Ep 109: How Supplements Can Fill Gaps in Conceiving and Pregnancy With Casey Seiden
Fertility Forward Episode 109:
We are taught that food should be our primary source of vitamins and minerals and while that is true, there is no shame in taking supplements to support your health; especially when pregnant or trying to conceive. Joining us today on Fertility Forward is the nutrition specialist, Casey Seiden, to discuss how supplements can fill gaps in your nutritional needs. Tuning in, you’ll hear all about why supplements are important, and the difference between prenatal and multivitamins. Learn why you should take prenatal vitamins before you plan on becoming pregnant, why we need to be mindful of the potential inability to absorb folic acid, and how anemia affects pregnant women. Casey also talks us through some of the most important supplements to take before delving into how our needs change after the age of 35. There is a common misconception that supplements should be taken first thing in the morning and in this episode, Casey explains that different supplements need to be taken at specific times of the day to optimize their absorption. Finally, our guest encourages us to accept the fact that we may need to take supplements to be as healthy as we can be. To hear all about how you can enhance your fertility journey, your pregnancy, and your life as a whole with supplements, tune in now!
Rena: Hi everyone. We are Rena and Dara and welcome to Fertility Forward. We are part of the wellness team at RMA of New York, a fertility clinic affiliated with Mount Sinai Hospital in New York City. Our Fertility Forward Podcast brings together advice from medical professionals, mental health specialists, wellness experts, and patients because knowledge is power and you are your own best advocate.
Dara: Hi everyone. I am really excited for our guest today. We have Casey Seiden back on our podcast with a lot more to share with us. Not only has she somewhat recently had her second little one, but is now coming on to share more than just her plethora of information on gestational diabetes, but having a chat with us today on supplements for fertility and supplements for pregnancy. So, Casey, thanks for, for being here. Happy New Year.
Casey: Yes, happy New Year. I'm super excited to be back. Thanks for having me.
Dara: We were just chatting. Of course! We're we're just chatting before, you know how we hadn't seen each other for a long time and I appreciate her taking the time out of her busy schedule and she's like, this is actually a nice break for me which is wild. But this is a break for you Casey.
Casey: Podcasts are fun. So it, it feels like a break from the, the work side of things.
Dara: I love your positive attitude and it is nice. It's nice to just have a chat. And today's topic I think is really something I know that we've spoken about in the past. There was an article that Casey had written and you know, it brought to my attention that we really haven't had a discussion on this podcast kind of like delving a little bit deeper into, you know, how supplements can be exactly what the name is, a great supplement to one's diet. So let's kind of jump in. Why do you think they're so important? I mean, I'm sure there's, there's many reasons, but why do women and men need to really consider their supplement routine prior to conception?
Casey: Yeah, when I reached out to you for that article, you know, you and I both agreed, like we come from very like food-first background. Like, we're always gonna try to help to optimize people's diet, but let's face it, when it comes to conceiving and pregnancy, we have higher nutrient needs and it can be really tough for a variety of reasons to meet those needs strictly through your diet. So, you know, supplements can help to fill those gaps, especially if maybe you've been found to be deficient in something. We need kind of higher doses from supplements. Pregnancy can also happen unexpectedly so you know, if you weren't planning on it then you know, taking, making sure that you're having supplements on board can bring you up to speed. And for maybe someone who's struggling from a fertility standpoint, certain supplements that are more difficult to get through food might help with, you know, things like egg quality, things like that.
Dara: Yeah, for sure. I remember when I was, I dunno, 18, 19 years old, my first day in nutrition class, my undergrad, we all walked in, I think it was a life cycles class. And I remember the first thing she said when we sat down, I think it was all women, maybe it was one man, but she made the assumption, okay, the first thing she said is every single woman in this room needs to be on her prenatal vitamin. And I thought she was crazy when she said that. I'm like, who's thinking about, you know, having a baby? But you know, when she, you know, kind of had her explanation of why we needed to take it, it was, you know, for her it was more to get in that habit. So I think you, that was great that you mentioned that, that I think it's great to get in a routine. A lot of times we often think about things after the fact and that's okay. It's better than nothing. But I think it's, you made a great point that it is great to have certain nutrients in your system going into a pregnancy.
Casey: Yeah, for sure. I was definitely the person who kind of poo-pooed supplements for a long time. You know, I'd see family members taking just this, like, medicine cabinet of things and I was like, is that really necessary? But the more that I learned and it through my work and research, like yeah, supplements can definitely have their place.
Dara: Yeah. The way I describe them is, you know, a safety net. It's a safety net for the days that, you know, you aren't able to get all of your vitamins and minerals through your food or like a buffer. But I think you made a good point. It's not something to rely on per se, but something to use as that buffer for sure.
Casey: Yep. Totally agree.
Dara: So maybe let's start with prenatal vitamins and kind of giving the listeners a general idea of like how are prenatal vitamins any different than multivitamins and in your opinion, do people need to be just taking a multivitamin or is that prenatal vitamin really much more essential?
Casey: Good question. Yeah, I, the, when we look at kind of what are the recommended daily allowances for vitamins and minerals that are, you know, established by the government and all the research that we've done, some of it not very accurate. The recommendations even lag behind what we're learning should actually be appropriate levels to supplement with but there are differences. A lot of vitamins, minerals, and other compounds, we have higher needs for them in pregnancy. So someone taking a multivitamin, you know, that might be fine, you know, if they're not trying to conceive, but I would suggest a specific prenatally focused one because it's gonna have higher amounts of nutrients to, again, fill those gaps for pregnancy.
Dara: Yeah, I think that's great. I think you made a great point that you know, there are specific ones that may be more helpful and especially, you know, I think a big reason, at least with the way we were taught that it's important to start taking the vitamins early is because especially if you have an, you know, an unexplained, like, you know, you, you don't even realize that you're pregnant. It's a great buffer, but especially going into the first trimester for, for folate or folic acid.
Casey: Yep. That is one of the key ones to have early and a lot of.
Dara: And there's a lot of debate, you know, and I'm sure you know, the jury is somewhat still out in terms of should people be taking a prenatal with folic acid or should people be taking prenatal that is has a methylated folate? Do you have opinion or any views on that?
Casey: Such a hot topic. You know, it's, it's hard to go near it because I think people can feel so passionately about it. I, personally, at the end of the day, something is better than nothing. Right? For some people it's maybe a cost issue because a lot of the prenatal vitamins that have the methylated folate in them are gonna be more expensive or a part of a regimen that's like eight pills and they're nauseous and they can't eat eight pills. So I'd rather them take something with at least a substantial amount of folic acid. But we do know, or we're starting to understand that probably more women out there have the genetic mutation that doesn't allow them to absorb and importantly utilize folic acid as best that they can. So that methylated version I like to use as a safety net for the majority of women just in case to cover the bases.
Dara: Yeah, I feel that way too. And just for our listeners, if they're not familiar, folic acid is the synthetic form of folate. So when we eat foods, when you hear foods that are rich in folate, you know, the green, dark leafy greens, and the peanuts, and the oranges a whole, you know, list of, of foods that are high in, in folate, that's the food form. Folic acid is the synthetic form, so the man-made form of it, which can be great, but for some people who have this genetic mutation, the MTHFR mutation, may not be able to fully process or metabolize the synthetic form. And you know, I think I'm still somewhat on the fence and this is where I'm still learning a lot, you know, and I've spoken to some doctors, they mentioned that, you know, if you're taking a high enough dose of folic acid, you should be fine. However, I mean that would probably increase the cost too to some degree. So for, you know, if you can find perhaps a, a prenatal vitamin that has the methylated folate, you may be paying a little bit more perhaps, but you may not necessarily have to supplement in addition to that prenatal vitamin with extra folic acid perhaps.
Casey: Well, and one of the concerns with the folic acid is sometimes people will take these mega doses and what if the body can't metabolize? There's consequences to having this, what they call unmetabolized folic acid hanging out in your bloodstream. So we don't want that. So there's trade-offs to maybe each form I think.
Dara: Yeah, for oh for sure. But that's, I think that's the where most people understand the basics of a prenatal vitamin. The reason why women should take it is for the folic acid / folate, which is important in the first trimester to help prevent neural tube defects.
Casey: Yeah. And all that research that we have on neural tube defects is the folic acid, not with the methylated form. So that's often where the controversy and people tend to butt heads on, they wanna stick with the research so they say folic acid no matter what.
Dara: I think we need to do more research then I think that's like a, I would love to do research if I had the time or the patients to look at a variety of different types of prenatal vitamins and really do some research and to see which one. But the hard part is who wants to be the Guinea pig for that?
Casey: Oh my gosh.
Dara: So what else besides folate / folic acid is typically found in a premeal vitamin that may be a little bit on higher doses than your average multivitamin?
Casey: Yeah, so another B vitamin. So folic acid is a type of B vitamin. So vitamin B12 you might find in a higher dose, especially the methylated form would be helpful. Things that aren't necessarily commonly put in higher doses in prenatals, but what I like to see in higher doses would be vitamin D.
Dara: Yes!
Casey: Big one. So many of us are deficient. We're in the dead of winter right now and we know that higher blood levels of vitamin D can be helpful for pre-eclampsia, gestational diabetes, placental development. So there's certainly a threshold that I like to see for that nutrient.
Dara: Well you and I also, I think we see a lot of patients with gestational or you know, PCOS and, and even with thyroid conditions and I, and there is a lot more research being done now in terms of how vitamin D or low levels of vitamin D, how that may negatively impact those types of situations or those conditions.
Casey: Yeah, it's always good to test your levels, but I think most of us would, could probably benefit from having a good amount of D in the prenatal if not like an additional supplement on the side.
Dara: I think the most I've found in a, in a prenatal is 2000 IUs. Have you found anything higher?
Casey: You know, I could like, I have a whole giant spreadsheet of like all the prenatal vitamins.
Dara: I love it. Well usually, so the ones that I typically suggest usually have anywhere from one to 2000 IUs of D three. Yeah. Which I think is great. I do think it doesn't hurt to get tested and that's what I, you know, I think it, it may be a, when someone is considering, you know, starting a family, I, you know and is perhaps struggling a lot of times the first line, you go to a fertility clinic when it's great and sometimes what can get lost and everything is going to your GP, going to your internist for your annual physical and getting your levels checked and getting a baseline of where everything is. And that can kind of be a great starting point in terms of okay, what do I need to take extra of? I had a friend who's a dermatologist who you know and I asked her way back when, like what do I need to do to preserve my skin? And she's like, wear sunscreen daily and take 4,000 IUs of D3. And she believes also, depending on where you live, but you know, this is my friend living in you know, Canada where it's super duper cold and the sunshine is definitely not strong and you know, vitamin D is, you know, the best source of getting vitamin D would be through sunshine and you know, strong sunshine. Not in the sunshine where we are in, you know, I'm in New York and remind me, where are you again, Casey?
Casey: Just outside the City in Jersey.
Dara: Okay. So yeah, northeast, you know, it's not like we're in Miami
Casey: Right. Yeah. I pulled up my spreadsheet. There are a few that now have 4,000 IUs and those are typically the ones I tend to recommend. So it's out there.
Dara: It is. That's great to know. So I'm sure you've seen also iron is something that, that's usually one other nutrient that I said that is usually higher in a lot of prenatal vitamins and that's something that I'm not sure if you've seen but I've seen a lot of my patients coming to me with anemia. Is it something that you see with your patient clientele?
Casey: I do. I see that fairly often and I also deal with a lot of multiple moms. So twins and triplets and their iron needs are really high. The funny thing with iron that'll surprise people though is that you know, we'll be going over what prenatal they're taking and they'll be like, it doesn't have iron in it. And I'm like, does it have calcium in it? And it'll often be that the prenatal will choose one or the other because calcium and iron as you know, will you know, compete for absorption. So iron is one of those things that people often have to take on the side, especially if they are anemic and they need a higher dose to like replete that level.
Dara: I learned something new, Casey, I had no idea. I knew about the, the calcium and the iron but I didn't realize that a lot of times why they removed the iron. I, I had the impression that they removed iron and I could be wrong because it can be a little bit more constipating for people. So like those chewable I believe in almost all I haven't found one but a chew, most of the chewable vitamins don't have the extra iron in it.
Casey: Yeah, that's very true. Yep. Or if they have like some prenatals will have iron in it, but it's like such a baby dose. Yes. Like it's hardly doing anything.
Dara: Yeah. They're only, I think most of 'em have like 67% of your daily, you know, it, it might be maybe 18 milligrams but not the 27 milligrams.
Casey: Say woohoo it's in there. But people don't understand that it's maybe not enough.
Dara: Are there any types of iron that you cause supplements that you like that can maybe help with constipation?
Casey: My favorite form of iron would be the biz glycinate form. That one just breaks apart and dissolves really nicely and doesn't cause that constipation so much.
Dara: Yeah, I think that one is also what I recommend and you know, if anything it's a great reminder if you're taking something that that could lead to a little bit more constipation. It's, it's a great reminder to keep up with your fluids, stay hydrated.
Casey: Fluids and fiber when you're increasing the iron.
Dara: Fluids and fiber and this is also something that I find it great for people to remember. So I love that you said, Casey, to remind people that iron and calcium don't help with each other's absorption. So the way I say it's like they repel each other. The way I tell people to remember that is they repel each other cuz they share a best friend and their best friend is vitamin C. So vitamin C and iron absorb well together. I learned this in school so it's not like I'm, you know, creating this on my own. But vitamin C and iron work well together and then vitamin C and calcium. So they're, that's how you remember they share a best friend so that's why they're mortal enemies.
Casey: I love that analogy.
Dara: Just an easy way. That's how I remembered it in school and it's stuck.
Casey: I love it.
Dara: So yeah, you've said vitamin D I think that's great to hear. Cause I know in some of the older formulations of prenatal vitamins, vitamin D you know, is not usually found and I'm happy to see in a lot of the newer brands out there, vitamin D is something that they're adding. Is there anything else that you notice that they're adding more nowadays or what you'd like to see be added?
Casey: Thankfully I think one of the things that's becoming a little bit more popular, maybe not in super high amounts but you could always take on the side would be choline.
Dara: Yes.
Casey: I knew I was gonna get the two thumbs up for that. Yes,
Dara: No one can see, but I'm like, yes, I, you know, when I hear choline I think of like egg yolks, which you know is a nice source of choline but it's nice to see. It's something that you, I also haven't seen, you know, maybe 15 years back, prenatal vitamins didn't really contain choline and you're seeing that a lot more now and there's definitely a benefit for a baby's, it's brain development, correct? Yeah.
Casey: Brain, eye development. Yeah. Cognitive development even as like a toddler. Yeah.
Dara: We all want smart babies, which all and that also can be found in DHA, which is your fish oil. What are your thoughts with DHA and whether it should be in a supplement or or taken separately or do people need it?
Casey: Again food first. Like, I think there's so many benefits to having, like, fish and seafood two to three times a week. Truly we know the concern related to, like, mercury is a lot less and so the benefits of take, eating your fish far outweighs that concern. But if you're, you know, someone that's not eating seafood, you're vegan, vegetarian or just have nausea and can't stomach it, I think taking a DHA supplement is a good idea. I don't know that I'm fully up on like the science of why we separate it, but I've been reading more and more about how there is a benefit to taking your DHA separately rather than like all included in your prenatal. So that's, that's what I'm tending to see more and recommending if people can take it on the side to just do that.
Dara: That's fascinating. I wanna look more into that as well. I know Nordic Naturals is, you know, an easy brand to find and it's, I'm not plugging anything, I don't, you know, work with any company but it's just, you know, off the top of my head something that where you can find a wide variety of different types and different amounts of your DHA, which is, you know, your Omega-3 and it, a lot of those omega threes if you're gonna get an O like omega-3 complex, it's gonna often have a combination of usually EPA and DHA, perhaps ALA if, you know, if you're vegetarian. But the, you know, I typically suggest DHA as the forefront even though EPA and ALA have some benefits as well.
Casey: Yeah, I agree with you on that.
Dara: Yeah. And it's, I'm happy that you mentioned the, the fish. I I I just like, you know, the, the egg dilemma where in the past a lot of people were anti egg yolks and now we're seeing that there's a lot of nutritional benefit and same thing with fish. It's nice to see that there's more of a conversation around that we should be less fearful of low mercury fish and if anything there's actually, you know, research that supports having it as opposed to not including salmon or other high omega-3 fatty fishes in your diet.
Casey: Definitely.
Dara: I dunno about you, Casey. Do you like do you like anchovies or sardines?
Casey: So I'll do anchovies in like dressings and sauces. I don't think I'll like eat them. Sardines, I would do like, like the very Spanish style. Maybe they're like fried or they're on like some kind of garlicky tomato toast. I never have them in my pantry. It's not a thing that I'm like, you know, gonna eat myself on the regular but I'll do it.
Dara: That's how I feel too. Like if someone else is gonna make it for me and there's enough flavor, other flavor to help ease, you know, the more of the sea flavor, it can be great.
Casey: Yeah. But I think tinned fish, I mean is so great. It's like having a moment Dara: It is!
Dara: It is!
Casey: Yeah, canned,
Dara: It's so trendy and expensive but but it can be delicious. Yeah So that's great. I think that the DHA is something to think, but, and that's great to hear that people should be aware of that. It may be even more beneficial to take it separately aside from having it in your prenatal vitamin.
Casey: Yep, exactly.
Dara: And I think it really is important especially, and you made a good point that you know, especially if you're not getting in your diet and that's something with, you know, working with vegetarians or vegans, they may have different needs than someone who's a carnivore.
Casey: Yep. Those people, right. Their supplement routine might look a little bit bigger, more extensive because they're just omitting those foods from their diet.
Dara: But you had mentioned that already the B12, they would likely probably need to have more of the DHA, perhaps the iron. But that's why I think it's great to have a baseline. I really do think it's great, great to have a baseline check of where your levels are and even that's fine annual and if, if it is low and you start supplementing, you know, it takes about three months for, you know, your body to hopefully absorb and maybe I may be off with that, but I believe it's about three months. And so it is good to, you know, you don't want to, to get your levels checked a week or, or two later, a month later, but give it some time before you recheck to see how your levels are.
Casey: Right. When I talked to someone who's maybe at week 10 and they were still struggling with nausea, you know, the whole first trimester and they're like, have I done something wrong? I'm like, well if you were, you know, if you'd been taking your prenatal prior to getting pregnant, like you're relying on those stores. So that's why another reason why it is important.
Dara: Exactly. To, to get them in early. So it's, and for me I often also say that it's, for the most part baby is okay, but I worry about mummy.
Casey: Yeah.
Dara: I worry about the long term effects of, of, you know mother's bones and, and all of that. So the must have supplements. Anything just to maybe review or go over what are, what do you think are like the highlights of what people really should be taking perhaps or looking for in their supplements?
Casey: I mean I think we just covered a lot of them. It's gonna be so dependent on the person, their age, what conditions they're dealing with, what their background is. But I think a solid quality, prenatal, additional vitamin D if the prenatal doesn't have enough, potentially iron, choline if they're not an A eater and, and the Omega, those would kind of be the ones I would throw in on the side.
Dara: That's great. And then for women who are over the age of 40, is there anything else that you think perhaps they may want to add to the mix?
Casey: Yeah, so this is one of the things I wrote about in that article that you helped me with. And you might have some thoughts or do this more in practice, but because our egg quality starts to decline after age 35, you know, we wanna try to support that. A few of the things that are kind of talked about and there's some evidence behind would be something like CoQ10, which is acting like an antioxidant and gonna help to preserve the egg quality. And then the other one, which I'm a little bit less familiar with using in practice or hearing about is that DHEA. I don't know if you use or have, are more familiar with that one?
Dara: Yes. I typically and usually it's the doctor who recommends it, but if they ask me, it can be great for patients with diminished ovarian reserve. So and the general guidelines, but again, you always wanna speak to your doctor just to let them, you know, depending on, you know, if you are going to your doctor for any type of specific treatment, you wanna make sure that there's no contraindications, but typically 75 milligrams a day, but split up three times a day, so it's 25 milligrams three times a day, which equates to 75 milligrams and taken up until a pregnancy.
Casey: Okay. So then they would stop it once once they conceive.
Dara: Exactly. So it's something that our body makes, but as we get older we may not make it and or utilize it as well.
Casey: Interesting. Okay. See I learned something new today too.
Dara: That's what I love. I mean that's what I love, speaking with other people in this field. I, you know, we're, we all have different interests. We all read up on different things or we all pick up on something different. So I think it's always great to collaborate and to Yeah, and, and to check in with each other every now and then just to learn. That's what I love about this field. It's always about, you know, it's always something new.
Casey: You can't be an expert in everything, even in the realm of pregnancy. There's all these phases of pregnancy and different population and postpartum. So it's a lot to know everything about.
Dara: I know. Do you feel like now with your experience with, you know, pregnancy and childbirth, has that even changed your interests and what your, you know, in your practice?
Casey: A little bit. Yeah. I mean I got my job at Maternal Fetal Medicine right as I was going through my own, like, fertility journey. And so it all just kind of coalesced and started and getting pregnant the second time was a totally different experience. And then, so now being postpartum again, I'm, you know, my interest has peaked a little bit from my first baby and now my second with things like lactation, like nutrition for lactation and postpartum support, nutrient repletion after pregnancy, you know, so much of this. So it's, yeah, I feel like my interest is always evolving in, in my work.
Dara: Which is nice. I, I feel similar to that's how I got into this specialty as well with my own fertility struggles. You know, being a patient at RMA and then, you know, letting them know that they could use a dietician to help support their patients. It's, you know, one less thing for, I think for doctors to have to, you know, they have a lot on their plate. So it's, it's nice to help support and also that's, it also forced, I'm sure both of us to really hone in on women's health in this specific time period, which I think is so interesting. Back to supplements, which I forgot to ask, this is something also that I think patients should, or people should be informed about is how to take supplements, especially our prenatal vitamins. Are there any suggestions you have on how to take when to take?
Casey: Usually I say to take it with food. A) it's gonna help to settle the stomach a little bit better and prenatals often have what we call our fat soluble vitamin, so that's A, D, E, and K and we need fat or some, you know, a mixed meal to help absorb those the best. A lot of the prenatals are all packaged in one. Right? That's a kind of a mix of nutrients. Ideally, you know, there's gonna be a prenatal that exists that separates out certain vitamins and minerals that are best taken in the morning, some midday or the evening. I know of one, but it's not out on the market yet. But, you know, optimizing the time of day can help with absorption. And we already spoke about, kind of, separating out certain competing ones. So if you have to take separate iron, just take it away from your calcium or your prenatal that has calcium in it. Same with the Omega.
Dara: I think that's great advice. Yeah, I think the hard part is a lot of people, you know, when we think of supplements, we think of, okay, first thing in the morning before we have breakfast or with our breakfast, but a lot of times it's like I take my prenatal vitamins and then I eat. And if a lot of those vitamins are being absorbed much faster and fat takes a long time to digest and go through your system, it's hard. You know, like sometimes people forget at lunch or a dinner. I often suggest, which I'm not sure if it's the best, but to take it before bedtime because hopefully most people don't forget to brush their teeth. So if you put it next to your toothbrush, you'll, you know, remember. But the only concern is if you've eaten four or five hours before, then it may not be as as helpful in terms of absorption.
Casey: Yeah, well that's good to hear you say that because that's when I take my prenatal vitamin still. Cause I always and I see it at the end of the night. I'm like, oh shoot, I didn't take it. And I usually have a snack like an hour before bed, so.
Dara: Perfect. You're, you're doing a great job. You're doing a great job. So I would love to have you back on when this new prenatal vitamin comes out so you can share it with the world, perhaps. Anything else that you would like to share with our listeners and definitely remind everyone where they can find you?
Casey: Yeah, you know, I think, you know, just with our whole conversation, like we love food, we love getting our vitamins and minerals through food, but don't feel bad if you need to take a supplement. Don't feel like, you know, if you become anemic or something like, oh, you've done something wrong. Pregnancy is really challenging for a lot of reasons. So sometimes we just need that help from a pill, a gummy, a powder, a liquid, just, you know, taking that supplement can be the best thing for you and baby. So that's how I kind of like to approach it. And yeah, you can find me. I mostly, again, I'm the dietician at Maternal Fetal Medicine Associates, so they have a few podcast episodes that you can listen to that I'm on talking about a variety of things. And then I'm mostly on social media. My Instagram, if you wanna follow me there is @eat.well.together.
Dara: It's my favorite Instagram handle by the way. I love it. And yeah, I'm happy that you said to not be afraid of supplements and that's I think really what I want our listeners to learn about today, even myself. And it's so nice to hear Casey, that you as well, like, we’re a little bit hesitant when, you know, starting to recommend supplementation because, or supplements because that's not really what we're taught. We are, we're taught food first, but I want everyone to hear that it's okay. And really, it is a great compliment to eating to well-round whatever well-rounded eating means. But, you know, eating whole foods and having a variety of foods, it really is a great compliment and it's not something to feel bad about if you need a little extra help. How we like to end our podcast is through words of gratitude. So Casey, what are you grateful for at this very moment?
Casey: This very moment I am super grateful that my little one who's four months old and just started daycare last week and had completely refused bottles up until this point, she has had successes all day yesterday and today I just got an update from her teacher. So I am so grateful that I don't have to be an anxious mess all day long, long
Dara: How nice is that, that's so nice that you're, that one less thing to have to worry about.
Casey: Yes.
Dara: I would say I'm excited. I'm going to see a play tonight. It's been, you know, a while since I've been on Broadway and I'm seeing a play called And Juliet, which I've heard great things about. So just grateful for spending time with friends in the new year and also speaking with a colleague. I really do enjoy speaking with other people in this profession and always picking up something new and catching up. So thanks Casey for coming on.
Casey: Thank you. Yeah, and I can even send you, remind me to send you the link to that article that you contributed on. That way you can put it in the show notes and people can look up the fertility supplements on that.
Dara: Amazing! Listeners, we are gonna send it to you as soon as it comes out. Thanks so much.
Casey: Thank you.
Dara: Thank you so much for listening today. And always remember: practice gratitude, give a little love to someone else and yourself, and remember - you are not alone. Find us on Instagram @fertility_forward and if you're looking for more support, visit us at www.rmany.com and tune in next week for more fertility.