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Free Guide: What Your Fertility Doctor Didn’t Tell You about Your Diet
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Erin Westaway, ND
Erin Westaway is a naturopathic physician with a private practice in Seattle, WA, where she focuses on fertility, preconception care, and teaching parents how to grow healthy families. A portion of her practice is dedicated to primary care medicine for the whole family.

Dr. Westaway came to medicine through her love of learning, her fascination with the impeccable balance of nature, and her curiosity about the human condition. She studied English literature at Bowdoin College and taught public school Arts and Humanities before returning to school to become a physician. After graduating from Bastyr University, she completed a two year residency under Dr. Molly (Linton) Niedermeyer at one of the oldest naturopathic clinics in the country, where she continued to practice for several years.

Her private practice – Prescribe Life Medicine – was born out of a desire to create a medical practice that allowed enough time and support for deep change and transformation of health. To accomplish this, Dr. Westaway draws on her extensive knowledge of physiology and biochemistry, her awe of human capacity, her love of story, and her first hand knowledge of dealing with chronic illness. In addition to her medical training, Dr. Westaway has extra training in nutrition, biofeedback, homeopathy, craniosacral therapy, visceral manipulation, herbal medicine, and counseling, and environmental medicine.

Transcript:

Hey. Welcome, everyone to another episode of Keto Chat. I am your host, Carole Freeman. Certified nutritionist, registered hypnotherapist, and I’m excited today because I’ve got an actually in-person live interview. Dr. Westaway is here in studio. We get to have some fun here. Welcome.

Thank you. I’m glad to be here.

Excellent, yeah. This is Bella, too. She’s a special guest co-host. Tell everyone. Who are you? Tell us a little bit about yourself?

My name is Dr. Erin Westaway. I’m a naturopathic physician, and I have a private practice here in Seattle, Washington. I’ve been doing family practice for years now, and seen all sorts of ages, all sorts of conditions, and I’m shifting my practice right now to focus a little bit more on fertility, and actually launching an online fertility health coaching program, as well, for people who want to naturally get healthier and boost their fertility that way, rather than necessarily going the medical route of IVF, and all the hormone, and that kind of stuff.

Excellent. Really, lots of work, and really powerful work. We both went to the same university, Bastyr. Take us back before. What led you to Bastyr and to become a naturopath?

That’s a little bit of a long story. I’ll try and give you the shortened version.

We’ve got time.

Basically, I had some health issues growing up, and was diagnosed with autoimmunity as a teenager, and had some stuff before then that it kind of took a while to figure out. Then, eventually was diagnosed with polycystic ovarian syndrome at a time when I’ve always been a learner. You know, they just said, “Here. Go on these medications for autoimmunity, go on birth control for the polycystic ovarian syndrome.” I just went, “But what’s going on in my body? That doesn’t make sense to me.”

I happened to have the incredible fortune at the time of having a roommate in college who was actually going to school to become a midwife. Literally, this was before the days of the internet research, right? I just sat down with her medical textbooks, and I read everything that I could to understand what was going on in my body. What I found was that there was a lot that related to blood sugar control with polycystic ovarian syndrome. It wasn’t just about sex hormones.

I went back to my doctor, and I was like, “I read this stuff, and it seems like I should be able to change my diet, and you know, make a difference.” They just sort of looked at me like I had three heads, and said, “No, just go on these pills forever.”

Yeah, yeah. Food has nothing to do with that.

“By the way, you might have a hard time getting pregnant later.” I’d always imagined myself as a mom, and so I ended up going to see a naturopath. Within two weeks … Well, first of all, she was the first doctor in my entire life, and I had seen a lot of doctors, who had ever sat down with me and actually explained, “This is how this connects to this,” and put my labs, and my symptoms, and all of that together.

I was like, “Oh. This is what I’ve been looking for all these years.” I followed the dietary advice that she gave me, and within two weeks, I would say 80% of all of the things I had been struggling with for almost 20 years were 80% better.

Wow, yeah.

I was like, “Wait a second.” You know, what I realized was that my health at that point was so dependent on the practitioner that I went to see, and what they knew or didn’t know. I felt like, A, I wanted more people to know about more possibilities, and empower people, and B, I wanted to know for myself.

I was an English major at the time. I was not doing the sciences. I graduated. I taught public school for a while, which I loved, but ultimately, I just couldn’t shake the bug of learning that stuff, and so I went back. I did all my premed requirements and ended up heading out to Bastyr.

Are you from Seattle area originally?

No, I grew up on the east coast in Massachusetts. I went to college in Maine. I put everything in my car, and drove out here.

And you stayed.

And stayed.

Well, that’s such a life-changing experience. I mean, my first visit with a naturopath was very similar. Whereas, you know, with a regular doctor, you get, you know, five minutes, if you’re lucky, or maybe seven. You know, a naturopath spends 60 to 90 minutes with you in a visit, and looks at you as a whole person, and everything, and explains things so much. It’s just really life transforming to have that experience.

You know, some people watching may not know what a naturopath is. They might have these preconceived notions about, you know, not a real doctor. Something like that. Talk about that. What is a naturopathic doctor?

We go to school. We go to naturopathic medical schools. We have our own programs, our own accreditation board, and all that stuff. We do a program that basically includes all of the biomedical sciences that an MD would get. We do clinical training. It takes between four to five, really four to six years, depending on the person and what’s going on in their life. You have to fit everything basically from conventional medical school plus all of our extra training in herbs, and homeopathy, and nutrition, and counseling, and all of the lifestyle things that either keep people well, or you know, out of balance, create disease.

It’s a lot of training, a lot of clinical training. Ultimately, I think what makes a naturopath different than other doctors is our philosophy. It’s really about finding the root cause of illness, what are the obstacles to cure, and helping people unravel that to actually create wellness, rather than just here’s the symptom, here’s the disease, and here’s the pill that we’ll use to counter it. It’s like, we want to unravel that ball of yarn and help you be as well as possible for as long as possible.

Nice, nice. Yeah, so I love that. You know, root cause. Conventional medicine is looking at what pill can treat the symptom, whereas naturopaths are looking at what’s out of discord in the body that we can help support and heal itself?

Absolutely.

Yeah. It makes sense, then, why your focus now is on fertility, because that’s where your struggles and inspiration to take that path in the first place.

Yeah. It’s interesting, because you know, we were just talking earlier. I’m Sagittarius, so I get interested in so many things. I loved doing family practice for a while, because I got to see all of the variety, and all of that stuff. I’ve been thinking so much lately about just where do I want that impact to be and who are the clients that I just really love working with? I think when a couple that’s trying to get pregnant, they’re often really motivated to make some great positive changes in their life. It’s just this amazing opportunity to help not only those individual people, but then this baby that’s going to come into the world, and you know, all of the generations to follow them. It feels like this really special time in people’s lives to get involved and help.

Yeah, and then you get to help the whole family from thereon. Yeah, yeah. Let’s talk about how does diet affect fertility? For a lot of people, they’re probably like, “That doesn’t have anything to do with it.”

Hugely. Actually, it’s one of the main things that we look at. There are several. In both men and women, one of the main components that can get in the way of fertility is inflammation, right? There are so many things in diet that can cause inflammation. Whether it’s adjust that, or eating way too much sugar, even if we’re eating good quality foods, right? We’re eating quality foods and there’s just so much in them in terms of chemicals, and pesticides, and all of those things.

We know there’s a big impact that pesticides can have. Simply shifting towards organic can make a big difference. Getting all of the nutrients that we need, and all of the minerals that we need. I did this research process where I literally just combed through all the research I could find on PubMed looking at sperm health for men, because it’s one of the big issues in fertility right now, is that sperm health is declining rapidly.

Everything that was coming up was all about nutrient deficiencies. It’s not being talked about. You know, when you go to a fertility clinic, often they’re not saying, “Well, are you getting enough zinc? Are you getting enough CoQ10 in your diet? How can you do that? Do we need to supplement?”

I think for a lot of people, it’s just too much sugar, and too many inflammatory foods all day long, that we’re not using that fuel, you know, in terms of how we exercise and things like that.

Well, let’s talk about inflammation. A lot of people have heard that term. People say it. I talk to people every day that I’m interviewing to work with me. They say, “I think I have too much inflammation,” but they don’t even really know what that means.

Know what that means, yeah.

What is inflammation?

Yes, okay. Well, first what I’ll say is that some inflammation is good, and too much inflammation in the long term, not so good. One of the things that we’re really talking about when we talk about inflammation is oxidative stress in the body. You’ve probably heard oxidative stress, you might’ve heard the term free radicals. Those probably also sound big to you, too.

Think about this. If you heat something up, you actually change the shape of it. Our bodies function on shape. It’s like fitting the key in the hole. Everything has to be the right shape. When things are the right shape, and they fit really well, we have health. When they’re the wrong shape, then they can actually do damage. When you have something that’s in an inflammatory state, you create this oxidative stress, which goes around, and it’s like little bullet holes in everything, right?

It can actually destroy tissue. We don’t want that happening. When someone’s experiencing inflammation, they might feel things like joint pain, or headaches, or sometimes it’s just fatigue or that kind of flu-like draggy thing, or you just kind of feel like you’re moving through mud. Those are all signs that there is inflammation going on in the body. Getting enough of the nutrients to help calm it down can be really helpful.

We actually need some inflammation. I think this is one of the big misconceptions, because everyone’s like, “Anti-inflammatory everything,” right? It’s like, great, but our immune system actually functions on temporarily creating inflammation. That’s how we destroy those bugs, right? We go in and use that inflammation to attack them. We also temporarily use inflammation any time we have a cut or a wound we need to heal.

The issue is that many people in our culture, with their diets and their lifestyle, are creating a situation where that inflammation can’t ever come down. You have basically, like I said, those bullets going everywhere all the time with no ability to clean up the rubble. Does that help?

Yeah. I think that’s great. Yeah, yeah. A lot of people, they know they’re inflamed. They just don’t know what is going on. Just like we hear, “Inflammation’s bad, we should get rid of it all.” Same thing with, “Cholesterol’s bad. We should have no cholesterol at all.” These are normal processes in the body. They’re really important. A lot of things in the body work with temporary short term things are really good in healing, but they shouldn’t be that way all the time.

Exactly. Just like we need our cholesterol in order to make every cell in our body. We need our cholesterol in order to make those hormones to function through our day, to get pregnant, to do all of those things. It’s our friend.

Yeah, yeah. Yeah. Just too much all the time never gets the body to repair itself.

Exactly.

Yeah, so let’s talk about, then, you know, a ketogenic diet, or keto approach. How did you stumble upon that?

[inaudible 00:13:40], one of my mentors, came to us and said, “You guys have to learn about this.” You know, it’s become such a powerful tool that she had really dug in and learned about. As I started digging into it, it’s like, okay, well there’s so many aspects to what the ketogenic diet can do for the body. I decided to try it on myself, because you know, I have to experiment before I can send it out to my patients, and to read a lot more about it.

One of the things that it can do, when done well, is it can really reduce inflammation in the body overall. I say that caveat around when done well, because I think sometimes people leave out the good nutrients that come from vegetables and stuff like that, and focus on just being in ketosis rather than getting the nutrition that they need.

It can be an incredible detox. Many of the toxins that we’re exposed to, just from being in our day to day life, right? You hear all the reports now about the heavy metals and everything. There’s lead. There’s mercury. They’re literally just in our environment at this point. A lot of those get stored in fat. What is a ketogenic diet? That’s a fat burning diet, right?

If we’re introducing really good, clean, high quality fats into the body, and we’re allowing the body to burn what’s there, we’re actually releasing and getting rid of what is stored with them. We actually turn over that dirty or contaminated fat that’s been storing all those toxins, get rid of it, and then our bodies can function better. As a detox, it can be really powerful.

I already mentioned it can reduce inflammation. It can help with balancing hormones. It can help the digestive tract heal. Many times I see clients who don’t do well … Maybe they want to eat more actually vegetarian, but they’re struggling, you know, digestively they can’t do that. They go through the ketogenic program, and then afterwards it’s like, “Oh, I can digest all these things I couldn’t digest before, and I actually have more flexibility and more range.”

It’s so great for managing blood sugar and helping control that, which is one of the main reasons that I did it for myself, was like the hangries. I wanted to get rid of the hangries. My partner is always like, “Oh, you’re so much nicer.” You’re just having people have that metabolic flexibility is huge, too.

I’m sure there are others I’m not thinking of in this moment.

Yeah, so what kind of results have you seen with, you know, people that are adopting this, or trying a keto approach for fertility?

Yeah. It’s really great … Well, it can be great in most partners, male or female. For men, I find it’s really great for helping to reduce that inflammation that we talked about earlier. Also, one thing that people may not know is that when we carry excess fat tissue in our bodies, fat tissue actually produces its own estrogen. It’s like its own little organ, and it just makes this extra estrogen. A lot of the chemicals that we’re exposed to in our environment, whether they’re from plastics or pesticides actually mimic estrogen in the body.

In general, both men and women these days are in these somewhat elevated estrogen states, instead of being in their own normal hormonal rhythm. One thing that can be really helpful is A, getting rid of those toxins, B, losing some of the excess fat, right? Then, you’re not making any extra estrogen in your own body, so it can help regulate hormones in that regard nicely.

Then, particularly for women who are struggling with polycystic ovarian syndrome, there’s a huge connection between the hormonal balance and the cystic ovaries that happen in polycystic ovarian syndrome and insulin. One of the main things that the ketogenic diet does, is that it completely shifts how insulin operates in your body, and resensitizes you to it if you’ve developed some insulin resistance, or diabetes, and overall, just reduces the amount that your body is producing. Which can then shift how the whole reproductive system changes and operates.

It can be really, really powerful particularly in that patient group, but I think, you know, in many fertility patients, for other reasons as well.

Yeah, yeah. This is really exciting to have such a powerful approach. Yeah, and we have, there’s a local lady that struggled with poly … PCOS, yeah. Also, precocious puberty, and has been told her whole life she can never get pregnant. She adopted a ketogenic diet, and started doing some fasting as well. She now, her twins just turned one years old, and yeah.

Yay. Oh, I love those stories. It’s so empowering, because it’s like we get these messages, I think, often from the medical community that are sentences, right? Like, you can never, or you will always struggle, or you’ll always need to. They’re so disempowering, and so I think finding something, like, “Wow, if I can really give my body what it needs in this way, then it’s a total game changer, right? My body can actually go back to doing what it was designed to do.” Which is such an amazing thing, I think, for a person to feel like they have that power over their own life and wellness.

Yeah, yeah. I just wanted to add in, too, that insulin is another one of those hormones in our body that people often think of like, “Well, we should get rid of that as well, too.”

No.

We need that as well, too.

Yes. Thank you for saying that. It’s all in the right amounts, right?

Anything of too much is not a good thing, and also-

Not-

Yeah, not enough is important. Most people don’t struggle with not enough insulin.

Right. Unless they’re type 1 diabetic, it’s not their problem.

Yeah, so what are some, you know, tips you have for people that are, you know, struggling with infertility, diet and lifestyle.

Yeah, so like I said, I think a ketogenic diet can be really helpful. It’s not the right thing for everyone, but I think for a lot of people it can be really helpful. If you were going to go more basic than that nutritionally, it’s like, cut out the sugar, eat more really great green leafy vegetables, particularly from the brassica family, which would be like your … or your cruciferous vegetables, would be like your Brussels sprouts, and cauliflower, and kale, and broccoli, and all of those are so great for helping balance hormones.

Lots of good oils, right? We’re always taking about, in a ketogenic diet, but even otherwise, you need those oils to make your hormones. Good omega-3 oils from fish, or getting good organic nuts and seeds, your grass-fed beef, and pastured chicken. Healthy animal fat if you’re choosing animal fat. Go organic. Just get rid of the pesticides in your life. Those are kind of the starting points of diet.

You know, we could get into lots of details, but other aspects. Well, I guess I would say two of the other big things that I see are sleep and stress, which also impact our metabolism, too. Even if it’s not a fertility client, say I have someone that we’re just doing a ketogenic diet for another reason, I know they’re so, so hugely important. I don’t know how much you see that with your clients, but getting enough sleep and really working on the stress changes our physiology in really powerful ways.

There’s a lot of research suggesting that not enough sleep, again, raises that inflammation. Just being under stress raises our inflammation. It’s not about you have to change everything in your life. It’s about how do you respond to that, right? A lot of the research shows that our health outcomes, you could expose five people to the same stressor, right? Maybe they lost their job, or maybe they, you know, whatever … maybe they’re going through a divorce, whatever it is. It’s not the stressor that tends to lead to the health outcome. It is the way in which the person responds to that stressor.

That can be hard, right? We have lots of learned habits around that, that we think of as … They become so automatic that we don’t think of them as a choice anymore. It can be really learning a new skill, and you have to work out that muscle that you haven’t been working out for a long time, to actually change that pattern of response, but when we learn how to do that, that can be one of the biggest game-changers that I see particularly in fertility, but in a lot of other things as well.

Then, I’ve already mentioned some of the toxicity issues, but plastics are a huge, huge one for fertility because of that hormonal disruption aspect. You know, the more we can do to have less plastic in our life, which is hard these days, right? I mean, thinking about it, any time I’m buying food, I’m like, “Hey, what’s this packaged in?” You know? Making some different choices that are not always about convenience, but ultimately they’ll help.

Well, and little things about, you know, don’t cook your food in plastic.

Please.

Don’t pick it up and microwave in plastic things.

Yes, please.

Something else that’s coming up lately, we’ve got plastics that are BPA-free, but we’re finding that they’re-

That they’re full of BPS, and BPF, which are worse. Which is why, just as far as I’m concerned right now, there’s no real safe plastic. As much as we can do glass, or stainless steel, or things that have been around a little bit longer.

Yeah, yeah. Glass and stainless steel. Yeah. You talked about a ketogenic diet being really great for detox. I wanted to dive in a little bit about how you support people during that process, right? It actually helps the liver work a lot better, but as people are getting rid of that stuff that they’ve had stuck around in their fat cells for a while … some people have some-

Symptoms.

… symptoms that come up.

Totally. That’s one of the things that I think a lot of people, when they’re losing weight, will experience feeling awful in the process. I think it’s one reason why a lot of people will stop whatever it was that was their program for weight loss, and not make it a long term thing. They don’t feel good.

If we can get people through that, then it’s like, okay, we can see is this diet working for them or not? Sometimes, if people are experiencing that detox, they might experience fatigue, they might experience more joint pain, they might experience that brain food, some of those symptoms I was talking about before.

A couple things that are really important. Don’t let yourself get constipated. That’s like my number one rule. I write it on everyone’s treatment plan. You’re not allowed to be constipated while you are losing weight. In general, I don’t want you to get constipated, but particularly them, because the body’s trying to get rid of waste. If our body’s constipated, it’s literally sitting in our digestive tract, and then reabsorbing into our bodies. We don’t want it to reabsorb it. We want it to get out.

That can be, you know, eating, again, those vegetables can really help, because that’s your main source of fiber when you’re on a ketogenic diet. A ketogenic diet can kind of inherently be a little bit constipating for some people. Making sure you’re drinking enough water. Sometimes I’ll have people on a fiber supplement as well to just kind of help flush things out, and magnesium can be really helpful for that, too, because it also helps with some of the other detox pathways.

Those are like the most basic basics. Exercise can also be helpful. Sweating, I always encourage. Whether that’s sweating through exercise, you know, a good hot yoga class, and you’re getting your electrolytes into rebalance, or you’re going to the sauna. Our skin-

That sounds wonderful right now.

After this, Carole and I will be-

We’re recording this in the end of November in Seattle, so it’s getting a little chilly around here.

Yeah, so our skin is a major detox organ. It’s a secondary detox organ, but we have so much surface area that it’s really great at getting rid of things, if the liver and the kidneys which are more primary, are overloaded. Sweating is great any way that you can.

Then, sometimes, I will also recommend that people do colonics, just depending on, you know, what’s going on digestively for them. That can be a really fast way of helping to clear some things out. Your lymphatic system is this beautiful highway system that runs through your whole body and carries both major elements of your immune system and a lot of fatty things that are moving through your body. When you’re detoxing, your lymphatic highways can get a little bit kinda of clogged down. Both the sweating in a sauna and the colonic can help that to empty faster, and help people feel better a lot faster.

I’ve had a lot of clients feel a little bit resistant to that last one, initially. I think in this country, we don’t talk about colonics a lot, or they’re considered kind of way out there, and a little scary. If you don’t know what a colonic is, basically, you have a little hose that goes into your rectum, and you fill your large intestine with water, which causes everything to flush out. It also allows your lymphatic system to dump, and your liver to dump and flush out.

It’s a Roto-Rooter for your intestines.

Basically, yeah. Like I said, if it’s something that you’re new to, it can be a little bit maybe intimidating or sound uncomfortable, but it can be really powerful. My clients all the time are like, “Really? Okay, if you say so, I’ll do it.” Then, they go and do it, and they’re like, “Oh my gosh. Why didn’t I do this sooner?” I’m just putting it out into the world that it’s maybe not as scary as you think.

Dry skin brushing, too?

Yes, is a great one.

Another one, some people-

Castor oil packs.

Castor oil. I’m just doing this, and she knows.

I know what you’re saying.

Castor oil pack, for some people, is really messing and overwhelming to try to do that, so I’ve had some of them do just a heating pad there can help a little bit.

My lazy man’s castor oil pack. What you’re talking about, castor oil is this fabulous oil, but it’s a little bit kind of viscous, so it can be a little bit stickier than you think of with a normal oil, which is why she’s saying it can get a little messy. Your liver is this awesome organ that does so much of your metabolism and detox. It’s basically this triangle underneath the right side of your chest. If you follow that line of the ribs down, up the side and across. It actually goes a little bit over here, too. I have people cover that with a cloth, with a couple tablespoons of castor oil on it. Usually, it’s a piece of flannel, cotton, or wool, but you can use an old T-shirt or pillow case if it’s clean. Then, you put a little heat on there and you hang out for 45 minutes to an hour.

Because that oil’s a little sticky, it can get on things. What I do when I’m lazy, is I actually have castor oil in a roll-on deodorant body.

I’ve seen those. You can buy it like that, yeah.

Yeah, and you just roll it on. I put on a T-shirt that I don’t care about, because I know it’s going to get a little bit oily, and then I just go to bed. The heat of the bed, I’ll be warm enough to activate it. Then you don’t have to sit there for an hour and go, “Okay, did I plan out enough time?” That’s my lazy person’s castor oil.

Oh, okay. Okay. Then, it’s not going to get … The T-shirt’s going to absorb, so it’s not getting on your bed.

Exactly. What I will say is that, so castor oil works by increasing both circulation and lymphatic flow in the area, so it’s going to help bring new good nutrients to whatever tissue it’s over, and clear out those waste products at the same time. You can use it over many areas of the body. It’s kind of in my first aid kit for all my patients like, “Have this at home, because you’ll use it for lots of things.”

Okay. Nice, nice. I’m curious, too, so you’re talking about the colon being one of the major detox pathways, and so don’t get constipated, but some people when they start out a ketogenic diet, they have chronic diarrhea. I know part of that is, you know, the body’s not digesting the fat yet, so that can cause that. I also wondered about, perhaps if the body’s not constipated, is that a sign of massive detox that you’re having diarrhea?

I think it can be. Sometimes, you can tell by if it has a really strong smell to it, or if it’s really floaty, that’ll kind of tell you what’s going on in terms of the liver and digestion. Generally speaking, if the liver is going to dump a bunch of stuff that it’s trying to get rid of, it can be a little bit caustic, so it can be a little irritating to the intestines. It can cause diarrhea.

Sometimes if it’s like, “Wow, that smell is so rancid and strong. Where did that even come from? What is that color?” That’s a good sign that it’s probably a liver dump. One thing that can help it to be a little bit less irritating when that happens is, including some extra lecithin as a supplement, which basically helps soothe, and helps you create bile so you can absorb the good stuff back in, those good fats. That’ll help you, actually, if you’re dieting your fats well, you shouldn’t have floaty stools. That can also help you determine, is this a digestion issue or is it an issue with the liver dumping?

I think it can definitely be both. The ketogenic diet also changes your gut flora. Sometimes, as you’re having bugs die in there that maybe weren’t supposed to be in there, because they’re not being fed by all of that sugar anymore, that can also cause a little bit of diarrhea at times, as well. It should pass. You know?

What I tell my clients is if it goes on … We’re not talking … If you’re having watery urgent diarrhea many times a day, like four to six times a day or something like that, you want to address it sooner than this, but if it’s more just like, “Ugh, it’s irritated, and my stools are loose, but they’re only happening up to three times a day.” I would say that should change within two weeks, and if it doesn’t then there’s probably something else that you need to shift to support your body through it.

Yeah. Sometimes, I tell them, it’s like, “That stuff needs to get out somehow, so let it out.”

I have seen sometimes, you know, when someone goes on, it’s a big dietary shift, right? Sometimes people will start eating a lot more of something that they hadn’t been eating previously, and what I do find is dairy is often one of those culprits, right? Frequently, when people are eating a fair amount of dairy on a ketogenic diet, you know, because we can get the good fats that way, if it’s good grass-fed dairy.

It’s tasty.

It’s delicious, and cheese is so handy and fabulous, right? It’s like this little packet of goodness. Some people just don’t tolerate it, and so I have seen where that is the cause of a lot of the digestive stuff. We just say, “Okay, let’s lose the dairy for a week or two, and see what happens.” It just fixes itself. That can sometimes be the problem.

Okay. Do you find, too, that then people kind of have their own unique body’s go-to detox pathway? For example, for me, about every 10 pounds that I would lose, I would have skin eruptions in the same places. For me, it was on my face, I would get some boils, and actually my inner thighs, I would as well, and then some other places as well, where it was like, “Yep, that’s another 10 pounds.” I just thought it was a very odd, interesting thing, the way the body worked, where that was where my body decided it was going to let some of that stuff out.

Totally. I think that’s absolutely true. I’m always fascinated, and this is sort of just my nerding out about it. What does that tell us about the person’s body, right? I’m always like, “Well, tell me. Where were the boils?” They’re like, “Really?”

Yeah. Then, it makes me think about the Chinese meridians, right?

Yes, so that can be a part of it. The way I think of it is what organs are stressed and overloaded, right? In an ideal world, if our liver, and our kidneys, and our lungs, and our digestive tract are really balanced and in great shape, we won’t have anything coming out of our skin, because we don’t need that secondary organ to be where we’re excreting things, because it’s all getting out where it’s supposed to.

When those other organs are under a little bit of stress, that’s when we start seeing things coming out through the skin. Then, I start paying attention to, “Okay, it’s coming out through the skin, and which Chinese meridian are we on? What part of the body is it on?” Does that lead me to it’s more kidney, or it’s more liver, or we need to pay attention? Plus, any other symptoms that you’re having at that time.

Sometimes, people will go through cycles where it’s like, you know, night sweats are one that I hear, too, where it’s like, “I’m getting hot flashes,” but they go away in three days. It’s just like, “Yeah, you were just detoxing, and now you’re good.”

Some of the other ones that I hear. I’m just thinking. Yeah, I think it’s more like the location. It’s not always boils. People get different rashes. They’ll get all kinds of rashes. Sometimes people will get rashes, and they’ll go like, “I haven’t had this rash since I was a little kid.” You’re actually healing back to that state, and you’re getting rid of stuff that you basically stopped excreting at that point, and you stored. Think of it in that way, of like, I love when my patients get rashes, because I’m like, “Yes, you’re healing. It’s coming out.” “But it’s hideous.” I’m like, “It’ll go away. Don’t worry.”

I know some friends of mine that done a ketogenic diet, and in the very beginning, there are these philosophical discussions about, “You know, is the fat in our body, is it first in, first out? Are we burning through fat that’s 10 years old now? Are these toxins back from my childhood?”

Right? It’s hard to know. I mean, I think some of that is [inaudible 00:37:52], but I totally think about that, too. What is it? The other thing that I think about with that location thing, just because it’s popping into my head, is where might the lymphatic system be a little bit clogged, right? If you’re doing your dry skin brushing or something, that might be … It might be that you need to focus on the area.

Our lymphatic system, I said before, is this highway through our whole body. It dumps into your cardiovascular system right around here. Most of it drains onto the left side of your body. You know, the little quadrant that’s just the right side of your body, that has a separate entry point into the cardiovascular system.

I think about it like this. If the lymphatic system is a highway, and it’s full of snow, if you start plowing the snow at the farthest away points from where you can get rid of it, you’re going to be pushing that snow with the snow plow, and eventually it’s going to get so heavy that you can’t push it anymore, and you’re going to get stuck. What I always tell people, is if they’re getting a rash in a particular area, that’s always in that area, or if you’re one of those people, you get a mosquito bite, and it turns into this big lump, it’s probably that your lymphatic system in that area isn’t flowing well enough. You actually need to move the area that’s between the rash and this point here, because you need to open that … You need to clear all the snow from that before you can push all this snow into that area. You need to unclog it. Does that make sense?

Yeah, that’s interesting. Yeah, yeah.

Some people will be doing their, you mentioned dry skin brushing earlier, which is where you’re gently brushing the whole body to move the lymphatics, and sometimes people are doing it in exactly the opposite order from how you … They’re starting way far out, and clogging their snow.

Oh, okay. Okay. You should start close here, and then work you way toward-

Exactly. You’re always moving in the direction towards this … It’s basically right under your left clavicle. You’re moving essentially towards the heart always, but doing it in areas where you start closer to the heart.

Okay, okay. I’d had people start far away, so we want to clear up the snow close here first.

Exactly, yes. Then, they’ll get a lot more flow, and it’ll be a lot more powerful of a tool.

Yeah, because the symptom that I see sometimes that makes me think that lymph is stuck in people, is in the very beginning of a ketogenic diet, when they get swelling in their feet and their ankles. I have them do things like put your feet up on a wall, dry skin brushing. Now, I know to tell them to clean it up here first before they get down here.

Start up here, yeah. The other thing that I think of for that one, at the very beginning of a ketogenic diet, our mineral balance tends to get disturbed, because initially we start making these ketones and the body’s like, “I’m not even sure what to do with these, because I haven’t seen them in so long.” Then, we just basically pee them out. When we’re peeing a lot more, people always come in, “I’m peeing so much.” Yes. It’s normal in the beginning, but you’re losing a lot of minerals with that, too.

I know you always talk to people about, “You have to do enough salt and that stuff, too.” If you’re not getting enough salt, or potassium, or magnesium, you’ll get that swelling also. That can just be a sign of needing more of those nutrients. Then, it should clear.

Okay. Yeah, yeah. Usually, it’s very short term. I tell them, too, that’s a good sign that you’re doing the right thing, because your lymph vessels probably are unhealthy as well as your blood vessels, too.

Exactly, yeah. That means things are starting to move. Any time we do that, right, we’re disrupting whatever balance the body has come to, and so often there’s a period of discomfort that we go through as the body’s relearning its new state, right? It’s like, “Oh, I have to move all of this stuff, and I have to do things that I haven’t done in a while.”

Another one that people sometimes complain about in the beginning of a ketogenic diet is bad breath. That’s another detox location, right?

Yes. Yeah, so both in the digestive tract, but in the liver again, you’ll get that coming up frequently. That should clear as well.

Yeah, yeah. Just more exercise and breathe heavier.

Tell people get the fiber, make sure the bowels are moving. It’ll take care of itself.

Nice, yeah. Okay, so what are some tips? If somebody’s watching this, they don’t live in Seattle, and they can’t come see you, what are some tips you have about just getting started on a ketogenic diet? Specifically for fertility. Let’s just stick with that.

Yeah, so fertility … In general, I like to keep it simple. I think you do a similar thing in the beginning, where it’s like, you know, if you’re someone who really loves to cook, and you want to geek out on finding lots of ketogenic recipes, great, but in general, it’s like if you just keep it simple and you make half your plate vegetables, and then you have a good protein, and a good fat source, again keeping organic, grass-feed, clean as much as possible. That’s a really simple way to do it. It doesn’t to have a big, complicated, scary thing.

I think if you’re getting to the point where you’re having some of those symptoms, right, with brain fog, and kind of flu-like symptoms, and they’re not clearing quickly, that’s a great time to reach out for more help. Whether that’s, you know, finding someone who works remotely. Both of us do. Finding someone locally in your area who can give you more support around those things.

Oh, that’s right. You do work remote.

Yeah. Yeah, and there are so many more resources out there now, which is really nice, that people can have access to. Set yourself up well. Unless insomnia is your issue, make sure that you’re sleeping, and make sure that you’re moving every day, because it’s going to help so much with getting through those shifts that your body is making, and supporting it, and producing ketones to actually feed your muscles, and your brain, and all of those things. I think just keeping it as simple as possible.

Drink tons of water. You will be thirsty. It’s normal. Sleep. I think the biggest thing is people sometimes don’t realize how much protein and how much fat they need in the beginning, and it’s scary for people, right? Particularly if you’re thinking about it for fertility, those vegetables are really important, and those good high quality fats are important. They’re important for anyone on a ketogenic diet, but the fats are extra important when you’re doing it for fertility.

We’ve been scared, I think, into thinking … as a culture, fat is bad, right? I find often when people are starting out, there’s this sort of emotional response to that that they have to busk through a little bit, and just reminding yourself that, no, you’re providing your body not only a fuel for your energy, but a fuel for your hormones, and all of those things. If you’re doing it with really high quality, really honoring that it’s a gift for yourself, and that it’s not some crazy bad thing that you’re doing that’s going to hurt you.

I think that is one of the hardest things for people. I don’t know if you see that as well.

A bit. A lot of the ladies I’m working with have already tried keto on their own and haven’t had really good success, so a lot of them have overcome that, but it’s still lots of people have that fear, right? Like, “Is this really good? Can I really eat bacon every day?”

It’s high quality. Yeah, and that’s what I think my clientele is often I’m explaining what a ketogenic diet is to them, and then we’re starting at the very beginning. They might have a little more of that, “Really?”

“Are you sure?”

“Okay. I’ll do what you say.” Yeah, I think just keeping it really, really simple. It’s nice you can actually, I think, really cut down your cooking time for that. It can be so simple, and so giving yourself that time to do something else that feeds you, and allowing it to be that simple.

Oh, yeah. Well, and I’m thinking of some, you know, talking about some of the myths out there, right? One of my newest clients starting working with a brand new medical doctor, and you know, so she goes in and says that I started this ketogenic diet, and the doctor’s like, “Oh, not a fan of it.” She says, “Oh, really? Why?” His objections were, one, that it was not sustainable, that you’re just going to gain the weight back when you go off of it. It’s expensive, and I’m trying to remember the other one that he said, too.

Then, she said, “Well, will it harm me?” He said, “No, no. That’s not going to be the problem.” The sustainable thing was really funny, because the argument that you’re just going to gain the weight back when you go off of it is so ridiculous, because that’s true of any diet, right? If you go back to your regular eating habits that made you overweight in the first place, yes, you’re going to gain the weight back. There’s no magic bullet that you just do this for two weeks and then you’re fixed forever. That’s just such a silly thing. People have actually adopted a ketogenic diet. They just know that it’s so much more delicious, and they feel full and satisfied, and they’re not hungry all the time. Instead of eating like a boiled chicken breast and plain lettuce. That’s not sustainable.

No. In fact, sometimes I have trouble convincing people to go off of it for when I want them to for certain reasons. You know, after they’ve done what I want them to do with it. It’s like, “Okay, let’s branch out a little bit.” They’re like, “But I feel so good. Why would I do that?”

Yeah, and that’s what I find with clinicians out there. Another one of my clients sent me an article that was written by a medical doctor about how bad and dangerous it was, and everything. I said what I see is that clinicians that have not tried it themselves, and are not using it therapeutically, they’re the ones that still think it’s dangerous and unsustainable. The ones that have actually tried it themselves, and noticed how great they feel, and then start to use it with their clients and patients, they’re the ones that know all that other stuff is just hogwash.

Absolutely. I think it is important to consider what is the long term plan going to be? I don’t typically … When I’m working with someone with a ketogenic diet, sometimes I will have them on it for months and months. In terms of long term for the rest of their life, generally what I say is, you know, I like people to get as much variety of nutrients as possible, and to have some flexibility in life, right?

I talk about health as freedom from limitation, and any nutritional limitations that we provide ourselves within a certain amount can be sometimes socially limiting. What I generally work with people on is what’s the diet that is going to help them maintain the health that they have created, right? That’s different for different people. It does usually involve some number of days per week of being in ketosis in the longer term.

Sometimes it involves one or two days a week of fasting, of longer fasting, longer term. Actually, there’s a fair amount of research showing that that’s good for our brains. That it’s good for our metabolism, that it’s good for our longevity. I think that’s just, it’s slower to hit the conventional medical world. They’ll get there, but you know, I do find that sustainability myth to be a little bit funny. It just doesn’t make sense.

How about the one that it’s too expensive?

Yeah. I don’t think it has to be that, either. I think it can be. I think I certainly allowed myself fabulous luxuries when I was doing it all the time, just because that was my way of making it fun, and giving myself treats, and I felt like I could afford to do that at that point. I don’t think it has to be, you know?

I do think the expense can be, and I want this for everyone, not just people who are on a ketogenic diet, is again, that quality of ingredient, right? It is not just about eat this amount of fat, or this amount of protein, but making sure that they’re really clean. That’s not a ketogenic thing. That’s an everybody should be doing that thing. There is a cost associated with that, unfortunately right now, in this country.

Beyond that, I don’t think it has to be any more expensive than anything else, you know?

Yeah, and the beauty is that you can buy, typically the highest fat animal protein foods are the lowest cost ones, right? Chicken thighs, and drumsticks, and wings are much less expensive than boneless skinless chicken breast.

We always joke about that in our house. Like, how did this come to be? Because it tastes better.

Well, yeah. You know, supply and demand right now, because people think that’s healthier, so the other stuff is discounted. So shh. Pretty soon it’s going to switch, maybe switch over the other way around, because people start saying like, “We don’t have to eat chicken breast anymore.”

I tell people cook in bulk, because you know, that also will save you some money, too. In terms of the vegetables, it’s just finding where can you get those good sourced organic vegetables easily in your … Sometimes, it’s you’re going to the farmer’s markets, sometimes maybe you’re going to the co-op, sometimes maybe you’re going to Costco. They have more and more organic vegetable selections lately, which I am happy about, because I think that makes it more accessible to more people.

In our neck of the woods, we have Grocery Outlet, which remarkably, sometimes has some great deals on stuff.

Yeah. I think Aldi is one that it’s in the Midwest, that is kind of similar to that, yeah.

Yeah. I think it’s just looking around and finding … It’s shifting your thoughts about where I’m buying things. For me, the other thing that I think about it is basically what am I valuing, and where am I putting my money, and for me, health is a huge value. I’m going to invest in that, and it might mean that I don’t buy as many fancy clothes, or whatever, because that’s what I value more.

Would I rather put my money into some really good food, and not have to be on medications later in life, and have a great quality of life, and enjoy my time here? Yeah.

Yeah. Nice. Well, was there anything else that you were hoping I would ask about, or anything else you wanted to share?

I guess the one thing that I would say about all of this is that it’s really just, there’s so much information out there I think, and I kind of alluded to this before, that it can be difficult to sort through. It doesn’t have to be complicated. You can get started on it. Do reach out if you’re feeling like it’s overwhelming, or I don’t know if I’m doing it right, or my body’s responding in this way that I didn’t expect. There are people who can help, and I think some people sometimes will go like, “Oh, well, I tried that and it didn’t work.”

It probably didn’t at that time, that’s why you feel that way. That doesn’t mean that it’s the wrong thing. It might mean that there are just some adjustment that you need to make, and maybe you need some support in figuring out what that is, right? Is it that you need to do more detox? Is it that you need to adjust, actually, what you’re intaking? Do we need to look specifically at your glucose levels or your ketones and see what’s happening?

There’s so much more information coming out all the time. You don’t have to be the one to sort through all of that, if it’s overwhelming. You know, reach out to people like us, who are studying it and learning all the time, and get some help, because we want you to be successful. We want you to feel good doing it.

Yeah. Nice. Well, I’ve got one final closing question. It’s your final day on Earth, the meteor’s coming at us, we’re all getting wiped out. What’s your final meal going to be?

My final meal. Oh. Might not be ketogenic.

That’s the fun of this.

I think there would be pumpkin pie involved. I actually just saw a great keto pumpkin pie recipe that I want to try out. I think there would be pumpkin pie, and there would probably be some steak. I think that would be happening. Potentially wrapped in bacon. And some avocado. Okay, maybe it would be ketogenic. It’s like all the really rich foods. No, I think I’d want some berries in there. Yeah, some really fabulous fresh fruit. Yeah.

Okay. Any beverage or anything to accompany that?

I think a really nice glass of wine. Red wine. What kind of wine? It would be a … I’m not sure what it would be. I’m thinking about my meal. It would be a really nice red wine. Yes.

Okay, nice. Well, thank you so much for being here. This has been really fun.

Thank you.

Sharing all this information, it’s really good stuff. I know that you … If you enjoyed this, if you watched this, we’ve got all of Dr. Erin’s links below. How to get in touch with her, connect with her. If you’ve enjoyed this interview, give us a thumbs up, hit the subscribe thing over there, and that’s going to get you all the other interviews that we have coming, as well as hit the little bell. After you hit subscribe, hit the little bell, and that’s how you’re going to get the notification that there is a new interview out.

Thank you all for watching. Thanks again for being here.

Thanks so much, Carole.

Bye now.

Bye.