New research presented at the European League Against Rheumatism has alarming consequences for fertility. Women with mild musculoskeletal pain were treated with three different non steroidal anti-inflammatory drugs (NSAIDS) for 10 days and then tested for ovulation. Compared to a 100% ovulation rate in the control group only 6.3% to 27.3% of the test group ovulated depending on the test drug with the drug diclofenac having the lowest rate (6.3%) and etoricoxib having the highest with just over one quarter of subjects ovulating. One of the drugs tested (naproxen) is a commonly used drug for period pain. It begs the questions how many women out there are tearing their hair out trying to fall pregnant whilst unwittingly taking these drugs and does it extend to all NSAIDS which includes over the counter medications containing ibuprofen. NSAIDS have been typically linked to erosion of the gastric lining but here we have another side effect with devastating consequences.

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Sometimes in clinic I may either get you to request your GP to order certain tests or I may order certain functional tests myself. As the latter are not bulk billed I usually reserve these for clients I feel will absolutely benefit from testing or those who have plateaued in their treatment results. The types of tests I may direct you towards your GP for include basic thyroid tests, iron studies, vitamin D, folic acid, B12, multiplex PCR (test for 10 different gastrointestinal infections) and homocysteine. These tests serve as a red flag for certain conditions and also inform my decision making around whether further tests are warranted. If you have had recent blood tests it is always a good idea to bring a copy along to your next appointment, even if you are told everything is OK. The ‘normal’ range is quite generous on a number of tests and sometimes I can look for patterns when all of the tests are viewed in conjunction with one another.

A number of other functional tests are also available which I may order to gain valuable insight into your condition. The information they provide ranges from the small but crucial to quite comprehensive overviews of certain systems in the body. A summary of the tests I commonly order are below:

  1. MTHFR (methyltetrahydrofolate reductase) gene mutation: a sizable proportion of the population has a mutation which controls the conversion of folate into its active form in the body. It has varying degrees of consequences for fertility, cardiovascular health, gastrointestinal health, detoxification capacity and mental health depending on whether you have one or two copies of the mutation. The mutation can occur at two locations on the gene.
  2. Pyroluria: A hereditary disorder which causes an excess of pyrroles in the blood due to a defect in haemoglobin (oxygen carrying molecule in the blood) synthesis. Pyrroles cause you to excrete vitamin B6 and zinc in large quantities causing a deficiency. The symptoms include anxiety, insomnia, problems concentrating, inner tension and problems with tissue integrity, including intestinal permeability. It is a vicious cycle condition in that it both causes and is exacerbated by stress and leaky gut.
  3. Functional Liver Detoxification Profile (FLDP): this differs from the standard liver function test your GP may order in that it provides insight into how well your liver is detoxifying and which detox process is malfunctioning so that appropriate herbs and nutrients can be provided to support that process. For example those with a salicylate intolerance show malfunction in a particular detox process called glycination.
  4. Thyroid Profile: expanding on the standard TSH (thyroid stimulating hormone) test your GP may order I may gain insight into whether your thyroid is functioning to capacity by ordering TSH, thyroid hormones (T3 and T4) an inactive thyroid hormone called reverse T3 (rT3) and thyroid auto antibodies.
  5. Hair Mineral Analysis Test: The hair gives most reliable insight into accumulation of toxic heavy metals but can also provide information about nutrient ratios in the body.
  6. Stool tests: These tests vary widely in their costs and the amount of information they provide. They can contribute to the understanding of how the gastrointestinal tract is functioning (e.g., breaking down food), inflammatory markers in the gut, amount and diversity of good bacteria and most valuably any infection, both pathogenic bacteria, yeasts and parasites and any overgrowth of commensal (normal) bacteria residing in the gut which can cause a host of symptoms in their own right.

These are just a snapshot of tests which are available to you. I always provide information and discuss costs before ordering tests but any of these tests are available to you at any time if they are considered appropriate.