Your Women’s Health Questions Answered by OBGYN Dr. Mallorie Cracroft

17:54Dr. Mallorie Cracroft:So to me, it sounds like you're very supportive of HRT as a tool in the toolbox and to feel healthy. We all have this toolbox of good food. And like I said, the controlling our stress diet exercise sleep you got it and if we're doing all those things right and still feeling off then hrt can be a supportive tool to our help absolutely yeah absolutely we always say that in menopause you can't really be in menopause i have to say in

18:22unknown host:post menopause and you don't say in the post menopausal you could say i'm in the post menopausal phase or i am post menopausal no one says that we always just say in menopause no one will fight do on it like it's fun it's just how we learn to say even though menopause is only one day it's a medical definition okay post menopause and women are like no i don't want to take hrt like i feel

18:42Dr. Mallorie Cracroft:okay i don't want to take hrt but then the other side will say but actually being really low on estrogen is harmful even for like the heart or the muscles or all sorts of things and actually i heard two ladies the other day arguing over this yeah so do all people in post menopause

18:58unknown host:need estrogen or not necessarily? This is such an important question because we don't know. We don't know this. We do have good studies supporting the use of estrogen. And here's the way that I tell my patients is there's good studies showing, for example, with the addition of estrogen, a decrease in all cause mortality. That's good. I want to die of everything less. I should add estrogen. The timeframe matters. So adding it earlier seems to have a better benefit than adding it late. And that's in terms of bone health, cardiovascular health, probably breast cancer, dementia. There's both sides.

19:34unknown host:Dementia is a really unclear space right now.

19:36Dr. Mallorie Cracroft:So maybe,

19:37unknown host:and if estrogen is helpful, then earlier is probably better. So here's where my hippie self has a little bit of a mixed opinion. So I love the idea of supporting our bodies naturally with what we do, right? Get enough sleep and eat the right nourishing foods and manage your stress. I believe in that deeply. So how does that relate then to we now believe that all women should come to me and get between two and four prescriptions that are that have a cost to them. They're not paid for by insurance frequently. They're a little expensive for some people. And now they're supposed to stay on four prescriptions throughout their whole life.

20:11unknown host:There's something that rubs me the wrong way about that. And I do it. And the data does support it. And I'm happy about it, that we have that as a tool. But I just think we have an incomplete story. I do have a belief that the better we're taking care of our bodies, the better the aging transition goes. That makes sense, right? I mean, name one part of your body that if you don't take care of it, that it does great. You know, we have to take care of our bodies. So I just like to acknowledge that there is a little bit of a disconnect. We have the holistic now and medical community saying adding exogenous hormones are the way to go.

20:46unknown host:And that is where the, what the data is showing. And it is what I do, but I also think there's so much to be said for supporting our body's natural aging processes, the best ways we know how many.

20:57Dr. Mallorie Cracroft:So maybe those two ladies I was talking about were both right in their own way. Exactly. Why do you didn't want estrogen? She has lived the most healthy lifestyle for the 40 years I've known her. Right. And so, and the other one, yeah, she's saying something, right? That women need estrogen, but there's truth to both sides.

21:14unknown host:Yes. So for example, bone health, bone health, we know benefits from estrogen, but what else benefits bone health? Adequate dietary calcium intake, adequate vitamin D, weight bearing, load bearing exercises on our bones. So when we do studies in Western medicine, we can't do a good study with multiple variables. It's science, right? Like if you have three variables. You can't study that very well. So Western medicine likes to have one variable. So they take the whole population and they say, what if we give you estrogen and we don't give you estrogen? And that's the data that we come up with. And it's no one's fault.

21:49unknown host:It's just the difficulty of science, right? But what if we took a study and we studied the hippiest people we could find? Like they've been living the healthiest lifestyles their whole lives. They live out in the woods and they grow their own food and they don't watch the news. So they're not stressed. What about those guys? Do they need estrogen? We don't know. We don't have that study. We'll never have that study. And that's why I don't, as a practitioner, I don't like to be super dogmatic. I think we should try to take care of ourselves the best ways we can for the state we're in. For some people, taking the best care of our bodies is not accessible to them.

22:24unknown host:Maybe they have to fix stuff first. But we should take the best care of our bodies we can. And then I'm really glad we have extra supports and tools, supplements, medications to help us get through life and feel the best we can. So if someone feels amazing, am I going to shove estrogen at them? No, I'm going to tell them the data we have with the limitations and let them decide for themselves. And if someone feels like trash, then I'm going to tell them the data that we have, tell them their options and let them decide for themselves, acknowledging that there are things we don't know about HRT and we're all just doing the best we can.

22:56unknown host:Love that.

22:57Dr. Mallorie Cracroft:Okay. So So one other question about HRT is you hear different things out there. Some are like, you can't take estrogen without progesterone, or you have to take testosterone with this. I mean, all these different combinations. So do we have to take certain things with other hormones or can they be done individually?

23:16unknown host:There's one given. You cannot have estrogen without progesterone because estrogen is our proliferative hormone. It's our growing hormone. It's get ready to have a baby. It makes hormones upregulate and grow bigger and bigger. Progesterone is its counterpart that says, we're good now. Settle on now. Go ahead and release, shed the lining, right? Have a period. And if you only have estrogen, this is, there should be no argument here. If you only have estrogen, proliferation goes and goes and goes until you get couples. Cancers. That's a given. You shouldn't argue with that one. Everything else. Could you have progesterone without estrogen?

23:49unknown host:Probably. Yeah. Could you have testosterone alone? Absolutely. Could you do any combination otherwise? Yeah. Okay. Talking testosterone, that's another trendy one.

23:57Dr. Mallorie Cracroft:And for women, I'm hearing a lot of women are claiming it as their cure-all to all of their problems.

24:04unknown host:What do you think of that? Yeah, I mean, we know that testosterone goes down as we age. And testosterone is actually one that we can test pretty well through a blood test. It's cheap and easy. So I like to see a testosterone on most of my patients. Because if a testosterone is super low in someone who's like 28 and I see that, that's not perimenopause. That's a sign of wear and tear in your body. That's a sign of stress and strain that your body is saying, I'm not going to contribute to hormones and testosterone. I got to survive. So that's one of the cues that I see when I have an unreasonably low testosterone that someone is struggling, whether that's inflammation or toxicity or stress.

24:43unknown host:It's something that I can point at and say, you should not have a testosterone level this low. Can I give them testosterone? Maybe. In younger folks, we don't have very much data or any real significant data on giving testosterone. So I am always going to want to support the body naturally before we do that. But we do know that it goes down through stress and strain and age. So if I have a 57 year old who says, you know what, I'm exhausted. I have no sex drive. I I've been trying to go to the gym and build muscle and I just, I'm not getting anywhere. And we test their testosterone and it's undetectable.

25:16unknown host:They're probably going to do really well with testosterone. But I will say in my practice, I would say about 70 % of women that I feel pretty strongly that testosterone is going to help them. I would say about 70 % of them do feel way better. 30 to even up to 50%, I would say don't. So it's not the cure all for everyone. And that can leave frustrated patients that are like, wait, my girlfriend's all said this was going to make me feel like a million bucks. I've taken it. I don't feel anything. Yeah. Sometimes it doesn't. Well, then those other dominoes maybe need to go back up. Yep. Okay. Are you talking testosterone cream pellets?

25:52unknown host:Yeah, I don't do a lot of pellets. I don't do pellets for the main reason that pellets overdose to start with. You get a big whopping dose and then it slowly degrades in your skin, right? You actually embed little pellets of medicine into your head and they just slowly degrade over time. I don't love the overdosing because people can have negative side effects. And once they're in there, they're in there. So I take care of a lot of people who have complications after pellets. I will do just about anything else though, a cream, a gel, a shot. Sometimes you do vaginal inserts or a vaginal cream.

26:24unknown host:So there's lots of different ways we do it. And it's nuanced. It depends on what we're trying to do and what you feel and how you feel with them.

26:30Dr. Mallorie Cracroft:So testosterone decreases as we age. So most people post menopause, well, I shouldn't say most people, but.

26:38unknown host:I will say there's a lot of wiggle room there. So I test testosterone levels on most of my patients. And I get women in their late twenties and early thirties with undetectable levels. And I get some 60 year olds who have great testosterone levels. And so I really do think testosterone can be a really good marker of stress and strain. It also does go down as you're aging. So I don't know what percentage of 80 year old women have awesome testosterone levels. It does go down as you age. Okay. So good to know. Let's take a quick break to hear from our show sponsor.

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27:50Dr. Mallorie Cracroft:Scout snacks are sweetened with things like organic dates and organic maple syrup, not refined sugars. They're soft, delicious, and easy to toss in a bag for school, practice or on the go. If you're looking for a snack that fits into real life and busy days, Scout is one I genuinely keep stocked in our pantry. You can find Scout Organic at scoutorganic.com and you can use my code JUSTINGREDIENTS for 20 % off. Simple ingredients, snacks your kids love, and one less thing to overthink.

28:21unknown host:Now back to the show.

28:25Dr. Mallorie Cracroft:all right i have so many more questions that i'm going to move on okay to the next topic let's talk i had a lot of people ask about annual screenings meaning pap smears and mammograms and

28:37unknown host:the alternative options that are out there yeah what are your thoughts on all of this it's complicated and it is nuanced the first thing that i would say is you have to understand what your risk tolerance is, what risk you're taking on yourself. So let's use mammogram as an example, because that comes up a lot, right? Mammograms are imperfect. I don't know anyone who would truthfully argue that. Mammograms find stuff that isn't anything that cause a lot of worry. It's radiation exposure a little bit, but it's still radiation exposure. And we're now saying kind of willy nilly, like make sure you get these every single year.

29:13unknown host:Now those guidelines have changed a little bit. They now say 40 to 45. They say every year or every other year, depending on your family history and your risk. But anyone who's making a decision about this needs to understand that if you're not doing mammograms, you're taking on some risk based on the data that we have. If you are doing mammograms, still a little bit of risk. And that's the hard part of science that we're in is there is no perfect way to go about it. There are other breastfeeding modalities. There's breast thermography. It has some great sides about it. It doesn't have radiation.

29:48unknown host:It's very easy. It's not as painful, but it doesn't do as good of a job at catching early cancers is what the data shows. So when people come to me and they say, I'm only doing breast thermography, I will give them the data that we have, and then I will respect their decision. But you just have to recognize that you may be taking a little bit of risk based on what we know. But I also think from the dogma of the medical community, there's a little bit of risk there with mammograms too. Just, you know, mammograms are not perfect. They're missing stuff frequently. We just don't have a perfect solution.

30:20unknown host:There's also QT imaging. That's the acoustic imaging. There's only a few centers around the United States that have this, where you lay on a table with a hole in it and your breast goes into water. The sound waves travel through the breast tissue to map out any lesions. And that's the one I'm the most excited about. But right now it's pretty expensive and really limited, but it's comfortable and very safe, no radiation.

30:41Dr. Mallorie Cracroft:so not a perfect choice out there everybody has to figure out their own risk and hopefully

30:48unknown host:science will provide something better over the years yep and we can't take away the ideas of what you're talking about is and let's do everything we can to minimize our breast cancer risk yeah right like that's alcohol and that's maintaining healthy body weight maintaining healthy blood sugar like there are things that we can be doing it's not just about i made a decision to screen and I'm, I'm, you know, I'm not going to do mammograms because those have radiation. Are you only doing that? Or are you also taking really good care of your body to decrease your risk that way? It's very different.

31:19unknown host:So I would say that when we're talking about annual screening, it's a little bit of an imperfect science. We're all doing the best we can. And if you follow the set guidelines, I think they're okay. I think they're pretty good. Mammogram, I would say, is probably one of the more controversial because of radiation exposure, but a lot of the other annual screening goes well. Now in my clinic, we do this in a way that I'm really proud of. And in a different way, we do an annual exam that includes a physical exam, but it also includes a comprehensive lab evaluation that are kind of the bread and butter for me.

31:48unknown host:So I want to see blood sugar markers every year, extensive blood sugar markers. So insurance will only pay for a hemoglobin A1C. That's a lab test that is a diabetes marker, but I want to know your fasting insulin. I want to know your triglycerides. I want to know your ratio of triglycerides to HDL, which is your good cholesterol. I want to know your fasting blood sugar. I want to know your uric acid. These are all things that help me understand how well you're fueling, how steadily you're fueling, how well your body is taking up energy. I care about that so much because that's what prevents a cancer.

32:18unknown host:So instead of only screening for the cancer, there's a set amount of lab work that I want to see on you every year. So that's part one is we do a comprehensive lab test. We also do a full conversation of what I call six pillars and the habits that go along with those six pillars. you could name these six pillars, right? Nourishment, movement, sleep, stress recovery and stress management, gut health, detox. So I wanna go through that every year with you and say, let's really talk about your food. Where is there an area that we can improve? Now, if we combine lab testing with those habits, then I can tell you, yes, you're doing pretty well, but we could do a little better and you'll get more benefit if you might feel well.

32:58unknown host:I won't say, I think patients like the idea of this type of annual exam, Let me do a physical. They like the idea of it, but it's effort. It's commitment. You have to decide that this matters to you. You have to decide that you're willing to spend the time and the money to come talk about your habits and then be open to changing them. And people sometimes think that's what they want, but they don't go through like that whole commitment process internally. And then they'll be like, nah, that's too hard. And that I get it, but it makes me a little sad because there's so much opportunity there. When we're talking about an annual wellness visit, like you want to go to the doctor every year so you can live your healthiest life possible.

33:36unknown host:It is about so much more than did you get your colonoscopy every 10 years. That takes me three seconds. Go get your colonoscopy or here's the other options. But I want to talk to you so much more about how we can help you live your healthiest life possible.

33:49Dr. Mallorie Cracroft:I love that. And a lot of doctors don't do that, but that's such a great option to think about. Like, it's just not the mammogram or the thermography. It's also the lab work of seeing your blood sugar, oops, your blood sugar

34:01unknown host:levels and you know, if you're vitamin D and your inflammatory markers, and you know, there's so many key pro or, um, there's so many key lab markers that are so valuable. That lab panel costs about a hundred dollars. I'm not talking about a thousand dollars worth of labs here, but if you go to a lot of conventionally trained doctors, insurance will pay for them. So they say, Oh no, no, no, you don't need that. Insurance said we don't need that.

34:24Dr. Mallorie Cracroft:Since when do we want insurance brokers to

34:27unknown host:decide what we don't need. Like forget about insurance. If I can give it to you at a reasonable price, then we should be doing that. Like just because insurance doesn't pay for it is not the right logic we should be using for anything. Right. Okay. So really quick pap smears then, same philosophy. Pap smear guidelines have changed. If you're low risk, you've never had an abnormal pap smear. You're in a monogamous relationship. No new exposures every five years is reasonable. I think having someone do an exam, a physical exam more often than that is a good idea. Any symptoms at all, any new sexual partner, you should have a more updated pap smears.

35:04unknown host:You know, pap smears are getting a bad rap out there on social media, though. I do. And I kind of think, I mean, this goes to my philosophy overall. And I'm proud of my philosophy because I was trained in conventional medicine. And now I'm trained in holistic, functional, integrative medicine. And so I'm really proud of the patient base that I attract, which is a lot of everyday normal people trying to get by, trying to do the best they can while holding down a job and raising kids and doing all these things and not becoming full on scientists and experts in every chemical and every little thing.

35:36unknown host:Right. Right. So my job is to manage fear in large part. And I think that we live in a toxic world and we could all make ourselves absolutely insane by trying to find every tiny thing that is bad for us. But you know what I think we should do? I think we should eat more broccoli. You know, I think we should sweat. I think we should drink a lot of water and I'm not making light of it because we do want to take good care of our bodies. But I think if we spend so much time on the friction of like, don't do that, that's dangerous. Don't do that. That's bad for you. Don't do that. Do you know, a pap smear is a plastic swab.

36:14It is a piece of plastic that I touch against your cervix.

36:18unknown host:That is it. There's no formaldehyde on it. It is a blank, it's not even sterile. It's just a piece of plastic. Interesting, because people out there are claiming differently. No, I mean, I've done. I know you've done it. Hundreds of thousands of pap smears. It is a piece of plastic I pull out of the drawer. Now I will walk you through the whole thing. I ask very gently. There's trauma involved, right? I have to, I go very slowly. I'll say, you'll feel my touch on your thigh before I touch anything. And then I touch the labia and I put a little bit of KY jelly or medical grade full of grossness gel.

36:52unknown host:I put that on a plastic or a metal speculum. The metal's been sterilized. the plastic are are clean that goes in the vagina and then i take a piece of plastic and i swab it around that is the entire cap smear so the only part of that i think you can really argue about is microplastics you know we get way more microplastics especially if you're doing it once every five years you're going to handle plastic touching your skin you know once every five years you could argue the gel and you know what you could do if you're worried about the gel you can bring your tube of coconut with you there you go and say do you mind using this instead but there is no toxic chemical that is applied from that piece of plastic good i get i get excited i get passionate well no i'm glad i should take that one off of our

37:35Dr. Mallorie Cracroft:worry list okay that is good because you know instagram people tiktok people they love to

37:42unknown host:just blow things up out of proportion because that's what gets them viewership that's true scare and fear tactics work it's true and do you know what that does is it massively dysregulates your nervous system, which is the number one worst thing you can do for your health. So instead of worrying too much, we should do what we can. We should learn. And this is, I will compliment you. This is one of the things I love about following your account and using your products is I don't have to be afraid. I just know, like I used to, I don't have to read the label because I know you did. And that's one of the ways that I can help regulate my nervous system and say, like, I cannot panic about everything that I put in my body.

38:19unknown host:I can go for a walk. I can do some breath work. I can turn off social media. And I do think our health would be better than agonizing over every tiny decision along the way. I don't think that's helping us.

38:32Dr. Mallorie Cracroft:I agree. And I think you nailed it on the spot by saying it gets engagement on people's posts and it makes people fear over unnecessary things.

38:40unknown host:Yep.

38:41Dr. Mallorie Cracroft:Okay. So moving on to a new topic, because I had a lot of people asking about pregnancy and postpartum, obviously I've got all ranges of women listening to this podcast. So let's talk about before getting pregnant. Are there specific tests or labs that people should do before trying to conceive?

38:58unknown host:Yes. And this is another thing I'm really excited about that we do in our clinic is a preconception visit. Have you ever heard of a preconception visit? No, no. Why don't we do this? Why don't we? I don't know. Data says that there's nothing really to do. So when I was in school, we learned about preconception counseling and it was about genetic testing for cystic fibrosis. I didn't get trained in anything about how to prep the body for pregnancy. And it's one of the most important things we can do. And here's why people don't think about this enough. Like, of course, it makes sense that if you are a healthy body before you conceive, you're going to be a healthier pregnant body, right?

39:34Dr. Mallorie Cracroft:Right.

39:34unknown host:Could you argue that at all? The other part of that that we think about is if you are a healthier body before you conceive and you're healthier through pregnancy, you're going to be healthier postpartum. That's a really big deal because you know what? Now you have a kid who's relying on you. And what I see so often, I get really excited. So I'm sorry if I'm bringing, you know, I'm urgent here, but I get so passionate about it because I see so many patients who come in after their third baby or their fourth baby or their fifth baby. And they say, I was fine until I had X number baby. And I've never been the same since.

40:08unknown host:And for some people, it's 10, 20 years later that they say, I've never been the same since. So just think about what's happening. You take a body that may not be in its very best state of health. You get pregnant. Pregnant takes away from our health. It does. That's just, it's wear and tear on the maternal body. And then maybe we recover some, but not all the way. And then you have another baby, which drops you further. And then you recover a little bit, but you have another baby that drops you further. And now you've got three kids. So how are you supposed to eat well? And how are you supposed to exercise?

40:37unknown host:And how on earth are we supposed to keep our stress intact? I say this as the mom and four kids. It's rough going as a mom. And the sleep is hard. So we should be doing everything we can to prepare our bodies for pregnancy. We shouldn't be waiting until we have infertility. We shouldn't be waiting until we have multiple discarriages. We shouldn't be waiting until we have a pregnancy complication or a postpartum complication. Let's do it first. And the reason I feel so excited about this is it's not that hard. It's a matter of telling people, how much protein are you eating? How many colorful fruits and vegetables are you eating?

41:13unknown host:How many nuts and seeds? How many, do they say vegetables? How much sleep? And then we do a lab panel that's very similar to what we do for the annual wellness. Although we do like a testosterone level and a couple other wellness ones. And we're saying these ones help moms be healthier and feel better. Who doesn't want that? I wish someone would have done this for me. Now, a funny story about that. I just had my fourth baby. I'm 44. It was not planned, which yes, as an OB, I should know better, but we've had infertility my entire childbearing years. So what have I done the last few years? I've taken really good care of myself.

41:49unknown host:I've worked really hard to learn how to take care of myself. And I did this preconception lab panel that I did not know was a preconception lab panel. I was just taking good care of myself and I fixed those things and ended up pregnant at 44. Wow. But it was, it was a wonderful, healthy pregnancy. And I, I, it was the hardest pregnancy. Don't get me wrong. Like it was harder at 44 than it was at 35. Sure. But I bounced back so quickly. I've now four months postpartum. I feel like a million bucks. Like I'm not just saying that I'm shocked by that. I feel so good. I can. And it took me time and I had to take steps and figure out how to get back to this point.

42:25unknown host:So it wasn't day one that I was like running and exercising. Right. But I knew what to do to get back. And that's what, that's what we should be doing. That's what's possible. We should not be in these giant slumps postpartum. And that starts with preconception.

42:38Dr. Mallorie Cracroft:That is so interesting because a lot of people do deal with postpartum. Yes. And congrats, by the way, on your baby. And I can't believe the baby's only four months and you're back to podcasting and back to your clinic.

42:51unknown host:Well, there's a, there's an argument against that. Like I should regulate my nervous system and be home more, but we're working well at balance. but yes, trying to balance. That's right.

42:59Dr. Mallorie Cracroft:All right. So a lot of people don't do, do deal with postpartum. So what are your tips and suggestions, especially those that didn't take care of their health beforehand or didn't even do these preconception labs? What advice do you give them?

43:11unknown host:There's a lot we don't understand about postpartum, but postpartum depression is what we're talking about. But one thing we do understand is that the postpartum transition is a state of depletion. You've just given up everything. You've just spent nine months, 10 months, giving everything to your baby. So one of the first things I do if I'm taking a patient who's just newly postpartum, I like to do it before then, but if I'm taking someone who's coming to me with postpartum depression, I want to know all their levels. Are you iron deficient? Are you vitamin D deficient? Are you B vitamin deficient?

43:40unknown host:What are your blood sugars doing? We have to make sure we prop you up at the very least. I also want to know about hormones. Hormones are tricky in postpartum because they do tank and they should because they can't stay at pregnancy levels forever. And some people are just sensitive to that transition. Sometimes we can nudge it up with hormone therapy. So taking hormones, there are some medications that sometimes we do get in a bind. And the most important thing is we get you feeling better. So as much as we want to do that without medications, we just have to get you to a safe place and get you feeling better because postpartum is not the best time to be like, well, are you exercising five days a week, you know, like we can't do that.

44:18unknown host:So sometimes we do have to use medications just to, I call it duct taping. And we got to duct tape you together for now. And I'll get you off of them. I will help you get off of them, but we have to keep you safe and we have to get you feeling better. And then there's some lifestyle things that are really important. Leave your home. People get in this cave mode and they don't leave their house because it's so difficult, but can you go out onto your porch? Can you just see natural daylight once a day, three times a day. Can you move your body a little bit? Even if you're not doing a routine, open up your body, get your arms swinging around.

44:51unknown host:That blood flow gets so stagnant when you breast feed a baby and I have my legs crossed, my arms crossed, and I'm breastfeeding a baby, and my whole body turns into this melty schlump and it feels so bad and so achy and everything starts to compound. So as we just move our bodies, we start to get these good endorphins going again. So we have to take all these little steps without asking too much of our minds. We have to take these little steps to support the body. And if there's anything that we as people who are not postpartum can do to support, it's bring them vegetables, colors, protein, fats.

45:26unknown host:Can we bring them really great foods so they can just get their body working? We have to recognize that the body is a machine that needs stuff. You can't expect your car to run without gas. You can't expect your body to run without fuel. So I know you're craving prepped french fries and you should eat those french fries if that's going to make you happy, but also eat the peas and the green beans and the broccoli. I love that. Okay.

45:50Dr. Mallorie Cracroft:This is another trendy thing out there that I want to ask you really quick. Have you been seeing the things out there about folic acid in the prenatal versus the

45:58unknown host:folate and that is the folic acid maybe causing postpartum issues to those that have the MTHFR gene? I've seen both sides and I honestly don't know what the answer is, except preconception testing a homocysteine level. It won't tell you whether your MTHFR gene mutation is present, but it will tell you how you're methylating. So if you have MTHFR gene mutation and you need more methylated B vitamins, your homocysteine and your B, mostly homocysteine will tell you that. So if you are on a prenatal and you get a homocysteine level and it's low, you should probably be on the methylated B vitamin. Like you should do that.

46:36unknown host:Other than that, we don't know because you can make the same argument that the studies show that folic acid is what prevents neural tube defects, not folate. That doesn't make very much sense to me, but that's what the data shows. So I think at fair minimum, test your homocysteine before pregnancy. Understand that you're methylating. you've got the right B vitamins before it's the best we can do right now.

46:58Dr. Mallorie Cracroft:I'm going to ask you one other thing that a lot of people ask about, and that is newborn care. So these moms are so worried about newborn care, meaning in the hospital, like the delayed court clamping, the vitamin K, the first bath, all these things to the point that I'm like, Oh my gosh, I'm glad I'm done with having six kids. They're confused out there.

47:18unknown host:So what do you say to that? I would say the very best newborn care that you can give your baby is to love that baby and to be a safe place for your baby. That's going to make me cry. It's your job to be the safe place for your baby, number one. And so it depends on where you're at. If trying to make these decisions is causing you to panic and shut down and have depression and anxiety, you got to do something different. So rely on someone else to make the decisions or just let some of those go because you need to be the safe energy. I, this is again, my hippie side coming out. Our babies feel us that I know it.

47:53unknown host:They feel our energy. They feel our vibration. They feel our vibe and you get to snuggle that baby. It's the very best thing you can do. So if you can't decide whether to get vitamin K or not to get vitamin K, snuggle that baby, right? Like you can do that. So my perfect game plan and what I have done with my children is number one, can you get that skin to skin right away? The more you can get that baby onto you, the better. Delayed cord clamping, absolutely. If your baby's not doing well, then you got to make an exception and the baby needs the support they get. But the more that you can be calm and slow your breathing and be a state of safety during labor, the less you're going to be in a state of fight or flight.

48:31unknown host:And I do think it has outcomes on how your baby comes out. So the more you can be in a state of safety, the more you can get that baby skin to skin. Delayed cord clamping, sure, but don't lose sleep over it if that's not in the cards for you. Most doctors are pretty good about that now. And then keep that baby on you as much as you can manage. Don't panic if they need to take the baby for safety, but as much as you can, keep that baby on you. Dad can hold the baby later. That baby needs mom. Getting the baby in a position where they can look at you, keep your breast exposed to them. Don't worry about getting it in their mouth.

49:03unknown host:Just keep their mouth right next to your breast. Just you looking at them, talking them, rubbing them, snuggling them. It is the very most important thing you can do. More than the vitamin K, more than the cord clanded. You just snuggle them, look at them, touch them, let them be near your breast. And then you get them to the breast when you can. And then from there, I think it gets a little more complicated. I don't like to bathe them right away. And most hospitals don't do that anymore and don't need to do that. So if you have a say in it and you can voice that, like don't bathe the baby, they don't need to be bathe and it's good for them.

49:32unknown host:So I like to leave cord clanding. Now I'm a doctor. I see complications. I like the vitamin K. I know I'll get pushback from the holistic community but if you've ever seen a cranial bleed on a baby you want that vitamin k on board and you don't know until you don't until it's a problem so i say vitamin k erythromycin ointment is for chlamydia and gonorrhea um eye infection that can cause blindness so people will say like i know a thousand percent that i do not have chlamydia i don't know make your make your decision i i did not have chlamydia and i said i don't even want to think about it just just do it and I'll wipe it off later.

50:09unknown host:And I don't think it's that big of a deal that we need to be worrying about it really one way or the other is blindness. And that's as doctors, we say, let's not do blindness, right? So we're always going to say, let's be on the safe side and just do the ointment. But if you really feel passionate and you know, a thousand percent sure, then I don't think it's the biggest deal to skip.

50:30Dr. Mallorie Cracroft:Well, and I've heard you say something before, which I like you were

50:33unknown host:saying like, don't sweat the small stuff with low toxins, like worry about the bigger decisions, right? Exactly. And that's where, when you get your baby home, don't slather them with a bunch of weird lotions. Don't have plugins in your house. You know, don't put a bunch of stuff on the baby. Watch your laundry detergent. I think those are far bigger decisions for the baby than the one time tiny little thing. You know, now a one time big thing is a different conversation, but a one-time tiny thing you gotta protect your nervous system you gotta just embrace that baby and be there for your baby it's so much more fun well thank you so much for being here my listeners

51:10Dr. Mallorie Cracroft:are gonna be like wait you didn't ask my question because there's still so many questions but thank you for answering all the questions that you did sure um you are amazing doctor i wish thank you so many more were like you that looked at the functional medicine side of things more and more people are asking questions, wanting to know the root cause of their issues. And so it is coming. We always end the podcast by asking five fire rapid questions. And so here's the first one. What emerging health topic excites you the most?

51:39unknown host:MCAS probably. MCAS. But so many of them, but that's probably the big one. Tell me really quick what that is. Mass cell activation syndrome is an immune system overaction that causes the body to freak out about every little thing. So you get patients who are tired and they get rashes and they have period problems and they have gut problems and they have brain problems. And they're like, why am I so unlucky that I get all of these problems? You don't have all those problems. You have one problem. You have one thing. And especially in the gynecology world, it's really starting to tie some pieces together, like chronic vaginal pain and painful periods and ovulation issues and mental health issues around the cycle.

52:17unknown host:So many of them are all tangled up in histamine and massive cells.

52:21Dr. Mallorie Cracroft:We have help. Once we identify that, we can help. But there's it's starting to get a little more data. Interesting.

52:27unknown host:OK, number two, what is a piece of advice you'd give to your younger self? Oh, I so wish I wish I would have had someone to tell me what I know now when I was younger, because I spent years not feeling well. I was exhausted my entire life. I'm 45 now and I feel so good. and I think like what could I have done if I felt this good always right so I do that to my younger self and I would give that now and people don't wait feel good love that hey number three what's

52:59Dr. Mallorie Cracroft:the one health practice you'll never compromise on no matter how busy life gets I'll be honest

53:04unknown host:life has gotten busy and I've compromised on all of them at some point so I'll be honest and I think that's important to say, they're all going to be in flows. You got to have your toolkit and what works for you. So what I do know is when I struggle, I know exactly what tools I'm pulling out and that's nervous system regulation, either prayer or grounding or nature that sleep, that's movement, that's vegetables and protein. Love that. Okay. What's your favorite just ingredients product and why? I am a big just ingredients fan and have been for years. So I could go through the list, but the newest one is the bone broth protein.

53:39unknown host:All right.

53:40Dr. Mallorie Cracroft:Last one. What is the best

53:41unknown host:ingredient you've found to life? Oh, I will say right now release. Like I am in such a personal state of growth and such an exciting state for me of self-discovery and recognizing what I don't mean anymore. And it is so exciting to say, I don't need to hold onto that coping strategy that was keeping me safe from, you know, 15 years ago, but now it's just doing me hard. Like the more I can shed that and just step into like abundance and love and warmth and light is, I am just like on a high of stepping into that version of life instead of this constricted, constrained, you know, version. I just want to release it all.

54:28unknown host:Whatever's not serving me, it can go away. I don't need it anymore.

54:31Dr. Mallorie Cracroft:You know, I have done over 200 episodes and no one has ever said release. I love that thought though. Yeah. I am really going to just ponder on that today. I really like that. I love it. Yeah. Well, tell everybody where they can find you because people are going to want to learn from you and your podcast is amazing. Women, if you need a podcast or want a podcast to learn more from hers is amazing. So tell them where they can find you.

54:57unknown host:well our company is uplift for her and we the podcast is the same name the clinic is the same name the clinic is local in salt lake and we have a few practitioners we have a health coach we have a dietician we have a therapist and we have lots of people that can help in a lot of different ways so right now the in-person is our health care practitioners but our health coach and dietician are not just in person they can be virtual awesome thank you again for being here you

55:22Dr. Mallorie Cracroft:just are incredible thank you so much it's been such a pleasure Thank you for being here and being part of this community. Don't forget to subscribe to the Just Ingredients podcast. We've got so much more to share with you. And if you're not already, come join us daily on all social media platforms at just.ingredients. Until next time, keep choosing what nourishes you.