Episode 12: Do you need supplements when you want to get pregnant?
Episode Summary
In this episode we explore the murky world of fertility supplements and what you need to think about, as a fat person, if you decide to use them to support you in getting pregnant
What to Expect from the Podcast
A refreshingly fat-positive perspective, exploring the unique nutritional challenges faced by those in bigger bodies, such as the impact of diet culture, higher potential nutritional needs, and barriers to access. With a focus on informed decision-making, we debunk myths around supplement quality.
Highlights
Navigating Supplementation for Fertility in a Bigger Body
Debunking Myths About Supplement Quality
Unique Nutritional Needs and Context for Fat Folks
Specific Recommendations for Key Supplements
Empowering Listeners to Take Control
Links and Resources
Nicola’s book, Fat and Fertile
Get Involved
Nicola would love to hear from you! If this episode resonates, share your story, ask a question, or leave a review. You can also join the Fat and Fertile Alliance—a friendly space to connect with others on similar paths.
Support the Podcast
If you’re enjoying Fat and Fertile, please share this episode on social or leave a review! Every share helps make this info more accessible to everyone who needs it.
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Hey, my lovely Welcome to fat and fertile the podcast. I'm Nicola salmon, fat positive fertility coach and author of the book fat and fertile. I'm obsessed with helping folks navigate getting pregnant in an anti fat world on this podcast, we'll explore the complexities that fat folks face when you want to grow your family. If you want to support this podcast, I would love for you to share it on social media or leave me a review on your podcast app. Are you ready? Let's dive in. You.
Hello, my loves, and welcome to fat and fertile. I hope that you are doing all right. Happy. January. It's been a while, I'll admit, but I hope that everything is going all right for you, and that 2024 is treating you okay. So far, I am super excited to hopefully touch wood be back in the podcast Mojo. I am getting some support in terms of helping me make sure that be a little bit more consistent than having a big four month break, but we shall see. I cannot promise anything, but I really, really wanted to come back and do some more episodes, because so many of you have popped into my DMs over on Instagram and said how much you're enjoying the podcast, how much it's helping so that is spurring me on to make some more episodes. I'm currently in my front room recording this with Huckleberry, my very energetics progress spaniel by my side, which isn't really very conducive to the deep, you know, quiet space that would be ideal for podcast recording, but we shall see how we get on done. It's better than perfect, right? That is what I tell all of my clients. Is what I tell myself on a daily basis. So here we are doing the thing, and today I really, really, really wanted to talk about supplements, so specifically folic acid, but supplements in general, because this topic is a minefield, and especially as a fat person, the reader research is really tricky to navigate. The advice that you see out there can be quite challenging, so I really want to break it down in a much more fat positive perspective, so that you are not peeing your money away every month, and you are doing the best you can with the resources that you have. We see supplements talked about everywhere in the fertility space. It really feels almost like an industry unto itself within the fertility industry. And do not be deceived, the fertility space is an industry. There are a lot of people making a lot of money out of folks needs and help that they require navigating getting pregnant, and it's so tempting to believe that supplements are just a magic pill that gonna fix everything it is. So like the marketing is there to support that. And of course, you want to find that one thing that is gonna make the difference, especially if you have been navigating this for a little while, and it's essential that we have all the information that we can so that you can make a fully informed decision about what supplements you take, specifically like all the information around folic acid, which is a massive, massively important supplement that You can take when you want to get pregnant. So let's dive into it. The first piece of the puzzle around supplements, especially for fat folks, is context. What is so special about us and why might supplements be useful for us as a population? And of course, this comes with a massive caveat that fat folks are not a monolith. We are not all the same. We do not share the same experiences. We do not share, you know, the same life, journey, bodies, all of those things. But it can be useful to make some you know ideas, some assumptions around folks that have shared similar experiences. So I don't know about you, but this is very true for me, is that I have. Had periods of my life where I have been chronically undernourished. I had a massive phase in my maybe teens, 20s of the remember the low fat phase, so I was chronically undernourished with the amount of fat that I was getting in my diet at points around, probably around puberty and in my early adult years, and I have had bouts of being chronically undernourished in many other ways through my life, because diet culture right, like because we are told that we need to make our body smaller, that often can lead to restriction of specific and macro nutrients, or specific food groups, which can lead to our bodies being undernourished at particular points in our lives, and if you are still needing to navigate getting pregnant and jumping through BMI hoops that may be put in your place. Maybe this is something that you're experiencing now. Like the traditional advice is that if you are over a certain BMI, that you should lose weight in order to get pregnant. So many folks may be in that place right now. And of course, it makes total sense. We know that age is a factor when it comes to fertility. So if you are told by your doctor, and if you believe that you need to be smaller in order to get pregnant, then of course, you're going to find the fastest way to do that, and that can often mean severely restricting different parts of your diet. Some of us have disordered eating, or eating disorders, which, again, can really impact our relationship with food. And I've such a common experience with clients that I work with that they report that they have a really poor relationship with food, like the way that they think about food, the way that they sing food, can be really tricky. So there is a lot of shared history that a lot of fat folks have around our relationship with food, around how we've been taught to feed ourselves, how we've been taught to experience food within our culture. And so it's understandable that maybe this is impacting the nutritional status of our body right now, and also it could be a possibility that we might have higher nutritional needs being in a bigger body. There are so many variables that impact our nutritional needs, such as our metabolism, our activity levels, our health conditions that we experience. So it may mean, it may mean that we do have higher nutritional needs in our bodies right now. So supplements sound good, right? Like they sound like an easy way that if we've been undernourished, if we aren't able to currently nourish ourselves with foods, it sounds like supplements could be a great filler for that in theory. And of course, even having access to supplements is a privilege, one that should definitely be acknowledged. You know, they come with a financial price tag. It is something that isn't available for everybody. So it's really, really important that we acknowledge that. So let's have a look a little bit into supplements. Supplement research is an absolute minefield. We are trying to identify specific outcomes in the body when there's like a million trillion on one things happening right? Like there are so many things that your body is doing at any given time. And we are trying to identify tiny little pieces of this puzzle. When there are so many variables, both going in and coming out, it is wild. And supplementation research is very limited. It doesn't get the same amount of money pumped into it as drugs do, because there isn't as much of a financial incentive. Obviously, there's not as much money to be made in the supplementation market as there is in Big Pharma, and some supplements do have some useful research to back them up, but most of the research is really, really limited. We can draw some conclusions from human studies, but it's really lacking when it comes to being able to make informed decisions about supplementation that you use and the impact on your health, on your well being, and especially on your fertility. So when it comes to supplements and the impact on your fertility, what should you do? Should you take them? Should you not take them? And really, it comes down to your individual circumstances. You need to weigh up the benefits versus the risks for you like that is all that you can do is take all the information that you have to make. Make an informed decision the potential benefit of supporting your nutritional needs versus the risk of paying your money down the toilet. We know that the majority of supplements generally are okay, but again, this is something that if you're going to be taking multiple supplements, if you're already taking medications, there can be
places where they like intersect and can impact each other's efficacy, so like how well they work. So please, please do your research. Please, please consult with healthcare professionals if that's available to you, but I'm going to talk us through a few of the most common supplements that I recommend to folks, and how they could be helpful, how they could not be helpful, so that you can go into this with a little bit more of an informed decision. So this is all with the caveat that the research is pretty, pretty poor. So the thing that I often recommend to folks is a multivitamin, and this can be any multivitamin. There was Laura Thomas, who is an incredible nutritionist, did a really good article, which I'll link to in the show notes recently about almost like this hierarchy of nutritional fertility supplements that we have in in the UK, but I'm sure it is like across the US, Australia, like anywhere in the kind of western world where we obsess over supplementation for fertility, I would say, like, it is a big industry, and we almost have this like idea that there's these, like, the cheap ones are the rubbish ones, and the more money you spend, the like, better it's going to be. And I loved her article, because she really dispelled this myth that, you know the cheapest chips supplementation is rubbish, and you need to be spending like 20 $30 pounds on a monthly supplement. And I have been so guilty of this, I am no nutritionist. I am not a dietitian. I come to the fertility world, very much from different training, like I did naturopathy, which, you know, kind of borders on nutrition, but, you know, is very much debunked in my mind, and lots of other research and training, but Nutrition and Dietetics is definitely not the one for me. So of course, I looked around at what other professionals were saying in the field, and it made sense, right? Like, I'm sure you've heard this idea that I need to get, you know, the more expensive, the better, quote, unquote quality ones to have a better impact. But actually, the research just doesn't support, just doesn't support that. So any multivitamin, you know, that's been designed for preconception care is great, anything, and I think of it like an insurance policy, like without going through intensive like blood screening to figure out if you have any places within your nutritional needs that are not being met. It's often just cheaper to do, you know, to take a multi vet to cover all your bases, and just think of it as an insurance policy. And the benefit of, well, of taking like a multivitamin is that you feel that you have a little bit more control. You feel like you're actively doing something to support your physical mental health. And I think that can be a good thing too. I don't think that should be overlooked in terms of like, having that little bit of control of something that you can actively do every day. Now let's get into folic acid. Because, again, this is one that Laura really debunked in her article, and something that I have been so so guilty of in my past, of recommending the quote, unquote, more natural version. And she goes into it into great depth in her article, which I will again, I will post in the show notes for you to have a read through, because it's really, really interesting. But I want to come at this from a more of a perspective of fat folks, because if you're in a bigger body, and specifically in a BMI of over 30, the advice in the UK specifically, but I'm sure is across the board when it comes to different countries, is to take a larger dose of folic acid. And it is a much larger dose. It's like 80 times the amount, which is a. It feels a little bit excessive, I'm going to be honest. So in the UK, if your BMI is over 30, they recommend that you take five milligrams of folic acid every day, and that is ideally at least three months before you get pregnant and through pregnancy. Now, if you are in a quote, unquote smaller body or have a BMI below 30, the recommendation is 400 micrograms. So it is a massive, massive jump. And the reason that this recommendation exists is because some of the research shows that folks in bigger bodies are deficient in folate or folic acid in their bodies. And this, again, is a tricky one to think about. It may be that we are undernourished in terms of our life experiences that we talked about earlier. It may be that we just have higher nutritional needs in terms of what our bodies need to function. And it may also be that the the range that is kind of delineated as what is normal versus like out of range is set for small people. This happens so often, like they decide on the range of this is what should you know happen for bodies based on people with a BMI somewhere like 20 to 25 so they don't take into account that maybe folks in bigger bodies might have a different normal range. So there could be many factors going on as to why, if you're in a bugger body, you might have lower amount of folate in your blood, like and none of them mean that you're a terrible person. None of them mean anything about your worth as a human, or that you're sick, or did you did something wrong? It doesn't mean any of that, but what it does mean is that you might benefit from taking a bigger dose of folic acid, which is why they recommend five milligrams. I don't necessarily agree that we need to take 80 times the recommended dose. There's a couple of research papers that are linked to that show actually probably 800 micrograms is enough for us to be able to kind of top up our levels to what they deem to be appropriate. But yeah, it's it is what it is. If you want to take a little bit more, that's fine. Taking five milligrams, like there's no most of the research shows there's no negative impact for taking that amount. If you don't need it, you'll probably just pee it out, because it's water soluble. Some people may experience a little bit of sickness or nausea with it, and you can experiment with that, like, if you're taking a five milligrams, you are feeling sick. If you stop and you stop feeling sick, then maybe you could just double up on a 400 microgram rather than taking the full five milligrams. But again, talk to your doctor. Talk to your healthcare providers. You want to make sure that you're getting enough folic acid, because that is really important for baby and for you to make sure that you guys are staying healthy. You may have also heard about the kind of hierarchy of vitamins within the folic acid industry. And again, something I was totally, totally guilty of believing, is that there is, like a folate, which is the more natural version. So of course, that's the one we should all be taking in supplementation form. And it wasn't until I read Laura's post that I really realized that I too had fallen for this nutritional marketing scam. You know, like we are all doing our best, you know, we cannot be experts in everything, and we want to think that we can trust the people who we go to who are talking about these things to help us navigate the research and make informed decisions. But, yeah, folic acid, the bog standard stuff, fantastic. Your Body absolutely can metabolize that, even if you have the MTHFR gene, which you can sometimes hear talked about, being something that will stop you from synthesizing that, but you absolutely can, it will absolutely make huge difference, and you do not have to spend hundreds of pounds on supplements every month in order to support your health and your well being. A couple of other supplements that I think are worth talking about are omega three fatty acids and vitamin D.
Omega three fatty acids are something that can be really important for our health, also our egg health. Of infertility, it also reduces inflammation, which can be really helpful, especially for us as fat folks, because we often can have chronic inflammation. I think this is due to weight stigma, but the jury's still out. So if you eat fish regularly, if you know that you have a good source of Omega threes, then there's absolutely no need to supplement that. If it's something that you know that you don't have regularly, then maybe it's something that you'd like to consider. Vitamin D, again, is something really important for fertility. If you live in the northern hemisphere, chances are you're probably low, especially in winter. So it's a great one to supplement. Vitamin d3 if you're in the northern hemisphere. And again, it's all fine to get the basics like you do not need to spend a fortune on these things. There are so many other supplements, so many other herbs, so many other possible things that you can take, and if you have the capacity to research them. If you have a trusted healthcare professional, you can talk to about them. If you have someone who you're able to get the informed information from so you can make a decision. Awesome, but we are often sold that is going to be the magic thing that will fix everything, and it isn't that's just not what supplementation is. It can sometimes be helpful, especially if you know we've been nutritionally deficient, but the most important thing that you can do is just feed yourself, keep yourself safe and take care of yourself like that is going to go so much further than any supplement could. So if it's available to you, then you could get blood tests done to look for potential deficiencies. This can be really useful for folate, for vitamin D. You know, you can get those things checked if you know, having more information is really important. To give you that information to make the decision. So great if you've got that available to you, amazing. But it's really useful to consult with a healthcare professional. Don't take my word for it. This is just a podcast on the internet. I always be thinking about your own case, your own situation, looking at the pros, looking at the cons, and making that decision for yourself. So in conclusion, fat folks absolutely may benefit from additional support with our nutritional needs, because of our lived experience, because of culture, of telling us to make our body smaller because of our relationships with food, because we might just need a higher nutritional need like and that might be it. But supplementation is a total minefield. When it comes to research, we do not just have enough good quality information to be able to say yay or nay as to whether these things are going to help you with your health, of your well being, with your fertility. So you need to make an informed decision about if supplementation is going to be useful for you. This could include testing. This could include speaking with a fat positive dietitian or nutritionist. Think about how you're going to get that information if doing testing or speaking to someone is going to be financially viable for you. I would love to know what your experience is with supplementation. I would love to know what you think about it. I'd love to know your thoughts on what you've tried, what's helped, what hasn't helped. Like, has the pressure of trying to figure out this magic code of supplementation been more stressful? Like, have you found it helpful to have something that you can control when it comes to taking supplements? Send me a message over on Instagram at Fat positive fertility, and let me know what you think. I am so grateful for your support with this podcast, for tuning in, for listening, sending you so much love, and no matter what, remember, you are totally worthy of all of the support you need to grow your family. See you next time. Thanks so much for joining me today for fat and fertile. If you want to learn more about how to have a fat positive facility journey, then I'd love for you to check out my book, fat and fertile, how to get pregnant in a bigger body. It's available everywhere via Amazon, so just search in your Amazon store for fat and fertile, or click in the link in the show notes, see you next time you.
Get Involved: Nicola would love to hear from you! If this episode resonates, share your story, ask a question, or leave a review. You can also join the Fat and Fertile Alliance - a friendly space to connect with others on similar paths.
Support the Podcast: If you’re enjoying Fat and Fertile, please share this episode on social or leave a review! Every share helps make this info more accessible to everyone who needs it.
Apologies for any typos - transcribed by https://otter.ai - it can make mistakes! If you need clarification on anything - please get in touch!