Discover Why Functional Labs Elevate Your Fertility

Kela Smith, PhD, DNM, DHM

Thank you. I’m excited to be here.

Aumatma Simmons, ND, FABNE, MS

Let’s dive right in because you’re such an expert in this space, of course, of fertility, and also how functional lab testing plays a role in identifying what’s happening under the surface. Let’s start with the basics. For those of our listeners and participants who don’t know or aren’t familiar with this term, what does it mean when we say functional lab testing?

Kela Smith, PhD, DNM, DHM

Yes. Functional labs are going to be different from than bloodwork that you would get at your Western medical doctor or clinic because Western medicine looks at different parameters. Functional labs are looking a little bit deeper. As you said, they’re looking at how we can make the body heal, how we can find the root cause, and how we can fix and optimize. Whereas bloodwork is looking at just a snapshot in time of what’s happening right when whatever is being tested is tested, whether that’s hormones, minerals, or whatever they’re testing. Those parameters are: do you need a prescription? Do you need to have surgery? Are you a good candidate for an art treatment like IVF or IUI? It’s a very different parameter. I’m looking to heal the body and make it work optimally, whereas functional or Western medicine, like I just said, is looking at those different parameters.

Aumatma Simmons, ND, FABNE, MS

Like functional beings, what’s happening in the body? What are the things that are interconnected with fertility that may not be optimal? Then Western medicine or the more conventional labs are looking at snapshots in time around what basic lab work is saying about, for example, in like, should you do IVF, should you do IUI? Answering basic questions. But they have a different lens that they’re looking at it through.

Kela Smith, PhD, DNM, DHM

Functional labs are also looking at optimal levels. I don’t want to see just what your baseline is. I want you to be optimal. That’s a different parameter that we’re looking at. Even when I do blood work with clients, it’s a different parameter that I’m looking at because I’m looking at healing and I’m looking at optimization.

Aumatma Simmons, ND, FABNE, MS

I’m curious, how often do you retest functional labs? Do you have a process where they do the lab testing and then they do whatever your action plan is based on their labs? Then do they ever, like, have reached a point where you’re like, things look better, or maybe we should retest this stuff?

Kela Smith, PhD, DNM, DHM

This is another place where functional labs are different because I’m also correlating what the lab test says based on what the symptoms are. Symptom reduction is the number one thing we can say. This is working. If you get pregnant and we’re working on fertility, that’s a telltale sign that what we’re doing is working, as well as symptom reduction. Your cycle gets more optimized, it’s more regular, and it has fewer symptoms. Maybe you’re working on weight loss, you’re losing weight, or you have brain fog or skin issues. All those have gone away. That’s the first place I look, and I say, just like you would do basic bloodwork, at least once a year you want to run some functional labs, especially if you’re still having symptoms. For me, I’m in perimenopause. I have very few symptoms of that. But once a year I go to my Western doctor, I have bloodwork, and I go to my functional doctor because we can’t treat ourselves. I have a functional doctor to go to, and she runs some hormone tests and some basic functional labs. I would say, to answer your question, I’d say once a year, maybe every two years, depending on what symptoms you have.

Aumatma Simmons, ND, FABNE, MS

In terms of the information that you’re attempting to gather from the functional labs, what do you find most useful as far as information goes? Which are your favorite tests for fertility or so?

Kela Smith, PhD, DNM, DHM

I love to run the Dutch test for hormone testing, and I did the one from Meridian Valley Labs because I feel like they make it a little bit easier to read more parameters. But when I run that test, I’m looking for not just what the hormone levels are, but how the body’s using the hormones, how they’re being methylated, which means neutralized, and how they’re detoxing and excreting. This is especially important for estrogen because I want to see the estrogen being recirculated back into the body, and that’s causing issues. Is the testosterone too high, and is it higher than the estrogen, meaning that’s going to affect ovulation and egg health? I also like to look at the stress hormone profile. I’m looking at cortisol, cortisone, creatinine, and adrenal gland reserve to see if this person’s in fight or flight and to see if their body is not going to accept a pregnancy because their stress hormones are super high or super low. They’re in the fatigue and burnout stages. That’s the first thing I’m looking at. I also love to look at the thyroid through urine because it’s just a different lens to look at the thyroid through. We’ll look at T4 and T3 and see if anything’s going on there, so the Dutch test is one of my favorites, I also like doing the microbiome analysis through Biomet X. I do that test particularly because, unlike some other tests such as the GI Map and different stool tests, they’re looking at what microbiome is there, but the Biomet X is looking at how it’s interacting with each other. It’s looking at the whole picture—the colony that’s in the gut—to say, Are there opportunistic bacteria in here that’s causing the bad guys to overrun the good guys? How are they? What is the relationship with the microbiome, what is it doing, and what is it doing for symptoms? I can also tell if a client is super inflamed by looking at that and what their microbiome is saying. As we know, an inflamed body cannot get pregnant or is very difficult because it sees it as a stressor; it’s like a fight or flight. The body’s not going to get pregnant in an environment like that. That’s the second test I like to do. The third thing I usually do is a mineral analysis. Most people are minerally deficient. They don’t realize that a lot of people have toxic heavy metals. They don’t realize they have that. I like to test minerals through tissue versus blood because, again, blood is just a snapshot. It’s a transportation mechanism, and it doesn’t show intracellular minerals, meaning they’re inside the cells. An example of that would be magnesium. Magnesium is in the cell. If you test it through blood, you’re not getting a good representation of the levels of my three go-to tests, and how I read them functionally means that these are the root causes that I see. That’s probably what’s causing these infertility issues, especially, or even if I’m testing somebody who’s in perimenopause or menopause, this is what’s driving that. This is what we need to do to fix and optimize.

Aumatma Simmons, ND, FABNE, MS

The mineral analysis you like through hair, which tissue?

Kela Smith, PhD, DNM, DHM

I like to do it. The hair tissue underwent mineral analysis. Hair because it’s the most and it’s noninvasive, it’s pretty easy for somebody to grab some hair versus if we were to test tissue, take a biopsy. If you will, that’s not an easy thing to do. hair.

Aumatma Simmons, ND, FABNE, MS

Why is it that these all sound like great tests? How come irregular Western medicine practitioners or reproductive endocrinologists? Why aren’t they doing these tests?

Kela Smith, PhD, DNM, DHM

As I said earlier, those practitioners are great. They have their wheelhouse of education. But they’re not looking to heal the body; they’re not looking to make the body optimal. They’re looking at what the parameters are for IVF. I apply for a prescription and, if you’re in menopause, a hysterectomy; that’s what they’re looking for. Bloodwork is cheap and easy, and it can tell them that. It can give them a baseline. It’s not going to show true healing. So that’s why a lot of Western medicine doesn’t use these tests when they’re not trained in this way; they’re not trained functionally and then healing the body. But then also these, the blood works cheap and easy, and that’s what they’ve been taught and that’s what they know how to do. That’s the reason. 

Aumatma Simmons, ND, FABNE, MS

It’s unfortunate. I feel like I don’t know if you’re this much, but I often get this message: But my doctor already tested all the things; they did all the lab tests. I’m like A. That would be thousands and thousands of dollars.  B. There would be so much information that it would be overwhelming for anyone to have that many lab tests like they know a doctor is testing every single test under the sun. If they’re proficient doctors, they’re probably picking and choosing what the right ones are for you and what’s happening to you.

Kela Smith, PhD, DNM, DHM

Yes, I hear the same thing. I want to reiterate what I just said: as functional medicine doctors, we all practice differently, but as functional doctors, we’re going to practice differently than Western doctors. It just depends, and that’s the thing too. I have a lot of clients come to me, and they’ve been with their Western doctors, and they’ve run all the tests, and everything’s normal, and they’re still not pregnant. Then they’ve got the title or the diagnosis of unexplained infertility. Then I have to remind them that that just means that the doctor hasn’t found what’s wrong yet, and we need to dive deeper. That’s what we do functionally.

Aumatma Simmons, ND, FABNE, MS

I agree so much with that approach. We just need to figure out what’s going on. You call this the hormone puzzle. Can you share a little bit more about what that is for you?

Kela Smith, PhD, DNM, DHM

The hormone puzzle is a protocol that I developed when I was struggling with my hormones or my fertility and hormone issues. The reason I did this is because I felt very out of control when this was happening. I felt like a lot of things were being done to me, and I’m a Type A personality. I wanted to take back some control, so I said, What can I do? What do I have under my control daily? That was the fundamental piece of what the hormone puzzle is today. I’ll go through it briefly, and then we can discuss it further if you want to dive in deeper. But so this is PUZZLE, an acronym because acronyms are fun in their early easy-to-understand form, so P is proper whole food nutrition, U is understanding supplements, Z zapping stress, Z is sleep, L is love and encouragement, E is exercise and environment. Those are all the pieces that I focus on daily to optimize my fertility and my hormones naturally. This is what I teach my clients how to do as well.

Aumatma Simmons, ND, FABNE, MS

I will want to dive a little bit deeper into this. You’re saying that you were going through your journey and that you were doing this for yourself. You came in with a background in this. Like, I feel like a lot of women are out there trying to figure it all out for themselves because they too are type A’s, but their profession might be something completely different, and they’re like, I’m just going to like Google all this stuff and try to put these pieces together. I just want to make sure that we highlight that you were coming in with a breadth of knowledge that allowed you to, like, break this down for yourself.

Kela Smith, PhD, DNM, DHM

Yes. I did come in as a personal trainer for ten years, so I knew health and wellness, but I did not know fertility as much as I do today, seven years later. I dove into research. I did not recommend you do that because it took me so many hours, so much frustration, and not knowing if I was doing it right. Now I have figured it out for you. I would recommend you work with a practitioner like me. We figured it out, and we can show you the way. 

Aumatma Simmons, ND, FABNE, MS

I find it like so many times people are like, my God, I’m spending like every waking hour doing all of this research. They will bring in, like the binders of research papers that they read through. I’m like, This is great; thank you. But yes, I read all of those papers, and I still think that we need to be using them. I just feel like if you’re not in the health and wellness field, you’re not necessarily a practitioner or a clinician. You got used to parsing through all of this and making sense of it in the context of what’s going on for your body.

Kela Smith, PhD, DNM, DHM

Another piece of that, too, is that I’ve been practicing, like I said, for seven years. I’ve seen so many cases, and I’ve seen the patterns and profiles. I can look at it as a case and say, I’ve seen this before. what to do here. Whereas you, as a layperson, even though you’re Googling and researching and maybe you’re reading some of the same stuff that I’ve read, you haven’t, and you don’t have the experience that you and I had that we’ve seen these cases and we know what to do. I agree with you there.

Aumatma Simmons, ND, FABNE, MS

I just wanted to make sure that those are, well, not great. Like, you can figure out the best supplements, the best, whatever, and you’re going to end up with a bag full of supplements to see which one is working.

Kela Smith, PhD, DNM, DHM

I had a client say to me recently too; she said, One thing I liked about working with you is that you helped me weed through all the noise because I thought I was doing all the things. But when you came in, you were like, No, this is what you need to focus on. You guided me through that. So she was so appreciative of that.

Aumatma Simmons, ND, FABNE, MS

That support is so valuable. Like we are not even, and you said this earlier like you have your functional doctor. I have a practitioner. I don’t think anyone should have to parse this out themselves for whatever is in our bodies because having a third person, or, I guess, a second person, someone who’s observing what is happening and reflecting to you, means that when you do this, you feel like this and like the AHAs and the transformation is happening in that connection. Someone is reflecting to you what it is that’s going on and what it might be connected to. I have those AHAs all the time with my practitioner.

Kela Smith, PhD, DNM, DHM

Another point to make is that, when you’re in it, it’s hard to see. It’s like, if you’re standing this close to the mirror, you’re not going to see yourself if you’re in it. You can’t see what somebody from the outside can see looking in. 

Aumatma Simmons, ND, FABNE, MS

That’s true. Let’s talk a little bit about supplements because people go down this rabbit hole a lot. I’m curious if you have top supplements for each of the functional tests that you do, or if you have top supplements just in general for fertility. Where can people get started with understanding your story?

Kela Smith, PhD, DNM, DHM

Before I get into supplements, I always like to talk to your doctor or your practitioner. You and I are both doctors, but we’re not the ones listening, probably. Let’s talk to your doctor before you add a supplement or change anything about what you’re taking. But that being said, I love the functional labs because they give me an idea of how we can customize your supplements based on what your labs say. You’re going to have a bio-individual supplement regimen based on your hard-core data. That’s super important. But for those of you who are listening, maybe you can’t afford to do labs yet; you haven’t gotten to that point yet. I feel like there’s a core of three supplements that everybody should be taking, no matter what their health condition, for fertility. But any hormones or just overall wellness. 

The first one would be a whole food, prenatal, or multivitamin, something that has good quality ingredients. then that’s easy to take. That’s going to fill in the gaps in your Whole Foods diet. I want you to start with a diet. This is going to supplement that. The second one would be a good-quality probiotic. I feel like pretty much everybody needs a probiotic. I recommend spore-based because they’re going to make it through the stomach acid and get into the intestines, where they need to do their work. You don’t have to take probiotics forever. Once you repopulate that area, you can go down to maintenance dosing. Tell people that good probiotics are expensive, but you don’t have to take one to two a day for the rest of your life. You can maintain it. Prebiotics are also good if you’re not eating a lot of fiber regularly and you’re not getting a good variety of different fibers for us SOS, XOS, all these different chains of fibers. If you’re not doing that, I would say a prebiotic is important. That’s the fiber that’s going to feed the probiotics so they can reproduce. then the last I say is a fish oil. If you’re not eating fish a couple of times a week—good, fatty, wild-caught fish—then you need to supplement these fish oils, EPA and DHA, because they’re going to help your body with inflammation. They’re going to give your body the fat that it needs to build. That’s the building block for hormones. It’s going to be important that you have good-quality fish oil in your supplement regimen. then other than that, based on what you’re struggling with, if you have a diagnosis, there are certain ones for PCOS, for Endo, and if you’re trying to do egg health or sperm health, there are all different supplements based on that. But that would all be individualized based on what your diagnosis is, if you have one. Again, that’s why it’s important to work with a practitioner to run some labs at that venture budget and to go from there.

Aumatma Simmons, ND, FABNE, MS

I love it. I agree with the core. That prenatal fish oil and a probiotic sound like a good starting point for most people. Until you have more information, what I appreciate about what you just said is that it’s easy, especially with fertility. There’s so much information on the interweb or Instagram, wherever you get your information, and everybody is talking about the latest and greatest supplement. Even I feel like a lot of reproductive endocrinologists have now taken on the supplement trend. There’s a doctor in the Bay Area who I love. He sends a lot of referrals, so I’m not badmouthing, but all of his patients come in with a laundry list of supplements, and the ones that end up working with me are like,  which one should I take out? They are all right, like, you don’t need a whole laundry list of things that are.

Kela Smith, PhD, DNM, DHM

I would say too that I have people that come to me, and I’m sure you do too, where they’re asking me about supplements. Then I say,  what are you eating? What does your diet look like? it’s terrible. I’m like, we have to get your diet right first before we can supplement. We have to have whole-food nutrition. I’m not saying you can never have a treat or anything that you love. That may not be 100% good for you, but it’s what daily by day and what is that willing to be the foundation. Get that where we need it first, and then do the supplements.

Aumatma Simmons, ND, FABNE, MS

I say that our entire program is all Type A’s. I don’t need you to do this 120%, which is what you think 100% looks like. I need you to do it 85–90%. “What? Do you want me to up my standard?” Like, we need to do 85 to 90%. It will be good. 

Kela Smith, PhD, DNM, DHM

I always say 80 to 90% clean whole food and 20% food for the soul. Have that yummy thing that you love, because it’s going to lower your stress and give you some joy to do it.

Aumatma Simmons, ND, FABNE, MS

Are there other tips that you would like to share about lab tests and advocating for themselves? Like, how do people, like, to start on this journey? I want to find answers, and I want to go beyond unexplained infertility and understand, like, why is this happening and what can I do about it?

Kela Smith, PhD, DNM, DHM

I would say, find a practitioner like you or me and get some functional lab tests. Run the three that I mentioned or the ones that work for me. I’m sure you have your favorite tests as well. Find a practitioner that you connect with, do some research, and see what tests they recommend for you. Then, once we get those tests, we can dive into a more bio-specific or bio-individual protocol. If you can’t afford the testing yet, then start with the basics of the hormone puzzle. Make sure your diet is between 80 and 90%. Make sure your hydration is good, and we still need to talk about this. That hydration is a huge piece of this puzzle. Make sure you’re drinking enough water and getting enough electrolytes. I feel like this one has missed a lot. Do you want your urine to be pale yellow? If it’s not, you need electrolytes. That’s too dark. You need more water. If it’s too light, you need electrolytes. Make sure your hydration is on point. Then the other pieces. I would also recommend making sure that you have a stress management plan. We all have stress. We can’t avoid it but if you have a plan to manage it and to put some boundaries in place around that, I feel like that is an important piece. Do some things to feed your soul. Like I said earlier, this can be non-food as well. This can be taking a walk outside with your bare feet, petting your dog, reading a book, or going to the beach—something that you love to do that will bring you joy. So getting those foundational pieces in place, I feel, is super important. Then, if it’s in your budget to run the tests, get some testing done, and dive deeper into what your hormone puzzle is, and how are we going to put it back together?

Aumatma Simmons, ND, FABNE, MS

I love it so much. This is so awesome. Where people find you, where should they find you and connect?

Kela Smith, PhD, DNM, DHM

The source on my website is the best place, and I am at coachkela.com. There, you can find a lot of educational information about fertility hormones, even some stuff about men’s health. You can grab one of my freebies, and we’ll have a free link or a specific link for this summit. But we are doing a cycle-optimizing quick start guide that is meant to help you optimize your cycle so that you can get pregnant. You can find that on my website as well. There will be a link in the show notes, I’m sure. Then I’m also on Instagram. That’s probably my favorite social media place to hang out, @kela_healthcoach and @hormonepuzzlemethod, and then Facebook is Kela Health Coach. I also have a podcast, The Hormone PUZZLE Podcast, and then I also have a second piece of my business. If you’re a practitioner listening to this and you want to dive into fertility coaching, you can go to fertilitycoachuniversity.com and learn more about our certification program. 

Aumatma Simmons, ND, FABNE, MS

Thank you so much today. For those of you listening in, thanks for joining us, and we look forward to seeing you soon on the next episode of Beyond Infertility Summit.