EP 305 Is Inflammation Getting in the Way of Your Fertility? | Sarah Wilson

The Wholesome Fertility Podcast

On tomorrow’s episode of The Wholesome Fertility Podcast, I welcome Dr. Sarah Wilson of @drsarah_nd. Dr. Sarah Wilson shares her personal journey with reproductive health and how she overcame challenges with her period and fertility. She emphasizes the importance of understanding one's own body and advocating for oneself in the medical system. Dr. Wilson discusses the role of the immune system and gut health in reproductive health, highlighting the connection between inflammation, gut bacteria, and hormonal balance. She explains how basic blood work can provide valuable insights into one's health and offers practical tips for addressing gut health issues. Dr. Sarah Wilson discusses the importance of gut health and its impact on overall well-being. She explains how the gut microbiome plays a crucial role in maintaining a healthy immune system and how imbalances in the microbiome can lead to various health issues. Dr. Wilson emphasizes the need to create a hospitable environment for beneficial bacteria to thrive and shares insights on the use of probiotics and spore-based organisms. Dr. Wilson provides practical tips for improving gut health, such as eating whole foods, avoiding processed foods, and managing stress. Guest Bio: On today’s episode of The Wholesome Fertility Podcast, I welcome Dr. Sarah Wilson, ND. Dr. Sarah Wilson discusses the importance of gut health and its impact on overall well-being. She explains how the gut microbiome plays a crucial role in maintaining a healthy immune system and how imbalances in the microbiome can lead to various health issues. Dr. Wilson emphasizes the need to create a hospitable environment for beneficial bacteria to thrive and shares insights on the use of probiotics and spore-based organisms. Dr. Wilson provides practical tips for improving gut health, such as eating whole foods, avoiding processed foods, and managing stress. Takeaways:

• Advocate for yourself and seek answers when faced with reproductive health challenges.
• Understanding the role of the immune system and gut health is crucial for reproductive health.
• Basic blood work can provide valuable insights into one's health and help identify patterns and tendencies.
• Addressing gut health issues, such as inflammation and imbalances in gut bacteria, can positively impact reproductive health. Maintaining a healthy gut microbiome is essential for overall well-being and a strong immune system.
• Creating a hospitable environment for beneficial bacteria to thrive is crucial for gut health.
• The gut-brain connection and the enteric nervous system play a significant role in gut health.
• Managing stress, eating whole foods, and avoiding processed foods are important for improving gut health.

Dr. Sarah Wilson, ND, is the visionary founder of Advanced Women's Health, leading a healthcare revolution across Canada with clinics in Ontario and British Columbia. Overcoming her own health challenges, Sarah is dedicated to empowering women to reclaim their vitality naturally, merging research-backed expertise with her passion for Naturopathic Medicine. Beyond her professional pursuits, she is the Mom to two latino boys under 5 and is a self-proclaimed personal development and mindset fanatic. www.advancedwomenshealth.ca Instagram: @drsarah_nd @advancedwomenshealthclinics For more information about Michelle, visit: www.michelleoravitz.com The Wholesome FertilityFacebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/ Instagram: @thewholesomelotusfertility Facebook: https://www.facebook.com/thewholesomelotus/ Transcript: Michelle (00:00) Welcome to the podcast, Dr. Wilson. Sarah Wilson (00:02) Thank you so much for having me. I am so excited. I just really can't get enough of sharing all of the information that women need about reproductive health and empowerment. So thank you for having me. Michelle (00:14) Love it. So I'd love for you to share your background and how you got into the work with reproductive health. Sarah Wilson (00:21) It's such a huge conversation, I think such an important one because for so many of us, we get into it because we needed the medicine, right? And we explored that. So my story I always say is a really winding one. I was in and out of hospital my whole life until I was 18 and I was diagnosed with celiac disease, but I didn't fit the bill. And it was a naturopathic doctor that really pushed for that initial diagnosis. And so then, as we all do, Michelle (00:28) Mm -hmm, yeah. Mm -hmm. Sarah Wilson (00:49) I avoided my calling and was trying to figure out how to recover and how to work within this and lost my period for almost five years. And so during this time, I was a researcher and I was seeing different naturopathic doctors. I was seeing different conventional doctors and specialists and people just kept saying they didn't know what was going on and they couldn't figure out why I was, like I wasn't exceptionally lean during much of that period of time. Like they just couldn't piece it together. Michelle (00:58) wow. Sarah Wilson (01:18) I had a doctor, think it was 21, 22, that was like, you might never have kids on your own. If you wanna get pregnant, come back to me, I'll give you a pill, we'll wish you the best. Michelle (01:28) So nonchalant. Sarah Wilson (01:31) And I just, I always say there's a few breakdown to breakthrough moments in my life and that was a big one where I was just like, absolutely not. I have the world available to me. I have all of this research. There must be something I can figure out. So that proceeded to really get me to push to work and find the research and piece things together. And I did bring back my period. And then when it came back, it was exceptionally painful. I was passing out. I had been on birth control. Michelle (01:37) Mm -hmm. Yeah, good. Mm -hmm. Sarah Wilson (02:00) since I was 13 because of the amount of pain and heaviness. And so that's what it was like, okay, now we have to navigate this world of endometriosis and what that means. so yeah, now fast all the way forward, I became an astrophysicist doctor. I have two babies with two tries. I do not live in chronic pain and I'm just so passionate about taking all that research. I had to figure out myself and... Michelle (02:09) Mm Mm Mm Sarah Wilson (02:26) had to bring into practice and navigate how to bring into practice to now be able to give that to patients across advanced women's health clinics in Canada. it's just, it's a very empowering end to a really challenging journey, which I think so many people listening have. Michelle (02:44) Yeah, for sure. What I love about what you were saying is that knowing that inner knowing you're like, no, absolutely not. Like you knew it in your heart. Because a lot of people hear that. And then they're like, okay, I guess that's just my fate. And I love, you know, I love when people are like, no, I'm gonna take no for an answer. I'm gonna figure it out. and it's also an intuition. It's like your own intelligence within you telling you, no, there's more to look into. I had a similar thing a little different, but similar. so what was it, let's kind of go back just because people might be in similar situations with their period, listening to this. What was it that really caused the five years without period? was it being on a pill for a long time? What was it that caused that? Sarah Wilson (03:29) So I was actually, my presentation of celiac disease was very different. I was 100 pounds heavier than I am now. I perfectly, I exercised and I was obese. And so what, the brain is such a beautiful thing. And what I believe happened is that being obese, going through puberty programmed my brain for what body fatness, quote unquote, I needed to have in order to be safe to have a baby. Michelle (03:36) Mm Mm Mm -hmm. Mm -hmm. Sarah Wilson (03:59) And so for most people, they lose their periods around 16, 18 % body fat. I tend to hover around 23, 24. If I dip below that, then my period starts to go as long, it goes wonky. It's much better now, but the research suggests that when you have inflammation interacting with your brain, when you have cortisol interacting with your brain, what happens is we actually change how sensitive we are to the signals between the brain and the ovaries. Michelle (04:08) Mm Mm Sarah Wilson (04:28) And so I think that in combination with all these set point theories, there's so many things happening now in the world of set points, that combination is what it was. So for me, getting my inflammation under control, which we'll talk about, getting an understanding that I had stress, but it was physiological stress. I had nutrient deficiencies, I had bacterial overgrows, I had inflammation, like I had all of those pieces. that were interacting with my brain and my hormones. And so I just needed to go through step by step. I needed to work on my gut microbiome. I needed to work on the nervous system component. But fundamentally, I needed to understand that my body, the way it works and its sensitivity is set at a slightly different point than other people's. Michelle (05:18) Yeah, well, for sure. I mean, I think that that's really at the crux of everything is that everybody has their own different set point and different like, you know, responses, their bodies respond to different foods, different environments, different stress factors, just so many things. And I think that that's the key. I often see a lot of people sometimes come in to see me and they're well, I'm taking this kind of like, combination herbs that I saw online or, you know, so, that's, that's one of the things that I really try to stress to people is that everybody's so different. And so when you were going through that, you were uncovering it. Obviously you had a natural path that you were working with. Yeah, multiple. So they, you had a team. Sarah Wilson (05:58) And multiple. Yeah, absolutely. And I think I always say I'm the most energetic scientist you'll ever meet in your whole life. Like data informs every single decision. And then you sit in front of the person in front of you and you say, OK, what's their energy? Right. Like what? How do you need to to build those things together? And so, yeah, I had a team I had. Michelle (06:09) Mm Mm right. Totally. Sarah Wilson (06:23) And I had multiple naturopathic doctors try to work their way through it. I had OB -GYNs and my family healthcare team trying to help navigate it. And it was just, I was in the typical situation. I was in the situation that 90 % of my patients are in. Everyone's like, you're fine. It's fine. Your blood work is fine. Right? And that's, think, even for me doing research, one of the projects I was on was we were studying metabolically healthy people, metabolically unhealthy people. Michelle (06:41) Right, exactly. Yeah. Sarah Wilson (06:52) We were studying them in lean and obese categories. And so the labs going through and they're pulling all this data. And it was the first time that I'm sitting there going, huh, okay. So we can have people that are metabolically very healthy and overweight. And we can have people that are very lean and extremely metabolically unhealthy. And this was, it was such a formative experience because I remember sitting there going. Michelle (06:55) Mm Mm -hmm, right. Sarah Wilson (07:20) The blood work, the way we're reading it right now means nothing. Right? Like we need to be rude. Michelle (07:25) There's so much more. It's just a snapshot. It's like a small, it's a small little slice. And I think that's something that I often see too, is that we make such generalized assumptions based on such a small little snapshot. And while that snapshot is very important, it's, it's kind of a piece to the puzzle. It's not the end all be all it's part of the whole picture. Sarah Wilson (07:28) Exactly. Exactly, and if we use a conventional reference range that's defined based on disease, like I think in North America, we've really lost the understanding that there's a line between health and disease. Like you don't just jump from one to the other like long jump, right? It's not like I'm healthy today and tomorrow I have a disease. Like there's this spectrum of dis -ease as we make our way to a condition. And I think identifying patterns in labs. and identifying tendencies is arguably more important than the snapshot itself, you're 100 % correct. And so we have to look at that data holistically and say, how is that changing? How is that modifying over time? But also I think there's so much research now where we can give people back the keys to the castle with that basic blood work, right? Even for example, everyone has had what we call a complete blood count. We've had multiple of them. So that's... A complete blood count is when we're looking at your red blood cells and your white blood cells. We're looking at the breakdown of those things. It's the thing you get when you walk into the doctor's office, when you get when you walk into the hospital, et cetera. They're always just saying, what's your white blood cells? What's your red blood cells doing, et cetera. And there's two white blood cells called neutrophils and lymphocytes. They are just representing two aspects of our immune system that are fighting bacteria and viruses and they're helping to support the system. But there is a ton of research coming out to show that the ratio between neutrophil and lymphocytes can tell us about the inflammatory status of the body. So if your NLR, as we call it, neutrophil to lymphocyte ratio, is higher than 2 .5 or 3, chances are you've got an immunological underpinning to what's going on. And so for me with endometriosis, I was in the hospital a while ago now, and I was having a flare, and I was worried about ovarian torsion, because at one point I had had a 10 centimeter endometrial. Michelle (09:30) Mm -hmm. Sarah Wilson (09:40) like it was very, very large and it's not there now, but I just wanted to go in and make sure that there wasn't something happening because it felt different. And my NLR was six, but outside of that, it was one or two. So this is something I always say to patients, you can even empower yourself just looking at that number and being like, if that number is jumping high and it's correlating with my symptoms, if I have worse menstrual pain or worse mood challenges or Michelle (09:42) Mm -hmm. Mm Mm Mm -hmm. Sarah Wilson (10:08) I get pregnant and these things jump and then I have a loss, what could that be telling you about your immune system? And I think there's such simple things. Of course, we can run super comprehensive panels of labs and get all of the autoimmune tests. And like I've heard you talk about them on the podcast before, right? You can get really comprehensive panels and that's wonderful. And I love that as a doctor and a researcher, I love data. But what I love even more is saying, let's look at the past two or three years. Michelle (10:26) Mm Mm Right. Sarah Wilson (10:37) What are these basic blood markers telling us about your tendencies and how much we need to dig into different components of health, like your immune system, your blood sugar, those types of things? Michelle (10:48) So you could see this basically on just general blood work. Sarah Wilson (10:53) Exactly. And so that's where I think for me. Michelle (10:55) And do people often look like, do doctors even know to look for that specific thing? So it's kind of one of those things that people don't really look for, but you can kind of dig up your own stuff and just look at the ratio yourself. Sarah Wilson (11:07) Exactly. Exactly. And that's why I think I come on these podcasts and I do these things because not everyone has access to a naturopathic doctor. Not everyone can be a researcher. Exactly. So to be able to look at that and start to question, even when I was in the hospital, I was like, are you concerned about that? And they're like, maybe you have a bacterial infection. It's not a big deal. Okay. Okay. Right? But it's... Michelle (11:16) Yeah, that's very empowering. Mm -hmm. Yeah. Sarah Wilson (11:30) It's those things that I want people to be able to grab onto and access for themselves because what I know to be true in my practice, seeing so many people, is when you give women access to information about their bodies, they change communities, households, everything. Like it is the most empowering thing for me to come on a podcast and talk about something and then... Michelle (11:46) Mm Yeah. Sarah Wilson (11:57) get someone message me and be like, my friend of a friend of a friend told me to look at this and now I'm concerned about it. And I'm like, yeah, you should probably get that investigated. And then it's ovarian cancer. You know what I mean? Like this is how powerful just these conversations are. Michelle (12:08) my God, yeah. Yeah, it's very powerful. mean, obviously when you do see that something's off, it'll get you at least to take the next steps or to investigate it more because you can't really make, you know that something's going on, but you have to like really move further and see what it is. But at least it's going to be an alarm to let you know something's going on. Sarah Wilson (12:35) Mmm. And a direction, right? I, every day, pretty much at this point, I'm talking to someone who's like, everything I was told was unexplained, right? And in the fertility world, if you're unexplained infertility, you either have a baby or you don't, right? So there's clarity in that, no one's saying, your infertility is in your head. But in every other aspect, there's not those clear end points. And so, Michelle (12:40) Mm Mm -hmm. Mm Sarah Wilson (13:07) if someone's dealing with chronic pain and they aren't getting investigated for endometriosis or some other condition, they can be told it's all in their head. So even if they can see on basic blood work, one or two things that are off, it's like, there, go there, let's do this. And I think that's what's so exciting to me. Michelle (13:24) Mm -hmm. Right, right. Yeah, definitely huge. So talk about the immune system. this is one of the things that you can look at, I know that there is a lot of a connection with autoimmune conditions and the gut health and, high inflammation and leaky gut. So talk about that, how people can look into it and how they can address it. Sarah Wilson (13:53) Absolutely. So I actually also was a microbiome researcher at one point in my profession. It's so important. And even now, like post pandemic, we've seen it so much more important because historically, what do we always say? Is 60 to 80 % of your immune system lives in your gut. Okay. So there is within your gut, there is, it's so interesting. Picture a PVC pipe, right? On the inside, if there's Play -Doh. Michelle (13:59) awesome. Amazing, though, but it's so important. Mm Mm Sarah Wilson (14:23) that's where the bacteria live, right? But that's actually outside of your body. And so that play -doh is either poop, in those of us who are lovingly chronically constipated, or it's the mucosal lining that the bacteria live within. So that's where the immune system is really, really critical, is within that putty lining. And so what happens is that immune system's job, because it's technically outside of your body, mouth. Michelle (14:26) Mm Mm Sarah Wilson (14:51) all the way down to your anus is outside of your body. Its whole job is to say, are you a food and you're safe? Are you a bacteria and you're safe? Are you a virus and you're not safe? Are you a bacteria and you're not safe? And the whole job of that immune system is to sample and navigate. Do I need to kick off an inflammatory response or do I not? Am I safe or am I not? And so what we're looking at is when we start to have allergies. and we start to have food responses and all these food sensitivities when we start to have bloating and gas changes in bowel movements. That's all telling us that our immune system either one has identified a bacteria or virus that needs to go and it's kicking off a response to it or two, it has what we call lost oral tolerance. It has lost the ability to know between what's good and what's bad. Michelle (15:46) Mm. Sarah Wilson (15:47) And so in both of those situations, that is going to result in inflammation, not just local to our gut, but throughout what we call our peritoneal cavity, right? So that's gonna be your ovaries. I always say, your bowel and your ovaries and your uterus are friends. Like for those of you who can't see it, they're touching, they're friends. So we have that inflammation in our reproductive system. We have that inflammation affecting our liver. then it goes into our bloodstream. It affects our joints, it affects our brain. That's why we talk so much about the gut brain connection, because there's that inflammation there. But as a practitioner, my job is to sit here and say, is it that we have so much inflammation? There is this absence of an ability to regulate, should I fight this or should I not? Is it that there's so much damage being caused by inflammation that now we have leaky gut or impermeability, right? Because the immune system will cause damage and it's trying to fight something and there's collateral damage. So is it that or is it that there's bacteria that need to be modified? And so I think it's really helpful, even like thought experiment to think about it in that way, because so much of the time when it comes to the gut, we Michelle (16:43) Mm Mm Sarah Wilson (17:05) are assuming that our symptoms are wrong. Like, what's wrong with my gut? Right? Like, we're a victim to it. Like, our immune system is doing something bad. But nine times out of 10, it's trying its best to protect us. And so our job is to say, what is it protecting you against? Michelle (17:08) Mm -hmm. Right. Mm Mm Right. Sarah Wilson (17:25) So when we're navigating and we're going through then, we hear all about probiotics and we hear all about these different things and all of them can be helpful and have their place, right? We hear about armor colostrum all the time these days on different podcasts, right? We hear about all these things. And so I always say, think about them and put them in the context of what I just said. So if we don't have enough good bugs and we add probiotics, which are good bugs, Michelle (17:36) Mm Mm right, yeah. Sarah Wilson (17:52) then that will take us so far. for, again, for those of you who can't see, I've got my hands up, right? Picture it like a bar graph. So if you don't have enough good bugs and that bar is low and you have too many bad bugs, then the dominant state is bad bugs. So if you add a whole bunch of good bugs, then eventually you can turn that dominant state into good bugs. But probiotics are transient, they leave the system. So you still have that low grade bad bug situation. Michelle (18:06) Mm Sarah Wilson (18:21) So this is where we hear about berberine, right? We hear about oregano, we hear about black cumin seed, we're hearing so much about all of these herbs now, because what they're doing is they're breaking down the bad bugs to allow the good bugs to grow, to repair the lining. it's, there's such a huge dance with the bugs in the gut and the immune system and how that affects the rest of your body, but what we know for darn sure is that Michelle (18:23) Mm Right. Right. Sarah Wilson (18:49) There are overgrowths that are happening more than they ever have been before of bad bugs. We know that. Michelle (18:55) Right. So we're talking about things like SIBO, you know, just that, because that ultimately it starts to kind of go from like the bowels all the way up. Sarah Wilson (19:04) Yeah, exactly. So SIBO is small intestinal bacterial overgrowth. So it's overgrowth of good bugs in the small intestine. We also have what we call CFO or overgrowth of yeast in the small intestine because the immune system can't defend against the yeast. Then we have bad bugs and parasites, right? So this is where we hear an overgrowth of, I'll throw some names, like Pseudomonas, C. difficile, Clostridium species, E. coli. We have an overgrowth of bad bugs in that situation. And those can be Michelle (19:11) Mm Mm Mm Mm -hmm. Bye. Mm Sarah Wilson (19:34) upper but they can also be lower down. And so that's always what we're navigating is saying, okay, is there, if you have an overgrowth of good bacteria and you add more good bacteria, you're gonna be the person who feels awful on probiotics. You take them, you're gassy, you're distended, okay, in that, yeah. Michelle (19:49) Right. Unless, unless they're spore based. Sarah Wilson (19:56) The SBOs are such an interesting conversation. They're such an interesting conversation because most of the research is coming out of two labs. And so I agree to some extent and I'm pensive. Yeah. Michelle (19:59) Yeah. Mm -hmm. Okay. No, tell me, tell me. I want to hear it because, because I've always been told and I've always learned that spore -based probiotics, because, they, they bypass the small intestine, they go all the way down to, you know, the colon that, and then they, and then they flourish and they change the pH and they, they make it so that it's more hospitable for the good bacteria to grow and not the bad bacteria. A lot of times there's like die -off symptoms and it Sarah Wilson (20:32) Exactly. Michelle (20:36) kind of shifts, even though it's transient, it does shift the pH to create it where it's better for a healthier environment. Sarah Wilson (20:47) Absolutely. So it's just like that bar graph, right? I always say if you give the environment for the good bugs to grow and there's not too many bad ones, then they will grow and take over. If you ever, I always tell people picture like an octopus or a cuttlefish, you know they change colors really rapidly? Our bacteria do the same thing. It's called quorum sensing. And so essentially if you create a hospitalable environment, you have enough mucus. This is the other thing, right? Bacteria need mucus. Michelle (20:49) Mm Yeah. Yeah. Mm -hmm. Yeah. Mm -hmm. Mm The mucosal lining. Yeah. Sarah Wilson (21:13) Exactly. So if you have that integrity, you add probiotics, and then you can change from a red environment, inflamed, the pH is off, there's bad bugs growing to a good environment. If you don't have that mucosal lining, if your immune system is too grumpy, or if you're in a situation where there's too many bad bugs, then you can't fix it by adding more. Michelle (21:17) Mm -hmm. Mm Mm Mm Sarah Wilson (21:40) And so that's where we're using antibiotics and antimicrobial herbs and things like that to get that down. Going back to the SBOs, the thing I find really interesting is there's so many, I could like nerd out on this stuff all day long as you can tell, but there's so many factors, right? So when we talk about it bypasses the small intestine, what they mean in that situation is that all bugs are either acid sensitive, temperature sensitive, Michelle (21:54) It's great stuff though. Sarah Wilson (22:09) oxygen sensitive or yeah, I went through acid. Those are honestly the main ones. There's nitrogen sensitive, things like that, but those are the main ones. So what they're saying is the acid sensitivity means that they will get, and the temperature and oxygen sensitivity means they're gonna get lower down. But what we're seeing more and more and more is that people's stomach acid is off, their pH is off throughout their whole system. They have all kinds of, Michelle (22:32) Mm Sarah Wilson (22:37) you know, temperature sensitivity changes. And we have all kinds of changes in the hydrogen, methane and oxygen levels within our gastrointestinal tract. So what happens is we're not actually controlling where it's going. We're controlling at what environment it takes hold. And because there's so much dysfunction within the gastrointestinal tract in so many of our patients, I'm concerned that it actually could take hold. and be present at higher levels of the gastrointestinal tract contributing to issues. And I've seen some... Yeah, that's BOs. Yeah. Michelle (23:10) You mean the spore based ones, the spore based? you, because from what I understand, looking into it is that it won't activate until it gets to the large intestine. Sarah Wilson (23:23) And that's based on the pH, the oxygen level and the temperature and all of those pieces. Michelle (23:29) Okay, I see. So you're saying that it could be a different pH and everything will shift if things are so off, up, you know, higher. Got it. Sarah Wilson (23:36) Exactly. Exactly. And I've seen severe constipation in patients that take SBOs. It's like the only side effect I see, because you're right, there is a lot less bloating gas, those like three to five day battle between the good and the bad bugs. There's less of that for sure. But I have seen like enough patients that got me saying, okay, what's going on there that take it. Michelle (23:47) Mm Mm -hmm. Mm -hmm. Yeah. Mm Sarah Wilson (24:04) and immediately they're super constipated. So we actually use them a lot in diarrhea because of the benefit of that. But it's definitely a space I'm watching the research. It's super interesting. I think just like, so I was, my God, how many years ago now was I a probiotic researcher? least 10. It's a different world, right? Like how exactly, so. Michelle (24:10) Mm -hmm. Yeah. Mm -hmm. yeah, they're learning so much so fast. Yeah. Sarah Wilson (24:30) Exactly. So that's where I always say, you know, you're a good practitioner when you want to refund everyone every five years. You're like, what was I doing? So I think it's just an evolving conversation, but they definitely do have utility for sure. I think there's just, for me, just having been in a research environment, I know how controlled all of those situations are. And so then when they come out into our patient situations, Michelle (24:35) Yeah. Yeah. Sarah Wilson (24:56) We just need to apply different lenses of thought to it. Michelle (25:01) Or I mean, you can also add something like Trifola while they're doing that so that you're kind of like counteracting the constipation aspect or maybe some more fiber eventually when they're ready, you know, because sometimes too much of that when things are not great can exacerbate. Sarah Wilson (25:17) Absolutely. And like we have studies now that are coming out to show that it's alarming. Over 50 % of people have what we call retained fecal matter, which is like constipation when they don't know constipation. And so I think there's so much that we're finding out and there's so much that's going on within the gut microbiome world that will be. Again, I'm just always so curious to see where it goes and to see what happens with it. Because even I wrote a book in 2018, I guess. So I was writing in 2017 on insulin resistance and how that worked. And like I talked about in Cretins in a big section of that book. This was like pre -Ozempic days. And people at that point were like, what is she talking about? And now it's so accepted. And that's what six years later, right? They're just like, of course. Michelle (26:08) Yeah. Sarah Wilson (26:11) So, so much changes so quickly. And I think just staying on top of it is something I value so much. Like even today, I'm teaching an intensive on post -viral immunology for other practitioners, right? So, I'm always trying to navigate what do I see in practice? Because we see thousands of people in advanced women's health. And how is that showing up in the research? And how do we mesh those things and adapt with those things? Because things change so quickly. Michelle (26:14) Yeah, for sure. Mm yeah, definitely. No, I agree. mean, everything just kind of out does itself. Something new comes along. what I find really fascinating is the gut brain relationship and the enteric nervous system and also the vagus nerve and how that impacts. It's kind of like the go between our brain and our gut. And, and also Sarah Wilson (26:50) Yeah. Michelle (27:01) the research on that where they've done like studies on meditators and like people in Tibet, Tibetan Buddhists, compared to people that are neighbors that eat the same food, they live in the same environment, but the gut microbiome of the meditators is so much more enriched. So it's kind of like a buy between, yes, we could work from the gut to the brain, then we can also work from the brain to the gut. And it's pretty fascinating. Sarah Wilson (27:12) Yeah. Yeah. Absolutely, and even to see the amount of research on people's levels and how that is directly related to yeast infections. We know that that whole gastrointestinal tract, vaginal microbiome, they are so, so, so closely tied to our nervous system and stress response. There's so much, I do. Michelle (27:34) Mm Mm That's interesting. Yeah. Sarah Wilson (27:52) stool testing on myself pretty frequently. I would say even more so than patients, I do it on my family. And it's so interesting to see how it shifts because again, diet and lifestyle can stay very similar. So it's like interesting what caused that shift, what caused that shift, how was stress involved with these things. it's, yeah, it's so fun. It's so fun. Michelle (27:58) Yeah. Mm -hmm. Yeah, it's fascinating for sure. And then also, think about the gut microbiome, I think about the changes, I think about inflammation. I think about the additives we're eating and we're exposed to. mean, those are the biggest things because it feels like it's outside of our control. I mean, it kind of is until we know about it. It's, know, we go eat some places, we have no idea what they're adding and we know that Sarah Wilson (28:33) Mm Michelle (28:40) thickeners, I mean, there's so many things that can be added. We know that they can really throw off the gut microbiome and that throws off inflammation. So it's kind of like an unintended consequence because you're not, most of us don't know that unless we're doing what we're doing and learn about it. Sarah Wilson (29:00) And then you're looking, is there SLS in this? Is this disrupting my microbiome? Michelle (29:04) Yeah, but that's what it is. And that's why when people say, I guess, to simplify it is just don't eat processed food as much as, try to avoid it as much as possible. Because even like the good kind can impact your gut. mean, like good processed food, because of all of the excess ingredients that they add in there, that could really throw off your microbiome. That's why when people say just, I guess, like, if you want to say something that's more generalized, is more whole foods, foods that come from the earth and also foods that are not sprayed with toxins, know, I mean, to try to avoid it. It does feel like an uphill battle. Sarah Wilson (29:44) Patients are so overwhelmed, right? It's you're trying to eat whole foods and then you look and they're like, okay, well, what about genetically modified agents? And then what about what's being sprayed on them? And I always say that in of itself is a stress response, right? So we talk about stress and then we make food such a stress. And so I always say to people, the reality is that you could probably do better than you're doing right now. Michelle (29:45) Yeah. Sarah Wilson (30:12) and what feels reasonable, what doesn't feel overwhelming, right? And we'll actually sit there and go through and say, okay, I need you to eat a low insulin demand approach, because insulin is such a huge inflammatory compound. Insulin is the hormone that controls blood sugar, but it's like 75 plus percent of us are insulin resistant in today's day and age. So it's a huge, it's an epidemic. So I'm like, okay, don't eat a ton of carbohydrates, Michelle (30:14) Mm Yeah. Yeah. Sarah Wilson (30:43) I hate good carbs, bad carbs, but berries, all of those highly colorful fruits and vegetables, don't count them. Eat away, enjoy your life. I'm not talking about that. We all know we shouldn't eat as much bread. Deep fried foods are not helping anyone, right? The starchy carbohydrates, rice, like that. We have to watch those things. We built a culture on creating addiction to carbohydrates. So we have to be careful of those things. But it's like, how can you add two servings of vegetables? If you can... Michelle (30:52) Yeah. Nope. True. Sarah Wilson (31:12) buy local and you know where they're coming from, rock on. Like it's summer here right now. There's farms that I know do not spray anything, but they cannot certify organic because they can't afford it. Okay, wonderful. I can go there, right? Buy frozen organic. It is pretty much the same price to buy frozen organic as it is to buy broccoli right now, right? And saves my life prepping it. It is picked right. Michelle (31:26) Yeah. Mm -hmm. 100%. Yeah. Sarah Wilson (31:41) It is frozen right away. There's benefits to it. So it's like, do that. Okay, then we look at our meat. How, or if you're eating meat or not, How is it being raised? Would you want to go visit that farm? Because if you would not feel good around that, then energetically that has an impact, right? What hormones are going into it? We look at those things. And the reality is, if you can't... afford to make those choices wonderful. That happens. What do we do to feel the best about the options that we have in front of us? Fundamentally, I always say balance blood sugar and a nervous system that is stable and you're not having anxiety every time you put food in your mouth because you don't know what's in it. That is going to take us almost just as far as micromanaging every piece and every ingredient. Whole foods more often eaten away that fills you up, that makes you feel good. And everything else from there is customizable. But I think I hear so many patients, they get so caught up in fresh, organic, grass fed, grass finished, researching the farm, and then they end up in McDonald's. Michelle (32:57) Yeah, that's not good. Yeah, yeah. Yeah. Sarah Wilson (32:59) because they're so overwhelmed, right? They're like, I'm just hungry. And so I always say like a happy balance is always gonna be the goal. Michelle (33:08) Yeah, no doubt, for sure. Sarah Wilson (33:10) And your microbiome loves colors and there's not many of those at McDonald's, so. Exactly. Michelle (33:14) Yeah, variety for sure. Yes, totally. And then you were talking about like symptoms even without a diagnosis, Sarah Wilson (33:24) So the blood work is one piece, right? So even without a diagnosis, you can do complete blood count. You can do something called a C -reactive protein, which is a marker of gut inflammation, liver inflammation. You can do an arethrocytes sedimentation rate. These are blood markers. But I also say, if you are struggling with joint aches and pains, if you feel like you're just getting older, if you are dealing with brain fog, if you... Michelle (33:26) Mm Mm Sarah Wilson (33:53) have pain with your periods that we have normalized so much as a society. If you have period poops, if you have PMS that is affecting your quality of life, like we have so many of these symptoms that we've been told, I'm just getting older, I have aches and pains, I'm just bloated and gassy, it's not a big deal, I just have brain fog, I'm losing my memory, right? I can't remember where I put my keys. I'm dealing with like menstrual challenge. That is all inflammation based, all of it. And as someone I think who lives in this world all the time, it's so easy to forget what it feels like to feel crappy until you get hit. And I have two small children. I have a two and a five year old. And so we're sick all the time, right? Like it's just the reality, daycare, school, people get sick. And It's so easy to just again, lose track of what good actually feels like. And it doesn't include those things, right? You should wake up in the morning feeling rested, unless you have a child who has nightmares about monkeys, which happened to me. Right? But you should be able to sustain that energy throughout the day without eating food. You shouldn't have to compromise your activity and your work schedule based on pain. Michelle (35:05) Right. Sarah Wilson (35:17) and energy levels and your menstrual cycle or your digestion. And so many people are living in that state where they are. Michelle (35:22) Yeah. And so when you do have people that come in with inflammation, what are some of the ways that you address that Sarah Wilson (35:33) absolutely. So my belief structures, there's only five to seven causes of disease, right? So we go through blood sugar dysregulation and insulin resistance, the gut microbiome, immune dysregulation, we've got liver issues, we have nutrient deficiencies, the nervous system, and then we have the components of cellular energy production, or what we call our mitochondria, right? So these are the components of health. And at the end of every piece of that, you're going to have a stress response and an inflammatory response, which is what most people are dealing with in today's day and age is they're struggling between that balance of stress response and inflammation. So my job is always going through those components and saying, which are the top two or three for you, right? If we're talking about microbiome issues and the immune system as two key pieces. And then we say, okay, let's compliment that with the nervous system because we just talked about that. If those are someone's top three pieces, then first and foremost, we have to go through and say, what are the biggest obstacles? What are your gut symptoms? Does that suggest that you might have an overgrowth of methane species? Right? Does that, that tends to be constipation, lots of gas that doesn't smell great. Is it suggesting that you have hydrogen overgrowth? Right? that's lots of gas that doesn't necessarily have a smell. We can go through, pick those apart. Do you have a history of parasites? Right, do you camp a lot? Those pieces, we're using antimicrobials in those situations to try to create some stability. We're trying to understand how that's gonna relate to blood sugar, et cetera. When it comes to looking at the immune system, there are key nutrients like vitamin D. If you don't have vitamin D, at the right level, which most of us do not, that's a master controller of your immune system. So we need to have that in place. We also need to look at your viral history. So we know right now, research is showing that you can retain components of viruses for years. We've seen that people have reactivation of chronic viruses and those are directly affecting the lining of their uterus, they're directly affecting their ovaries. Michelle (37:44) Mm Sarah Wilson (37:55) and their whole pelvic health. So in that situation, we're saying, okay, what antivirals need to come into the mix? And what do we need, again, to look at from a holistic perspective? I know you've had so many people on here that talk about NAC and N -acetylcysteine and alpha -lipoic acid and CoQ10. And oftentimes what they're doing is just helping with those inflammatory cycles. Michelle (38:22) Mm Sarah Wilson (38:22) right, they're helping to restore balance to that inflammatory pathway. And then the nervous system comes in because that affects blood flow that affects your immune system's ability to do its job. And we say what works for you? Is that nerve nerves, right? That's where our valerian our passionflower, our zycephos come into the mix and are so beautiful. Is that going to be something where it's we're looking at meditation and walking? and all of those pieces. that's really the approach I take, is I say, in those five to seven different causes that someone could have, what are the most important pieces for them? And then we dig into it at depth to say what components, whether that's using blood work, whether that's using functional testing, honestly, at this point, having seen as many patients as I've seen, sometimes it's insane. You're like, okay, I think we need anti -microbials. some valerian and passion flower, and we need to correct the nutrient deficiencies that are present with respect to vitamin D and some of those antioxidants. We need to get enough protein, more colors, Bob's your uncle. But it's, I always say, health is so simple, and we have so much time and energy dedicated to making it really hard. And... Michelle (39:31) Right. Sarah Wilson (39:42) the more sophisticated I get, the more sophisticated the research gets, the more I go down rabbit holes, the more I come back to the same things. And I think there's so much peace in that too, to know that, yes, I have a lot of patients with very chronic health issues, with very significant imbalances, but the body wants to come back to those places and we just need to figure out which levers to pull to get it back to health. Michelle (39:49) Right. I love how you put that. It's true. It's just like, are the levers to pull, to try to help it do its job. what it wants to do really, it's like its purpose. Sarah Wilson (40:24) Exactly. it's so, like sometimes you're pulling the same levers in rotation, right? You're like, okay, blood sugar, stress response, liver. And then you're like, inflammation, gut microbiome, stress response, blood sugar, liver. It's, you sometimes have to cycle back to those pieces. There's like the layers of the healing onion. So as we always say, but it's, there's so much simplicity that can be had within all of it. And I really want people to feel that because I think, Michelle (40:28) Mm -hmm. Right. Yeah. Sarah Wilson (40:50) There's a lot of energy now being dedicated to feeling like health is gate kept and it's not, right? This is why we come on these podcasts. This is why we do these things. If anyone today says, I feel empowered, I can take action here. I'm gonna add more vegetables. I'm gonna add more colors. I'm gonna go for a walk after my meals, ideally in nature. I'm gonna look at what brings me joy. Michelle (40:57) Yeah. Sarah Wilson (41:17) and include more of that. I'm gonna work on my boundaries, I'm gonna correct my nutrient deficiencies, and I'm gonna look at my microbiome. You will get so far, so far in your health. And that to me is just, it's so beautiful. Michelle (41:26) Yeah. yeah, for sure. mean, it's really empowerment. So, well, this is great. You shared so much amazing information. I could definitely keep talking to you because there's just so much that we can keep unpacking. But if people are interested in working with you, want to find out more about you, how can they find you? Sarah Wilson (41:53) Yeah, absolutely. Well, thank you. know I was, these are always such loaded conversations because we start and it's like, do we go here? Do we go here? So exactly. Michelle (42:00) I know. There's just a, a, branches out and it has, it starts to take a life of its own. And then I'm like, okay, well, we still can't keep going, going, going. at one point. Sarah Wilson (42:11) I know totally. Yeah, so I, as I said, for anyone listening in Canada, I own Advanced Women's Health. So we have clinics across Ontario and BC and we're expanding. I have a whole team of practitioners that do clinical rounds every day and I work with all the time. For those of you in the US, I do have courses where I train naturopathic doctors. So if you like this approach and you want people who are in the US and beyond. then you can always reach out to my team as well. Their email is just info at advancedwomenshealth .ca and they've got that list of practitioners. So in either situation, we can help you out. I also poke around on Instagram. I do not post on there as much as I should, but it's always a goal. And yeah, I'm just so happy to connect with the audience. Michelle (42:52) Amazing. Well, Dr. Wilson, this was very informative and I love the fact that you do so much research and this is based on like real data and real information and you really understand it. Your mind tends to work that way, which is awesome because you have to find a career where your mind is really able to absorb that information and then apply it. And it sounds like you found a perfect. career for what you do and you're passionate about it as well. Sarah Wilson (43:20) Thank you. Yeah, no, I'm so fortunate. I love what I do. And like, I'm so fortunate that I get to build a team of people that begrudgingly love my brain. They're always on calls because we meet every day. So our team of practitioners meets every day and they're always asking questions and I'll spin out on something and I'll be like, welcome to the Ted Talk. Sorry, that just happened. Michelle (43:31) No, it's very interesting. Amazing. That's great. Well, that's how you know you love it. That's how you know it. Sarah Wilson (43:44) Yes. Yeah, exactly. Exactly. Well, thank you so much for having me. It's been such a joy. yeah, I just I love sharing this information. I'm happy to come back and share more anytime. Michelle (43:55) Yes. So thank you so much for coming on.