By Nurse Mark

 

Many of our readers know that Dr. Myatt has been working closely with a an infertility specialist in New York city. Dr. Jeff Braverman is a Reproductive Immunologist and In Vitro Fertilization specialist who sought Dr. Myatt’s collaboration several years ago as he looked for ways to improve his already impressive success rate with the difficult cases.

More recently, a prominent doctor in the San Francisco area, Dr. Christo Zouves, has been corresponding with Dr. Myatt and is recommending natural supplementation to his IVF and fertility enhancement patients as well.

We are pleased to see increasing numbers of otherwise conventional allopathic specialists taking advantage of the powerful synergy that natural supplementation can bring to their treatment protocols – and we just love it when these women are able to tell us “I’m pregnant !”

Along with becoming pregnant comes fear however: “What if I do something wrong and hurt or even lose my baby?”

After all the hard work and often great expense of achieving conception, it’s no surprise that our new moms-to-be are leery of almost everything: there is so much misinformation out there and most of it consists of dire warnings about what can harm their precious new child.

Indeed, if a mom-to be were to follow all the advice available to her from “friends,” family, acquaintances, and most especially the internet there would be very little she would be allowed to do for the next nine months but breathe – very carefully, of course!

Everywhere she looks – anything she might wish to do – it all carries a risk; at least according to one self-proclaimed expert or another.

It is especially so when it comes to vitamins, minerals, herbs, and other natural substances. There is a very large segment of the conventional, allopathic medical and nutritional community that is adamantly opposed to the use of anything non-prescription at any time, and the occasion of pregnancy gives them the opportunity to double down on their dire warnings about the evils of vitamins and herbs. Standard conventional advice with regards to natural supplements is always to “use with caution” and to immediately “discontinue all use” during pregnancy because “not enough is known about the safety of these substances during pregnancy”.

Not enough is known by whom I wonder? By the conventional practitioners who had to turn simple, inexpensive fish oil into a hundreds of dollars per bottle Big Pharma prescription drug before cardiologists would prescribe it to their patients?

Plenty is known about these natural supplements by the practitioners of natural medicine who rely on the experience and wisdom of thousands of years of use of these things and our readers and customers know that they can depend on Dr. Myatt and The Wellness Club to give them straight, well-researched answers to their questions.

And so, Michele recently wrote to ask:

I am interested in finding an alternative to Maxi Flavone during pregnancy since I’m concerned about using green tea (which I understand affects folic absorption) and ginkgo (which I understand may not good for pregnancy).

If you recommend Maxi Flavone during pregnancy, can you give me some background?

 

Maxi Flavone is one of our most requested supplements by our fertility patients. Dr. Myatt and Dr. Braverman worked extensively together to ensure that this would be an optimal broad-spectrum herbal antioxidant, anti-inflammatory, and TNF inhibiting formula that would be safe for use during pre and post conception. It has proved to be highly effective.

However, I had a niggle about Michele’s question – I remembered hearing something about this a number of years ago, so I set about refreshing my memory. Here’s what I found:

The caution with green tea centers around the ability of green tea to block the absorption of folate / folic acid – which of course is essential to fetal development.

More specifically, it is the tannins in green tea that have this blocking effect.

Those same tannins are also found in black tea, and  wine (horrors – not wine!). Nuts that can be consumed raw, such as hazelnuts, walnuts, and pecans, contain high amounts of tannins. Almonds have a lower content but it’s there. Herbs and spices such as Cloves, tarragon, cumin, thyme, vanilla, and cinnamon, and most legumes contain tannins. In other words, tannins are ubiquitous.

It appears that massive  amounts of tea or other tannin-containing substances must be consumed, and consumed at the same time as folate-containing foods for this effect to be problematic or even apparent. According to an article fro 2009 published in the Journal of Physiologic Pharmacology: (1)

Greeen tea extracts lower serum folates in rats at very high dietary concentrations only and do not affect plasma folates in a human pilot study.

 

The worry about Ginkgo relates to single study / report that suggested that women who take ginkgo during pregnancy may be putting their fetuses at risk of abnormal development and warned that all pregnant women should avoid using ginkgo.

It turns out that the authors of the study claimed to have found excessive colchicine levels in the blood of the women studied, and inferred that the ginkgo must have been adulterated with colchicine to cause this.

It appears that the “researchers” fell victim to a basic chemistry mis-identification error because Ginkgo leaves contain a naturally occurring, nontoxic substance that is almost identical in structure to colchicine. The researchers who published the original report did not perform the test needed to differentiate these two compounds even though the blood levels of “colchicine” they claimed to have found should have set off alarms for them. If it really were colchicine these would be quite toxic levels and the women would have been very sick indeed. In other words, this was a seriously flawed study.

Here is the original (flawed) study: http://www.ncbi.nlm.nih.gov/pubmed/11559040

Bastyr University published and article explaining the faults and flaws of the study in detail: http://www.bastyrcenter.org/content/view/610/

The Council For Responsible Nutrition issued a report refuting the claims of the study: http://www.crnusa.org/Shellnr082901gingko.html

And other industry bodies have also weighed in with their rebuttals, such as The American Botanical Council http://cms.herbalgram.org/herbclip/pdfs/100511-211.pdf.

So, the bottom line:

There is no solid evidence that either green tea or ginko (when used sensibly) have a negative effect on fetal development or pregnancy.

“All things in moderation!”

And Michele is right – she knows that it’s possible, even likely, that the stressors that were causing her to experience inflammation and high TNF levels have not suddenly disappeared now that she is pregnant. So why discontinue a supplement that has been helping to keep inflammation and THF levels under control?

There is one caution that may apply – ginko may have a mild antiplatelet effect and so there have been cautions to be careful with its use around the time of delivery – in order to minimize any risk of prolonged bleeding – according to an article in the Canadian Journal of  Clinical Pharmacology from  2006: (2)

Ginkgo should be used with caution during pregnancy, particularly around labour where its anti-platelet properties could prolong bleeding time.

 

These “anti-platelet” concerns could indeed be real, especially to a woman who is Vitamin K deficient – so, the solution? Ensure that Vitamin K levels are optimized by either enjoying a diet rich in Vitamin K containing foods or by supplementing to make up any shortfall. There is no “hyper coagulability”  associated with even high doses of Vitamin K and Vitamin K is important to fetal development.

 

References:

 

1.) http://www.ncbi.nlm.nih.gov/pubmed/?term=19826188

J Physiol Pharmacol. 2009 Sep;60(3):103-8.

Greeen tea extracts lower serum folates in rats at very high dietary concentrations only and do not affect plasma folates in a human pilot study.

Augustin K, Frank J, Augustin S, Langguth P, Ohrvik V, Witthoft CM, Rimbach G, Wolffram S.

Abstract

Green tea catechins (GTC) have been shown to inhibit the activities of enzymes involved in folate uptake. Hence, regular green tea drinkers may be at risk of impaired folate status. The present experiments aimed at studying the impact of dietary GTC on folate concentrations and metabolism. In a human pilot study (parallel design) healthy men consumed for 3 weeks 6 capsules (approximately 670 mg GTC) per day (2 capsules with each principal meal) containing aqueous extracts of the leaves of Camellia sinensis (n=17) or placebo (n=16). No differences in plasma folate concentrations were observed between treatments. We further fed groups of 10 male rats diets fortified with 0, 0.05, 0.5, 1, or 5 g GTC/kg for 6 weeks. Only at the highest intake, GTC significantly decreased serum 5-methyl-tetrahydrofolate concentrations in rats, while mRNA concentrations of reduced folate carrier, proton-coupled folate transporter/heme carrier protein 1, and dihydrofolate reductase (DHFR) remained unchanged in intestinal mucosa. Using an in vitro enzyme activity assay, we observed a time- and dose-dependent inhibition of DHFR activity by epigallocatechin gallate and a green tea extract. Our data suggest that regular green tea consumption is unlikely to impair folate status in healthy males, despite the DHFR inhibitory activity of GTC.

 

2.) Can J Clin Pharmacol. 2006 Fall;13(3):e277-84. Epub 2006 Nov 3.

Safety and efficacy of ginkgo (Ginkgo biloba) during pregnancy and lactation.

Dugoua JJ1, Mills E, Perri D, Koren G.

CONCLUSIONS:

Ginkgo should be used with caution during pregnancy, particularly around labour where its anti-platelet properties could prolong bleeding time. During lactation the safety of ginkgo leaf is unknown and should be avoided until high quality human studies are conducted to prove its safety.

PMID: 17085776 [PubMed - indexed for MEDLINE]