Before pregnancy even starts, there's a window that quietly shapes a lot of what comes next, and most of us never hear about it. This episode is part of the Trimester 0 preconception podcast festival, and I'm sitting down with Kelly Moline, PharmD, the pharmacist and functional medicine practitioner behind the Moline Method. We get into how she combines her knowledge as a pharmacist with her functional medicine expertise, what actually matters about folate timing, how gut health and thyroid function connect, whether all that lab testing is really necessary, and what her patients almost always assume is fine when it isn't. If you're even thinking about trying in the next year, or just curious about the science, this one's for you.

If you like the conversations we have here, and your curiosity does not stop at wellness, come join the Mavens. The Smart Girl Newspaper is my free weekly newsletter for women who want to truly understand the things they are curious about, from their health to the wider world. New issue every week, link in the show notes.

Links:

Moline Method Website: https://molinemethod.com/

Functional Medicine for Moms (Spotify): https://open.spotify.com/show/2xfnGf8367wtHEuXp4BJQs?si=73e3c9c627ef490d

Functional Medicine for Moms (Apple): https://podcasts.apple.com/us/podcast/functional-medicine-for-moms-first-time-parents-navigating/id1821035310

Kelly’s Instagram: https://www.instagram.com/functionalmedicineformoms

Preparing for Pregnancy Guide: https://molinemethod.com/fertility

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And so if we constantly are under fight

or flight, our body's saying, "We don't

2

need to reproduce right now," right?

3

"We're fighting for our lives.

4

We're running from a tiger.

5

I don't know what you're doing."

6

So we are not gonna do that.

7

We're not going to make a baby.

8

That does not sound safe.

9

Let's not forget about your partner.

10

They are half the equation 'cause I

have so many women doing all of these

11

things to get their body ready for

pregnancy and to optimize everything,

12

and then their husband is like, "I don't

think I need to do anything," you know?

13

Like, "I'm just here for a

day," and then that's it.

14

But they need to be

optimizing everything, too.

15

Kelsy: So in this trimester zero

preconception phase, what is one

16

of the things that many women think

is normal that you often flag?

17

. Dr. Kelly Moline, PharmD:

18

So a lot of the time many women

think that their, , period symptoms

19

may be normal, whether that is heavy

periods or irregular periods or a

20

lot of blood or very little period.

21

So even when they come in and

they're like, "Yeah, it's great.

22

My period lasts a day," that's something

that I wanna flag because that means

23

we're likely not getting that hormone

cascade that we should be getting.

24

And then I see a lot of the

digestive symptoms as well.

25

And gut health always

relates to hormone health.

26

It's how we are detoxing our hormones.

27

So if we also have a lot of gut

issues or even simple things like

28

fatigue or anxious feeling or not

sleeping at night, all of those

29

things are reasons I wanna dig deeper

30

Kelsy: I've always been curious,

how can you tell what is normal

31

when it comes to menstrual flow?

32

Dr. Kelly Moline, PharmD:

33

I think there's a little bit

of range with normal as well.

34

But I like to have that usually

four to six days is gonna be more

35

normal, and not the super heavy,

big clots, that type of thing.

36

I want that to be manageable.

37

We're not bleeding through pads

or tampons within an hour or two.

38

And yeah, it shouldn't wreck your life.

39

And even those PMS symptoms of the

week before, and you're getting very

40

irritable, and you're having maybe

headaches or other symptoms like that,

41

we want to address that as well, because

there's other underlying things going on.

42

And the more we can correct, the

better chance that we have for

43

conceiving, but then also having

a healthy pregnancy and healthy

44

postpartum delivery, baby, all of that

45

Kelsy: So some of these symptoms

you're mentioning, fatigue,

46

headaches, I feel like those can

be very subjective and broad.

47

But you're saying - you see those

as indications that there might be a

48

deeper issue that affects that sort

of hormonal song and dance, I call it.

49

Like hormonal balance I feel like is

relative, but those expected hormonal

50

fluctuations that we experience,

those things like a headache, like

51

fatigue, like menstrual flow, all of

those can indicate deeper issues going

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on that might affect our fertility?

53

Dr. Kelly Moline, PharmD:

54

Yeah.

55

So all of those symptoms are, signs

and symptoms are really just how

56

your body is telling you something.

57

So we need to be able to listen to those

and identify why they're happening.

58

And so that's all root cause medicine

is identifying why something's

59

happening so that we can address

that so it stops happening like that,

60

because we need to listen to our body.

61

Rather than what a lot of

my pharmacy degree taught me

62

was, "Oh, you have a headache?

63

We can treat that with a pill.

64

Oh, you're having fatigue?

65

Let's get some coffee in there," right?

66

We need to see what's going on,

and then we can, uncover the root

67

cause and optimize from there.

68

Kelsy: In pelvic floor PT, the joke for

us is that a lot of physicians and other

69

healthcare practitioners will say, "Oh,

your pelvic floor is super contracted?

70

Drink some wine.

71

Oh, you're having pain with sex?

72

Drink some wine."

73

So it's the unauthorized prescription

of alcohol to help with relaxation.

74

Very similar to what you were

saying for pharmacy, but maybe

75

in a slightly less regulated way.

76

So speaking of pharmacy, you

started out as a pharmacist.

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What was that impetus for going

from pharmacy to becoming a

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functional medicine practitioner?

79

Why did you feel called to

transition to this more sort of root

80

cause holistic form of medicine?

81

Dr. Kelly Moline, PharmD:

82

Yeah, that's a great question.

83

So I am still practicing as a pharmacist

as well, so I'm working part-time at an

84

independent, in a compounding lab where

I work a lot with hormone replacement

85

therapy and that type of stuff too.

86

, But When I graduated pharmacy school, I

went on to do my residency, and that's

87

what brought me here down in Texas.

88

And I was kind of all over the place

that year from teaching at the college,

89

, working retail at the independent

pharmacy, and working in ambulatory

90

care, so working with a lot of chronic

disease from diabetes, , smoking

91

cessation, lipids, blood pressure, all

of that, working closely with providers.

92

And then at the independent pharmacy,

they also wanted me to start a

93

weight loss program where it was

a lot of diet education, not like

94

the GLP-1s that we think of today.

95

That was not taking place yet.

96

So I was doing a lot of that,

but there were also a lot of

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women who were doing everything,

quote-unquote, but not losing weight.

98

And so I wanted to understand why,

and especially the women, that

99

it was happening to the most was

around those transitional periods,

100

so perimenopause and menopause.

101

So that led me into digging more into

hormones and gut health and detox.

102

And then also on the retail side, I

saw people on more and more and more

103

medications, but not feeling better.

104

You know, they come to the pharmacy, and

now we have a new symptom, whether that is

105

from life or from a previous medication.

106

And what do we do about it?

107

We give them another medication.

108

And so it really felt like

this never-ending cascade,

109

and you know, my passion is to

understand why that's happening.

110

And so I just kept asking

more and more questions.

111

I ended up finding a functional

medicine course, and so I got certified

112

in functional medicine throughout

that process too, and then I brought

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functional medicine to the pharmacy.

114

And so that was really fun.

115

And then when I got pregnant with my

first baby, I decided to bring that

116

independently so that I could also have

more flexibility with being a mom and

117

then have more say with that kind of stuff

too and lean into different directions.

118

But yeah, that's kinda why I transitioned,

and now I'm in the compounding lab in that

119

same pharmacy, but I really love it 'cause

I think it goes hand in hand with a lot

120

of what I do with functional medicine too.

121

But I see both sides, that hormone

replacement therapy, the thyroid, even

122

GLP-1s and how those can be used as tools,

but not always the answer as well and how

123

we still need to work on things like gut

health, detox, nervous system regulation,

124

cortisol balance, all of that too.

125

Kelsy: And it's nice because I feel

like you're one of the few that has

126

that expertise from both, where you're

able to not view an issue or a challenge

127

from one lens, but you're able to

pull from both for whatever patient's

128

in front of you, whether you're at

the compounding pharmacy or whether

129

you're in your own private practice.

130

So I feel like having that multifactorial

view, that multi-expertise lens to look

131

at a problem through is always beneficial

132

Dr. Kelly Moline, PharmD:

133

Yeah, I think sometimes both sides,

whether that is like the Western

134

medicine versus the Eastern medicine

and the more, , natural medicine kinda

135

demonize each other because there's a

lot they don't know about each other.

136

Where I've heard a lot of people

in this holistic world just say,

137

you know, "Medications are bad.

138

We don't want them," and they don't know

a lot about them, so they must be bad.

139

And I, I see their effects and what

they're intended for use, but are also

140

can be a lot of side effects and risks

that come with medication, and I think

141

that should be part of the conversation,

and sometimes they are used for a tool.

142

And I always try to say if we can do

shortest duration for lowest dose,

143

and then, figure out the root cause,

that would be the best approach if

144

that needs to be part of the equation.

145

But then on the flip side, I

see a lot of Western medicine

146

practitioners, demonize holistic

medicine and say, "That's just bogus.

147

There's no science behind it,"

which is absolutely false.

148

There is a lot of science behind it.

149

There's a lot of history behind it.

150

And then if you talk to a lot of people

who have had really good functional

151

medicine providers, they'll say

their experience with it and how they

152

really did feel better in it, too

153

Kelsy: It's one of the reasons I love

being a physical therapist, 'cause I do

154

feel like we get the traditional Western

medicine education, but we ride this line

155

between Western and Eastern, and I love…

156

I've had a few traditional Chinese

medicine practitioners on the

157

podcast, and a wealth of knowledge,

and a lot of the things that they've

158

been practicing for, you know,

centuries, research is catching up to.

159

So I do feel

160

Dr. Kelly Moline, PharmD:

161

Yeah

162

Kelsy: This nice, puzzle, this link

between the two, and when you're able

163

to combine that and when you're able

to ride that line and get expertise

164

from both and view things from both

areas, and not just Western and

165

Eastern, but more like holistic

versus a little bit more medicalized

166

part of treating the whole person.

167

I feel like it's such a wonderful

opportunity to help someone

168

in the best way possible.

169

So speaking of your background

as a pharmacist and now as a

170

functional medicine practitioner,

you founded the Molling Method.

171

So talk to us a little bit about that and

specifically a few of the pillars that you

172

look at when treating someone who is in

this trimester zero preconception phase.

173

. Dr. Kelly Moline, PharmD:

174

So Moline Method is

really my method, right?

175

It's my name.

176

But a lot of it comes from my

functional medicine training, but then

177

also my pharmacy background as well.

178

And kinda to your point earlier,

when someone comes in, they're not

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usually starting from ground zero,

zero supplements, zero medications.

180

They usually have maybe a couple

medications on board, or they've

181

tried different supplements.

182

And I've seen so many practitioners

on both sides say, "I don't know what

183

that is, so you can just stop it."

184

Or, you know, like, I can come in and

say, "Okay, this medication, yes, it

185

can be solving this issue or addressing

this issue, but it's also causing

186

these other effects, or we're having

nutrient depletion from it, so we

187

also need to have, uh, more nutrient

balance," whether that is replacing the

188

vitamin B12 or whatever the medication

is depleting, we can help do that.

189

And then with the supplements too, I

can look at it and say, " Okay, this

190

can be a good supplement, or it can be

not a good quality supplement based on

191

the form it is or whether or not they do

testing, what the pharmaceutical grade is.

192

And so we can get to a

better stance on that.

193

So I really do like to analyze people case

by case and what they're coming in with.

194

I And by that I mean, like,

their symptoms and stuff too,

195

and any labs they may bring in.

196

And if we don't have labs,

we can get simple labs.

197

I have on my website some basic

foundational labs, and I have three

198

different price points if or not we want

to include more hormones in that as well

199

along with semen analysis for our males.

200

And then I have my preparing

for pregnancy guide too.

201

So those are things that I would

really love people to start with

202

in trimester zero to get prepared.

203

And then if you need functional testing,

that is where we can really work

204

one-on-one because we've identified

red flags from the labs before or, your

205

doctor has, or you're having more symptoms

like what we talked about earlier, or

206

having digestive symptoms and you wanna

look into gut health, male and female as

207

well, , because both is gonna impact their

fertility and the health of the baby.

208

So we want to look at it

from all points if possible.

209

And so, I always go by what are

our symptoms, what do we wanna

210

do functionally, and then what

do we have the means for and

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what do we have the time for?

212

If we have the time f- to detox

and that kind of stuff, and if

213

that's needed, then we'll do that.

214

If we don't have the time because we're

trying to conceive, like, yesterday, then

215

we're not gonna do a full detox because

that's not gonna be safe in trying to

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conceive or even up to three months

trying to conceive because the egg itself

217

and the semen itself is being created,

, 90 days prior to it being released.

218

So we want the healthiest

baby on all aspects.

219

So I really do take that case

by case, and that's one benefit

220

of working directly with me.

221

But I know that not everyone

needs the expense of functional

222

testing, and so that's why I offer

things on my website as well.

223

Because when I was trying for this

pregnancy and I was looking into

224

ordering all of these functional

tests for me and my husband, and

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we didn't have any issues, right?

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And we already have a healthy baby at

home, and I'm like, "Okay, do I wanna

227

spend this much money on all of these

tests even though I know it's important,

228

but I'm not having any symptoms?"

229

And you know, we are also trying

to save some money here and there.

230

Um, so what can we do that makes sense

that we can still get really good

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information from and make , items to do?

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So I created, some simple blood work that

is honestly even more affordable a lot of

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the time than asking your doctor for them.

234

'Cause I got some blood

work even from my midwives.

235

I'm like, "Okay, let's add this on."

236

I'm like, "Why is it that expensive?"

237

or It's more affordable on my website,

so that was, like, a plus of adding

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it there especially for I think a lot

of people are really optimistic when

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they're gonna start trying to conceive.

240

They're like, "Oh,

we're, yeah, we're fine.

241

We're, we don't have anything going on."

242

So this is just a great way of seeing if

that's true or do we need to dig deeper?

243

Kelsy: I love that you mentioned

your personal experience too.

244

As someone who is a functional

medicine practitioner realizing,

245

okay, not everyone is appropriate

for maybe that level of expertise.

246

Especially like you said, if you're

relatively confident in how your body

247

functions, you've had a successful

pregnancy before, maybe someone just wants

248

a little bit of guidance and specific

labs and not necessarily that one-on-one.

249

So I love that you mentioned that

250

Dr. Kelly Moline, PharmD:

251

Yeah

252

I also pair it with my Preparing for

Pregnancy guide, because I wanted

253

to put labs in there in the guide

of these, this is the standard range

254

that, you know, Western medicine

or your typical practitioner might

255

be looking at, that is like, this

would be indicated of medication,

256

or this is indicative of disease.

257

But we're not waiting for disease to

do something about it, so we're going

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to do something to try to optimize it.

259

So I also include the optimal range

for fertility in all the markers and,

260

or most of the markers that I include

in my guide, 'cause it can get long.

261

But then I say what the optimal

range is, and then lifestyle

262

recommendations and diet

recommendations to help you get there.

263

Because yes, of course, we can work

one-on-one to optimize your vitamin

264

D level, but I don't think people are

dumb, and people can like figure out

265

that they can just take more vitamin D.

266

And if we can get that low-hanging fruit

by doing it a little bit DIY, then I want

267

more people to have access to that too

268

Kelsy: I love it.

269

I also wanted to ask you, you

mentioned if people have time, you

270

might recommend some sort of detox.

271

Dr. Kelly Moline, PharmD:

272

Mm-hmm.

273

Kelsy: That process look like

and who would that be for?

274

What might they come to

you with symptoms of?

275

Dr. Kelly Moline, PharmD:

276

Yeah.

277

So I look at organic acid testing in some

of the tests that I offer, and so I can

278

see how your body is handling toxins.

279

And it tests for toxins that are

in our day-to-day, so it's not

280

necessarily saying stay away from

these specific toxins, which if we can

281

stay away from toxins, we wanna do.

282

But we live in this world, so

we want our body to be able to

283

process those efficiently, and

sometimes it's not doing that well.

284

And the toxins tend to stay in our fat

tissues, and that can go towards our

285

brain, it can go just in our fat, and then

it can also go to a baby or it can go to,

286

the egg or the sperm and damage the DNA.

287

And symptoms can look all over the board.

288

So it can be headaches.

289

It can be we're not losing fat, and

we have a trouble with weight loss.

290

It can be hormonal issues.

291

It can be we've been on a lot

of medications, and our liver

292

has had to process all of these

or even a lot of supplements.

293

And it can be even, like, gut pathogen

killing through a protocol, which gets

294

you to the other side so much better

for your gut health, but that's also

295

a lot that the liver has to handle.

296

It can be the cortisol cascade

if we have really high cortisol.

297

Like, all of that goes through the

liver, and the liver does a really

298

good job, but it does slow down

over time, and it does clog up.

299

And so when it slows down, it

just keeps the toxins in our

300

body, and that's not what we want.

301

But we also don't wanna detox when we're

trying to conceive, when we're pregnant,

302

or when we're breastfeeding because

when we're detoxing, we're pulling

303

those toxins out of the tissues and

mobilizing them, and that's where they

304

can go cross through the pl- placenta.

305

That's when they can get to the embryo.

306

That's when we can get to the brain.

307

That's when we can get through

the breast milk and toxins can

308

end up where we don't want them.

309

So timing of that is very important

as well and working with, hopefully,

310

a healthcare practitioner to help that

protocol and help you respond well 'cause

311

if you're doing a detox at a not a great

time, you could also feel really crappy

312

from a detox, so we wanna avoid that too.

313

Kelsy: And you mentioned if someone has

enough time, what might that timeline look

314

like for someone who is in trimester zero

and they're like, " I'm really flexible

315

on when I want to try and conceive.

316

I notice that I might have some of these

conditions that might need a detox."

317

How long will that usually take?

318

And I'm sure there's a range.

319

Dr. Kelly Moline, PharmD:

320

Yeah, definitely a range.

321

Depends where we lie.

322

I like to do, like a supplement

that has a week protocol with it,

323

and that's works really well for

a lot of people to kickstart it.

324

And if we need a little bit more, then

I like to add liver toning supplements

325

for about two months after that.

326

So it depends where we are,

but I like to finish at least

327

three months prior to conception

328

Kelsy: Okay, I love that.

329

And I love the explanation of

detox because detox is such a hot

330

topic that it's nice to better

understand the science behind what's

331

actually happening during a detox.

332

We talk about liver detox, we

talk about just detox is such a

333

hot item word and clickbaity word

334

Dr. Kelly Moline, PharmD:

335

Uhum

336

Kelsy: it really helps to understand

how you approach it from a more

337

medical and scientific lens.

338

Dr. Kelly Moline, PharmD:

339

Yeah, we're not talking

about the juice cleanse.

340

That's completely different.

341

Kelsy: Good point.

342

I'm glad you mentioned the juice

cleanse, 'cause I do feel like

343

people will be like, "Oh, detox."

344

That's why I wanted, even for

my own curiosity, like what

345

does that actually look like?

346

You mentioned a lot about gut health.

347

I want to out some more hot topic phrases

and I guess systems of the body, and

348

I want you to run through how you view

them from a functional medicine lens.

349

So we'll start with gut health, which

we've already covered a little bit,

350

but also nervous system and hormones.

351

Are those three related at all?

352

And what are some of the broad ways that

you look at some of those like hot phrases

353

when we talk about health and wellness?

354

Dr. Kelly Moline, PharmD:

355

Yeah, great question.

356

So when I was digging into functional

medicine before I found my course

357

or anything, I'm like, "Let me just

get into thyroid," or, "Let me just

358

get into gut health or cortisol."

359

And then I'm like, "I can't just

get into one because they're

360

all related to each other."

361

So backing up, I think everyone knows

that to conceive, we have to have

362

hormone balance of some sort, right?

363

Hormones have to be working, and that's

gonna relate to gut health because

364

your hormones, how they get excreted

from the body is through the gut.

365

So if the gut is backed up, if it's

inflamed, if it's not absorbing

366

nutrients properly, that's not

gonna happen efficiently, and then

367

we can have a hormone imbalance.

368

For example, estrogen gets cleared

through the gut, and if we have

369

constipation or other gut issues,

we're gonna have estrogen dominance,

370

which means more estrogen compared

to progesterone, and that is not a

371

good look for fertility or symptoms.

372

And you might have more of the anxiety,

the rage, the bloating, the headaches.

373

So we want to correct

that for our hormones.

374

And then nervous system regulation, in

my world, that means cortisol balance.

375

And cortisol is our stress

hormone, and we need that.

376

That's made from our adrenal glands, and

we want that to rise in the morning and

377

fall throughout the day and be low by

bedtime so you get good quality sleep.

378

But when we're stressed and we're under

fight or flight, then cortisol gets high,

379

and that's a normal, healthy response.

380

We want that to happen, absolutely.

381

And other things are

happening when that happens.

382

So it's pulling resources

from the rest of our body.

383

It's pulling glycine, which is an amino

acid in the gut, to make quick energy.

384

But constantly pulling that is gonna

then cause leaky gut as well, um,

385

which is holes within the gut lining

that can cause more inflammation, more

386

prone to food sensitivities your immune

system's gonna be lower, all of that.

387

So they're all related and we

want to have cortisol balance.

388

We don't want it too high or too low.

389

When our body's constantly pushing

out that cortisol and pushing out

390

those stress hormones, then eventually

it's gonna down-regulate that to

391

protect itself, and then we're

dragging throughout the whole day.

392

And then we have a flat cortisol line,

which is also not what we want, and then

393

we might have trouble sleeping at night.

394

So we want to help regulate

that, correct that rhythm.

395

That can help correct the, the

different hormones, estrogen and

396

progesterone, because when we have a

lot of cortisol, that's gonna steal

397

a pre-component to make progesterone

called- Pregnenolone, it's a precursor

398

so that we have that pregnenolone steal.

399

And so if we constantly are under fight

or flight, our body's saying, "We don't

400

need to reproduce right now," right?

401

We're fighting for our lives.

402

We're running from a tiger.

403

I don't know what you're doing.

404

so we are not gonna do that.

405

We're not going to make a baby.

406

That does not sound safe.

407

So we need to have our nervous system

regulated, whether that is cortisol

408

balance, whether that is the deep

breathing, that's gonna help for sure.

409

If it's chiropractic help getting

outside, like all of those things, right?

410

I'm not saying supplements and

medications are for the answer for

411

everything because part of what I do is

I bring in all aspects of health, and

412

we need to have lifestyle and nutrition

there, and that should be really 80%

413

of what you're doing so that we can

eventually take away the supplements

414

and live that healthy lifestyle as well

415

Kelsy: That is a perfect explanation of

sort of the link, and I know that is so

416

much broader than that, and you do such

a good job of simplifying it for me as

417

the lay understanding, lay understander

of this education and this complexity

418

that's within the whole human body.

419

in functional medicine, the

thyroid is also a huge component.

420

Can you talk a little bit

about the thyroid, what role it

421

plays in our bodies, and how it

affects how we feel and function?

422

Dr. Kelly Moline, PharmD:

423

So the thyroid is actually a gland that

sits the base of your neck right here.

424

It looks kinda like a butterfly, and

it's our thermostat, it's our ultimate

425

regulator in our body, and it's

constantly assessing how we're doing.

426

And for the thyroid to work properly,

we need to be in that rest, digest,

427

recovery, , state, where when we have

that fight or flight state where our

428

cortisol is going up and you're f- flying

from the tiger, whatever then it's always

429

gonna down regulate the thyroid, always.

430

And so I have a lot of people

that are on thyroid medication.

431

Working in a pharmacy, that's our

top prescribed medication by far.

432

So the thyroid medication is being

prescribed a lot because people

433

are looking at thyroid testing,

typically just a TSH, which is

434

thyroid-stimulating hormone, to see

how loud the body is telling the

435

thyroid to make more thyroid hormone.

436

And if it's really, like, yelling loud,

we're like, "Oh, the thyroid must not

437

be listening 'cause it's not working,

so we should give it thyroid hormone

438

replacement," AKA levothyroxine or

something like that, and th- because

439

it's not working, so that's our solution.

440

Which really it may just be not

working and it's not listening, not

441

because it can't work, but because

it's working on everything else in

442

the body just to try to stay alive.

443

So it has that cortisol cascade

like we talk about, and it's down

444

regulating our metabolism, so

you might feel the weight gain.

445

You might feel cold, tired.

446

Those are all symptoms of,

like, low thyroid production

447

or low thyroid, efficiency.

448

And so we want to help the body get

into that rest, digest, recovery

449

nervous system regulation first.

450

And then a lot of times

the thyroid can pick up.

451

Sometimes we need to give it

some of those building blocks

452

to make the thyroid hormone.

453

Sometimes we need to work on the cellular

level where the thyroid hormone is

454

being converted to the active version,

so it can actually work on the cells.

455

So there's a lot of different

pieces that can work together

456

to get the thyroid working.

457

But it is one of those things that I

think needs to be checked for, especially

458

when we're talking about fertility,

because it's a great indicator on where

459

the body is and it doesn't always mean,

oh, we just need thyroid replacement

460

hormone or l- levothyroxine, but there

could be other things going on, other

461

inflammation going on that can help.

462

And just because TSH may be normal

and I have an optimal range but I also

463

like to dig deeper into the thyroid

and look at those, , single thyroid

464

hormones T3, T4, reverse T3, free, um,

all of those things, antibodies to the

465

thyroid to see what else is it doing

rather than just looking at TSH too

466

Kelsy: It sounds like with all

of this, the nervous system is

467

a good place to start, a good

sort of action item to tackle.

468

It's all integrated, and it's all

intertwined, which I feel like is

469

one of the reasons it's nice to

have someone walk you through this.

470

But there any that you would recommend

in regards to nervous system regulation

471

or maybe not even regulation, just

like helping the nervous system to

472

be able to get from that fight or

flight response to that rest, digest

473

part of the whole nervous system?

474

Dr. Kelly Moline, PharmD:

475

So try to figure out why it's happening.

476

Okay?

477

So rather than our nervous system is

off, so now we need this supplement or

478

this medication or this to do, if we can

back up and figure out why our nervous

479

system is off, that can be really helpful.

480

Is that stress that we can

remove from our day-to-day?

481

But sometimes it's not.

482

Sometimes it's a stressful job

and we can't just leave our job.

483

We have a family to provide

for or something like that.

484

But sometimes we can remove certain

stressors whether that is emotional

485

stress or could be physical stress

going on, whether that is pain or it

486

could be like a gut pathogen going on.

487

It could be toxins going on.

488

So I deal with a lot of the

chemical side, but there's also…

489

There's so many different types

of stressors, so if we can

490

figure out why that is happening.

491

So for example, like I have people

that are like, "I think I'm fine,"

492

but then we dig into their gut health.

493

I'm like, "Oh girl, you have a lot

of pathogens, and that's causing

494

stress on the body and inflammation."

495

So that's something

that we'd wanna address.

496

But we can also help by doing the other

things like the deep breathing, like the

497

prayer meditation like the eating better,

not having those blood sugar spikes

498

all the time 'cause that's gonna cause

inflammation and that's hard on the body.

499

So if we can eat more whole foods

and reducing like those processed

500

simple sugars and that type of thing.

501

If we can get out in nature.

502

If we can get sunlight in the morning,

'cause that's gonna help reset the

503

circadian rhythm or your sleep-wake cycle.

504

And then have dim lights

and dark at bedtime.

505

So there's a lot of lifestyle things that

we can add to help reduce the stress.

506

But if we can also see what may

be causing it, and you may know

507

what's causing your stress.

508

And sometimes writing it down and

figuring out like, "What can I control

509

and what can't I control, and is this

really a priority to stress about?"

510

and maybe just like leave

it there on the paper.

511

But yeah, Those would

be my recommendations.

512

Kelsy: Do you have a favorite

sort of breathing pattern

513

that you recommend for people?

514

Is there a count or something that

you like to do with your patients

515

that you find extremely helpful?

516

Dr. Kelly Moline, PharmD:

517

So I originally was taught boxed

breathing, but then now I like

518

a four-six-eight breathing.

519

So having the longer exhalation versus

inhalation puts your body into that

520

rest, digest, recovery mode better.

521

So what that means is we breathe in for

four counts, hold for six, and breathe out

522

for eight, and then you can repeat that.

523

And I even do that a lot of times before

bedtime if I have trouble falling asleep,

524

'cause then again, it puts our body

back into that rest, digest, recover

525

Kelsy: That's what I'm

going to take with me.

526

I love knowing what other people do

for their breathwork because I'm…

527

Box breathing is just easy

because it's counting, right?

528

And it's the same time, but I

love the 4-6-8, so I'm definitely

529

gonna have to try that one out.

530

So another thing that I hear often

in this functional medicine space

531

is about folate and folic acid.

532

And college, I've told this story

before, but my professor was

533

like, " Every woman of childbearing

age needs to be on folic acid."

534

So I was under the assumption

that I needed to be on folic acid.

535

And within the last, I think probably

two or three years, I've heard more

536

about certain bodies not accepting

folic acid or that form of folate.

537

So to us a little bit about folate

and how we can get the right version

538

for our bodies in the right form,

and why that actually matters.

539

. Dr. Kelly Moline, PharmD:

540

So folate is vitamin B9, and folic

acid is the synthetic version of that.

541

But it's not apples to apples in the body.

542

Some bodies will accept it and utilize

it like folate, and some have a

543

gene variation frequently known as

MTHFR, where they can't process that.

544

And that's super important for a lot

of things going on in the body from

545

mitochondrial health, cellular health.

546

But especially when we're talking

about pregnancy and preconception,

547

we're talking about the nervous system

developing, the neural tube defects.

548

So that's why it's the general

recommendation to have,

549

quote-unquote, folic acid.

550

But I think it should be replaced as

folate because so many more people

551

are finding out that they have

this gene variation called MTHFR.

552

And what I thought was very interesting

is even if you don't have that

553

variation, your husband might, and

then that is going to influence

554

the gene variation of your baby.

555

And so your baby might have a gene

variation that you don't have, and that's

556

gonna affect how they're developing,

their risk of miscarriage, all of that.

557

So if we can take the easy route and

take folate instead of folic acid,

558

that's typically my recommendation.

559

Kelsy: Okay, I'm shocked.

560

This is amazing because I knew you were

the perfect person to ask about this

561

because it's something that has been

drilled into us, I feel like, as women, is

562

folic acid, neural tube development, like

all of these things that I hear about.

563

But if my body can't process it in

the right way, and I had no idea

564

it was a synthetic form either.

565

So this is all new information to me.

566

That is crazy, especially the

male component of it all, too

567

Dr. Kelly Moline, PharmD:

568

Yeah, and even in my last pregnancy,

I was doing even more research, and

569

tongue ties and lip ties can also

be from lack of vitamin Bs as well.

570

So making sure we have those methylated

versions of the vitamin Bs or those

571

active forms in quality supplements

can reduce the risk of the tongue

572

ties, lip ties, cheek ties of our

infants, which can leader, lead

573

to feeding struggles and speech

struggles and more symptoms like that.

574

Kelsy: Yeah, dental development.

575

I have a cousin who just turned 18,

and she got her tongue tie fixed at 18

576

years old because she was having so much

TMJ and dental issues related to it.

577

So

578

Interesting.

579

I'm gonna have to bring that up to them

too as something that might be in their

580

genetics to understand for when she

potentially tries to get pregnant too

581

Dr. Kelly Moline, PharmD:

582

For sure

583

Kelsy: Okay.

584

So if someone has, let's say, three

months before they are trying to

585

conceive, what would be some of the

586

checkboxes?

587

And I know we've covered all of

them, but if someone is like,

588

"Okay, I am in trimester zero.

589

I'm looking to check the boxes on

my health to prepare my body in

590

the best way for pregnancy," what

would be some of those boxes for,

591

that you're giving your patients?

592

Dr. Kelly Moline, PharmD:

593

So I would love for people to look into

my Preparing for Pregnancy guide because

594

it is gonna have a lot of those steps,

and I do have a timeline too of, okay,

595

we're six-plus months out, now we're

three-plus months out, we're one-plus

596

month out, and then we're trying to

conceive, and what that looks like.

597

And then on the other side too, have

we been trying to conceive for one

598

month, three months, six months, a year?

599

Because we're gonna take different

steps before we're just asking, maybe

600

even going to a fertility clinic,

like, "I've been trying to conceive.

601

What do I do?"

602

And if you're under 35, they're gonna

say, "Try to conceive for a year.

603

If you haven't, come back to us.

604

We'll do something.

605

We'll look into it.

606

Maybe we'll do IVF."

607

And we jump to that

conclusion a lot of the time.

608

So I wanted more of what we can do to

optimize before, but then also during,

609

because a year is a long time to get those

negative pregnancy tests over and over,

610

and I've been through that waiting period.

611

I actually had a miscarriage first, and

so having that experience, I don't wanna

612

wait until I have two, three miscarriages

before someone will even help me.

613

So I wanted to give women and couples

the information that I really wish I had.

614

So I spent a lot of time making this

Preparing for Pregnancy guide, and

615

I had so many questions from people

saying, "Just tell me everything."

616

And I'm like, "Everything?

617

That's a lot of information."

618

So I put a lot of stuff in there from

gut health, nervous system regulation

619

diet, supplements, and then the labs.

620

So if you're able to get labs for

both couples, just the foundational

621

ones to look at metabolic health, to

look at lipids, to look at thyroid,

622

to look at your nutrient status.

623

So we're looking at iron stores, we're

looking at vitamin Bs, , we're looking

624

at magnesium, we're looking at vitamin D.

625

So that can be really helpful to see

where we need to start with and optimize

626

before we're trying to get pregnant.

627

But other things I would

do is regulate sleep.

628

That's a huge one if we're able to.

629

If you're not able to sleep at night,

that isn't gonna be helpful for

630

recovery and all those things, and you

might need to look into that further.

631

That would be a sign or a symptom

that something else is going

632

on, why you're not sleeping.

633

So maybe it's your progesterone

isn't being optimized and

634

so now we're not sleeping.

635

So that progesterone dip

can cause insomnia too.

636

So there's a lot of things that we need

to look at, but then regulating your

637

stress, uh, being able to, just manage

stress better, whether that is emotionally

638

or through supplements, through

breathwork, all of that can be helpful.

639

And then the diet component,

managing blood sugar, managing

640

your metabolic health.

641

If we have a really high BMI or we have

a big body fat percentage, then trying

642

to work to help re-reduce that just to

optimize it, , because that can lead

643

to more inflammation, more health risks

down the line for you and for baby.

644

, Those would be great

places to get started.

645

But then also your partner.

646

Let's not forget about your partner.

647

They are half the equation 'cause I

have so many women doing all of these

648

things to get their body ready for

pregnancy and to optimize everything,

649

and then their husband is like, "I don't

think I need to do anything," you know?

650

Like, "I'm just here for a

day," and then that's it.

651

But they need to be

optimizing everything, too.

652

Their metabolic health, , they

can look into their labs, they can

653

optimize their nutrients, and then

also things like reducing heat exposure

654

to the testes is really important

because that's gonna damage the

655

sperm, it's gonna dan-damage the DNA.

656

So staying away from hot tubs

or saunas during that time.

657

My husband loves saunas.

658

And I had to tell him, like, "During

this time, I am so sorry, but

659

we're gonna cut that out, right?"

660

Or let's start with, like, reducing it

quite a bit, and then he did cut it out.

661

And I'm like, it's just such a

short time for the man to do those

662

things, and I'm like, for me, I have

pre-pregnancy, pregnancy, postpartum,

663

like, don't even get me started.

664

But yeah, he was more than willing.

665

He knows his side of it.

666

And if we have women doing

everything, they're 50%.

667

50% is not a passing score.

668

So we need the other 50% to come in and

do their job, too and get their health in

669

check and reduce other external things,

whether that's smoking, vaping is really

670

common or is in now and get their health

in check and optimize the best they can.

671

And it, and I go into a lot of

male fertility in my guide as well

672

because it is so important, and I

also talk about it in my podcast.

673

I have my husband on my podcast, and

I also had a male fertility expert

674

from the semen analysis company.

675

So we can also do semen analysis to see

exactly where we are, which is a great

676

start to see how much we need to do.

677

Do we need to get into supplements

or are we doing pretty good and

678

we just need to sit tight, right?

679

Kelsy: Walking through all of that

is perfect too, because it really is.

680

That's why I feel like where your

expertise lies it's very holistic.

681

You are covering a whole lot of different

aspects of the body and systems of the

682

body, and I appreciate you simplifying

all of it for us a little bit today, even

683

though I know it is way more complex than

what you're even telling us about today.

684

So to end, is there anything we

haven't covered today that you wish

685

every woman in trimester zero, this

preconception phase, understands?

686

Dr. Kelly Moline, PharmD:

687

I would love for people to know that you

need to prepare, and I think we just live

688

in sometimes a really optimistic world,

which can be great for reducing anxiety.

689

Like, we don't need to be

anxious about infertility, right?

690

But in the same sense, we prepare for a

year, 18 months, two years for a wedding,

691

but they don't prepare to get pregnant

and to carry life and to create a life.

692

And so we need to have that

side too, and just knowing how

693

important it is to get healthy.

694

And then, the baby's health for

the course of their life is gonna

695

start with you parenting before

you even have a baby, right?

696

Of knowing that falls on your shoulders,

but in the best way because you're gonna

697

be able to bring this beautiful life

into the world that you and your partner

698

created, which is the best feeling.

699

And things happen, and that,

those are things we can't control.

700

Like my first, my water broke

early, and then we ended up in the

701

NICU, and that was a whole thing.

702

But now she's beautiful and healthy

and all of that, and we're so

703

excited for baby number two now.

704

So I'm just, this is like a real

passion of mine to help other women

705

and couples get there and to have

their own growing families too.

706

Kelsy: I love that.

707

Dr.

708

Kelly, thank you so much for

joining us today on the podcast.

709

I will leave the link to her

website, The Moline Method, in

710

addition to her Preparing for

Pregnancy guide that she mentioned.

711

She has spent so much time on this.

712

It is just jam-packed of

a lot of the questions.

713

We were only able to scratch the surface

today because it is so much more in depth

714

on, in her Preparing for Pregnancy guide,

but I will leave the link to that below.

715

I'll leave the link to all of her

social channels, too, and the link

716

to the Functional Medicine for

Moms podcast on Spotify, Apple.

717

But wherever you get your podcasts,

she is also there, her and her

718

husband do some great episodes.

719

I think that's super special that your

husband comes on for certain episodes,

720

and they cover everything from some of the

women's health topics to even things like

721

parenting and allergies for your children.

722

And just it covers the broad range of

what women during this phase care about.

723

So I will leave all of those links below.

724

But Dr.

725

Kelly, thank you so much for coming

on Wellness Fixes the Pod, and I'll

726

see you guys again on the next episode