likelihood of postpartum cavities.

Eating balanced meals with adequate protein, fat, and minerals helps stabilize blood sugar and reduce cavity risk.

What You Can Do If You Already Have Postpartum Cavities

If you’ve already been diagnosed with postpartum cavities, please know that this is not the end of the story. Dental treatment is sometimes necessary, but it should be paired with systemic support.

Addressing mineral repletion, gut health, hormone balance, and stress can slow or halt the progression of postpartum cavities and reduce future risk. Many women find that once these underlying issues are addressed, they stop developing new postpartum cavities altogether.

Practical Daily Habits to Support Oral Health Postpartum

Gentle but consistent oral care matters. Check out these tips:

• Use a soft toothbrush, particularly an electric one with a rotary head. We use the Oral B Pro 1000
• Avoid aggressive brushing (much easier with an electric brush), and consider remineralizing tooth powders or pastes. Rinsing with water after nighttime feeds or snacks can reduce acid exposure and help prevent postpartum cavities.

Avoid constant sipping on sweetened beverages, including juice and sweetened coffee drinks. Even “natural” sugars contribute to postpartum cavities when exposure is frequent.

Preventing Postpartum Cavities in Future Pregnancies

If you’ve experienced postpartum cavities once, you may be at higher risk in subsequent pregnancies. The good news is that prevention is possible.

Entering pregnancy with strong mineral reserves, supporting gut health, managing blood sugar, and prioritizing postpartum nourishment can dramatically reduce the risk of postpartum cavities the next time around.

Final Thoughts on Postpartum Cavities

If you are dealing with postpartum cavities, you are not alone, and you are not broken. This is a common and understandable outcome of the intense demands placed on the body during pregnancy and postpartum.

With the right support, education, and nourishment, it is absolutely possible to protect your teeth, restore balance, and move forward with confidence. Postpartum cavities are not just a dental issue—they are a whole-body message asking for care, rest, and replenishment.

And that message deserves to be heard.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Postpartum Cavities appeared first on Dr. Alexandra MacKillop.

Genetic testing often enters the fertility conversation through IVF, when embryo testing before transfer identifies certain chromosomal and inherited risks. Many couples appreciate this information, though there are potential moral concerns regarding what to do with carriers. Embryos aside, however, gene testing before pregnancy can also offer insight into a mother (or father’s) health as it applies to successful conception, miscarriage prevention, and reducing risks for the baby both before and after being born. Moreover, valuable genetic insight does not require IVF. This is great news, as most couples actively seek ways to conceive naturally and avoid invasive reproductive technology. Gene testing before pregnancy delivers similar information through the lens of functional medicine while still supporting informed and proactive choices.

Why Complete Gene Testing Before Pregnancy?

When mothers and couples have access to their genetic information, they gain clarity. This clarity pertains not just to potential diagnoses, but about long-standing health patterns and inherited vulnerabilities that may otherwise go unnoticed. Gene testing before pregnancy allows care to shift from reactive to truly preventive. Rather than waiting for complications to surface during pregnancy or delivery, couples have the opportunity to intervene early with lifestyle strategies to support their genetic, and epigenetic health.

This kind of foresight is foundational in functional medicine. Strategies like nutrient repletion, supporting detoxification pathways, reducing inflammation, and optimizing hormone balance are far more effective when they’re guided by genetics instead of reactions or guesswork. After all, you can’t correct, prevent, or support a risk you don’t yet know exists.

Who Should Consider Gene Testing Before Pregnancy?

Genetics are part of everyone’s health story. Our genes carry disease risk, but our environment and exposures throughout life, both positive and negative, influence whether those genes are expressed. High-quality nutrition, for example, can help quiet genes associated with cancer risk as well as fertility-related conditions like PCOS, endometriosis, and autoimmune disease. On the other hand, environmental toxins, chronic stress, and repeated or high-dose antibiotic use can switch these same genes on. When that happens, health can suffer in ways that directly and sometimes dramatically affect fertility.

Because of this, it’s reasonable to argue that nearly everyone can benefit from understanding their genetic health, and many may want to consider gene testing before pregnancy as part of a proactive approach to family planning.

Age adds an important layer of urgency to this conversation. After age 35, egg quality naturally declines, and genetic vulnerabilities tend to exert a stronger influence. Issues like chromosomal instability, impaired methylation, oxidative stress, and clotting tendencies can impact fertility and pregnancy outcomes more significantly. This is not just a maternal issue. Paternal genetics matter as well, since a healthy pregnancy and child require both a healthy egg and a healthy sperm.

In this post, we’ll explore five ways prospective mothers and fathers can use gene testing before pregnancy to optimize their own health and support the long-term health of their future children.

1. MTHFR (Methylenetetrahydrofolate Reductase)

One of the most commonly discussed genetic findings in preconception care involves the MTHFR gene. Variants in MTHFR can affect folate metabolism, methylation efficiency, and the body’s ability to detoxify effectively. Impaired methylation has been linked to miscarriage, preeclampsia, placental dysfunction, and neural tube defects.

Gene testing before pregnancy gives prospective parents the opportunity to identify these risks early and support detoxification and DNA synthesis before those demands increase during pregnancy. Testing for MTHFR typically identifies variants such as C677T or A1298C through saliva or blood samples. An individual may carry one copy (heterozygous) or two copies (homozygous) of a given variant, which can influence how significantly methylation pathways are affected. Insurance coverage varies and is often dependent on a history of pregnancy loss or clotting disorders.

From a functional medicine perspective, these findings guide targeted interventions, including the use of methylated folate and other B vitamins, limiting exposure to synthetic folic acid, and reducing environmental toxin burden. This becomes especially important when evaluating standard prenatal vitamins, many of which may not be appropriate for individuals with certain MTHFR variants.

2. Factor V. Leiden

Clotting genetics are another critical piece of the preconception puzzle. Inflammation and abnormal clot formation pose serious risks during pregnancy and can contribute to pregnancy loss at any stage. One of the most well-known examples is Factor V Leiden, a genetic variant that increases the tendency toward excessive clotting and can interfere with normal placental blood flow. This disruption raises the risk for miscarriage, stillbirth, fetal growth restriction, and preeclampsia.

Gene testing before pregnancy can identify whether an individual carries one copy (heterozygous) or two copies (homozygous) of this variant through blood or saliva testing. Insurance coverage often depends on family history or a record of prior pregnancy complications. When clotting risk is identified early, care can focus on reducing inflammation, supporting healthy circulation, and coordinating obstetric management, including anticoagulation when clinically appropriate.

• Treatment: Strategies usually include blood thinners (anticoagulants) such as low molecular-weight heparin (LMWH) and sometimes, aspirin. Functional medicine also offers natural benefit from higher dose fish oil. Talk to your doctor about your options for Factor V as well as mutations in Prothrombin G20210A (below).

3. Prothrombin G20210A

Another important clotting-related gene to consider is the Prothrombin G20210A mutation. This variant also increases the risk of abnormal clot formation and can compromise placental circulation. Pregnancy places significant demand on vascular health, and genetic interference in these pathways raises the risk for both maternal and fetal complications.

Gene testing before pregnancy can identify this mutation through standard laboratory testing, with insurance coverage typically following the same criteria used for Factor V Leiden. From a functional medicine perspective, this knowledge allows care to focus on prevention rather than crisis management. Targeted nutrient support, inflammation control, and proactive monitoring can be put in place early, empowering mothers to pursue appropriate maternal care long before a pregnancy complication ever occurs. As a functional medicine doctor, my #1 treatment is a whole foods, ancestral diet that includes organ meats, fish and healthy animal fats.

4. COMT (Catechol-O-Methyltransferase)

Genetics related to hormone metabolism also play an important role in fertility and overall pregnancy experience. Variants in the COMT gene influence how the body clears estrogen, regulates neurotransmitters, and responds to stress. Slower estrogen metabolism can contribute to hormone dominance, implantation difficulties, and more pronounced pregnancy symptoms. Increased stress sensitivity disrupts cortisol balance, which in turn affects immune tolerance and hormonal signaling throughout pregnancy. COMT variations may also influence how an individual responds to certain antidepressant medications, a consideration that is especially relevant given how many women are using these medications prior to conception or during pregnancy.

Gene testing before pregnancy often evaluates COMT through saliva-based genetic panels. Insurance coverage is uncommon, and self-pay rates vary depending on which other markers are involved on the genetic panels. (I’ve seen anywhere from $100 to $350). In functional medicine, these results guide strategies such as supporting estrogen detoxification pathways, improving stress resilience, and providing targeted micronutrient support. Because stress and impaired hormone metabolism can significantly challenge both conception and pregnancy, addressing these risks proactively allows many of these obstacles to be prevented rather than managed after the fact.

5. CFTR (Cystic Fibrosis Transmembrane Conductance Regulator)

Carrier screening plays a crucial role in responsible family planning. CFTR gene testing identifies carrier status for cystic fibrosis and sheds light on certain male fertility issues. An estimated 1 in 25 people is a carrier of CFTR mutations, so couples benefit from knowing this about themselves before conception. Gene testing before pregnancy uses blood or saliva samples to determine carrier status rather than disease presence. Insurance frequently covers this screening during pregnancy planning or when family history exists. Genetic counseling supports informed decisions when both partners carry variants.

Taken together, these tests form a powerful foundation for prevention, but modern prenatal care rarely encourages couples to complete this testing outside of IVF offices. However, all couples deserve to know the truth about their health so they can hopefully avoid the pain and devastation of fertility and pregnancy challenges. Gene testing before pregnancy replaces uncertainty with strategy. Each result informs nutrition, supplementation, and lifestyle choices for maximally effective preventative medical care.

Functional medicine is founded on this level of personalization. Work with a functional medicine doctor to unlock your own genetic potential to maximize your health, fertility, longevity and more.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

Don’t miss out! Join the email list.

Sign Me Up!

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Want more Grab a copy of my new book, The Postpartum Check-In !

Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Gene Testing Before Pregnancy: Why and How to Harness the Power of Your DNA appeared first on Dr. Alexandra MacKillop.

• What are peptides?
• Are they safe?
• How can they benefit my health?
• Where can I get them?

You can find answers to all of these questions and more in today’s article.

What Is Peptide Therapy?

Peptide therapy is a medical treatment that uses specific peptides—short chains of amino acids naturally found in the body—to target and enhance various biological functions. By mimicking or influencing natural processes, peptide therapy offers the potential to support a wide range of health goals, including improved skin health and slowed aging, accelerated injury recovery, boosted muscle growth, enhanced fat metabolism, regulated hormones, a strengthened immune system, and improved sexual function. Because peptides are highly targeted and generally well-tolerated, this form of therapy is often used in functional and regenerative medicine to promote healing, performance, and overall wellness.

The peptide therapy that has gained the most notoriety (and controversy) in recent years is the class of peptides known as GLP-1 agonist drugs. These drugs contain the active ingredient, Semaglutide, which is a peptide that looks and acts similarly to the body’s own GLP-1, and brings about many similar effects, like blood sugar control and satiety in appetite.

Other peptides provide similar mimicking effects, though they don’t all act like GLP-1. Instead, other peptides impact a wide variety of biological functions. For this reason, it’s important to remember that peptide therapy cannot be used to affect just one single function of the human body. Because these peptides affect so many other areas of the body, just like how GLP-1 affects both blood sugar and appetite, it’s impossible to isolate just one effect of a given peptide.

Many peptides are very early in their research timeline, meaning that there is very limited data available about their safety, and even how they work in the body. We may have identified some applications for use, such as one particular parameter of health (i.e. muscle recovery for BPC-157) but we have yet to understand fully how this peptide affects the other bodily systems. This is particularly the reason that peptides, especially Ozempic and other drugs akin to semaglutide that have gained notoriety, are so controversial. There’s just a lot that we still don’t know, and might never know.

However, particularly in circumstances where few good options exist, peptide therapy might prove to be one of the best options out there. Let’s discuss how peptide therapy can offer benefits, in spite of some of the potential risks.

How Can Peptide Therapy Benefit Health?

Peptide therapy can be applied across a wide range of health and wellness areas, with specific peptides targeting different physiological systems.

Anti-Aging Peptide Therapy

In the area of anti-aging and longevity, peptides such as CJC-1295, Ipamorelin, Sermorelin, collagen peptides, IGF-1, and Thymosin Beta-4 (TB-500) help boost growth hormone levels, improve skin elasticity, enhance energy, support deeper sleep, and promote overall cellular repair and regeneration.

Peptide Therapy for Sports and Recovery

For sports medicine and injury recovery, peptides like BPC-157, Thymosin Beta-4, IGF-1, GHRP-2, GHRP-6, and Hexarelin are used to accelerate healing from injuries, reduce inflammation, regenerate muscle and connective tissue, and support faster recovery times. In the context of weight management and metabolism, peptides such as AOD 9604, CJC-1295, Ipamorelin, and Carterine (GW-501516) play a role in stimulating fat breakdown, increasing metabolic rate, enhancing lean muscle retention, and improving energy levels during fat loss efforts.

Peptide Therapy for The Immune System

For immune system support and inflammation reduction, peptides like Thymosin Alpha-1 (TA1), BPC-157, and vasoactive intestinal peptide (VIP) help strengthen the immune response, reduce systemic inflammation, and support healing, especially in autoimmune or inflammatory conditions. In the area of sexual health and hormone support, PT-141 (Bremelanotide), Kisspeptin, and Gonadorelin are used to enhance libido, improve erectile function, and regulate reproductive hormones, making them useful for both sexual performance and fertility.

Peptide Therapy for Muscle Growth

Lastly, for muscle growth and performance enhancement, peptides such as Follistatin, IGF-1, GHRP-6, GHRP-2, Hexarelin, and Carterine are employed to promote muscle hypertrophy, increase strength, enhance endurance, and inhibit myostatin—a natural limiter of muscle growth. Collectively, these peptides offer a broad therapeutic toolkit for improving physical health, performance, recovery, and overall vitality.

Which Types of Conditions Benefit from Peptide Therapy?

Neurological & Cognitive Disorders

• Cognitive decline / brain fog
• Alzheimer’s disease / dementia (e.g., Cerebrolysin)
• Depression & anxiety (via BDNF-related peptides or ones that support neurotransmitter balance)
• Traumatic brain injury (TBI)

Peptides like Dihexa, Selank, and Semax are neuroprotective and enhance focus, memory, and mood.

Musculoskeletal & Injury Recovery

• Tendon, ligament, and joint injuries
• Osteoarthritis
• Post-surgical healing
• Muscle recovery & growth

Common peptides: BPC-157, TB-500 (Thymosin Beta-4) – promote tissue repair, angiogenesis, and reduce inflammation.

Anti-Aging & Longevity

• Decreased growth hormone production
• Fatigue / low energy
• Wrinkles, thinning skin

Peptides like Ipamorelin, CJC-1295, and GHRH analogs stimulate natural growth hormone production.

Metabolic & Weight-Related Disorders

• Obesity / weight gain
• Insulin resistance / Type 2 diabetes
• Low energy

Peptides: GLP-1 agonists (e.g., Semaglutide, Tirzepatide), AOD-9604 for fat loss, Motilin agonists for digestion.

Hormonal Imbalances

• Low testosterone / estrogen / thyroid
• Adrenal fatigue
• Sexual dysfunction

Peptides can modulate LH/FSH, improve libido, and optimize endocrine system. Example: Kisspeptin-10 for LH/FSH stimulation.

Immune System Modulation

• Autoimmune diseases
• Chronic inflammation
• Recurrent infections

Peptides like Thymosin Alpha-1 and Thymosin Beta-4 support immune regulation and antiviral defense.

Skin, Hair & Aesthetic Applications

• Hair loss (androgenic alopecia)
• Skin aging / damage
• Scarring

Peptides like GHK-Cu (copper peptide), Melanotan II (for tanning, though there are many documented risks), and others are used cosmetically.

Sleep Disorders

• Insomnia
• Poor sleep quality

Peptides such as DSIP (Delta Sleep-Inducing Peptide) are being explored for sleep enhancement, and even has clinical utility in management of withdrawal from alcohol and opiates.

What Are Some Types of Peptide Therapy?

Here’s a list of some common peptides used in peptide therapy and their potential benefits:

1. Growth Hormone-Releasing Peptides (GHRPs)

• GHRP-2 / GHRP-6 / Ipamorelin: These peptides stimulate the release of growth hormone (GH) from the pituitary gland, which can help improve muscle growth, fat loss, and recovery.
  • Benefits: Increased muscle mass, fat reduction, better recovery, enhanced energy.

2. CJC-1295 (Modified GRF 1-29)

• A synthetic peptide that stimulates the release of growth hormone by enhancing the action of ghrelin.
  • Benefits: Increased muscle mass, fat loss, improved skin elasticity, enhanced sleep quality.

3. BPC-157 (Body Protective Compound-157)

• A peptide that promotes healing and tissue repair. It’s often used for injury recovery.
  • Benefits: Accelerates wound healing, reduces inflammation, improves joint health, and promotes tendon and ligament recovery.

4. Thymosin Beta-4 (TB-500)

• A peptide that plays a role in tissue repair and regeneration.
  • Benefits: Accelerates healing of wounds and injuries, especially related to muscles, tendons, and ligaments. Helps with inflammation and scar tissue reduction.

5. Melanotan II

• A peptide that stimulates the production of melanin in the skin.
  • Benefits: Used for tanning purposes, and some studies suggest it could also have appetite-suppressing effects and potentially improve erectile function.

6. Thymosin Alpha-1 (TA1)

• A peptide that modulates the immune system and helps in the recovery of infections.
  • Benefits: Enhances immune function, reduces inflammation, and may improve the body’s response to viruses or other pathogens.

7. IGF-1 (Insulin-like Growth Factor-1)

• A peptide similar to insulin that promotes cell growth and development. It’s sometimes used to help build muscle and support repair after intense workouts or injury.
  • Benefits: Promotes muscle growth, speeds up recovery, supports tissue repair, and enhances fat loss.

8. Carterin (GW-501516)

• A peptide used primarily for fat loss and endurance enhancement.
  • Benefits: Improves endurance, promotes fat loss, increases metabolic rate, and boosts cardiovascular performance.

9. PT-141 (Bremelanotide)

• A peptide used to treat sexual dysfunction, specifically in people with low libido.
  • Benefits: Increases sexual arousal and libido in both men and women.

10. Follistatin

• A peptide that inhibits myostatin (a protein that limits muscle growth), promoting muscle growth.
  • Benefits: Muscle growth, enhanced recovery, and potentially improved fat metabolism.

11. Kisspeptin

• A peptide that plays a role in reproductive health, influencing sexual function and fertility.
  • Benefits: Regulates puberty onset, increases LH and FSH (important hormones for sexual function), and can be used to treat infertility.

12. Gonadorelin

• A peptide that stimulates the release of hormones like luteinizing hormone (LH) and follicle-stimulating hormone (FSH), supporting sexual health.
  • Benefits: Increased testosterone in men, ovarian function in women, and potential fertility enhancement.

13. Hexarelin

• Another peptide that stimulates the secretion of growth hormone.
  • Benefits: Supports muscle growth, fat loss, and recovery, with fewer side effects than other growth hormone secretagogues.

14. AOD 9604

• A modified fragment of human growth hormone (hGH) that targets fat burning.
  • Benefits: Stimulates fat breakdown without affecting muscle tissue or increasing appetite.

15. Vasoactive Intestinal Peptide (VIP)

• A peptide with anti-inflammatory and immunomodulatory effects.
  • Benefits: Used for conditions like autoimmune diseases and chronic inflammation, improves circulation, and has potential neuroprotective properties.

16. Sermorelin

• A peptide that stimulates the release of growth hormone from the pituitary gland, used for anti-aging and muscle-building.
  • Benefits: Enhances growth hormone release, promotes muscle development, fat loss, and better sleep quality.

17. Collagen Peptides

• Peptides derived from collagen, commonly used for skin, hair, and joint health.
  • Benefits: Improves skin elasticity, promotes joint and bone health, and may reduce wrinkles.

Peptide therapy represents a promising frontier in modern medicine, offering targeted support for everything from anti-aging and muscle recovery to immune health and hormone regulation. While some peptides like GLP-1 agonists have gained widespread attention and sparked debate, many others are still being explored for their broad and sometimes unpredictable effects on the body. Despite the need for further research, peptide therapy holds significant potential as a versatile tool for enhancing overall wellness, addressing chronic conditions, and improving quality of life. As interest grows, it’s important to approach peptide therapy with informed guidance and professional oversight to safely unlock its many benefits.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

Don’t miss out! Join the email list.

Sign Me Up!

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Want more Grab a copy of my new book, The Postpartum Check-In !

Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Everything You Need to Know About Peptide Therapy appeared first on Dr. Alexandra MacKillop.

Why Do You Need a 12 Week Weight Lifting Plan?

Weight lifting has a profound impact on cortisol, insulin, progesterone, and fat metabolism. These benefits, combined with the increased calorie burn at rest, make it a foundational practice for body contouring and fat loss.

Here’s the thing though: these lab markers need to be tested and then retested in order to show results. Progesterone takes up to three months to see changes, and markers like hemoglobin a1c for blood sugar and insulin resistance depend on the three-month life cycle of your red blood cells. This means that if you want to see meaningful changes in these markers, you need to give it a solid three-month go. In other words, you need a 12 week weight lifting plan!

If you’ve been relying on cardio for weight loss or hormone balance, it’s time to reconsider. Let’s dive into how weight lifting works, from a hormonal perspective, and why it’s non-negotiable in any sustainable weight loss or body transformation plan.

Why Weight Lifting Affects Cortisol

Cortisol is the body’s primary stress hormone. Produced by the adrenal glands, cortisol’s job is to help the body respond to stress—whether physical, emotional, or environmental. But when cortisol levels remain high over long periods, the body shifts into a state of chronic stress, which leads to fat retention, particularly around the abdomen.

Cardio, especially intense, long-duration exercises like running or high-impact aerobic routines, elevates cortisol levels. While this isn’t inherently bad, consistently high cortisol can cause muscle breakdown and interfere with the body’s ability to burn fat. Weight lifting, on the other hand, works with the body’s stress response to improve the overall balance of cortisol.

Intense weight lifting increases muscle mass, which in turn helps regulate cortisol. More muscle means a better ability to manage stress and burn fat. When you build muscle through weight lifting, your body becomes more resilient to stressors, reducing the overproduction of cortisol and preventing the fat-storage response. The increase in muscle tissue also supports better sleep and recovery, which are crucial for keeping cortisol at bay.

In a 12-week weight lifting plan, cortisol levels stabilize as your body adapts to progressive overload. This enables a balanced stress response, leading to reduced belly fat and improved overall body composition.

Why Weight Lifting Affects Insulin Sensitivity

Insulin is another key hormone in fat metabolism. When we eat carbohydrates, insulin is released to help our body absorb glucose. Over time, excessive sugar and refined carbs cause the body to become insulin resistant—a condition where the body doesn’t respond to insulin properly, leading to higher blood sugar levels and fat storage. This is particularly common in conditions like PCOS, which are often characterized by insulin dysregulation.

Insulin resistance is a significant barrier to weight loss, particularly when fat cells become saturated with excess glucose. Traditional cardio routines don’t effectively address insulin resistance in the way weight lifting does. Weight lifting, however, improves insulin sensitivity, allowing your body to process glucose more efficiently and burn fat as fuel instead of storing it.

Weight lifting forces the body to use energy in the form of glucose and fat during the recovery process. As muscle fibers break down and rebuild, the body becomes more efficient at using insulin and glucose. This process not only improves energy production but also reduces fat storage, as your body begins to burn fat at rest instead of relying on glucose.

Incorporating a 12-week weight lifting plan into your routine leads to a significant increase in insulin sensitivity, making it easier to lose fat and maintain a healthy weight. As your muscles grow, the increased demand for glucose helps clear excess sugar from your bloodstream, further promoting fat loss.

Weight Lifting and Hormones

Progesterone is a vital hormone for women, playing an essential role in regulating the menstrual cycle and supporting fertility. Progesterone is produced from pregnenolone, a precursor hormone that is the building block for several other steroid hormones, including cortisol, estrogen, and testosterone.

When the body is under chronic stress, as it often is with long bouts of cardio, the adrenal glands prioritize cortisol production through a process known as pregnenolone steal. This happens when the body diverts pregnenolone from progesterone production to make more cortisol, which lowers overall progesterone levels. Low progesterone can lead to symptoms like irregular periods, mood swings, and difficulty losing fat.

Weight lifting, however, helps prevent pregnenolone steal by reducing chronic stress and improving the body’s ability to manage cortisol levels. The controlled stress of weight lifting encourages hormonal balance, ensuring that pregnenolone is used to produce progesterone, not cortisol. As a result, weight lifting supports the body’s natural progesterone production, which helps balance estrogen and supports fat metabolism.

Additionally, weight lifting helps improve thyroid function, another factor in hormonal balance, which is often impacted by excessive cardio and stress. For women looking to optimize hormonal health and fat loss, weight lifting is far more effective than cardio, especially when it comes to maintaining or increasing progesterone levels.

The Impact of Muscle Mass on Calorie Burn at Rest

One of the most overlooked benefits of weight lifting is its ability to increase calorie burn at rest. Unlike cardio, which burns calories during the activity itself, weight lifting creates a lasting metabolic effect. This is because muscle tissue requires more energy to maintain than fat tissue. The more muscle you have, the higher your resting metabolic rate (RMR) becomes.

When you lift weights, especially with progressive overload (increasing the weight or intensity of exercises over time), you create muscle micro-tears that require the body to expend energy to repair and rebuild the muscle fibers. This process, known as muscle hypertrophy, boosts the afterburn effect (known as excess post-exercise oxygen consumption or EPOC), causing the body to continue burning calories even after the workout is over.

With each lift, your body burns calories not only during the session but also in the hours and even days following the workout as muscle tissue recovers. Over time, this leads to a significant increase in calorie expenditure, even while you’re resting or sleeping. This increased calorie burn at rest directly supports fat loss, helping to reduce body fat percentage without the constant need for cardio.

Why Weight Lifting is Essential for Body Contouring and Fat Loss

When it comes to body contouring—changing the shape and composition of your body—weight lifting is non-negotiable. It’s not just about burning fat; it’s about building muscle that will give your body the tone and shape you desire. Unlike cardio, which tends to result in general weight loss, weight lifting allows you to sculpt and define your body by increasing muscle mass.

Muscle is denser than fat, meaning that as you build muscle, you’re not just losing fat—you’re reshaping your body. This is why weight lifting is the key to long-term fat loss and contouring. As you continue to increase muscle mass through weight lifting, your body naturally becomes leaner, firmer, and more toned. Plus, muscle tissue is metabolically active and burns more calories, even at rest, making weight lifting an investment in your long-term fat loss goals.

For body contouring specifically, lifting weights boosts your metabolism in a way that cardio can’t. It allows for fat loss while maintaining or increasing lean muscle mass, ensuring that you’re not just shrinking your body, but actually shaping it. This makes it far more effective than cardio when it comes to achieving your desired physique.

12 Week Weight Lifting Plan

If you’re ready to get serious about your hormone health and fat loss, there’s no better time to start than now. A 12-week weight lifting plan will transform your body, boost your metabolism, balance your hormones, and reshape your figure. Over the course of 12 weeks, the gradual increase in weight and intensity will allow you to build muscle while optimizing your hormonal profile. By the end of the program, you’ll notice improved insulin sensitivity, reduced cortisol levels, balanced progesterone, and a significant increase in calorie burn at rest.

Are you ready to transform your body and health with weight lifting Check out our 12-week weight lifting plan at the end of this post to get started on the path to hormonal harmony, fat loss, and a body that feels as good as it looks.

The post 12 Week Weight Lifting Plan for Hormone Health appeared first on Dr. Alexandra MacKillop.

If you’re wondering how to naturally increase fertility, the most important thing you should know is that fertility isn’t just about the reproductive organs—it’s a whole-body indicator of health. As a functional medicine doctor, I’ve helped countless patients learn how to naturally increase fertility by addressing imbalances across all systems of the body. If you’re trying to conceive without resorting to pharmaceuticals or IVF, this guide will give you the strategic, root-cause roadmap to reclaim your fertility naturally.

Why Increase Fertility Naturally?

Natural fertility optimization isn’t just about conception—it’s about creating the healthiest possible environment for you and your future child. Couples choose to increase fertility naturally because they want to avoid synthetic hormones, invasive procedures, or expensive treatments that ignore the real cause of the issue. They want to heal, not override, their bodies. IUI, IVF and other fertility treatments can alo be extremely costly, which is another important reason to consider learning how to naturally increase fertility. However, even when pursuing fertility treatments, or perhaps undergoing a process of egg retrieval for egg freezing or a sperm harvesting for sperm freezing, it’s still a good idea to take all possible measures to increase fertility naturally so that the eggs have the best possible chance of success.

Conventional medicine often reduces fertility to a hormone problem. But infertility is a signal—your body is telling you something is off. When we listen, investigate, and treat the underlying dysfunction, the result isn’t just fertility—it’s vitality, balance, and lasting health.

Lifestyle Practices That Harm Fertility

Before we can build fertility, we need to stop destroying it. The modern lifestyle is fertility-toxic. Here’s how:

• Chronic Stress: Activates the HPA axis and shuts down reproductive hormones. Cortisol hijacks your cycle, suppressing ovulation and libido. It also significantly suppresses testosterone production and sperm quality in men.
• Poor Sleep: Disrupts circadian rhythms and hormone production—especially melatonin and progesterone, as well as testosterone in men.
• Toxin Exposure: Pesticides, BPA, phthalates, and heavy metals mimic hormones and disrupt endocrine balance. There is also data out there that exposure to plastics in clothing also act as fertility disruptors, creating changes in electrical and magnetic signaling that negatively impact ovarian function and sperm quality. Look for clothing that is free of plastics, PUFAs, and other synthetics.
• Nutrient-Deficient Diets: Low-fat, high-sugar, or overly restrictive diets destroy hormone production and egg quality. Our ultra-processed modern diet is void of nutrients despite being rich in processed carbohydrates and seed oils. In fact, both simple carbs and seed oils have been proven to negatively impact fertility. Aim to include high-quality animal proteins and fats as well as organic, darkly colored fruits and vegetables like berries and leafy greens. I also recommend a daily carrot salad for hormone balance.
• Overtraining/Under-Eating: Particularly common in driven, Type A women, this leads to hypothalamic amenorrhea, where the brain shuts down ovulation entirely.
• Alcohol, Caffeine, and Smoking: All three impair egg quality, sperm health, and hormone balance. I recommend avoiding all three if you’re TTC.

A note about these lifestyle factors: These foundational elements are pretty universal amongst articles describing methods for how to naturally increase fertility. Because they’re so ubiquitous, it may seem tempting to overlook them in search of something more direct, more exclusive, or more granular. While I do offer such recommendations below, I want you to know that lifestyle is the single most important factor in fertility as well as in health as a whole. It will do you no good to look to supplements or anything else for how to naturally increase fertility while overlooking the lifestyle. There is no supplements, and honestly no drug, that can undo the effects of poor sleep, high stress, toxin exposure, calorie deficits, substance abuse, and a poor diet.

How to Naturally Increase Fertility by Identifying the Root Cause of Fertility Disorders

To truly increase fertility naturally, you must identify why your body isn’t conceiving. Here are the most common root-cause conditions that sabotage fertility:

1. Thyroid Disorders

Low thyroid function (hypothyroidism) decreases progesterone, disrupts ovulation, and increases miscarriage risk. If your TSH is “normal” but you’re still tired, cold, or constipated—get a full thyroid panel. Subclinical hypothyroidism often flies under the radar. Hyperthyroidism, such as seen in Graves’ disease, also negatively impacts fertility. If you’re wondering how to increase fertility naturally, you should start by getting your thyroid thoroughly checked out.

2. PCOS (Polycystic Ovary Syndrome)

PCOS is an insulin-resistance and androgen-dominance issue. It impairs ovulation, leads to cystic ovaries, and causes irregular cycles. You must correct blood sugar dysregulation, reduce inflammation, and support hormone detoxification to restore ovulation.

3. Endometriosis

This inflammatory, estrogen-driven condition causes pelvic pain and infertility by distorting reproductive anatomy and disrupting implantation. Gut health, immune balance, and estrogen metabolism must be addressed aggressively.

4. Hypothalamic Amenorrhea

This is the brain pulling the emergency brake on fertility due to perceived stress or lack of energy availability. It’s common in athletes, perfectionists, and under-eaters. Recovery requires restoring adequate caloric intake, body fat, and nervous system calm.

5. HPA Axis Dysfunction (Adrenal Fatigue)

The hypothalamic-pituitary-adrenal axis controls the stress response. When it’s dysregulated, it suppresses reproductive hormones. You must rewire the stress response through nervous system regulation, sleep, and adrenal support to restore fertility.

How to Naturally Increase Fertility with Supplements

Certain nutrients powerfully support reproductive function. Many of these are key players in my practice for optimizing fertility:

• Myo-Inositol: Improves insulin sensitivity and ovulatory function—especially critical for PCOS.
• CoQ10 (Ubiquinol): Enhances mitochondrial function in eggs and sperm, improving quality and developmental potential.
• Omega-3 Fatty Acids: Reduce inflammation and support hormone production.
• Methylated B Vitamins (especially B9/Folate): Crucial for methylation, egg health, and preventing neural tube defects.
• Magnesium: Calms the nervous system, supports adrenal function, and improves sleep—all essential for fertility.
• Vitamin D3: Regulates hormone production and immune balance. Low levels are directly linked to infertility and miscarriage.

How to Naturally Increase Fertility by Looking at the Whole Body

Your uterus does not operate in a vacuum. Fertility is the result of systemic harmony, not isolated hormonal tweaks. Here’s how the entire body affects your ability to conceive:

Brain & Nervous System

The hypothalamus and pituitary gland orchestrate your reproductive cycle. Chronic stress rewires your brain to shut down reproduction. Nervous system regulation—via breathwork, somatic practices, and trauma healing—is fertility medicine.

Gut Health

The gut regulates nutrient absorption, immune response, and estrogen metabolism. Dysbiosis, leaky gut, or SIBO drive inflammation and hormone imbalance. Heal the gut, and you lay the groundwork for conception.

Liver Function

The liver detoxifies excess estrogen and metabolizes hormones. A sluggish liver leads to estrogen dominance, PMS, and ovulatory issues. Support with cruciferous vegetables, dandelion root, NAC, and targeted herbs.

Blood Flow

Pelvic blood flow is essential for ovarian and uterine health. Sedentary lifestyle, poor circulation, and inflammation impair oxygen and nutrient delivery to reproductive organs. Movement, dry brushing, acupuncture, and castor oil packs all enhance circulation.

Musculoskeletal System

Tension in the pelvis, scar tissue, or misalignment in the spine can block blood flow and nerve signaling. Bodywork (chiropractic, craniosacral therapy, pelvic floor therapy) helps clear the path for conception.

Lymphatic System

The lymphatic system clears cellular waste and toxins. A stagnant lymph system clogs hormone pathways and raises inflammation. Rebounding, sauna, hydration, and manual lymph drainage support this overlooked detox pathway.

Final Thoughts: Fertility Is a Barometer of Health

To naturally increase fertility, you must stop chasing hormones and start chasing health. When your body feels safe, nourished, and in balance—it will create life. This isn’t theory. I’ve seen it happen over and over with patients who were told their only option was IVF.

Natural fertility is not luck. It’s the result of uncovering root causes, supporting the body as a whole, and restoring biological wisdom. Your body is not broken. It’s communicating.

You just need to learn how to listen—and how to heal.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post How to Naturally Increase Fertility appeared first on Dr. Alexandra MacKillop.

Why Women Seek Functional Medicine PCOS Treatment

Many of my patients come to me looking for an alternative to the birth control prescription given to them by their OB/GYN. Others have friends or family with a PCOS diagnosis, and are wondering if that’s the reason for their own irregular and/or painful cycles. Some ladies worry if they’ll ever be able to have children, since PCOS has complicated their fertility, and still more patients come to me out of desperation—they’ve already worked with another “natural doctor” who had put them on an extremely restrictive diet and told them to lose weight. I have even heard of PCOS patients being prescribed gluten-free, dairy-free, low-carb, sulfur-free diets. Functional medicine PCOS treatment offers hope of realistic, sustainable treatment where most other providers give a grim prognosis or simply leave patients feeling overwhelmed.

In this post, we’ll be diving into the details about PCOS: what it is, what it isn’t, how it’s managed by most healthcare providers, functional medicine PCOS treatment strategies, and more. As a starting point, I encourage you to check out my fertility overview post (Female Fertility 101) if you aren’t familiar with the ins and outs of your menstrual cycle. That post lays the groundwork for understanding the status quo of periods, hormones, women’s health, and it’s important to understand these topics before we start talking about with cycles that fall outside of the norm. [Although it’s the most common, it’s not the only period problem faced by women. To learn more about what your period can tell you about your health, check out this post.]

What Is PCOS, and How Is It Diagnosed?

PCOS stands for Polycystic Ovarian Syndrome, one of the most common endocrine and metabolic disorders in women of reproductive age. The syndrome is defined by hormonal imbalances and ovarian dysfunction, and it’s diagnosed only after other causes for the patient’s symptoms have been ruled out (such as hypothalamic amenorrhea). Because of this, many women have to go through a frustratingly long and drawn out process in order to get answers for their health struggles. However, functional medicine PCOS treatment offers faster results because it gets to the root cause.

Functional Medicine PCOS Diagnosis

The name “polycystic ovarian syndrome” is a bit of a misnomer, because although ovarian cysts are common in PCOS patients, they aren’t part of the diagnostic criteria—many women with PCOS don’t have any cysts on their ovaries at all. Rather, a PCOS diagnosis is given when at least two of the three following criteria are met: [Reference]

• Hyperandrogenism (elevated androgen hormones, assessed via lab work)
• Anovulation or oligo-ovulation (absence of ovulation or infrequent ovulation, usually leading to irregular cycle length)
• Polycystic appearance of ovaries (assessed via ultrasound imaging)

The general consensus in the medical community is that a PCOS diagnosis should be given when a woman has either polycystic ovaries and/or irregular cycles in addition to high androgen levels on her blood work. When making the diagnosis, doctors are careful to rule out other causes of high androgens, such as adrenal disorders, thyroid disease, drug-induced androgen excess, and other hormonal disorders, as well as alternative causes for irregular cycles.

Types of PCOS

PCOS patients typically fall into two different categories: insulin resistant, and non-insulin-resistant types. As is the case with most hormonal disorders, more than one level is out of balance. The vast majority of women who suffer from PCOS also present with insulin resistance, glucose intolerance, dyslipidemia, and elevated levels of inflammation. Part of what makes treating PCOS so complex is that these hormonal imbalances feed off of each other: elevated insulin levels trigger a feedback loop via the HPATG axis that leads to further androgen levels, and vise-versa. Apart from the insulin resistance piece, functional medicine PCOS diagnosis further divides PCOS into 4 separate categories which you can read about here.

Symptoms of PCOS

The symptoms experienced by women with PCOS vary because not everyone meets the same diagnostic criteria, and the extent of those experiences can vary too. Some women experience only mild elevations in androgens, and symptoms are consequently lesser. Women who have cysts on their ovaries often experience pain related to the formation and/or rupture of cysts, which are symptoms that wouldn’t be experienced by women who do not have cysts. Likewise, symptoms for women who concomitantly deal with insulin resistance face different symptoms than women who do not.

• Symptoms Related to Excess Androgens
  • Excessive hair growth (face, chest, back, buttocks)
  • Thinning hair
  • Oily skin
  • Cystic acne
• Symptoms Related to Anovulation/Olig-ovulation
  • Long cycles (more than 35 days) or irregular cycle lengths
  • Difficulty conceiving or repeated miscarriages
  • Abnormal uterine bleeding
• Symptoms Related to Polycystic Ovaries
  • Painful periods and/or pelvic pain
  • Sudden, intense abdominal pain resulting from ruptured cysts
• Symptoms Related to Insulin Resistance
  • High blood pressure and/or high cholesterol
  • Fatigue after meals
  • Weight gain, especially in the abdominal area
  • Dark patches of skin, particularly along neck creases, in groin and under breasts (this is called ancanthosis nigricans)
  • Skin tags

Due to the fluctuating hormones, many women also experience generalized symptoms related to hormonal imbalances, which include (but are not limited to): fatigue, insomnia, anxiety, depression, headaches, etc.

Functional Medicine PCOS (Causes and Treatment)

The root cause isn’t really known. The current understanding is that it’s a mixture of genetic predisposition and environmental triggers, but other theories include nutritional conditions in the uterus, prenatal exposure to androgens, insulin resistance on an and more [reference]. Because of this, most treatments focus on managing symptoms—painful periods, irregular cycles, insulin resistance, etc. Hormonal contraceptive use also can induce a reversible type of PCOS, but the symptoms can continue for months or even years (called “post-pill PCOS”).

On a physiological level, we know that elevated androgens and insulin resistance result from dysfunction in the hypothalamic-pituitary-adrenal-thyroid-gonadal axis. In women with PCOS, the pituitary gland releases higher-than-normal levels of luteinizing hormone (LH), which stimulates the ovaries to produce more testosterone than usual. (Ovaries normally produce some testosterone, but problems result when they produce too much.) This over-stimulation of the ovaries by luteinizing hormone also cancels out the mid-cycle LH surge that typically triggers ovulation.

Pituitary Hormones and PCOS

At the same time, the pituitary gland releases lower-than-normal levels of follicle-stimulating-hormone, which prevents eggs from reaching full maturity. When this happens, the follicle does not release the egg (ovulation does not occur, AKA anovulation). The immature egg either dissolves, or remains in the follicle, forming a cyst. Since the follicular remnant after ovulation (called the corpus luteum) is responsible for producing progesterone during the luteal phase, many women experience additional symptoms related to low progesterone levels. (Read more about luteinizing hormone, follicle-stimulating hormone, progesterone, and the luteal phase in this post: Female Fertility 101)

The Birth Control Pill and PCOS

Most OB/GYNs prescribe oral contraceptives as a first line of treatment for PCOS, because the artificial hormones suppress the natural cycling of luteinizing hormone, follicle-stimulating hormone, estrogen, progesterone, and testosterone. The simulated hormonal environment causes the endometrial lining to develop and shed as it would in a natural period, but it take the ovaries out of the equation: no egg matures, no egg is released, and fertility is not possible.

My goal as a functional medicine doctor is to promote the natural fertility of my patients, empowering them to have healthy cycles rather than suppress the normal functioning of their bodies. That being said, sometimes the healthiest thing for a patient and her values is to reduce the pain, control the hormonal dysfunction, and reach a place where she feels that her health is manageable. If that means medication, that’s okay—the most important thing is that she is able to manage her wellbeing according to her values.

Prescription Medications for PCOS

Another medication used in the treatment of PCOS is spironolactone, which is typically used as a diuretic drug for individuals with cardiovascular disease. However, this drug also has a secondary effect of reducing androgen levels in the body, which can be helpful in controlling irregular bleeding, hair growth, and other symptoms of high androgens in women with PCOS. Like birth control pills, using spironolactone targets hormonal pathways of PCOS without addressing the root cause. This is where functional medicine treatment for PCOS can fill a huge gap and meet a huge need.

The third medication that is used in the management of PCOS is metformin, which is a drug typically given to patients with diabetes. Metformin improves insulin resistance, which can be helpful in the treatment of PCOS because of the amplifying effect that insulin plays in the production of testosterone. When insulin sensitivity improves, often testosterone levels follow suit. You can read more about the use of metformin as a fertility drug (and natural alternatives) in this post.

Functional Medicine Treatment for PCOS: Lifestyle & Supplements  

Most of my patients come to me because they are looking to avoid the use of prescription drugs in managing their fertility. If that describes you too, keep reading!

1. Lifestyle Factors for Balancing Hormones: The #1 thing we can do to support hormonal balance is building a foundation for well-being. This means taking nutrition, rest, exercise, stress management, and psychological/emotional health into account. Neglecting even one of these areas can create huge interruptions in the HPATG axis, making symptoms of PCOS and other hormonal disorders so much worse. These lifestyle factors include eating enough (in terms of calories, macronutrients, and micronutrients) as well as eating frequently enough to keep blood sugar stable. It also involves balancing exercise and rest to prevent elevations in cortisol, the stress hormone, which interrupts the production of sex hormones like progesterone. This is part of the reason why stress management, sleep hygiene, and social support are so important.
2. Eating a Diverse Diet:Gut health is a huge topic in the media lately, and research continues to show that the best way to support GI health and microbiological diversity is to eat a varied diet, with many different types of plant foods and fibers. The more restrictive our diet (limiting the types of foods we eat to just a few varieties), the more likely we are to disturb our gut microbiome, which plays a huge role in balancing our hormones. (Did you know that bacteria both produce and metabolize hormones When we disturb our gut microbiome, it affects our bodies ability to make hormones as well as clean out the old, broken down ones.) Gut health also helps modulate blood sugar control, which is an important consideration in insulin-resistant PCOS. Check out this study to learn more about the relationship between PCOS and the gut microbiome.
3. Micronutrient Balance: Research has shown that women with PCOS tend to follow certain patterns of vitamin deficiencies, including vitamin D and B vitamins (especially folic acid). Vitamin D plays an important role in supporting the thickness of the endometrial lining, which is often depleted in women with PCOS due to low progesterone levels. Likewise, B vitamins such as folic acid play an important role in follicular maturation, and supplementing with elvels at 700 μg/day can support successful ovulation. Other nutritional deficiencies have also been identified in the majority of women with PCOS, including calcium, zinc, selenium, and chromium. [Reference] While the best way to prevent nutrient deficiencies such as these is to eat a varied and balanced diet (and avoid restriction of food groups of calories), some women may benefit from using supplements—especially Vitamin D. Studies have also shown that supplementing with omega-3 fatty acids, such as those found in cod liver oil, prevent excess inflammation, help manage dysglycemia, and support hormonal balance in women. [Reference]
4. Evidence-Based Supplements:
   1. Inositol: Inositol is a type of sugar alcohol that has been shown to improve insulin sensitivity, lipid synthesis, hormonal signaling, and maturation of oocytes (female eggs) during the follicular phase. Supplementation of inositol in women with PCOS lowers androgen levels, improves insulin sensitivity, and increases rates of ovulation in women with anovulatory cycles. Supplementation is effective when administered in ratios of 40:1 of myo-inositol to D-chiro-inositol, at levels of 4000 mg per day in conjunction with 400 μg of folic acid.
   2. Alpha-Lipoic Acid: This chemical is a free-radical scavenger, meaning that it prevents premature breakdown of biochemicals and hormones in the blood stream. Studies show that supplementation with alpha-lipoid acid decreases prevalence of ovarian cysts and increases progesterone levels in women with PCOS.
   3. Melatonin:While this hormone is typically thought of as a supplement for promoting sleep, it is not a sleeping pill, but rather a hormone. (There are many reasons to avoid using melatonin as a sleep aid, but that’s a topic for another post.) When used in women with PCOS, supplementation at night has been shown to improve ovulation rates, corpus luteum formation, progesterone levels, and pregnancy rates for those who are trying to conceive. Melatonin supplementation also decreases hirsutism and androgen levels when used at 10 mg/night.
   4. Black Cohosh: As described in this post about fertility drugs, research has shown that dosing 20 mg daily of black cohosh at the beginning of the cycle modulates the LH surge during the follicular phase, improving rates of ovulation. This supplement also results in higher progesterone levels during the luteal phase, improving the thickness of the endometrial lining and supporting a luteal phase that is long enough for implantation and pregnancy in women who are trying to conceive.

Closing thoughts…

As if the symptoms of PCOS aren’t difficult enough, the journey towards a diagnosis to explain the symptoms, and finding a treatment strategy that works for you in the context of your own life can add enormous loads of stress to an already challenging life experience. There is a whirlwind of information out there, which only adds to the confusion and frustration of trying to manage your health. It can be a lonely and scary place, but I want you to know that you’re not alone. Consider making an appointment with a functional medicine doctor who can deliver personalized care and help you achieve your health goals.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

Don’t miss out! Join the email list.

Sign Me Up!

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Functional Medicine PCOS Treatment appeared first on Dr. Alexandra MacKillop.

Have you heard of estrogen dominance Or maybe, you already know you’re dealing with this hormone imbalance. Excess estrogen (or deficient progesterone) disrupts hormonal balance, triggering symptoms such as weight gain, mood swings, heavy periods, and fatigue. Functional medicine targets root causes with precision, and understanding why you have estrogen dominance is key to treating this condition. Herbs for estrogen dominance play a pivotal role in restoring estrogen balance by supporting detoxification, improving insulin sensitivity, and enhancing progesterone production. Below, I detail clinically supported herbs for estrogen dominance that that effectively address their mechanisms, and recommended dosages.

As we get started, here are a few key things to keep in mind when it comes to estrogen dominance:

• Estrogen dominance is a condition in which negative symptoms occur because of a high estrogen level in relation to progesterone
• Estrogen dominance may be caused by excess estrogen production, deficient progesterone production or both
• Certain underlying diseases and syndromes increase risk of estrogen dominance, like obesity, PCOS, type 2 diabetes and hypothyroidism
• Even if you have symptoms of estrogen dominance, it doesn’t necessarily mean you have it. It’s essential to test your hormones and understand your diagnosis before using any treatment strategies

Herbs for Estrogen Dominance, Explained

1. DIM (Diindolylmethane): Detoxify Excess Estrogen

DIM is one of the most powerful herbs for treating estrogen dominance. This is a compound derived from cruciferous vegetables, promotes healthy estrogen metabolism by enhancing Phase 1 and Phase 2 liver detoxification pathways. It shifts estrogen breakdown toward beneficial 2-hydroxy metabolites and away from harmful 16-alpha-hydroxy metabolites linked to estrogen dominance and cancer risk. Impaired gut function or excess production of estrogen are key candidates for treatment with DIM.

• Dosage: 100-200 mg daily
• Evidence: A randomized controlled trial found DIM supplementation significantly improved estrogen metabolism in women with estrogen dominance symptoms [2].

2. Calcium D-Glucarate (CDG): Support Estrogen Clearance

CDG inhibits beta-glucuronidase, an enzyme that reverses estrogen conjugation in the gut, preventing reabsorption and facilitating elimination. This reduces circulating estrogen levels, decreasing estrogenic load. Those who eat a diet high in ultra-processed foods and sugar are likely to benefit from supplementation with CDG when high estrogen levels have been documented on labs at any point in the cycle. This could be considered either a food or one of the best herbs for estrogen dominance.

• Dosage: 300-400 mg daily
• Evidence: Clinical studies demonstrate CDG enhances detoxification and lowers estrogen recirculation, supporting hormonal balance.

3. Berberine: Target PCOS and Insulin Resistance

Polycystic Ovary Syndrome (PCOS) drives estrogen dominance via insulin resistance and androgen imbalance. Berberine improves insulin sensitivity, regulates blood glucose, and supports gut microbiota diversity—addressing core PCOS mechanisms. Berberine may also be helpful in those with impaired gut detox pathways due to imbalances in good and bad bacteria, as berberine affects microbiological diversity.

• Dosage: 500 mg twice daily with meals
• Evidence: Multiple randomized trials show berberine’s superiority to metformin in reducing insulin resistance and improving ovulatory function in PCOS patients.

4. Evening Primrose Oil: Boost Progesterone Production

Evening primrose oil supplies gamma-linolenic acid (GLA), a precursor to prostaglandins that stimulate progesterone synthesis. Increased progesterone balances excess estrogen, alleviating symptoms like breast tenderness and PMS. If estrogen dominance and related symptoms are caused by deficient progesterone, meaning there isn’t enough progesterone to balance out otherwise normal estrogen levels, EPO may be the right solution.

• Dosage: 1,000-2,000 mg daily
• Evidence: Clinical reports confirm evening primrose oil’s efficacy in improving luteal phase defects by increasing progesterone.

5. Fish Oil: Modulate Inflammation and Hormonal Balance

Omega-3 fatty acids reduce systemic inflammation and improve insulin sensitivity, indirectly supporting estrogen metabolism and progesterone activity. Inflammation is a major driver of excess production of estrogen in men and women from abdominal fat cells.

• Dosage: 1,000-3,000 mg EPA/DHA daily
• Evidence: Supplementation reduces inflammatory markers and improves hormonal profiles in women with hormonal imbalances.

6. Fenugreek: Support Hormonal Regulation

Fenugreek seeds contain phytoestrogens that modulate estrogen receptor activity and stimulate progesterone production, improving estrogen-to-progesterone ratio.

• Dosage: 500-600 mg daily
• Evidence: Controlled trials indicate fenugreek improves hormonal balance and reduces estrogen dominance symptoms.

7. Fennel Tea: Natural Estrogen Modulator

Fennel contains anethole, which exhibits estrogenic activity that regulates menstrual cycles and reduces estrogen dominance symptoms such as bloating and cramps.

• Dosage: 1-2 cups of fennel tea daily
• Evidence: Clinical use supports fennel’s effectiveness in managing menstrual disorders related to estrogen imbalance.

8. Cinnamon: Improve Insulin Resistance and Hormone Balance

Cinnamon enhances insulin sensitivity and lowers blood glucose, indirectly reducing ovarian androgen production and estrogen dominance, especially in PCOS.

• Dosage: 1-3 grams daily
• Evidence: Studies confirm cinnamon’s role in metabolic and hormonal regulation in women with insulin resistance.

9. Chamomile: Calm Inflammation and Support Progesterone

Chamomile’s anti-inflammatory properties reduce systemic inflammation that disrupts hormone production. It also supports progesterone synthesis through improved adrenal function.

• Dosage: 1-2 cups chamomile tea daily or 300 mg extract
• Evidence: Research validates chamomile’s efficacy in reducing inflammation and improving hormonal balance.

10. CBD Oil: Regulate Endocrine and Stress Response

CBD modulates the endocannabinoid system, which influences hormone regulation and reduces cortisol-driven estrogen dominance. It also supports liver detoxification.

• Dosage: 10-50 mg daily, titrated individually
• Evidence: Emerging studies demonstrate CBD’s role in hormone balance and stress reduction [20].

11. Boron: Enhance Hormonal Balance and Bone Health

Boron increases circulating levels of free testosterone and estrogen metabolites, promoting a favorable hormonal environment and supporting bone density.

• Dosage: 3-6 mg daily
• Evidence: Clinical trials report boron’s capacity to increase steroid hormone levels and improve metabolic health.

12. Black Cohosh: Promote Ovulation and Progesterone Production

Black cohosh exhibits estrogenic effects that stimulate ovulation and improve progesterone synthesis, directly countering estrogen dominance.

• Dosage: 40-80 mg daily standardized extract
• Evidence: Clinical trials validate black cohosh’s role in improving luteal phase and balancing estrogen-progesterone ratio.

13. Adaptogens (Reishi): Balance Stress Hormones and Support Endocrine Health

Reishi mushroom modulates the hypothalamic-pituitary-adrenal axis, reducing cortisol and supporting overall endocrine harmony, which indirectly regulates estrogen dominance.

• Dosage: 1,000-1,500 mg daily
• Evidence: Studies show Reishi’s efficacy in reducing stress-related hormonal imbalance and inflammation.

Functional medicine’s approach to estrogen dominance requires targeted, evidence-based herbal interventions. DIM, CDG, berberine, evening primrose oil, fish oil, and other botanicals address detoxification, insulin resistance, inflammation, and progesterone support. Combining these herbs with lifestyle modifications establishes hormonal balance and improves patient outcomes.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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The post Herbs for Estrogen Dominance and Hormonal Balance appeared first on Dr. Alexandra MacKillop.

Please note: When referring to hormonal contraceptives, birth control pills or “the pill” in this post, I am referencing medications containing both estrogen and progesterone analogs (estradiol and progestin).

The menstrual cycle plays a powerful role in women’s health, and not just in terms of fertility. As I often say, our periods tell us way much more about our sense of well-being than whether or not we’re pregnant, and that information is so, so important! If our cycle is out of sync, it’s really important for us to address those concerns early so that the underlying causes–like thyroid, metabolic, adrenal, or other hormone imbalances—don’t worsen and lead to disease.

Masking the Root Cause

Because of their ability to give us early warning signs about our health, our periods are referred to as our “fifth vital sign” along with heart rate, blood pressure, temperature, and breathing rate. When it comes to our cycles, deviations from the norm often signify an underlying health concern that will intensify, eventually leading to a more serious problem. For example, most chronic illnesses that we see today are either triggered or worsened by stress. Even if a person isn’t experiencing a flare up of their chronic symptoms (or maybe they have a genetic predisposition that hasn’t yet manifested), our bodies can send us warning signals that our stress is reaching a critical level through changes to our menstrual cycles. Stress interrupts the delicate web of signals between our brains and the organs that secrete our hormones (sex hormones, thyroid hormones, metabolic hormones, and more) leading to missing, painful, or irregular cycles. (For more about the details of what your period can tell you about your health, check out this post.)

Birth Control Pills Shut Down Our Natural Hormonal Processes

As I explain in my book, Go with Your Flow, the main event of our menstrual cycle isn’t the bleed, but rather it is ovulation–the release of an egg. The first two weeks of the cycle are all about ramping up the hormonal signals (mainly estrogen) required to mature and release an egg so that your body can become pregnant. After ovulation, progesterone takes over, preparing the uterus to become a suitable environment for a growing baby if the egg meets a sperm along its journey through the fallopian tube. As you learned in sex ed, the egg passes through if it isn’t fertilized, and the uterine lining sheds away. This shedding of menstrual blood–your period–marks day one of the next cycle.

Birth control pills are made up of chemicals that resemble estrogen and progesterone, overriding your body’s natural signaling pathways. Their purpose is to prevent the release of an egg while still allowing your body to “go through the motions” (i.e. by thickening and shedding the uterine lining every 28 days.) While it might seem easier to just not have a period at all, the processes that take place during your cycle are about more than fertility, and shutting them down completely would be very dangerous, leading to osteoporosis, heart disease, and other health problems. So in lieu of completely eliminating your period, the pill shuts off the “main event” of your cycle, aka ovulation, while setting up a carefully curated hormonal environment that mimics a healthy period.

Except it isn’t a healthy menstrual cycle because it isn’t a menstrual cycle at all. It’s just a bleed. Without being able to control their own hormonal fluctuations, our bodes lose their ability to communicate with us about our hormonal health status.

Because of the way that the false periods induced by birth control pills so closely resemble healthy cycles, the pill is often prescribed for reasons other than contraception. Patient suffering from hormonal acne, PMS, painful periods, PCOS, and other women’s health conditions are often given birth control pills because it seems to solve these problems. But the root cause of these issues goes much deeper, and the pill simply masks over the real issue. It’s kind of like breaking your toe and “curing” the problem by chopping off your whole leg. It completely misses the point. Your toe stops hurting, but only because you don’t have one anymore! The same is true of using the pill for non-contraceptive purposes. Your period seems normal but only because you aren’t really having your cycle anymore! As a result, the underlying cause is left to fester, and often returns with a vengeance as soon as you come off the pill.

Health Risks

In addition to masking over our health problems, the pill often outright creates health risks of its own. Here are just a few:

• Infertility: Despite being often marketed as a “fertility drug,” the pill does not support the optimal function of the female body. It actually does the opposite, by shutting off reproductive function and inhibiting ovulation. Unfortunately, many women struggle with fertility problems even after they discontinue use of the pill. It’s not as if ovulation magically starts up again after being chemically prevented. It takes time for the body to re-learn how to secrete hormones in a balanced and functional way. Sometimes, the body can’t reach that place post-pill on its own without medical support.
• Hormone Imbalances: Even if ovulation resumes, many women find that they struggle with metabolic, thyroid, adrenal, or other hormonal imbalances outside of fertility upon coming off the pill. As I describe in this post, our various hormonal systems are all interrelated, so when we so drastically interfere with one aspect of the HPATG axis (as is the case with the pill), other bodily systems can become imbalanced too. Symptoms like fatigue, weight gain, thinning hair, insomnia, and more can all point back to hormonal contraceptive use, or discontinued use.
• Blood Clots: A widely known fact in the medical community that is seldom talked about in a clinical setting is that oral contraceptives containing estrogen or estrogen analogs increase the risk of blood clots forming, even in otherwise healthy women with no underlying conditions. While certain factors increase risk of this phenomenon (smoking, being over 35 years of age, prolonged inactivity, and family history), the likelihood of blood clots goes up dramatically for all women. These blood clots form in deep veins of the body (most often the legs), and if they break off, they can become lodged in the heart (causing a heart attack), lungs (causing a pulmonary embolism) or brain (causing a stroke). This risk is increased even if a woman follows a healthy lifestyle. [Note: Blood clots from using oral contraceptives is often presented as a low risk, but it’s not really that low. Different sources say different things, but it’s typically discussed about as being about 1/1,000, or 0.1%. Let’s add some context…the CDC estimates that 28% of US women are currently using oral contraceptives, which is about 10.6 million women. I’ll let you do the math, but 0.1% of 10.6 million isn’t a small number—and it seems even larger when it’s someone you know. I personally know of three women in from my own personal life (not even counting patients) who experienced this in their twenties.]
• Heart Disease: Long-term exposure to hormonal analogs like those found in the pill act like a biochemical source of stress in the body. These chronic stress exposures alter the metabolism of lipids and carbohydrates in the body, raising blood cholesterol and triglycerides and increasing risk of chronic disease, especially heart disease in women. Once again, this is true even for otherwise healthy individuals.
• Increased risk of some cancers—namely breast and cervical cancer. Breast cancer is the number one most common type of cancer among women, and cervical cancer is the fourth most common type of cancer in women, worldwide.
• Insulin Resistance: One of the ways that oral contraceptives affect metabolism is by increasing blood glucose levels and subsequent insulin secretion. With time, this can increase risk of insulin resistance and the development of metabolic syndrome and/or diabetes.
• Gallbladder and Liver Dysfunction: Part of the role of the liver and gallbladder in our health is to detoxify our bodies from old, broken down hormones, red blood cells, and other waste products. This is a natural and normal process, but sometimes it can become overloaded if the amount of waste buildup is higher than the normal capacity of these organs. Sex hormones like estrogen are one of the major substrates of the liver and gallbladder, and can “clog up” the system leading to low-grade damage. Some women who experience this manifest skin reactions like itching, rashes, or yellowing of the skin (jaundice).

Female Empowerment

It still blows my mind that so many important women’s health topics are still taboo. Sure, sex is a private matter, but healthcare information shouldn’t be limited or kept secret. As women, we deserve to understand our bodies, including the implications of the medical interventions we receive. Ovulation and menstruation are normal and necessary parts of a healthy woman’s body if she is of reproductive age, and these functions (or lack thereof) give us valuable insight into our well-being. They don’t need to be shut off, and we don’t need to be quiet about it.

Our level of understanding of the female body in science doesn’t require us to subdue our femininity in order to allow us to make family planning decisions in accordance with our values. Likewise, we deserve better medicine—safe and effective, individualized treatment plans that address the root cause of symptoms, whether in terms of our reproductive health or otherwise. If the birth control pill fits your goals and values for your life, that’s awesome! I totally support you. But I also want you to know that if it doesn’t, there are other options for you that protect your health and your values, and which allow you to make informed decisions on behalf of both your family and your own body.

Censorship of these conversations limits a woman’s access to essential information about her sense of well-being. Sexual health isn’t gross or weird, and it shouldn’t be hush-hush. In fact, every single person on earth is only here because of the function of a woman’s reproductive system. The female body is amazing, and each of us should have the privilege of understanding it on a personal level, especially when making the very personal decision about whether or not to use hormonal contraceptives.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Risk of Blood Clots and Other Dangers of Hormonal Birth Control appeared first on Dr. Alexandra MacKillop.

What Is Letrozole?

Letrozole is a medication primarily used in the treatment of breast cancer but is also widely prescribed to women struggling with infertility, especially those diagnosed with polycystic ovary syndrome (PCOS). It works as an aromatase inhibitor, reducing the production of estrogen from precursor molecules like DHEA and other androgens. By lowering estrogen levels, Letrozole stimulates the release of follicle-stimulating hormone (FSH), which, in turn, promotes ovulation. Ovulation is essential for conception, and Letrozole helps correct the problem of excess estrogen (estrogen dominance) by regulating the brain-ovarian axis. However, the way it accomplishes this is by overriding an inborn system rather than helping to support the natural design of the body. Natural Letrozole alternatives accomplish the same goal without relying on prescription drugs that block hormone systems.

Doctors typically prescribe Letrozole to women who don’t respond to Clomid (clomiphene citrate) or for those who have PCOS but are looking for a less invasive alternative to injectable fertility drugs. It’s generally favored for its relatively mild side effects compared to other fertility medications. If you are looking for natural alternatives to Letrozole, you’re reading the right article.

Why Is Letrozole Prescribed for Fertility?

Letrozole is prescribed when women fail to ovulate on their own. Not ovulating is a key cause of infertility. However, the number one thing to consider when looking for natural alternatives to Letrozole and other fertility drugs is answering the question of why a person is not ovulating to begin with. I see three main reasons in my practice for lack of ovulation which include:

• Hypothalamic Amenorrhea (a condition in which the body’s stress response inhibits ovulation)
• PCOS (a condition in which high androgen levels prevent ovulation)
• Perimenopause (a condition in which aging of the ovary and reduce egg quality lead to irregular or absent ovulation)

There are many hormone imbalances that can cause lack of ovulation, including hypothyroidism and hyperthyroidism, though those are separate imbalances that typically don’t result in a Letrozole prescription.

The condition of hypothalamic amenorrhea, in my opinion, is not an appropriate time to use Letrozole because the body is already in a suppressed estrogen state. In this case, natural letrozole alternatives and addressing the root cause are much more effective. In perimenopause, FSH levels may already be high, and using Letrozole to further increase them may not actually help. However, estrogen levels are often also high in the early stages of perimenopause so advanced maternal age, in my clinical experience, is a more appropriate use of Letrozole. That being said, natural alternatives to Letrozole are often more appropriate and more effective. For PCOS, this would be the classic use of Letrozole because high estrogen and low FSH are common in this condition. That being said, understanding the root cause of PCOS is essential when treating the condition naturally and identifying viable natural alternatives to using Letrozole or other fertility drugs.

While Letrozole does its job effectively in many cases, it’s not without potential side effects like headaches, fatigue, and ovarian cysts. For those seeking to avoid pharmaceutical options, natural Letrozole alternatives provide a safe, non-toxic way to stimulate ovulation and improve fertility.

How Does Letrozole Compare to Other Fertility Medications?

Compared to other fertility medications like Clomid (clomiphene citrate) and injectable gonadotropins, Letrozole is less likely to cause multiple births (twins or more). Clomid, for instance, can lead to a higher incidence of multiple pregnancies, whereas Letrozole tends to result in single, healthy pregnancies. Letrozole is also often preferred over Clomid for women with PCOS due to its more favorable side effect profile.

Injectable gonadotropins, another common fertility treatment, stimulate the ovaries to produce eggs directly, often resulting in more aggressive stimulation and a higher risk of ovarian hyperstimulation syndrome (OHSS). Letrozole, however, works in a more controlled manner by stimulating the body’s natural hormone production.

Despite these benefits, Letrozole still relies on hormone manipulation, which can be taxing on the body and may result in rebound hormone imbalances after pregnancy. This is why many patients turn to natural Letrozole alternatives—herbal supplements that naturally support the body’s hormonal balance without the need for synthetic drugs.

The Mechanism of Action Behind Letrozole and Natural Alternatives

Let’s Review: Letrozole operates by inhibiting the aromatase enzyme, which is responsible for converting androgens into estrogen. As estrogen levels decrease, the body responds by increasing the production of follicle-stimulating hormone (FSH), which stimulates the ovaries to release mature eggs.

Natural Letrozole alternatives work by leveraging similar mechanisms to promote fertility. They either directly inhibit aromatase or support the body’s endocrine system to regulate hormone production, such as estrogen levels. While these alternatives don’t work as rapidly as prescription medications, they offer a gentler and sustainable way to address infertility.

Root Causes of Infertility and Letrozole Prescription

When Letrozole is prescribed, the root cause of infertility is often related to hormonal imbalances, specifically in women with PCOS. PCOS leads to an overproduction of androgens (male hormones) which are converted into estrogen at high levels. Very high levels of this nature contributes to the inhibition of ovulation seen in PCOS. Letrozole works by reducing estrogen, thus triggering ovulation and improving the chances of pregnancy.

For other women, infertility can result from issues like poor egg quality, irregular cycles, or insufficient progesterone. In such cases, Letrozole is used to support ovulation, but it may not address underlying hormonal imbalances or deficiencies. Natural Letrozole alternatives, however, take a more holistic approach by addressing the broader spectrum of hormonal imbalances contributing to infertility.

Natural Letrozole Alternatives for Fertility

1. Resveratrol
   
   • How It Works: Resveratrol functions as a direct and effective natural aromatase inhibitor. In women with estrogen-dominant conditions or polycystic ovary syndrome (PCOS), this conversion process becomes dysregulated, leading to suppressed ovulation and hormonal imbalance. Resveratrol blocks the activity of aromatase at the cellular level. It binds to the enzyme’s active site, reducing its ability to synthesize estrogen from androgen precursors. This inhibition lowers circulating estrogen levels, which signals the hypothalamus and pituitary gland to increase the release of follicle-stimulating hormone (FSH). Elevated FSH promotes the development and maturation of ovarian follicles, which directly supports ovulation and improves the chances of conception, acting in direct similarity to Letrozole and offering a natural Letrozole alternative.
   • Advantages: Unlike Letrozole, Resveratrol offers this action without the synthetic load on the liver or disruption of other hormonal systems. It also delivers strong antioxidant and anti-inflammatory support, which helps reduce oxidative stress in the ovaries and improves overall endocrine function. For women seeking natural Letrozole alternatives, Resveratrol provides targeted hormonal modulation. It mimics the clinical benefits of Letrozole—ovulation induction, estrogen control, and follicular development—through a plant-based, bioavailable pathway that supports the body rather than overriding it.
   • Typical Dosage:
     • Dose: 150–250 mg per day
     • Standardization: Choose trans-resveratrol supplements with 98–100% purity to ensure bioactive effectiveness
     • Form: Capsule or softgel, ideally in a micronized or liposomal form for increased absorption
     • Timing: Take once daily with food, preferably in the morning to align with cortisol rhythm and minimize GI upset
     • Duration of Use
       • Use for a minimum of 8–12 weeks to support estrogen clearance, normalize ovulation, and improve egg quality
       • Best applied during follicular phase or as part of a broader preconception protocol when preparing the body for ovulation
     • Synergistic Combinations
       • Combine with quercetin or EGCG to amplify aromatase inhibition and antioxidant protection
       • Pair with NAC or milk thistle to support phase I and II liver detox—crucial for estrogen metabolism
       • Use alongside inositol for added insulin regulation in PCOS-driven infertility
2. Green Tea Catechins (EGCG)
   • How It Works: EGCG, the active polyphenol in green tea, acts as a potent natural aromatase inhibitor. It directly suppresses the activity of the aromatase enzyme, which converts androgens into estrogens. EGCG not only inhibits estrogen synthesis by directly binding to and blocking aromatase (similarly to Resveratrol) but also modulates gene expression linked to estrogen metabolism. It downregulates CYP19A1, the gene encoding aromatase, further limiting estrogen production at the source. The result: restored ovulatory cycles, improved egg maturation, and increased fertility potential.
   • Advantages: Unlike synthetic drugs, EGCG delivers this hormonal recalibration without liver toxicity, ovarian overstimulation, or long-term endocrine disruption. There is also robust evidence regarding the benefits of EGCG for modulating other estrogen-dependent diseases, like estrogen-dependent cancers. EGCG offers a biologically intelligent solution—working with the body’s natural systems to correct the root dysfunction behind anovulatory infertility. As a natural Letrozole alternative, EGCG provides targeted, reliable aromatase inhibition. It shifts the hormonal environment in favor of ovulation and conception, while simultaneously reducing oxidative stress and inflammation—two major contributors to ovarian dysfunction.
   • Typical Dosage:
     • Therapeutic range: 300–400 mg per day, standardized to ≥90% EGCG
     • Form: Use decaffeinated green tea extract capsules or powders to avoid overstimulation
     • Timing: Divide the dose into two servings (e.g., 200 mg AM, 200 mg PM) to maintain stable blood levels
     • Duration: Use for at least 3 menstrual cycles to assess full impact on ovulation and hormonal balance
     • Critical Guidelines
       • Always take EGCG with food to reduce potential gastrointestinal irritation.
       • Avoid taking EGCG within two hours of iron or folate supplements—it interferes with absorption.
       • Combine with antioxidant cofactors like quercetin or vitamin C to enhance bioavailability and reproductive tissue protection.
     • Cautions
       • Doses exceeding 800 mg per day increase risk of liver stress, particularly in women with compromised detox pathways (e.g., MTHFR mutations, sluggish phase II liver detox).
       • Monitor liver enzymes if using alongside other herbs or medications.
3. Saw Palmetto
   • How It Works: Saw Palmetto delivers powerful endocrine modulation by directly inhibiting both aromatase and 5-alpha reductase—two key enzymes involved in hormonal imbalance. As a natural aromatase inhibitor, Saw Palmetto blocks the conversion of androgens into estrogens at the tissue level, particularly in adipose and ovarian tissue. By blocking this pathway, Saw Palmetto reduces DHT load, rebalances androgen levels, and removes one of the most common roadblocks to ovulation.
   • Advantages: Unlike synthetic drugs that override the endocrine system, Saw Palmetto reestablishes proper feedback between the hypothalamus, pituitary, and ovaries. It stabilizes estrogen and androgen levels, supports follicular development, and promotes timely ovulation without the side effects linked to pharmaceuticals like Letrozole. As a natural Letrozole alternative, Saw Palmetto addresses the same root dysfunction—excess estrogen production and androgen imbalance—through targeted, multi-pathway inhibition. It restores hormonal order and fertility function with precision and without compromise.
   • Typical Dosage:
     • Dose: 320–400 mg per day
     • Standardization: Use extracts standardized to 85–95% fatty acids and sterols—the active constituents responsible for enzyme inhibition
     • Form: Softgel or liquid extract for superior absorption
     • Timing: Take once daily with a fat-containing meal to optimize bioavailability
     • Duration of Use:
       • Use consistently for at least 8–12 weeks to see measurable shifts in hormonal patterns and ovulatory cycles
       • Best used as part of a comprehensive protocol that includes blood sugar regulation, adrenal support, and anti-inflammatory nutrition
       • Combine with zinc for enhanced 5-alpha reductase inhibition, or vitex/inositol to further regulate LH, FSH, and ovulatory signaling
       • Stack with EGCG or resveratrol when estrogen suppression requires broader enzyme inhibition
     • Cautions
       • Avoid use during active attempts at conception without supervision, as it may suppress DHT levels beyond optimal range if overdosed
       • Monitor for mild gastrointestinal discomfort or changes in menstrual flow—these reflect hormonal shifts, not toxicity
4. Grape Seed Extract
   • How It Works: Grape Seed Extract contains proanthocyanidins, which exert strong antioxidant effects while simultaneously blocking estrogen biosynthesis via aromatase inhibition. This dual action not only promotes ovulation but also protects ovarian tissue from oxidative stress—one of the hidden drivers of poor egg quality and anovulation.
   • Advantages: As a natural Letrozole alternative, Grape Seed Extract delivers precise hormonal recalibration without the synthetic overload of pharmaceuticals. Its high concentration of proanthocyanidins neutralizes free radicals and halts the oxidative stress that fuels chronic inflammation in reproductive tissues. This antioxidant activity protects ovarian follicles, preserves egg quality, and stabilizes the endometrial environment—critical factors for successful conception and implantation.
   • Typical Dosage
     • Dose: 150–300 mg per day
     • Standardization: Choose extracts standardized to 95% proanthocyanidins—the active compounds responsible for aromatase inhibition and antioxidant effects
     • Form: Capsule or powder; use encapsulated form for precise, therapeutic dosing
     • Timing: Take once or twice daily with meals to improve absorption and reduce gastrointestinal irritation
     • Duration of Use
       • Continue for at least 8–12 weeks to lower estrogen levels, support ovulation, and improve overall reproductive function
       • Integrate into the follicular phase of the cycle or use as part of a full preconception plan to reset hormonal balance before conception attempts
     • Synergistic Combinations
       • Stack with resveratrol or EGCG to intensify aromatase inhibition and estrogen detox
       • Pair with vitamin C to enhance antioxidant capacity and stabilize proanthocyanidin activity
       • Combine with inositol or chromium to simultaneously support insulin sensitivity and ovarian function in PCOS cases
     • Cautions
       • Avoid combining with blood thinners or high-dose NSAIDs without supervision, as Grape Seed Extract also promotes vascular flexibility
         Monitor menstrual cycle shifts—reduced estrogen load often triggers faster follicular development and earlier ovulation
       • Doses above 400 mg daily increase risk of gastrointestinal symptoms and do not increase therapeutic effect proportionally
5. Shatavari
   • How It Works: This botanical works on multiple levels. Its steroidal saponins bind to estrogen receptors and modulate their sensitivity, reducing the overstimulation caused by high estrogen levels. At the same time, Shatavari supports the adrenal glands and reduces cortisol output, protecting the reproductive system from stress-induced dysfunction, particularly relevant in cases of Hypothalamic Amenorrhea, PCOS and Perimenopause.
   • Advantages: Shatavari enhances follicular development, supports egg maturation, and improves cervical mucus quality—three non-negotiable factors for natural conception. It also stabilizes progesterone levels post-ovulation, supporting luteal phase health and implantation.
   • Typical Dosage:
     • Dose: 500–1000 mg per day
     • Standardization: Use standardized extracts containing 10–20% steroidal saponins, the bioactive compounds responsible for aromatase inhibition and hormonal support
     • Form: Capsule or tincture; choose high-quality, standardized extracts for consistent potency
     • Timing: Divide into two doses daily, preferably with meals to enhance absorption and minimize gastrointestinal discomfort
     • Duration of Use
       • Administer for at least 8–12 weeks to achieve meaningful hormonal recalibration and improved ovulatory function
       • Most effective when incorporated into a broader fertility protocol focused on stress reduction, blood sugar balance, and anti-inflammatory nutrition
     • Synergistic Combinations
       • Combine with ashwagandha or rhodiola to support adrenal function and reduce cortisol’s disruptive impact on reproductive hormones
       • Pair with vitex or inositol to enhance follicular maturation and regulate pituitary hormone signaling
       • Use alongside Grape Seed Extract or Resveratrol to strengthen aromatase inhibition and estrogen metabolism
     • Cautions
       • Avoid excessive dosing beyond 1000 mg daily to prevent hormonal overstimulation or digestive upset
       • Monitor menstrual cycle and ovulation patterns closely—Shatavari’s potent endocrine effects often manifest quickly in cycle regularity and luteal phase support
       • Not recommended during confirmed pregnancy without professional guidance due to its hormonal activity

The road to conception can be difficult and frustrating, but you don’t have to rely solely on pharmaceutical treatments like Letrozole to address infertility. Natural Letrozole alternatives offer an empowering way to regulate hormones, promote ovulation, and support overall fertility health. Whether you choose EGCG, Shatavari or other herbal remedies, these natural options provide a gentler, holistic approach to fertility, addressing the root cause of hormonal imbalances while avoiding the side effects of synthetic medications.

Incorporating natural Letrozole alternatives into your fertility journey is a step toward taking control of your reproductive health. With patience and proper guidance, these natural remedies provide an effective, safe, and sustainable solution to support your body’s ability to conceive.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

Don’t miss out! Join the email list.

Sign Me Up!

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Natural Letrozole Alternatives: Holistic Fertility Treatment Through Functional Medicine appeared first on Dr. Alexandra MacKillop.

Polycystic ovarian syndrome (PCOS) affects millions of women worldwide, presenting a variety of symptoms, including irregular menstrual cycles, acne, weight gain, and infertility. Traditional approaches often focus on symptom management, but functional medicine offers a deeper, more sustainable solution by targeting the root causes of PCOS. Rather than simply masking symptoms, functional medicine works to restore balance within the body through personalized, holistic interventions. Here’s how functional medicine addresses PCOS from every angle to promote lasting health.

Functional medicine goes beyond treating symptoms—it strives to correct the underlying factors that drive disease. With PCOS, this means addressing not only hormonal imbalances but also lifestyle factors that exacerbate the condition. These factors include sleep hygiene, nutrition, exercise, stress, and toxin exposure.

For effective treatment, patients must embrace behavioral changes. Functional medicine emphasizes:

• Improved Sleep Hygiene: Consistent, restful sleep is crucial for regulating hormones and blood sugar.
• Nutritional Adjustments: A balanced diet that supports stable blood sugar and reduces inflammation can help correct insulin resistance, a key factor in PCOS.
• Exercise Patterns: A tailored exercise regimen can regulate hormones and boost metabolism.
• Stress Management: Chronic stress elevates cortisol, which worsens insulin resistance and hormonal imbalances.
• Reduction of Toxic Exposures: Avoiding endocrine-disrupting chemicals, such as those found in plastics and personal care products, helps restore hormonal balance.

By focusing on these lifestyle changes, functional medicine doesn’t just alleviate symptoms but rewires the body’s health from the inside out.

Sleep as a Treatment for Polycystic Ovarian Syndrome

Sleep plays a pivotal role in functional medicine, particularly in its relationship to cortisol and blood sugar regulation. Poor sleep disrupts hormonal balance, elevating cortisol levels. This, in turn, increases insulin resistance—something that directly affects around 70% of women with PCOS.

Lack of sleep leads to:

• Higher cortisol levels, contributing to increased blood sugar and insulin resistance.
• Disruption of the body’s natural circadian rhythm, affecting the timing of hormone production.
• Increased cravings for high-sugar and high-fat foods, which worsens blood sugar management.

4 Strategies for Better Sleep Quality:

1. Consistent Sleep Schedule: Go to bed and wake up at the same time every day, even on weekends, to regulate your circadian rhythm.
2. Limit Blue Light Exposure: Avoid screens (phones, computers, etc.) at least an hour before bedtime. Blue light interferes with melatonin production.
3. Create a Sleep-Inducing Environment: Ensure your bedroom is cool, dark, and quiet. Consider using earplugs or a white noise machine to block disruptive sounds.
4. Relaxation Techniques: Engage in deep breathing, progressive muscle relaxation, or meditation before bed to activate the parasympathetic nervous system, signaling the body to wind down.

Nutrition as a Treatment for Polycystic Ovarian Syndrome

Managing blood sugar is central to PCOS treatment. Women with PCOS often struggle with insulin resistance, making blood sugar control a crucial factor. Functional medicine promotes a low-carb, blood sugar-controlled diet that focuses on whole, nutrient-dense foods.

Key Strategies:

• Low-Carb, High-Protein Diet: Emphasizing lean proteins, healthy fats, and low-glycemic vegetables supports stable blood sugar levels.
• Continuous Glucose Monitoring: Using a continuous glucose monitor (CGM) allows you to track postprandial glucose levels. The goal is to keep glucose levels under 110 mg/dL, which prevents insulin spikes and the inflammatory response that worsens PCOS.
• Protein and Fiber: Protein stabilizes blood sugar by slowing digestion, while fiber slows the absorption of sugar, preventing blood sugar spikes. Including protein at every meal—especially lean meats, fish, eggs, and plant-based proteins—is crucial for blood sugar regulation. Likewise, fiber-rich foods such as leafy greens, avocados, and legumes help maintain glucose balance.
• Ketones: Among low-carb diets, keto is one of the most effective for reversing insulin resistance. But it’s also the most intense. If a keto diet is not sustainable or realistic for you in the context of your health, there’s good news. Research shows that supplementing with exogenous ketones in the form of beta-hydroxybutyrate reduces both androgens and blood glucose in women affected by PCOS.

Exercise as a Treatment for Polycystic Ovarian Syndrome

Exercise is vital for hormone balance and glucose management. While all forms of exercise benefit metabolism, weight lifting stands out as the most effective for improving insulin sensitivity.

Why Weight Lifting Works Best for PCOS:

• Muscle Mass and Insulin Sensitivity: Strength training builds lean muscle mass, which helps the body use insulin more effectively, lowering blood sugar.
• Increased Resting Metabolic Rate: Muscle tissue burns more calories at rest than fat tissue, enhancing fat loss and supporting hormone regulation.
• Cardio versus Weight Lifting: The research here is mixed. Many sources claim that resistance training is more effective than cardio for controlling PCOS, but other quality, high-power studies also show that the reverse is true. As a functional medicine doctor, I simply recommend that my patients pick a type of exercise that they enjoy and then do it regularly. If 30-50 minutes of exercise, 5-days per week doesn’t alone improve insulin resistance, then the problem isn’t exercise and we need to look more broadly at overall health and lifestyle.
• Yoga: Yoga, while not as effective as resistance training for glucose control, still offers benefits by reducing stress and improving hormonal balance. A review study published in Evidence-Based Complementary and Alternative Medicine found yoga to improve menstrual regularity and reduce symptoms of PCOS.

Environmental Toxins: A Hidden Factor in Polycystic Ovarian Syndrome

Endocrine-disrupting chemicals (EDCs), found in plastics, personal care products, and household cleaners, are major contributors to hormonal imbalances in women with PCOS. These chemicals mimic estrogen in the body, exacerbating symptoms such as weight gain, acne, and irregular periods.

To minimize toxin exposure:

• Switch to BPA-Free Products: Avoid plastic containers and opt for glass, stainless steel, or BPA-free plastic.
• Use Natural Personal Care Products: Choose cosmetics and toiletries free of parabens, phthalates, and other chemicals that disrupt hormonal balance. Screen the safety of personal care products using databases such as the Environmental Working Group or Yukka.
• Air Purification: Invest in a high-quality air purifier to reduce indoor pollutants and environmental toxins.

Stress Managementas a Treatment for Polycystic Ovarian Syndrome

Stress drives androgen production from the adrenal glands, worsening symptoms like acne, excess facial hair, and hair thinning in PCOS. High cortisol levels also impair insulin sensitivity, further compounding metabolic issues.

3 Strategies for Stress Management:

1. Mindfulness Meditation: Daily mindfulness practice reduces cortisol levels and improves emotional well-being.
2. Breathwork: Controlled breathing exercises activate the parasympathetic nervous system, helping to manage stress and reduce its impact on hormone production.
3. Regular Physical Activity: Engaging in activities like yoga, walking, or swimming helps balance stress hormones and improves mental clarity.

Supplementation as a Treatment for Polycystic Ovarian Syndrome

In my practice, supplements play a huge role in managing patient health, particularly with PCOS. Here are some of the most common supplements I use to treat PCOS, and the research that backs them up:

• Inositol: This supplement, specifically in the form of myo-inositol and D-chiro inositol, has been shown to improve insulin sensitivity and ovarian function. The research pretty much shows a consensus on the effectiveness of this supplement across subtypes of PCOS. (Here’s one example.)
• Licorice Root: Licorice has anti-androgenic properties that can reduce elevated testosterone levels, improving symptoms like acne and excess hair growth. Much of the research on licorice has been done on rats, but we also have strong data on its use traditionally in treating PCOS.
• Peony Root: Peony has been used in Traditional Chinese Medicine to regulate menstrual cycles and support ovarian health. This herb is particularly useful for adrenal-driven PCOS and improving fertility.

By incorporating these strategies into a personalized treatment plan, functional medicine addresses PCOS from all angles, targeting not only the symptoms but also the root causes of the condition. Whether through dietary changes, targeted supplements, or stress management techniques, functional medicine provides a comprehensive, sustainable solution to hormonal imbalance in PCOS. Polycystic Ovarian Syndrome is a complex and multifaceted condition, but with functional medicine’s holistic approach, women can find relief and restore hormonal balance. By addressing lifestyle factors like sleep, nutrition, exercise, and stress, and incorporating smart supplementation, functional medicine provides a path toward long-term wellness.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

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