Personalized Prenatal Supplements For PCOS

Doreen Bloch

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. My background is that I started my career in the data industry. My first company, which I founded in 2011, focused on data analytics. I’m kind of a numbers nerd who also loves health and wellness. My journey with Ellement began after my pregnancy. I have a five-year-old, and I experience that a lot of people who are looking to get pregnant or who are pregnant have the same type of conversation that they had with their OB-GYN, where maybe they’re trying to get pregnant or they already are the OB and say, “Great, you need to take a prenatal.” “Okay, which one should I take?” has been 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. yet the response to which prenatal should I take? Has classically been, though it doesn’t matter. Just take anything. They’re all the same. 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 prenatal, and said, “Wait, these have different dosages. There are different forms and factors. Which one is going to be best for me, and what are the differences with all of these different ingredients?” So that set me on the journey to the starting Ellement. I connected with amazing medical advisors, including Dr. Nathan Fox in New York. He’s an OB-GYN and MSC, and he’s also on the editorial board of obstetrics. Other advisors throughout the process of creating Ellement include Dr. Shannon Clark and Dr. Marcia Simmons, who focuses on fertility. There have been lots of incredible practitioners who have supported me in making Ellement what it is today. I’m excited to get into all of the details with you about why this is such a revolutionary product.

Felice Gersh, MD

Well, I hope you had a very successful, full pregnancy, whatever prenatal vitamin you took at that time. But it is very important. What goes into a vitamin includes each of the vitamins. Maybe some other ingredients, like minerals, and also, like you said, additives. Maybe you could start with 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; maybe just talk about what the essentials are that should be in every such vitamin.

Doreen Bloch

What’s such a big question to answer? Because part of the challenge is that it 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, generally prenatal supplements out there. 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 are a lot of social media debates, and a lot of times, which version should I have? We offer both on most of our prenatal. We can also customize that for folks. We also like to see and recommend vitamin C and iron, especially for people who are iron deficient. 

That’s it, and I can come back to this as we continue the conversation. But iron dosage is one area where we see people wanting to be much more nuanced about how they approach iron supplementation and other important ingredients. Calcium, magnesium, and choline, as I mentioned, are fat-soluble vitamins like vitamin D, vitamin E, omega-3, and vitamin A. There are different forms there as well that are important to pay attention to. It runs the gamut. The other important piece, and I’m glad you mentioned this, is the additives. There are certain things that we recommend not including at a prenatal, and we can go more into that shortly. I also want to make sure that at some point we talk about bioavailability and how Ellement approach that.

Felice Gersh, MD

Well, those are all critical things. Now, let’s start with the things that you don’t want, like different colored dyes. Maybe certain other preservatives and things are shiny on the top, making it smooth and shiny for the coating. Then there are capsules, tablets, and powders. Talk a little bit and help explain what you want. What should everyone avoid? Look at the label because you read the label. A lot of people don’t read labels. What are some of the buzzwords that you want to avoid?

Doreen Bloch

By no means was this an overnight learning process for me. It took me three years of R&D just to be able to understand how to read the labels more effectively. I went back to school at Stanford Medicine to get certified in nutrition science, to understand this at a deeper level, and, of course, to lean on our medical advisors as well. You’re right that supplements in general, not being an FDA-regulated category, can get away from an industry perspective by putting some less savory ingredients into their product. So a lot of times, the reason for that is just due to manufacturing processes. You can imagine that there are powders that are being mixed with these raw materials in these large vats at these manufacturing facilities, and for the product to get smooth and be distributed, they need to include things like silica and titanium dioxide. There are certainly other artificial dyes and colors to make the product look more uniform. Those were the types of things that I did not want to compromise on. 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 that I hope that for a subsequent pregnancy, I can have this product, knowing what I know now. So I do say that and do recommend to folks that those are 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. It does go even beyond supplements, but there are some indications that it might be genotoxic. The EU had given it that label at some point. This is the type of thing where, despite a lot of these ingredients, there is still a lot more to be learned. There is a lot of research going on to understand the best form factor for each ingredient. But our perspective is if you can avoid including these additives, let’s just avoid including them. I’m proud that we were able to find a manufacturer that’s U.S.-based and does smaller batches. 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 ingredients; there are no fillers, no flavors, and no colorants; it’s just the ingredients that you need and nothing else.

Felice Gersh, MD

Well, that sounds encouraging for anyone who wants to avoid as much as they can. potentially toxic things. I know there are things called flow agents. Is that important to keep manufacturing it, or is that something that can be eliminated?

Doreen Bloch

All of those additives can be eliminated when you’re working with the size of the product being manufactured. 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. How Ellement is designed is 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 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 binding fillers. I know it’s tough sometimes, especially in the first trimester, when there can be more nausea. We understand pill fatigue is very real, but we try to make it as easy as possible to take it throughout the day. You know what’s most important to take with the different components if you’re not able to necessarily take all of them at once. There are lots of layers to that question, but hopefully, that helps answer it.

Felice Gersh, MD

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 and take one in the morning? Or is it important to keep it on schedule? Morning pill in the morning, capsule in the night, one at night.

Doreen Bloch

Such a great question. the reason why we designed this, and as far as we know, Ellement is the only prenatal on the market that offers this kind of intelligent, time-based routine. That’s because we are the only ones to manufacture this cool. It’s like a dual-sided packet. You can see that it is just perforated down the middle. And by the way, these are biodegradable. You don’t have to feel wasteful about having these daily packets. We have zero plastic in any of our packaging, so it is very eco-friendly. But the morning packet is focused on water-soluble ingredients. That’s where you’re getting your B vitamins. It’s also when we recommend taking iron and vitamin C; these are ingredients that are best taken with water versus the PM side, which are your fat-soluble ingredients and minerals, but especially the fat-soluble ones, which are best taken with food. With the AM, at least, with my routine, I take those first things 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 knowing 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. It’s one of the most common fun facts that I see people are just not aware of: that calcium and iron inhibit each other’s absorption. You never want to be drinking milk or eating something high in calcium while you’re taking your iron. That’s why it’s separated in this way, which is optimizing for absorption. Meanwhile, with the PM capsules, you could take them with lunch if you want, but I would say a lot of people like to take them with dinner, especially since magnesium can have some sleep benefits for some people. It is separated in that way, but there is some flexibility as well, and our customer support team is amazing at helping people personalize the routine for them.

Felice Gersh, MD

I’m going to ask you some very specific questions. Many women have PCOS, and I want to go into PCOS in more depth. 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, and then they have to wait 30 to 45 minutes before they eat. Is it okay if they take their morning capsule with breakfast, or should they space it out and take it between breakfast and lunch? If yes, how can you manage that one? This comes up a lot in my practice.

Doreen Bloch

It’s a great question regarding PCOS, Hashimoto’s, or any kind of thyroid challenge. This is one of the main reasons that we have customers customizing their packets around iodine, and it’s empowering 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 mg or CG of iodine daily, especially during pregnancy. Then, a lot of times, people who have thyroid issues are stuck, feeling like there isn’t a product easily available for them. Ellement makes it very easy to customize the iodine dosage. That said, if people are also taking additional medications, for example, we have a customer who is taking, I’m not going to say this, levothyroxine. Did I say that right?

Felice Gersh, MD

Perfect.

Doreen Bloch

You can see I usually stay in my lane and just type these things out, but so a sample weekday 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 to ten, then they can take their AM packet at 11. AM is still kind of in that space between breakfast and lunch, and then they take their PM packet with dinner. It is very much possible to accommodate medications as part of the protocol, and we’re very, very thoughtful in our team. We can work with other practitioners to make sure that we’re customizing the routine accordingly.

Felice Gersh, MD

No, it’s perfect. That’s just what I was thinking—just slip it in between breakfast and lunch. In terms of the well, if you have nausea in the early part of pregnancy, that might be another way to deal with it. Would you like to just put it a little bit later in the day?

Doreen Bloch

What’s been exciting for a lot of our customers is that they switched over to us from another prenatal that they were taking. Because we’re able to isolate the most common culprit of nausea, which is iron, we’re able to deal with that in a variety of ways. As I mentioned, first of all, iron dosage is important. For example, a lot of prenatal needles are at 27 milligrams a day of iron. We start at ten milligrams a day. Even for some people, we include them every other day. They get a bit of respite from having that often nausea-inducing ingredient. We also 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 nausea. There are more ways to customize, especially around that particular ingredient.

Felice Gersh, MD

Oh, yes, iron can be a troublemaker. You mentioned that magnesium can also help with sleep. Magnesium comes in many forms. I was wondering if you customize that or if you use standardized magnesium, and which form you like to use.

Doreen Bloch

Ellement includes magnesium malate and magnesium citrate. Those forms are favored. They’re very effective for absorption, and we include that as a 50/50 blend. It’s also a type of form that is typically very well tolerated by most people, and we find that by including two different forms of magnesium, it provides a broader spectrum of bioavailability. That was recommended 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, malate and citrate, are certainly best in class.

Felice Gersh, MD

Well, that’s 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. That sounds like a great blend between the gut and the brain—kind of balanced out. that two thumbs up for that blend. I love it. In terms of vitamin C, do you take it in the morning because it’s water-soluble? Do you like to say you’re in flu season? Do you ever like to customize it and say, “Oh, I’m prone to getting colds and the flu,” and you give a little extra vitamin C? Is that something that you can personalize?

Doreen Bloch

That’s what’s so powerful. I’m so proud of the system that we built because it has this modular design where we can increase certain ingredients at certain times and decrease them at others. If someone is looking for additional vitamin C coverage within their package, we can provide that. It goes to all of the different ingredients that are included in the omega-3s. That’s one where we also see people wanting to increase their dosage, depending on their stage and their particular needs for choline. I wanted to mention that this is where the process of signing up is powerful. Every 30 days, we check in with our customers, asking them, How are you feeling? What do you need, or are there any changes required for your next box? That’s something that no other prenatal brand does. You’re in good hands because it’s not just about one-time personalization. It is exactly to your point about whether it’s a full season or if you are at a different stage, like having progressed in your pregnancy or your postpartum; whatever it is, we can accommodate that and truly personalize every box that you receive.

Felice Gersh, MD

Let me see if I understand this. You produced the vitamin and the package for each separate patient. Each packet is truly customized. You don’t have to pick formulation A or formulation B; each one is truly customized.

Doreen Bloch

Truly customized. We do all the hard work for you, so you don’t have to worry about anything. Just let us know. We have a very detailed onboarding form, so that’s where we’re capturing information about your context, your history, and what needs you have. Whether you’re the type of person who needs ten milligrams of iron, no iron, 40 milligrams of iron, iodine, or no iodine, whatever it is, we can accommodate that because we are packaging it fresh for you every month.

Felice Gersh, MD

Who is the individual or individuals that are helping each patient know what to do? You work predominantly with patients with their providers, or both, or how does that work?

Doreen Bloch

Yes, it’s such a great question. We work directly with the customer, and as I mentioned at the start of the conversation, I come from a data background and a tech background. There isn’t necessarily anyone behind the scenes helping with this. It’s all kind of automated; I wouldn’t call it AI; it’s not to that level, but there is a science and a data-driven algorithm behind it. All of that was designed with our medical advisors and practitioners. So it is all science-based; it’s all grounded in clinical research, and we adjust that whenever there is new clinical research available. 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 added surge of 900 milligrams daily. 

It was the type of thing that we were able to do very quickly because we were able to adjust the algorithms in our system. For anyone who is at that stage, make that recommendation, and then we could act upon it if they opted into that. So it is a very powerful set of tools that, 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. I also want to mention the pre-eclampsia risk. One thing that is very, very unique about Ellement is that, 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. There are times when we will interact with a patient’s practitioner, but I would say that in 90% of the cases, we’re just working directly with the customer.

Felice Gersh, MD

Well, that’s wonderful that you can personalize to that degree. I’m so glad that you’re so on top of the whole issue with choline because that’s so important for brain development and, of course, omega 3. Do you put the omega-3s in a separate gel cap, or how does that work? How many of you showed the pack but didn’t open any? How many capsules or gel caps would typically be in one of those AM and PM packs?

Doreen Bloch

It depends on the person. I would say that the preconception, which we have with about 50% of our customers, starts before they’re even or around the time that they’re trying to get pregnant, but certainly before they are pregnant. 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, an iron vitamin C capsule. They’re cute. I can show you. There is one in this packet. Can you see it? I don’t have the iron in this particular one because I take iron with me every other day. But here, you can see our fertility booster. Then there are all of the B vitamins. They’re in standard size. then on the PM side, it could range from two to nine. Some customers are taking seven or eight capsules in the evening. I would say that’s more than is typical. But we do have some people who are taking full advantage of 900 milligrams of choline and higher dosages of calcium and magnesium, especially when they’re closer to labor and delivery.

Felice Gersh, MD

Well, you mentioned a few products, like Inositol. Women with PCOS have very special needs in terms of trying to deal with fertility, ovulation, induction to be, having optimal eggs and then optimal embryos, and also dealing with metabolic issues like insulin resistance. Give me an idea of some of the extras that you mentioned, Inositol. 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?

Doreen Bloch

PCOS is one of the personalization vectors that we see to be fairly common within the Ellements community. We also see, I would say, anemia and thyroid disease, which are 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 and regulating menstrual cycles. Omega3, DHEA, and BPA can also be supportive, and vitamin D helps with hormonal balance. all of those ingredients, we can customize vitamin D in particular. We start with 4000, and I would say that’s probably on the higher end of what we see from other natal vitamins. We felt like that was optimal to address the needs of most people in the US, who tend to be more deficient in vitamin D. When it comes to omega-3s, we do include both DHEA and BPA in our fish-based capsule. We also do offer a 100% vegan capsule, but that only has DHEA and not EPA because it’s an algae-based formulation. We do recommend that, but some people prefer it. Before I was pregnant, I preferred to eat plant-based food. But it wasn’t for me to be so rigorous that I could take a fish-based capsule. We do see that sometimes people say, 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 DHEA. We start that at 200 MCG, but it can go up from there. That’s also one where, because it has some blood-thinning properties, sometimes we do recommend that if people do want to take those much higher dosages, they align with the practitioner to make sure that everyone’s on the same page around what the dosage should be for that particular person. Finally, with Inositol, we tend to see people start at 500 milligrams daily, but because that’s primarily for fertility benefit, I would say that the majority of our customers who have PCOS are at a 1000 MG per day level, and those capsules just need to automatically also be CoQ10 so we can customize that further. But I would say most people are on that particular routine. I would say for PCOS, generally, we see people at the 2000 MG level for Inositol, and we do include, by the way, Myo-Inositol as the form.

Felice Gersh, MD

That’s a lot of important information. I was going to ask you when I first started to talk with you, well, what about expiration dates? But I guess they don’t like any kind of worry about the expiration date because these are made almost on demand.

Doreen Bloch

Yes, I love that description on demand. Because of the modular design, we’re ordering the inventory of the capsules fresh. You’re not sitting on a shelf for 12 to 18 months at a store, oxidizing, being exposed to humidity, and all of these other kinds of environmental factors. It truly is exceptional quality. While we haven’t yet done a full-fledged, best-in-class clinical study to compare Ellement versus other prenatal, we have done some preliminary pre-post testing around the survey design, which was basically looking at people’s blood levels of things like iron, vitamin D, and some others before starting Ellement and then checking after 40 days of using Ellement. I will tell you that our medical advisors are extremely skeptical that we would see any difference in the blood levels, especially for things like vitamin D, which most off-the-shelf prenatal are. 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. What we saw was that within 30 days, 80% of the customers had shown increased blood serum levels of vitamin D. There were other increases as well for iron, which were certainly very successful. So we credit that, I would say, twofold. It’s the bioavailability separating by time of day. It’s the exceptional quality of the ingredients, with no fillers or binders, and also the freshness. It’s a very important point that these supplements haven’t been around for two years. It is packed fresh for each individual every month.

Felice Gersh, MD

I was just going to ask the question: when people order their supply, do they order one month or six months? But it sounds like it’s one month at a time.

Doreen Bloch

Exactly one month at a time. When people go to our website, which is helloellement.com, that will link everything for everyone, but they can choose from a sample box. We encourage people to see if that works for them, especially because it is a capsule-based approach. Maybe people are switching from a gummy to 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. It is 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 because there are so many benefits to continuing your supplementation routine postpartum as well, especially due to blood loss after labor and delivery, mood, and hormone fluctuations. Vitamin B can be very important. There are 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 every month, we do have this approach of checking in. We have a feedback form where you can let us know if anything’s changed so that we can customize it accordingly. It is, I would say, almost like having 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 and for your needs at any given time.

Felice Gersh, MD

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. They need to have all those extras coming in because they have to share them. That’s such a good piece of advice to continue. That’s why I want to change the vocabulary. They should be prenatal and postnatal vitamins, but you can just call them Ellement. You don’t have to give it a more specific name.

Doreen Bloch

That’s why I love that.

Felice Gersh, MD

This is a wonderful company that you’ve created, and, borne out of your confusion when you went to the store, it’s like, “What the heck is going on?” But I read the label, so that’s like, how many things? It’s a spark; it just went into you and, like, you just felt, it’s not there. I need to create it myself. That’s great ingenuity there. Oh, I’m so excited to learn about you. It’s wonderful to see women supporting women and creating something that is so universally important for every woman trying to achieve pregnancy, being pregnant, and afterward, and for women with PCOS to be able to personalize for everyone. But, particularly for women with PCOS, they can also include some of these other locals, like special extras that help to benefit them in their fertility journey. Thank you, Doreen, so much for joining me and sharing your wealth of knowledge and all about your company. I wish you so much good fortune with it. Hopefully, everyone out there will try to get a sample pack and start experimenting with how it’s affecting them on their fertility journey. Just repeat 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.

Doreen Bloch

Thank you so much for all the kind words and well wishes. It’s been a labor of love. It was inspired by my frustration and confusion. I feel so blessed that I found such great supporters along the way. We continue to grow the community of folks who are looking for a more personalized approach. For anyone curious to learn more, if you would like to get a sample pack, or if you just want to engage and ask me questions or ask our team questions, the website is helloelement.com and our email address is [email protected]. I look forward to speaking with you, and I thank you so much for the time today.