Personalized Prenatal Supplements For PCOS

Introduction to Personalized Prenatal Vitamins 0:00

Welcome. I'm your host, Dr. Felice Gersh. And we are going to have a really fun interview talking about something that is really important for every woman with PCOS who is even considering getting pregnant or perhaps is pregnant. And my guest who is going to do a deep dove into this topic with me is Doreen Bloch. Now, she has created a very revolutionary, very novel prenatal vitamin, which is really personalized. And she's going to explain all about this. And first, I hope, Doreen, that you will also tell us about your own personal story.

Like, how did you even get involved in this and creating a vitamin and a company and all of this designed to help women with PCOS? I can't wait to hear this story. So let me introduce you again. Here is Doreen Bloch. Tell us all about your journey and your wonderful vitamin product. Thank you so much. I'm so thrilled to be here with you today and to share more with the community about Ellement, which is the first personalized prenatal background. I started my career in the data industry. So my first company that I ever founded in 2011, which focused on data analytics, I'm kind of a numbers nerd who also loves health and wellness.

And my journey with Ellement began after my pregnancy. I have a five year old and I experi and I think what a lot of people who are looking to get pregnant or who are pregnant, the same type of conversation that they had with their ob gyn that maybe they're trying to get pregnant or they already are in the OB says, great, you need to take a prenatal. Okay, which one should I take? And I think the standard response for decades, of course, we know that it's important to have folic acid, especially in those critical early months, pre-conception, as well as in the first trimester and that's why prenatal supplements are recommended by essentially 100% of OB-GYNs.

And yet the response to which prenatal should I take? Has classically always been, though it doesn't matter. Just take anything. They're all the same. And so being more of a data driven person, I went to the drugstore or the grocery store, started looking at the back of the bottles of the prenatal and saying, wait, these have different dosages. There's different forms, factors. Which one is actually going to be best for me, and what are the differences with all of these different ingredients? And so that set me on the journey to starting Ellement.

Doreen Bloch's Background and Ellement's Origin 3:00

And I connected with amazing medical advisors, including Dr. Nathan Fox in New York. He's an OB-GYN and MFM, also on the editorial board of obstetrics. Other advisors throughout the time of creating Ellement into Dr. Shannon Clarke, Dr. Aumatma Shah Simmons, who focuses on fertility. So lots of really incredible practitioners who have supported me in creating Ellement to what it is today. And I'm excited to get into all of the detail with you about why this is such a revolutionary product. Well, I hope you had a very success, full pregnancy, whatever prenatal vitamin you took at that time.

But it is very important. You know, what goes into a vitamin includes each of the vitamins. Maybe some other ingredients like minerals, and also, like you said, additives. So maybe you could start with what are the essential vitamins and minerals that you think should be in a prenatal vitamin and also during pregnancy. I know sometimes they call them prenatal, but they're also natal, right. So maybe just talk about what are the essentials that should be in every such vitamin. What's such a big question to answer?

Because part of the challenge is that it really depends on each person. It depends on your nutritional preferences. Just to give one example, if someone adheres to a vegan or vegetarian diet, maybe they're not eating eggs daily. We would suggest that it's important to include choline in your prenatal regimen. But there are certainly some ingredients that we see as being very common, and we have a lot of data around, you know, generally prenatal supplements out there. So, for example, B vitamins.

Again, of course, you want to make sure it has folate. We include both folic acid and methyl folate. I know there's a lot of social media debate, a lot of times around which version should I have? We offer both in most of our prenatal URLs. We also can customize that for folks. We also like to see and recommend vitamin C iron, especially for people who are iron deficient. That's and I can come back to this as we continue the conversation. But iron dosage is one where we see people really wanting to be much more nuanced about how they approach iron supplementation, other ingredients that are important.

Calcium, magnesium, choline, as I mentioned, the fat soluble is like vitamin D, vitamin E, omega threes, vitamin A, there's different forms there as well that are important to pay attention to. So it really runs the gamut. The other piece that I think is really important, and I'm glad you mentioned this is the additives. There are certainly things that we recommend not to include at a prenatal, and we can go more into that shortly. I also want to make sure at some point that we talk about bioavailable bility too, and how Ellement approaches that.

Well, those are all critical things. Now, let's start with the things that you don't want. You know, like there are different colored dyes. Maybe there are certain other preservatives and things that maybe are shiny on the top, making it like smooth and shiny for the coating. And then there is capsules, there are tablets, you know, there could be powders. So talk a little bit and help explain what should you want? What should everyone avoid? You know, look at the label because you read the label, a lot of people don't read labels.

So what are some of the buzzwords that you want to avoid? Certainly. And by no means was this an overnight learning process for me. It took me three years of R&D just to be able to really understand how to read the labels more effectively.

Key Prenatal Nutrients and What to Include 7:00

I actually went back to school to Stanford Medicine to get certified in nutrition science, to really understand this at a deeper level and of course, leaning on our medical advisors as well. So you're absolutely right that supplements in general not being an FDA regulated category can get away from an industry perspective with putting some less savory ingredients into their product. And so a lot of times the reason for that is just due to manufacturing processes. You can imagine that there powders that are being mixed, these raw materials in these large vats at these manufacturing facilities, and in order for the product to get smooth and distribute it, they need to include things like silica, titanium dioxide.

There's other certainly artificial dyes and colors to make the product look more uniform. And those were the types of things that I did not want to compromise on. And I by the way, I did have a very easy and successful pregnancy the first time around, and I hope in the future it will be the same. But I did say, you know, I really hope that for a subsequent pregnancy that I can have this product knowing what I know now. And so I do say that and do recommend to folks that the two primary things to watch out for.

My recommendation again would be titanium dioxide and silica. Titanium dioxide in particular, interestingly, has been going through and I haven't looked lately at the status, but I was going through a class action lawsuit related to being used as a food colorant in Skittles, I believe it was, or some kind of other Mars candy. So it does go even beyond supplements, but there's there's some indication that it might be genotoxic. I think the EU had given it that label at some point. So this is the type of thing where, you know, a lot of these ingredients, there's still a lot more to be learned.

There's a lot of research going on to understand the best form factors of each ingredient. But our perspective is, if you can avoid including these additives, let's just avoid including it. So I'm really proud that we were able to find a manufacturer that does it's U.S. based and they do smaller batches. So they don't need to have those additives to support the manufacturing process Ellement is truly the cleanest product on the market. There are no added, it's no fillers, no flavors, no colorants it is just the ingredients that you need and nothing else.

Well, that sounds encouraging for anyone who wants to avoid as much as they can. You know, things that are potentially toxic. Now, I know there are things called flow agents. Is that something that is important to keep the you know, to manufacture it, or is that something that can be eliminated? Right. As far as I know, those all of those additives can be eliminated when you're working with the kind of right sized amount of product being manufactured. And I can't speak to other brands and how they manufacture, but in my experience, doing the R&D process, when you're working with a facility that is processing in some cases millions and millions of capsules a day, they need those different additives to be able to usher things along in their manufacturing. So really how element is designed, it is in more of a modular system.

What that means is that instead of cramming all 30 ingredients into one giant capsule, we have different capsules for different needs and four different components, and therefore we can swap out what is in the packet, which you can see here. It's separated by AM Pills and PM, so it's very nicely organized for everyone in their routine and they are capsules. I know you had asked about this a little bit before. Capsules truly are the best way to avoid any of those binders fillers. I know it's tough sometimes, especially in that first trimester for folks when there can be more nausea.

We understand pill fatigue is very real, but we try to make it as easy as possible to kind of take it throughout the day. And you really know what's most important to take with the different components if you're not able to necessarily take all of them at once. So lots of layers to that question, but hopefully that helps answer. Now, when you have the morning and the evening, can you flip them? Can you take them both together if you're like forgetful or like you forgot your morning one, can you just take both at night?

Or like I said, flip them, take the night, one in the morning? Or is it really important to take it on schedule? Morning pill in the morning, capsule in the night, one at night. Such a great question. So the reason why we designed this and as far as we know, element is the only prenatal on the market that offers this kind of

Avoiding Additives and Choosing Better Capsule Formats 12:00

intelligent, time based routine. And that's because we are the only ones to manufacture this really cool. It's like a dual sided packet. Hopefully you can see that it just is perforated down the middle. So, and by the way, these are biodegradable. So you don't have to feel wasteful about having these daily packets. We actually have zero plastic as well in any of our packaging, so very eco friendly. But the morning packet is focused on water soluble ingredients. So that's where you're getting your B vitamins.

It's also when we recommend to take the iron and the vitamin C, these are ingredients that are best he can only with water versus the PM side are your fat soluble ingredients and minerals, but especially the fat soluble is which are best taken with food. So with the AM, at least for example, with my own routine, I usually take those first thing in the morning just on an empty stomach with water. Sometimes when I have iron in my packets, because iron can cause some nausea or digestive discomfort, we recommend know if you have a little bit of orange juice or some kind of citrus food.

It's okay to do that. Just avoid calcium. A lot of times people don't know this. I think it's one of the most kind of common fun facts that I see people are just not aware of is that calcium and iron inhibit each other's absorption. So you never want to be drinking milk or, you know, eating some food that high in calcium while you're taking your iron. So that's why it's separated out in this in this way that is optimizing for absorption. Meanwhile, the PM capsules, you could take it with lunch if you want, but I would say a lot of people like to take it with dinner, especially since magnesium can have some sleep benefits for some people.

So it is separated in that way, but there is some flexibility as well and our customer support team is amazing and helping people really personalize the routine for them. Now I'm going to ask you some very specific questions. Okay. So many women who have PCOS and I definitely want to go into PCOS in more depth. So many women with PCOS happen to have Hashimoto's thyroiditis, so they have to take thyroid, which they have to take first thing in the morning without food, you know, and then they have to wait 30, 45 minutes before they eat for those women.

Is it okay if they take their morning capsule with breakfast or should they space it out and take it between breakfast and lunch or yeah, how can you manage that one? So this comes up a lot in my practice. So it's a great question regarding PCOS and what Hashimoto's or any kind of thyroid challenge. This is one of the main reasons that we have element customers customizing their packets is actually around iodine and it's especially empowering I think for those customers because the majority of prenatal supplements include iodine just as part of the standard protocol.

The reason for that is that the CDC recommends 150 and CG of iodine daily, especially during pregnancy. So then a lot of times people who have thyroid issues, they are stuck feeling like there isn't a product easily available for them. Element makes it very easy to customize the iodine dosage. So that said, if people are also taking additional medications. So for example, we have a customer who is taking I'm not going to say this right levothyroxine did I say that right. Okay, everything's okay.

You can see I usually stay in my lane and just type these things out, but so a sample weekdays schedule for someone who is taking that particular medication would be to take their medication, let's say at 7 a.m. on an empty stomach as directed. Maybe they eat and drink from eight till ten, then they can take their AM packet at 11. AM still kind of in that space between breakfast and lunch and then take their PM packet with dinner. So it is very much possible to accommodate medications as part of the protocol and we're very, very thoughtful in our team can always work with other practitioners to make sure that we're customizing the routine accordingly.

No, it's perfect. That's just what I was thinking, you know, just just slip it in between breakfast and lunch. Right. And in terms of the well, if you have nausea in the early part of pregnancy, that might be another way to to deal with it. Like to just put it a little bit later in the day? Yeah, exactly. And I think also what's been really exciting for a lot of our customers is that they switch over to us from another prenatal that they were taking. And because we're able to isolate the most common culprit of nausea,

Morning vs Evening Packets and Absorption Tips 17:00

which is ion, we're able to then deal with that in a variety of ways. As I mentioned, first of all, ion dosage is important. So, for example, a lot of prenatal needles are at 27 milligrams a day of ion. We start at ten milligrams a day. And even for some people we include ion every other day. So they get a bit of respite from having that often quite nausea inducing ingredient. And then also we have certain hacks that we can recommend, like taking a little bit of vitamin C or some food that has vitamin C to kind of minimize that that nausea.

So certainly there's more ways to customize, especially around that particular ingredient. Oh, yes, iron definitely can be a trouble maker. And how about, like you mentioned, magnesium can also help with sleep. So magnesium comes in a number of forms. So I was wondering if you customize that or, you know, you use sort of standardized magnesium and which form do you like to use. Element in new bones, die, magnesium mallet and magnesium citrate. And those forms are favored. So there high bioavailable bility, they're very effective for absorption and we include that as a 5050 blend.

It's also a type of form that is typically very well tolerated by most people, and we find that it by including two different forms of magnesium, it really provides a broader spectrum of bioavailability. So that was a recommendation made by some of our practitioners and that's what we include off the shelf. But yes, there could be ways to personalize that further if somebody wanted to. But we find that those two options, the mallet and citrate, are certainly best in class. Well, I think that's actually a great combination because the citrate form can help with women who have more constipation, but you don't want to overdo it because then they might get diarrhea.

So that sounds like a great blend between, you know, the gut and the brain, kind of a balanced out. So that two thumbs up for that blend. I love it. And in terms of vitamin C, I mean, is there a you take that in the morning because it's water soluble? And do you like like say you're in flu season? Do you ever like say customize it and say, oh, I'm really prone to getting colds and the flu and you give a little extra vitamin C? Is that something that you can actually personalize? Absolutely. That's what is so powerful.

And I'm so proud of the system that we built where it does have this modular design where we can increase certain ingredients at certain times, decrease them at others. So absolutely, if someone is looking for additional vitamin C coverage basically within their package, we can provide that. And it really goes to all of the different ingredients that are included in putting omega threes. I think that's one where we also see people wanting to increase their dosage, depending on their stage, depending on their particular needs, Colleen, as well.

And I also wanted to mention that this is also where elements process in terms of after signing up is really powerful. Every 30 days we are checking in with our customers, asking them, how are you feeling? What do you need or any changes required for your next box? That's something that no other prenatal brand does. So you're really in good hands because it's not just about a one time personalization. It is exactly to your point about if it's full season or you are at a different stage, like progressed in your pregnancy or your postpartum, whatever it is, we can accommodate for that and truly personalize for every box that you receive.

So let me see if I understand this. You actually produced the vitamin and the package for each separate patient. You don't like it? Yeah. So each packet is truly customized. Like you don't have like you can pick formulation A or formulation B, each one is truly customized. Truly customized. We do all the hard work for you so you don't have to worry about anything. Just let us know. And we have a very detailed onboarding form, so that's where we're capturing the information about your context, your history and what needs you have.

So whether you're the type of person who needs ten milligrams of iron, no iron, 40 milligrams of iron, iodine, no iodine, whatever it is, we can accommodate that because we are packaging these packaged fresh for you every month. And who is the the individual or individuals that's helping the each individual patient to to know what to do or do. You work predominantly with patients or with their providers or either or or how does that work? Yeah, it's such a great question.

Managing PCOS, Thyroid Issues, and Nausea 22:00

We work directly with the customer and there's a lot of as I mentioned at the start of the of the conversation, I come from a data background, a tech background. So there isn't necessarily any person behind the scenes helping with this. It's all kind of automated, I wouldn't call it I, you know, it's not to that level, but there is a science and it a data driven algorithm behind this. And all of that was designed with our medical advisors, so with practitioners. And so it is all science based, it's all grounded in clinical research and we adjust that whenever there's new clinical research available.

I think the best example of this was when Dr. Fox, one of our advisors, reached out with a new journal article that had been published about the benefits of increasing choline supplementation in the third trimester to an adult surge of 900 milligrams daily. And it was the type of thing that we were able to action very quickly because we're able to adjust the algorithm algorithms in our system. And for anyone who is at that stage, make that recommendation and then we could act upon it if they opted into that.

And so it is a very powerful set of tools that said for circumstances where let's say someone has a certain thyroid disease protocol that they need to get buy in from their practitioner around or let's say for PCOS management, there may be some nuances there. And certainly I also want to mention pre-eclampsia risk. One thing that is very, very unique about element, as far as we know, no other prenatal offers this we can also target low dose aspirin if that's something that a practitioner or a patient wants to help with.

Compliance around elder usage for reducing preeclampsia risk. So there are absolutely times where we will interact with a patient's practitioner, but I would say in 90% of the cases, we're just working directly with the customer. Well, that's really wonderful that you can personalize to that degree. And I'm so glad that you're so on top of the whole issue with Colon, because that's so important for brain development. And, you know, as is, of course, the Omega three. So do you put the omegas three in, I assume a separate gel cap or how does that work?

And how many like you showed the pack but you didn't open any? How many like capsules or gel caps like for omega three would typically be in one of those AM and PM packs. Such a great question. So it really depends on the person. I would say that, you know, the preconception which we have about 50% of our customers who are starting before they're even or around the time that they're trying to get pregnant, but certainly before they are pregnant. And that is very well-supported now by many practitioners who are recommending starting three months in advance of trying to conceive even now six months in advance, and primarily again for the folic acid.

But I would say a typical routine for pre-conception would be two or three capsules in the morning that may impede what we call our fertility booster, which includes Inositol Coenzyme Q10, a tiny, tiny little iron vitamin C capsule. They're really cute, actually. I can show you. I think there's one in this packet. Let me see it. It's my. Oh, no, I don't have the iron in this particular one because I take iron on me every other day. But here you can see our beautiful little fertility booster. And then here are all of the B vitamins.

So they're on standard size. And then in the PPM side, it could range from 2 to 9. There are some some customers who are taking even seven or eight capsules in the evening. And I would say that that's more than is typical. But we do have some people who are taking full advantage of, you know, 900 milligrams of choline, you know, higher dosages of calcium, magnesium, especially when they're closer to labor and delivery. Well, you mentioned a few products, like you said, Inositol. So women with PCOS have very special needs in terms of trying to deal with both fertility, ovulation, induction to be, you know, having optimal eggs and then optimal embryos and also dealing with metabolic issues like insulin resistance.

So give me an idea of some of the extras that you mentioned, Inositol. You know, what have people put into their different packets when they're trying to optimize both fertility and then assuming they're successful when they are pregnant and they have PCOS? Yes. So PCOS is one of the personalization vectors

Customizing Magnesium, Vitamin C, and Other Add-Ons 27:00

that we see to be fairly common within Elements Community. We also see, you know, I would say anemia, thyroid disease again is quite high up there as well. But for PCOS in particular, there is early evidence at this point that inositol can be quite helpful in improving insulin sensitivity, regulating menstrual cycles. Omega three DHEA and BPA also can be a supportive and vitamin D for helping with hormonal balance. So all of those ingredients, we have the ability to customize vitamin D in particular.

We start out with 4000 I use I would say that's probably on the higher end of what we see from other natal vitamins. We felt like that was really optimal to address the needs of most people in the US who tend to be generally more deficient in vitamin D when it comes to the omega threes, we do include both DHEA and BPA in our fish based capsule. We also do offer a 100% vegan capsule, but that only has not the EPA because it's an algae based formulation. So we do recommend that, you know, there are some people who prefer to actually this is me. Before I was before I was pregnant, I preferred to eat plant based.

But it wasn't for me necessarily so rigorous that I can take a fish based capsule. So we do see that sometimes with people saying, I'm eating vegan, but I'm okay to take a fish based capsule so then they can optimize for the full benefits of the day. And we start that at 200 MCG, but it can go up from there. And that's also one where because it has some blood thinning properties, sometimes we do recommend if people do want to take those much higher dosages to align with the practitioner, to make sure that that everyone's on the same page around what the dosage should be for that particular person.

And finally, with Inositol, we tend to see people start off at 500 milligrams daily, but for and that's primarily motility benefit, I would say that the majority of our customers who have PCOS are to a 1000 MKG per day level and those capsules just need to automatically also be co Q10 so we can customize that further. But I would say most people are on that particular routine. So I would say for PCOS, generally we see people at the 2000 MCG level for Inositol and we do include, by the way, Myo Inositol is the form.

Okay. Well that's a lot of really important information. And I was going to ask you when I first started to talk with you, well, what about expiration dates? But I guess they really aren't like any kind of worry about expiration date because these are made almost on demand. Yes, I love that description on demand. Yes. So, you know, again, because of the modular design we're ordering the inventory of the capsules fresh. You're right. It's not sitting on a shelf for 12 to 18 months at a store oxidizing being exposed to humidity, all of these other kind of environmental factors.

It truly is exceptional quality. And, you know, while we haven't done yet a full fledged, you know, best in class clinical study to compare element versus other prenatal, we have done some kind of preliminary pre post testing around you know, the survey design was basically looking at before starting element what were people's blood levels of things like iron vitamin D and some others and then checking after 40 days of using element. And I will tell you our medical advisors work

PCOS-Focused Fertility Support Ingredients 31:00

extremely skeptical that we would see any difference in the blood levels for especially things like vitamin D, which most off the shelf prenatal is. When you look at their clinical studies, if they've done any at all, we'll do a test for vitamin D over 90 days. And what we saw was within 30 days, 80% of the customers had had shown increased blood serum levels of vitamin D. There were other increases as well for iron, certainly very successful. And so we credit that to, I would say twofold. It's the bioavailability separating out by time of day.

It's the exceptional quality of the ingredients with no fillers, no binders, and also the freshness. So I think it's a very important point that these supplements aren't sitting around for two years. It really is packed fresh for each individual every month. So I was just going to ask the question, when people order their supply, like do they order one month, six months? But it sounds like it's one month at a time. Exactly one month at a time. And when people go to our website which is helloellement.com it's two L's so helloellement.com of course will link everything for everyone but they can choose between a sample box.

So certainly we encourage people if you want to see if that works for you, especially because it is a capsule based approach. Maybe people are switching from a gummy or a powder or something like that. They want to see if it works for them. They can start with the sample box, which is seven days, but then they would move to the monthly subscription. Easy to cancel at any time. If it doesn't work for you or you're at the end of a particular stage, we typically see that people stay with us throughout their pregnancies and then for at least a few months postpartum, I feel like this isn't talked about enough that there are so many benefits to continuing your supplementation routine postpartum as well, especially due to blood loss after labor and delivery, you know, mood and hormone fluctuations.

So B, vitamins can be very important. So there's certainly a lot of benefits there. But every month, because you are engaging with us and we're going to send you your new fresh box on a monthly basis, we do have this approach of checking in. We have a feedback form where you're letting us know it's anything's changed so that we can customize accordingly. So it really is, I would say, almost like having a, you know, a supplement guru in your back pocket that you're able to rely on and know that we're going to be able to personalize, surely, for your stage, for your needs at any given time.

Well, I 100% agree that these should be continued postpartum, and hopefully the women are nursing for at least a few months and they have a little munchkin that's taking a lot of their nutrients from them.

Fresh Monthly Packs, Results, and Postpartum Use 34:00

So they need to have all those extras coming in because they have to share them. So I think that's such a good piece of advice to continue. It's that's why I want to change the the vocabulary. So they should be prenatal natal postnatal vitamins but you can just call them elements, right? Because you don't have to really give a more specific name to it. That's right. I love that. And I think this is a wonderful tool company that you've created and, you know, born out of your own confusion when you went to the store, you know, it's like, what the heck is going on?

But I read the label, so, you know, that's like how many things, you know, it's a spark, you know, it just like went in to you and like, you just felt, it's not there. I need to create it myself. So that's real great, you know, ingenuity there. And oh, I'm so excited to learn about your it's very, you know, it's really wonderful that to see women supporting women and creating, you know, something that is really so universally important for every woman trying to achieve pregnancy, being pregnant and afterwards, and for women with PCOS to be able to personalize for everyone.

But, you know, particularly women with PCOS, that they can also include some of these other local like special extras that that help to benefit them in their fertility journey. So thank you, Doreen, so much for joining me and sharing your wealth of knowledge and all about your company. And I wish you so much good fortune with it. And hopefully everyone out there will try to get a sample pack right and and start experimenting with how it's affecting them and on their health fertility journey. And just repeat again for everyone who wants to give this a try and connect with you and your company.

Just tell them again how to connect and how to move forward. Thank you so much for all the kind words and the well-wishes. And it's it's really been a labor of love. And it was absolutely inspired by my own frustration and confusion. And I feel so blessed that I found such great supporters along the way. And we continue to grow the community of folks who are really looking for a more personalized approach. So for anyone who is curious to learn more, if you would like to get a sample pack, if you just want to engage in and ask me questions or ask our team questions, the website again is helloellement.com and our email address is support@helloellement.com So looking forward to speaking with you and thank you so much for the time today.