EP 279 Is “Unexplained Infertility” an Acceptable Diagnosis?
On today’s episode of The Wholesome Fertility Podcast, Dr. Briguglio, a fertility health expert, shares her passion for empowering patients and addressing the challenges of unexplained infertility and overreliance on IVF. She emphasizes the importance of comprehensive testing and addressing root causes to improve fertility health. Dr. Briguglio also discusses the interconnectedness of physical and mental health and the significance of individualized testing in the initial consultation. Additionally, she highlights the importance of iron and ferritin levels and addresses the challenges of vegan diets and cholesterol. In this conversation, Dr. Samantha Briguglio discusses the role of cholesterol and inflammation in health. She emphasizes that cholesterol is not the villain it is often portrayed to be and that it is needed for hormone production. Dr. Briguglio advocates for a balanced approach to diet and lifestyle, focusing on sleep, diet, and movement. She encourages individuals to find their own natural path to healing and emphasizes the importance of empowering people with information. Takeaways Comprehensive testing and addressing root causes are crucial for improving fertility health. The physical and mental aspects of health are interconnected, and addressing both is important for fertility. Individualized testing and a holistic approach are key in the initial consultation. Iron and ferritin levels play a significant role in fertility health, and vegan diets may present challenges in obtaining necessary nutrients. Cholesterol is not the villain it is often portrayed to be and is needed for hormone production. Nourishing the liver and eating enough fiber can support healthy cholesterol levels. A balanced approach to diet and lifestyle, focusing on sleep, diet, and movement, is crucial for overall health. Empowering individuals with information allows them to make informed choices about their health. Dr. Samantha Briguglio is a licensed Naturopathic Medical Doctor and the founder of Walk the Natural Path Hormone Health and Fertility Care. Dr. Briguglio has a passion for helping women achieve their wellness and/or fertility goals, and she treats – and teaches – her patients from a mindset of natural healing that treats the root cause of their symptoms. Website: www.walkthenaturalpath.com Instagram @walkthenaturalpath Facebook: www.facebook.com/walkthenaturalpath For more information about Michelle, visit www.michelleoravitz.com The Wholesome FertilityFacebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/ Instagram: @thewholesomelotusfertility Facebook: https://www.facebook.com/thewholesomelotus/ Transcript: Chapters 00:00 Introduction and Passion for Fertility Health 04:09 Passion for Empowering Patients 07:07 Challenges with Unexplained Infertility and Overreliance on IVF 11:03 Importance of Comprehensive Testing and Addressing Root Causes 16:35 Interconnectedness of Physical and Mental Health 24:06 Importance of Iron and Ferritin Levels 25:56 Challenges with Vegan Diets and Cholesterol 26:52 The Role of Cholesterol and Inflammation 30:05 Nourishing the Liver and Eating Fiber 35:03 The Importance of Sleep, Diet, and Movement 37:34 Finding Balance in Diet and Lifestyle 43:20 Empowering People with Information 45:30 The Inspiration Behind Walk the Natural Path Michelle (00:00) Welcome to the podcast, Dr. Brigulio, right? Brigulio is how you pronounce it, or Sammy, right? Awesome. Dr. B, awesome. So first of all, I love your Instagram. I'm going to say that. You guys got to check out her Instagram. It's going to be in the episode notes. I kind of want to lead with that because she has fabulous content, really rich with information and tips. Samantha Briguglio (00:05) Yes, you did that nicely. Or Dr. Bean. It's easier. Michelle (00:25) for fertility care and health. And before we get started, I would introduce yourself and also share how you got so passionate in specifically fertility health. Samantha Briguglio (00:39) Yeah, well, thank you so much. It's really fun to have a platform like Instagram to share all this stuff with and help educate people. But hi, I'm Dr. B. Virgulio, Samantha Virgulio. I actually just got married. So legally, my name, I just changed my name. Thank you so much. It's been really, really fun. But I am keeping Dr. B for business purposes. So you can always remind me, remember that. Michelle (00:54) Congratulations. Samantha Briguglio (01:09) I'm Dr. B, so you don't have to worry about any changes. But how I got infertility, I feel like it's kind of a long story, but I'll try to keep it as short as possible because this also has to do with how I got into natural medicine, which actually stemmed from when I was a child. I was pretty sick as a kid. And I was pretty sick. Long story short, my mom really fought for me and found natural medicine. And I went from being on like oxygen treatments like two to three times a day. Yeah, it was pretty crazy to being a total normal kid who played a bunch of sports and just loved running around and just basically natural medicine changed the trajectory of my life. And so I became super passionate about it. Went to college, was kind of like, eh, I don't wanna go to med school. That looks really hard. Michelle (01:38) Oh wow. Samantha Briguglio (02:00) trying to find other avenues, but I always got brought back to natural medicine. I was like, this is just where I'm supposed to be. Actually wanted to go into pediatrics originally and ended up not doing that because I wasn't able to get enough training, like hands on, like one-on-one with kiddos. And I just felt like that was really irresponsible. It's like all of a sudden started a practice where I was working with kids and I didn't feel like ready or trained enough to do that. And... In my last year of school, I actually found a fertility course. It was like an extra like, I don't know, $600 on top of all the other loans I was taking out. So I was like, oh, this looks fun and interesting. I fell in love. Like I just fell in love. I actually, the person who wrote the course is Dr. Jacqueline Chassie at the time. She just changed her last name. I guess it's a few years now. Seamonton, I think it is. If anyone wants to find her, her courses are great. Michelle (02:44) Wow. Samantha Briguglio (02:56) but Hello Fertility is her Instagram actually. But she is an amazing teacher and I went on to join her year-long mentorship in fertility after I graduated, which obviously kind of like changed the course of my life and career. And I just felt so in love with it. Part, I was actually really good at it, right? Like sometimes like you're just good at something or not. And I was like, I don't want to be a jack of all trades anymore. And I just felt like I... Michelle (03:01) Mm-hmm. Samantha Briguglio (03:25) my intuition just went very hand in hand with the fertility practices, treatment, and just diving into that and learning more. I loved it, I enjoyed it. And then later on, I'm talking to my mother and my grandmother, and I'm telling them how I'm so drawn to this, and I find out my mom went through her own journey with miscarriages and loss, and then my grandmother, took her 10 years to conceive, I'm like, no wonder I'm drawn to this. I'm supposed to help all these people. My family had this struggle, so like. Michelle (03:51) Wow. Samantha Briguglio (03:55) Now I get to help and get back. So kind of a long story. I try to give the most important pieces, but there it is. Michelle (03:59) That's incredible. Amazing. No, it's interesting because my mom had secondary infertility with me. tried for a while. So she had a really hard time. She also thought she was going to lose me at different times, like lost a ton of weight. So it's kind of interesting that you say that. And it's pretty wild because it does kind of hit home. I don't know, I do believe that subconsciously we can almost feel something in ourselves. There's just certain things that call to us and we just feel like this is it. This is what we're supposed to do. And I totally understand what you're saying. It really, really resonates with me. So that's cool. Samantha Briguglio (04:38) Yeah, right, you just keep getting pushed down a path where eventually you're like, okay, I'm surrendering, this is what I'm supposed to do. Like that's basically what happened to me. Michelle (04:48) Amazing. Well, you're so good at it and I can feel the passion. I really can. That's one of the things that I love Instagram. I have to say, I mean, with social media, it's like a blessing and a curse, right? But there's so many amazing things about social media because you're able to connect with people in a different way and get to know people. And people are able to share stories and information. You can get tons of information on Instagram, especially it's really big in the fertility world. So I feel like there's just so much content, but you can really feel a person's passion and also just drive to learn and provide quality information. And I find that with your account, it's actually one of my favorite accounts, I'll be honest, because it teaches me and this is where I love it. I'm like, when I feel like I'm getting, as a practitioner, I'm learning so much, I'm like, I got to have them on the podcast. I got to pick their brain. Samantha Briguglio (05:42) You're so sweet. Thank you. I feel like, yeah, no one's ever told me I run short on passion, that's for sure. Michelle (05:42) For my guests and for me. Well, it works for you and it works amazing. And so we were talking actually in the pre-talk about certain things that we feel really passionate about. And as practitioner, I find, and I know that you're great because we talked about it, that usually your passion, it's like the P, right? The P, because P for passion and P for pissed off. It's very fine line between the two because Samantha Briguglio (06:15) R-heh! Michelle (06:19) The things that we're passionate about, we've also been pissed off about. Meaning, for me, it's like I'm being told that you can't do something. I've always had that even in my life. I'm like, no, screw you. I can do it. Don't tell me I can't. I feel that passion with my patients. When people tell them they can't, and then I see that they can, and I'm like, I can't why are you telling them they cannot do it? I don't like that. It pisses me off, but I feel very passionate about empowering. So you feel like that too. We talked about a couple of things. So I'll let you have the mic. Samantha Briguglio (06:57) Yeah, yeah, we talked about two main things, right? I think the first one was the unexplained infertility. That diagnosis drives me nuts. Because I probably said a couple bold things about it on Instagram before, and one of them that I felt like it was lazy medicine. And I feel like that seems harsh, but it's kind of the reality of it, right? Because I'm like, you're being lazy. You're not doing any more tests, you're not trying to figure out like what could be this underlying cause, you're just saying like, oh, the things that are obvious are all good. So we don't know there's it's unexplained. And so that drives me nuts. Michelle (07:35) It feels like you're putting it back on the patient. That's what it feels like. It feels like, oh, well, we don't know. So here you go. Samantha Briguglio (07:41) Yeah, 100%. And then, you know, leading to the other thing that we kind of talked about is that then it's like, okay, well, we don't know, so IVF is your only answer. That drives me nuts. I think IVF is amazing. I think it has a time and a place. I think it has helped a lot of families, especially with, you know, certain diagnosis, especially anatomical ones, but like to be like you have unexplained, let's do IVF, or, you know, we haven't even pulled your progesterone yet, but we don't know what else is wrong. So like, let's just go to IVF. Like it just... Yeah, talk about getting heated and passionate, which just drives me insane, because I feel like it's unfair and you're not doing your duty to your patients and it's at the end of the day, kind of lazy. Yeah. Michelle (08:22) Yeah. And I'll tell you, um, I feel like there's this common misconception. I feel like that it's almost, I almost want to say it's due to marketing because we have been conditioned to believe that if we pay an arm and a leg for something, it's a guarantee that we're going to get the best of the best. And I think that that's what it is. People think that it's a guarantee to go through the IVF process. And I've actually found, and again, same as you, I completely agree. Samantha Briguglio (08:39) Yeah. Michelle (08:52) that IVF's incredible. It's an amazing thing to have. It's amazing. The technology's beyond. I remember going and doing acupuncture for a transfer, and every time I go, I'm beside myself on the incredible opportunity that so many couples have. So 100%, yes, for that. However, in some cases, I've actually found that my patients have had many failed IVFs. retrievals and transfers. And then they went on and did better getting pregnant naturally at an older age in their forties. So like that kind of, it challenges that whole idea or mindset that it's a guarantee and it's like the only option for some people. So I'd love to get your thoughts on that. Samantha Briguglio (09:40) Oh yeah, I've had many patients that have tried multiple IVF things like three to four even, and come back and get pregnant naturally. IUI same thing, a lot of IUIs and then they'll get pregnant naturally. And they're like, I don't really get it. I'm like, it's because we had to treat the root cause. Like one of them that really stands out in my mind is that they had actually got health issues and everyone was like, their hormones looked actually pretty decent. Even their A quality wasn't bad, but their gut was like not okay. Like not okay at all. Like diarrhea episodes daily, which is that's, that's not a healthy gut. And I was like, Oh my gosh, what? And so we treated and we treated for a little bit and they started to heal and started to feel better. And then all of a sudden, like a couple months later, like boom, pregnant and healthy pregnancy. And I just tell, like, it's just a testament to like, the reproductive system can be fine. But if something like your thyroid or your Michelle (10:10) Mm-hmm. Oh wow. Samantha Briguglio (10:40) your other systems that we have that make our whole body, right, is impacted. That can cause issues. Your body sometimes doesn't want to, you know, carry another life if everything isn't okay. Michelle (10:54) Yeah, totally. And so you mentioned actually a really important one, gut health. Western medicine is amazing in what they're amazing. You know, everybody has their own toolbox and like things or specialties. And so that's not something that's typically looked at or like, you know, tested. They'll do like, they'll look at like ultrasound, they'll look at like Samantha Briguglio (11:09) Mm-hmm. Michelle (11:14) the tubes, they'll look at like the anatomical, they'll do the blood work, the hormones. And obviously, when they come to you, it's a whole other detail of testing. So let's talk about some of the things that are often missed in conventional medicine that you look at that they may not know about. Samantha Briguglio (11:36) Yeah, I'll definitely talk to that. I do also wanna say like some things are also best in combination. So I love natural medicine and I think it can do amazing things, but a lot of times also like a combination of like conventional and natural is also really amazing. I've won, like for example, endometriosis patient that it's been really beneficial for them to have both, right? They have like the laparoscopic surgery done and now we're working on inflammation and reducing all these other things, but. Michelle (12:02) Right. Samantha Briguglio (12:05) they're feeling so much better. So like I said, I can get heated about some things, but I also am very appreciative of all forms of medicine. It's just like, we all, we just have to stay in our lane and also know that it's okay if there's, if someone's taking from all different types. If anything, that's good, right? Michelle (12:14) Yeah. Yes. I always say like a team, a well-rounded team with all their different strengths. Samantha Briguglio (12:32) Exactly. So I just wanted to say that too. But when it comes to things that I look at that are going to be different, I mean, who I feel like the list can be kind of long, actually. I mean, I asked from everything like, what are your bowel habits or your bowel movements to your, you know, what's your gum health like, do your gums bleed a lot to, you know, do you have headaches, musculoskeletal pain, we focus a ton on stress. And it's not like the type where it's like, oh, you're stressed, like, just don't stress, right? No, we like figure out like, root cause of that stress. And if that root cause needs to be explored more, it's like, okay, do we bring another person onto this team? Obviously we focus on a ton of diet and lifestyle habits. I just ask about them. And then we talk about what we can improve versus what we don't need to improve. Thyroid health, like I said, the list can kind of go on and on, but it can be from anywhere from like your daily habits to environmental exposure, you know, a job at the workplace. I actually see a lot of blue collar men. Michelle (13:14) Yeah. Samantha Briguglio (13:32) I find that to be very common, either blue collar or very like high stress jobs are a lot of men that I see for like sperm count and quality. And you know, like I said, I feel like the list could go on and on. There's always kind of something and I kind of say there's like the most obvious things, which to me are like diet and lifestyle, gut health, like thyroid health. And then there's like the small things like anti sperm antibodies and you know, like an immune flare or Michelle (13:48) Yeah. Samantha Briguglio (14:00) you know, skin conditions or, you know, maybe some of the things that seem a little less obvious, like reproductive microbiome. Uh, and there's kind of almost tests for all of this now. It's just also, it can't be really expensive. So like I said, I like to start with like the really big layering things, make sure those are good before I move on to the smaller things. Michelle (14:12) Mm-hmm. Yeah, I mean, there's so many things that I definitely want to talk about with what you just said. Like one of the things, you know, it's interesting how people are saying, oh, just stop being stressed. Sometimes you're stressed because your body's stressed. Like if your body or your gut's off, it's going to impact your mind. Well, in Chinese medicine, we learn about how everything's so interconnected. So like how your body feels if your body's not getting the nutrients it needs, it's going to feel stressed. I mean, have you ever felt hangry? You know that like impacts. Samantha Briguglio (14:41) Yeah. Michelle (14:50) immediately or if you're not getting enough sleep, if you're not getting good sleep, that's going to impact your stress levels. So it's so intricately connected. And when you have that calm, or even your gut health is better, your mind starts to feel better as well. Samantha Briguglio (15:06) Yeah, I love that analogy of have you ever felt a hangry? I think that's so perfect. I haven't heard it, but that's so good. Like, yeah. Like sometimes if you're not, no, you don't even know sometimes you're not even not feeling good, but it could be manifesting as an emotional response or something. I know I was feeling a little extra stressed out and I myself did a gut health test on myself and I was like, whoa. Like honestly, I would expect more physical symptoms, but I think mine were manifesting a little bit different. And I'm like, wow. Michelle (15:14) It's like perfect example, right? Right. Well, that is such a good point that you bring up because I think that, like for example, my patients who are sensitive to gluten, they end up feeling really well after removing gluten, but not for the reasons they think. Like they say, if I eat bread, I'm fine. I don't feel bloated or anything like that. But with food sensitivities, it doesn't necessarily have to show up as digestive discomfort. Samantha Briguglio (15:49) Yeah. 100%. Michelle (16:01) And I think that that's like, you know, so that's like one example of how things can impact you, you don't even realize that you could have something and that has nothing to, like, you're not going to feel it directly as that. It could show up as headaches or low energy. It could be so many things. Samantha Briguglio (16:17) Yeah, brain fog, anxiety, joint pain. Joint pain's a big one that everyone just brushes off as like musculoskeletal issue. And I'm like, no, that's like an inflammation issue, right? Like, why are you? Like, so yeah, no, I, for sure. Michelle (16:24) Right. Oh yeah. Yeah, for sure. So how do you figure out like where you start with the testing? Like when you first see people, I mean, I'm sure it has to do with a lot of what they'll tell you. Samantha Briguglio (16:42) Yeah, so, you know, initially, depending if I have like a single visit or I see a fertility for two. So I see, you know, people individually, but I see the couple together, which also I think super important. I feel like one person always seems to get ignored. Like there's never like, let's treat both. It's like, oh, there's a abnormal semen analysis. Let's treat the guy. And then like the female side's forgotten. Or, oh, so this person has endometriosis. Let's make sure we focus on that. And then to see the male sides. Michelle (16:53) Yeah, that is. Samantha Briguglio (17:10) forgotten. So it's like, I really like the fact that fertility for two. Honestly, it's mostly for affordability that I do the fertility for one just because if we can try to do something, but I always think, you know, treating both is the best. But when it goes, sorry, back to your question. So when I see people as either 60 or 90 minute visit, depending if it's one or two, and we ask I mean, I ask a lot of questions. First, I just kind of give them the floor. I'm like, share your story with me. Like, tell me, right? I think intuition's so important. And a lot of times, like couples end up telling me what I need to hear in that first part, because they're just, they don't even know it's like this most important thing, but I'm like, whoa, like that was huge. Like, okay, writing that down. Then I ask a lot of questions that like, will branch off of what they share with me. And then we dive into, you know, family history, their own history. Michelle (17:53) Yeah. Samantha Briguglio (18:05) you know, general review of systems, which basically means checking in with every, from like head to toe, every single system of the body. And we have them answer questions like, are you bloated? Yes or no, right? On the female side of things, definitely diving into the menstrual cycle, like a full dive in. Usually it takes us like, sometimes 15 to 20 minutes just to talk about the cycle, which probably seems like a lot, but like, no, I ask a lot. I ask like questions from like, what size are your clots to Michelle (18:27) Yeah. Samantha Briguglio (18:34) how many tampons do you fill to tell me about all of your symptoms and like the timeline that you have them within your cycle. So we really take a deep dive into that. Um, and then, you know, from there I kind of compile, like all their symptoms, come up with the ideas for the labs that I want to draw. And then based off symptoms and labs, we form a treatment plan. Um, based off all of that. Michelle (19:00) Are there some common labs that you usually, almost for everybody use, or one test that you typically feel like everybody should take? I know it's kind of like a one-size-fits-all, but... Samantha Briguglio (19:12) Yeah, you know, no, for sure. Right? Yeah. Like, I know what you're trying to say. You're like, I know it's individualized, but what are labs that are for everyone? Yeah. So yes, and I tell a lot of people that right, because I'm like, you can go get all these basic labs, but I might be asking for you to get other labs based off what you tell me. So just be prepared to go twice. So a lot of time, they just have people wait to come get labs. So they're not going back and forth. Because that takes time. And I'm like, I'm like the person that like, I just want to do all at once. Michelle (19:18) Yes. Yeah. Samantha Briguglio (19:41) Um, but there's going to be the classic, the day three of your cycle. So third day of bleeding and then seven days after a predicted ovulation labs, the day three ones are going to be like the estradiol, the FSH, the LH, the seven days after ovulation would be progesterone. Um, usually with like the day three lab, I also order, um, like a CBC, a CMP. So that's like your, your blood counts looking at red blood cells, white blood cells, the CMP is kind of looking at kidney, kidney liver. Michelle (19:41) Yeah. Samantha Briguglio (20:09) and then like lipid panel looking at like cholesterol. So just like those basics are always really nice. I do, I used to wait to order insulin, but now I'm just starting to do it more for everyone just because there's just been, like it's really hard to guesstimate who's gonna be having elevated insulin because I've ordered it on some people that I'm like, I just feel like I need to order it. And then it comes back super high. I'm like, okay, they are not a typical candidate for insulin. Michelle (20:21) Mm-hmm. Mm-hmm. Samantha Briguglio (20:36) But like I ordered it and they have like an insulin of 24, which is like way over my range of what I like to see it in, right? So I kind of started doing that one a lot. Obviously a thyroid focusing on like the TSH, free T4, free T3, thyroid antibodies. And then another one I actually also really like, vitamin D, cause that can be in relation to like miscarriage and loss. So just making sure that's elevated in general. Michelle (20:37) Bye. Yes. Samantha Briguglio (21:06) I do an AMH if they haven't gotten one done. That one, obviously I wouldn't get for guides too, but so far all the other ones that I've listed can also be for men. And then another one that I think I would do for a lot of people would also be ferritin. So ferritin is a lot lower in a lot of people now. It's the storage form of iron. It's something that... Michelle (21:24) Mm-hmm. Mm-hmm. Samantha Briguglio (21:32) the more research I've done, the more I'm seeing that, they always talk about iron being too low and can cause like a bunch of issues in pregnancy and then also to try to conceive, but people forget that ferritin is a storage form and if it's lower, usually that means that we are actually low, we're giving all our storage to like the active form. And so we wanna make sure that's elevated enough and there's a lot that can go into that, but that's been another one that I've been Michelle (21:56) Mm-hmm. Samantha Briguglio (22:01) doing a lot of research on lately and most people, it comes back super low. So it's just kind of where I just started doing it. I used to only do it. Yeah, they ignore all the time. And it's something that I would only do for those who had like a heavy menstrual cycle or history of endometriosis or like a gut health issue where they had problems of absorption. But now I'm just like starting to do it more often for everyone because. Michelle (22:06) Oh, interesting. It's actually something that a lot of people ignore. They like totally overlook. Samantha Briguglio (22:24) Again, it's like most, a lot of people are having it super low. So I'm like, okay. And with ferritin though, then you have to go into, sorry, I'm like totally like going on a rant here, but I'm like, I have to finish it out. Yeah. Well, but I'm like with ferritin it's nice too, because first you can treat it with like iron and like vitamin C, right? Like see if that's, that's the culprit. And then you test it and if it's gone up, usually that is the issue, but it can also be due to like Michelle (22:34) Oh no, I do the same thing. That's how I always think. I go everywhere. Samantha Briguglio (22:52) Like low ferritin can be due to chronic inflammation or an underlying like disease or like virus or bacteria in your system that you need to figure out to treat. And so sometimes I'll just do the iron first and then we can go to the other piece if we, if it's not working, cause that means that there's definitely something else going on. Michelle (22:57) Mm-hmm. Yeah, I mean, interesting, you know, talking about iron. What I find interesting about it, and I remember like listening to a podcast and they talked about how it's better to have things like beef liver, like through foods, because it has a well-rounded combination of nutrients that helps iron absorb better versus when you're just taking iron and sometimes the body doesn't know what to do with it. And it just kind of, it almost gets toxic, the amount of iron because it's not. Samantha Briguglio (23:40) Yes, yes, it's totally can. Michelle (23:42) Yeah, so let's talk about that because I think it's really important to talk about because people might be like, oh, you know, if that's what it is, let me just take iron. But like, that's not always the solution. Samantha Briguglio (23:53) No, you're totally right. I mean, obviously like a beef liver on eating more meat cooking with a cast iron pan There's the good old fat. There's the good old fashion iron fish like there's so many different things you can do um some people Usually I give iron to people who have a hard time incorporating like meat or have a hard time cooking like it's very individualized Right, like it's you kind of have to meet the patient where they're at um, but things that I will recommend for iron and Michelle (24:00) Right, yeah. Yeah. Samantha Briguglio (24:20) Just clarification, this is not medical advice. This is just things I like to do in my practice. But I like to do actually, there's a lot of studies on dosing iron every other day actually is helpful for absorption, pairing it with vitamin C. So that either means like eating an orange or getting a supplement that has vitamin C in it or taking vitamin C with the iron. That's gonna, and those things make a big difference, right? So they sound little. Michelle (24:24) Yeah, yes. Samantha Briguglio (24:49) A lot of people worry about constipation with iron and that's where they're like, oh, that can be an issue too. So if you just eat it, it'll be better. Eating it's always gonna be better. I'll never take away from that. But just cause we're also on the side of supplementation, there's different forms of iron. And I like an iron bisglycinate form that's actually absorbed a little bit easier and usually doesn't cause constipation. I say usually because I had to get a constipation one time. I was shocked, but it did. Michelle (25:14) Mm hmm. Okay. Yeah. Samantha Briguglio (25:17) And so that's where I'm like, let's just really focus on like cooking with the cast iron and iron fish and like the, let's have, let's eat meat, right? Like, let's try, I mean, the leafy greens, people talk about that all the time. They can be helpful, but they're not digested. They're just, they don't, they're not in our body. Yeah. It's not the same. Michelle (25:26) Yeah. It's not the same. And then on the other hand too, like, I mean, I have like one patient that... Her doctor said, stay away from eggs, stay away from red meat, because your cholesterol is high. So I wanted to talk to you about that, because I know that there's like this school of thought that just avoid all the things that have cholesterol and you'll be good. Or why is the cholesterol in there in the first place? Could it be covering up an underlying inflammation? Because in Ayurvedic medicine, they talk about like, vata pitta kafa, I don't know if you're familiar with like the different elements. Samantha Briguglio (26:04) Oh yeah, oh yeah. Michelle (26:06) Yeah, yeah. So when something gets really inflamed, they say kafa, which is a little bit more of that moist, heavy substance, comes over to protect. So the same thing with amyloid, with Alzheimer's possibly. Is it because, does it come in to protect something? It's like this coating, same thing with cholesterol. So does that come in to coat the walls because there's inflammation? Samantha Briguglio (26:33) So I feel like I have to answer a couple other things before I answer that question. One of the things is I don't think cholesterol is the villain that it used to be. So there's a lot of studies that say like, more cholesterol is better than not enough cholesterol. And cholesterol is needed to build, it's a building block for our hormones and things like that. Michelle (26:47) Mmm. Samantha Briguglio (26:52) cholesterol is needed. People villainize it so much, but even the bad versus the good, the HDL is the good, the LDL is the bad, we still need LDL cholesterol. These things our body needs. One of the theories, and it's a more recent one, but it's still a few years old now, is that it's not actually the amount of cholesterol that's an issue. It's more related to if there is inflammation or not. If you're saying, on one end you're like, is the cholesterol being there as like a protective thing for inflammation? Or is cholesterol being that elevated not as terrible as we think it is, but we need to make sure that like the inflammation is monitored and reduced? That's always like a big question. And then another one is like looking at ratios. Like cholesterol ratios are actually the most important thing, right? So, Okay, we could have elevated, you know, LDL or total cholesterol and triglycerides. But what if we have like an HDL that's like in the eighties or 85 or something? That's to me, if we have a cholesterol that's even like, you know, it seems to be extremely over the limit, but we have this really strong HDL, like maybe it's not as big of an issue as we think it is. Right. Michelle (28:10) Mm-hmm. Samantha Briguglio (28:16) Also a lot of times instead of eating things that have less cholesterol, I usually just encourage eating more fiber. So fiber actually binds with cholesterol and then we just poop it out. So like instead of like limiting all these things, I'm like maybe you're just not eating enough fiber. Maybe it's the other thing. Maybe it's not that you're eating too much of something. Maybe it's a lot. Maybe it could be either a combo or maybe it's you're not eating enough fiber, which most people don't. Right? Because fibers and like veggies and things like that. Michelle (28:23) Mm-hmm. Mm-hmm. Mm-hmm. Samantha Briguglio (28:44) So it's like maybe we just need more fiber, nourish the liver a little bit more, and then our cholesterol issue goes away. So sometimes it's kind of a combo. Sometimes yes, it might be accompanied by the inflammation. Maybe is it the chicken or the egg, right? Is it the inflammation that's causing cholesterol or is it cholesterol that's causing more inflammation? At the end of the day, I feel like we truly don't know that answer 100% yet, because different studies keep coming out on it, but. Michelle (28:44) Right. Bye. Bye. Samantha Briguglio (29:10) Overall, I would say my biggest thing and my biggest recommendations to treating cholesterol are actually by nourishing the liver and eating enough fiber. Obviously, if they have a really bad, high fatty diet with like really bad fats, like unsaturated fats, then that's an earth saturated fat. I'm like, wait a minute. What I said was wrong. Michelle (29:19) Yeah. Saturated fence, yeah. You know what it is? We talk too much about this all the time and it's just our brain's like, uh? Samantha Briguglio (29:39) Yeah, I totally my brain was like, whoopsies, at least I caught it quickly. Whew. Um, you know, basically we do want to limit that limit that, right? But like eliminating the good fats, like avocado and eggs and stuff. Like that's, that's not what we want to do. That was a big rant, but there we go. Michelle (29:43) You did. Yeah. No, I mean, I will say like, you know, when people say I can't have eggs, I can't have the yellow of eggs. I'm such a great food. But then of course, I'm always afraid to say, don't do what your doctor said. Like I will never say that. It's just, you know, so I wanted to get your opinion on it because you hear just so many different opinions on everything that it gets very confusing. And then sometimes the mainstream opinion isn't updated. Samantha Briguglio (30:09) Right. Right. No, they say it takes 10 years in medicine from an article coming out to making actual changes. And then by the time that happens, there's a new article that comes out. Michelle (30:24) I'm finding that like, yeah. Yes. then of course, you don't want to, again, step on other people's toes and you're like, well, I kind of remember hearing a study that says the opposite of this, you know, and I'm not talking about this specifically, I'm just saying in general. So sometimes, you just get so many different perspectives. But then of course, as a practitioner, you have to be very careful as to what you're Samantha Briguglio (30:45) Yeah. Michelle (30:54) suggesting and you don't want to go cross basically somebody's other treatment plan with their practitioner, that kind of thing. So I'm sure you know exactly what I'm talking about. Samantha Briguglio (31:06) Totally. Yeah. And you know, I also just give patients options. I'm like, we can try this and let's monitor. Let's like do this way for a couple of months and then get your labs drawn and then do this way for a couple of months and get your labs. Like we can, you know, if their cholesterol isn't like in scary high levels, then I'm like, it's like we have room here. There's room. I'm like, how long do you think your cholesterol has been like this? Like we don't have to like change things tomorrow. Like we can just start slowly working on it. Like I said, if it's not in a dangerous place, but Michelle (31:12) Yes. Mm-hmm. Yeah. Samantha Briguglio (31:35) Usually it's not. And so I think the fiber thing is honestly the most underrated thing there is. And then, yeah, and then eliminating the bad fats versus and keeping the good fats. Because the good fats are what keep your HDL high and they're helpful for that really good ratio. So we don't wanna eliminate the good stuff, we wanna eliminate the bad stuff. Michelle (31:37) Yeah. That's a good point, yeah. Right. So the good stuff meaning avocados, salmon, you know, like good. Yeah. Samantha Briguglio (32:06) eggs, nuts, you know. Yeah, that's, yeah, exactly. Michelle (32:12) very important information. So, foods, I think that that's a huge thing because a lot of, we just don't, we're not conditioned to eat healthy. I just feel like there's a, you know, this quick fix and a lot of processed foods and people don't have the time or the energy to cook. But that's one thing that I've at least seen that has been a little bit more difficult is really implementing a new way of living because it's so intricately connected to our behavior and it impacts inflammation, it impacts fertility like in so many ways. And then also like certain food additives that can impact gut microbiome, like thickeners, Samantha Briguglio (32:48) Yeah. I know and now there's like this thing that where it's like natural and holistic medicine is like kind of trending Like let's just like call it what it is, right? Which is cool because when I first started I would tell people what I do and they have no idea Like no one knew what I was gonna do Yes, it's more mainstream, which is awesome Michelle (33:02) Mm-hmm. Yes, we're becoming mainstream. Yeah. Samantha Briguglio (33:16) But now it's like also been taken to the extreme. So I'm like, oh goodness, now we're like flying on this other side where it's like, oh God, like everyone's eliminating everything and like, it's just been crazy. And so now people come to me and they think I'm like chill. They're like, that's it? I'm like, yeah. And I'm gonna. Michelle (33:33) Wait, so tell me, tell me, what do you say typically? What are your big things that people should pay attention to and what kind of things should they be a little more lax on? Samantha Briguglio (33:44) Yeah, so like the thing I'm most strict about is sleep. I will always be like sleep over everything, sleep rules. Sleep is like, you will not, if you wake up early to sleep, your workout, your workout's not gonna be as effective than it would have been if you just like slept a little bit longer and then maybe try to get like a shorter workout in, right? Like it's, things like that, I will always stand by sleep first, always, always. Second, honestly, diet and movement. Michelle (33:50) Yeah. Samantha Briguglio (34:15) They're kind of linked for me now. It always used to be diet first, then movement, but now there's just so many, like there's so many people going through a lot of like stress and like mental health struggles that, yes, I can help with, but I feel like movement just helps set the tone for so many people's day where it like allows them, they move, it like allows them to like follow up with more healthy habits. So it's like this weird, you know what I'm saying? Michelle (34:39) Oh, yeah, it's somatic. I mean, yes, because we were talking about how your emotions are very much tied to your body. That's why somatic therapy is so powerful. Probably another step over talk therapy, which is why things like yoga really impact the mind because when you're moving, you're sort of processing emotions and emotional states. Samantha Briguglio (34:50) Mm-hmm. Yeah. Michelle (35:07) in a different way. And it also helps you cognitively. I mean, there's just, so movements like very underrated. Samantha Briguglio (35:13) Yeah, well, and they, cause they only, people, I feel like we're only looking at it from like a, what does movement do to your body versus what diet does do to your body, right? And, but we're forgetting like the, oh, if I move and I feel good and I'm happier throughout the day, I'm more likely to like pick the healthier choices and eat the healthier foods than, and get restful sleep and all these other things. So honestly, they're kind of tied for me. Sometimes movement ranges up. I don't know, you know. Michelle (35:33) True. Yeah. But I also say if you're getting good sleep, you're going to be less likely to grab that sugary snack. Yeah. Samantha Briguglio (35:50) That's exactly so this is where it's kind of like all of it matters a lot, but that's why sleep is like number one for me um But sleep so like obviously the diet and the movement piece But when it comes to diet, I feel like a lot of people are really strict now There are so many bad foods. Yes, there are so many seed oils and all of that But I feel like now people are going on the other side of getting really stressed out about what they're eating how much they're eating Michelle (35:56) Yeah. Samantha Briguglio (36:15) you know, making sure they're getting all their nutrients in. Now I'm like, oh God, we've like over-corrected for a lot of people now that are in this wellness space. I'm like, okay, we need to like chill out a little bit. Like not everyone needs to eliminate gluten and dairy. If it bothers you, eliminate it. If you have an issue with it, eliminate it. If you're allergic to it, eliminate it. But like, if you eat it and you feel fine, like let's just not cut out another food, right? You know. Michelle (36:15) Mm-hmm. Mm-hmm. Samantha Briguglio (36:42) A lot of practitioners believe that like no one should eat that and dairy is super inflammatory. And I'm like, well, yeah, but like quality matters always. If you're getting a good organic dairy, that would be helpful for some people. Michelle (36:49) It's true. Yeah. Same thing with organic weed because it's not sprayed with glyphosate. I think that that's a big thing too. I mean, I'll be honest, I mean, it's just the world we're living in right now. It's a little bit of an uphill battle, but I agree with you that it can almost manifest, and I've talked about this before, it can almost manifest very similar to an eating disorder. Samantha Briguglio (37:02) Okay. Yes. Michelle (37:15) I mean, because people get so upset and it really impacts them how they're eating. So it's a fine line of having a balanced perspective on food. Samantha Briguglio (37:27) Yeah, yeah, it's orthorexia that it's literally actually has a technical name now and that means you're so stressed about eating healthy You either like just won't eat at all Which is actually not good for women. They'll say like for men It's actually better to fast than eat the unhealthy thing But for a lot of women it's better to like actually eat the unhealthy thing than to fast for too long fasting still. Okay but that's sorry, that's a whole nother conversation, but um Yeah, so I go from the approach of 80-20 rule Michelle (37:33) Mm-hmm. Yes. Yes. Samantha Briguglio (37:57) and making it sustainable. So I'll tell my patients like all the time, I'm like, you're not a perfect person. You can't be perfect all the time. And if you're gonna stress about being perfect all the time, that's a whole nother thing we have to deal with. So instead, let's give you freedom to live your life. I go out, I go out and eat french fries, like all the time, I love french fries. Like I guarantee those are not always fried in like olive oil or whatever. They're definitely fried in probably like a seed oil or canola, like I know that, but I love them. Michelle (38:17) Me too. It's good. Yeah. Mm-hmm. Yeah. Samantha Briguglio (38:26) But the rest of the time, you know, I get my movement in, I'm drinking tons of water, I'm sleeping like nightly, like I take care of my mental and emotional health, like I'm doing all these other things that, so when I eat the French fries, it's not that big of a deal. I'm like, yeah. And so that's where I want people to feel free now. Michelle (38:37) Mm-hmm. Right, I get, no, I get what you're saying. Samantha Briguglio (38:50) They can be as careful as they want as long as it doesn't cause like chronic stress. Like if avoiding all of that stuff actually helps you and relieve stress, great. But for majority of people I've seen, it really causes a lot more stress. So I become very picky about a couple of things and then I kind of just say, I'll help you with the other stuff, right? Like eliminating sugar, that's a big one. That one to me is a bigger deal than like the dairy and the gluten, right? So for me, I'll be like, okay, let's eliminate Michelle (39:12) Mm-hmm. Samantha Briguglio (39:19) Let's reduce sugar, but I'll give them ways to reduce it. How do we make our own healthy Reese's cup at home? That's not gonna be bad. You can have a couple Reese's cup, honestly a day if you're making them out of organic dark chocolate and organic peanut butter that has only, the only thing is in it is peanuts. I'm not always worried about that then. And they'll be like, oh, okay, I'll make those. I love to cook or I love to bake, great. Michelle (39:27) Mm-hmm. Samantha Briguglio (39:49) I'm like, awesome. So like, boom, like that's already helping their sugar habits, right? Talking about pairing foods, like instead of taking away, taking away, taking away, more like add in, right? Like if they really like their smoothie in the morning that has all this stuff in it, they say smoothie is not that great and it's not good on the stomach and all of these things. I know in Chinese medicine, it's actually probably not good at all because they say you wanna start with like warm, right? Like they're like, let's, we want. Michelle (40:14) But you know, it's funny that you say that because I do tell people the 80-20 rule as well, but I do that with raw. So like if they love their smoothie, fine, but just make it like 20% and that's your 20%. You know, or if you're like, if you're having smoothies and then a ton of salads and then all this raw stuff, fine, then that starts to add up. But I say the same thing. leave it out for a little bit so that it's not freezing like frozen. Just kind of like let's do this balanced. Samantha Briguglio (40:44) Yeah, and sometimes I'll be like make it a little bit thicker. So like let's maybe add some oats or some chia seeds or some more veggies to it to add some fiber and then like maybe eat it with a spoon instead. So that's getting those like chewing mechanisms going. We're really just starting our digestive system a little bit more than just drinking something. But you can compromise. Yeah, you can compromise and just add things in. You don't have to like completely take away everything. And I think a lot of people. Michelle (41:03) Right. That's a good point. You want those enzymes. Yeah. Samantha Briguglio (41:13) or shocked by that, surprised by it, but they like also kind of love it because it's like, whoa, this is actually doable. Michelle (41:19) It feels good. It feels safer, first of all. It doesn't feel as pressure filled. And it also is, like I know from a mindset, from a subconscious mind thing, because I studied hypnotherapy, I feel like behavior and like our, what is it that stops us from changing habits? You know, like we all have habits and we repeat, Samantha Briguglio (41:23) Mm-hmm. Michelle (41:44) And one of the biggest almost like laws is that you cannot create a vacuum. And that's why it never works to just stop anything. So you have to just substitute. So I love that you said that like intuitively you're almost like realizing that about the mind. If you're giving the mind a substitute or instead of this, then have that, but it's kind of similar and then it's much easier to start a new habit that way. Samantha Briguglio (41:50) Mm-hmm. Yep. Yeah, and you just have to give people kind of a chance instead of saying like, do this, do that. You're just like, okay, let's add, or let's, yeah, like you said, substitute. So, very, I'm also very passionate about that, as you can see. Michelle (42:22) Hmm. I love that. Yes. Yeah. Well, I mean, you know, these things are important for people to Because once you have this information, you have a lot more empowerment. And I feel like people just don't have that information. everybody deserves to know that. I love this conversation. I mean, I can keep talking to you for hours, but obviously we have like a limit on time. But I definitely love picking your brain on these things. And I think that you have a really nice balance on how you look at it. So for people who do want to work with you or like learn more about you, how can they find you? Samantha Briguglio (42:52) Thanks. Yeah, well, we kind of talked about Instagram earlier. That's a very easy way. Walk the natural path on Instagram. I do have a website. It's also walk the natural path. So anything with that, your odds are you're gonna find me somewhere. So you can reach out, yeah, in DMs. Sometimes I'm a little bit slower. So sometimes I recommend filling out like a new patient form or booking a consultation call with me so you can chat a little bit about like your case and then what I can do to help or if I feel like we're a good fit. Michelle (43:16) I love it. So you help people virtually too. I just want to mention that, not just locally. Awesome. Samantha Briguglio (43:35) Yeah. Yep. Virtually too. Yes. Michelle (43:40) Also, so what was the inspiration to walk the natural path? Because I see you actually walking many natural paths and hiking, and I think that's so cool because you do a lot of like nature walks. Samantha Briguglio (43:52) Yes, oh my gosh, such a passion of mine. I honestly like I used to do like one a week for sure I need to get back to it. Since the wedding has been a little crazy. But walk the natural path actually came from the idea of creating an Instagram to help promote natural medicine before it kind of dove into this like mainstream thing, right? And I don't know, the name just like came to me, which was actually pretty crazy because I feel like I'm not the most creative person. So for that to happen, I was like, oh, this is it. And then it just kind of took off. And then when I switched the Instagram over to my business, it just, I think it just stuck and it was close to my heart. And my name is Dr. Samantha Berguglia, which is very, very long. And I was like, a lot of people just go by like. Like my bestie is like Dr. Sienna Miller. I'm like, that's so cute, that's short. And that's kind of like what her business is. And she has a different title now, but I just, I decided to go with it and it stuck. And like you said, it's part of who I am. I walked nature trails all the time. Michelle (44:51) us. Because I see you walking nature trails, which by the way, that's a whole other topic. But I think that doing that is also really good for our health. Samantha Briguglio (45:05) Yeah, in our hearts and yes, but I guess really what it's about though is it's saying like I'm walking the natural path to like healing Like at the end of the day, it's like always walking This natural path and natural though can mean anything to anybody, right? So not to get on a whole nother convo, but just to wrap it up it can mean You know the like the actual natural medicine that everyone really thinks about but it's the natural path for you So that could also be like combining Michelle (45:13) Yeah. Yeah. Samantha Briguglio (45:35) conventional IVF plus natural medicine. That can be your natural path. So it's what feels natural to you. It's kind of supposed to be interpreted, but yeah. Michelle (45:47) I love it. Well, that's a great note to end with. And this is an awesome conversation. I'm so glad we finally met. I know we were like DMing each other back and forth on Instagram for a while and following each other. And then I was like, I got to get her on the podcast. I really like the stuff that she's putting out. So thank you so much for coming on here, Dr. B. Samantha Briguglio (46:07) Aw, thanks for having me. This has been wonderful.
