October 9, 2025 • 43 mins
What if the very nutrient celebrated for preventing neural tube defects is now tipping into excess, disrupting biochemistry, fuelling anxiety, and shaping the health of the next generation?
In this thought-provoking conversation, clinician–researcher Carolyn Ledowsky - now nearing the end of a four-year PhD - shares her evidence-based re-evaluation of folic acid, methylfolate, and the overlooked role of men in preconception care.
Carolyn unpacks why folic acid isn’t the villain, but why unchecked intake poses real risks. We explore unmetabolised folic acid and methylation bottlenecks, the stability challenges of methylfolate, and why folinic acid may offer a practical interim solution. She outlines a pragmatic public health roadmap: cap daily intake at 400–500 mcg, remove voluntary fortification to prevent hidden excess, and individualise care with methylfolate plus B12 and cofactors where needed.
This conversation also delves into recurrent pregnancy loss and the striking results of tailored protocols - removing folic acid, lowering fortified foods, using methylfolate, testing MTHFR/DHFR status, and including the partner. Importantly, Carolyn brings men into focus, highlighting emerging evidence that male folate metabolism and genetics directly influence fertility and pregnancy outcomes.
And in a surprising clinical insight, she reveals how elevated B6 often normalises quickly with lysine - reshaping how we think about nutrient “toxicity” in the post-viral era.
If you care about smarter prenatal nutrition, realistic fortification policy, and giving couples the best chance of healthy conception, this episode provides a science-led roadmap for clinicians, policymakers, and future parents alike.
Connect with Carolyn: mthfr support
Read Carolyn's Paper:
Health effects of excess folic acid use and high blood folate during preconception and pregnancy: a systematic review
Shownotes and references are available on the Designs for Health website
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:12):
Welcome back to Wellness by Designs.
I'm your host, Andrew WhitfieldCook, and joining us again today
is Carolyn Ludowski, nearly Dr.
Carolyn Ludowski, who's anaturopathic practitioner,
clinician, researcher whospecializes in methylation
issues.
And today we're going to bediscussing indeed that and her
(00:32):
research.
Welcome back to Wellness byDesigns, Carolyn.
How are you going?
SPEAKER_01 (00:36):
I'm well, Andrew.
Great to be back again.
SPEAKER_00 (00:40):
Great to be speaking with you again.
This is such a it's a vitalpiece of research that you're
doing.
Um, because there were some sortof hints along the way, but I
think we should get into it.
And and I should say for allthose people who might not have
listened to Carolyn's previouspodcasts, listen to those as
well because you'll learn a heckof a lot of the backstory that
(01:03):
we're going to be talking abouttoday.
So we've spoken about yourresearch before.
Um, can you give us an update onwhat's happening with that and
where it'll be lying with yourPhD project?
SPEAKER_01 (01:15):
It's very nearly at the end, Andrew.
I'm very pleased to say.
Um it's it'll be the finalsubmission in December.
So at the moment it's head down,12 hours a day writing and just
pulling it all together, whichis is it's very, very exciting.
So, yes, it's been a long fouryears, but I would be very glad
(01:38):
to get to the end of it.
SPEAKER_00 (01:40):
I I gotta say though, four years, like you, I
mean, you are a machine.
Anybody who's worked with you,anybody who knows you you're a
machine, but this has takenother people, not this, but you
know, other people's PhDprojects can take, you know,
four, five, seven years.
You've done a heck of a lot infour years.
What is this based on withregards to the research, though?
(02:03):
Have you seen this exponentialincrease in what we're going to
be talking about today?
SPEAKER_01 (02:08):
Look, it's really interesting, and and as my PhD
supervisor, one of Amy Steelesaid to me, you know, you you
had so much knowledge about MTHfar and methylation and folic
acid and methylfolate cominginto this.
So it may not be that I havelearned more.
(02:29):
I certainly have aboutmethodology, I certainly have
about how you approach theresearch, because at the very
beginning she said to me, youknow nothing, you have to let
the research guide you.
And so that is a very difficultprocess for a practitioner who
(02:49):
knows clinically the effect thatshe can get from methylfolate as
opposed to folic acid,particularly infertility.
So it is a completely differentskill set to actually start at
the very beginning and say, youknow nothing, the research must
guide you.
And so that's a reallyinteresting process that, as a
(03:13):
researcher, you go through.
And what's very exciting is theresearch has guided to the point
that I'm not as fanatical as Iwas.
I'm a lot more balanced, but Ihave still the very strong uh
(03:34):
opinion, and now backed up byresearch, that if you exceed
certain levels of folbic acid,it's definitely problematic.
And what we don't know, which ishas to be established with
further study, is what is excessand what does it look like?
(03:56):
Because the Institute ofMedicine in the United States
back in 1998 said, well, it's athousand micrograms, but that's
only based on it masking a B12deficiency.
It has nothing to do with thebiochemical way that folic acid
(04:17):
is processed.
And this is my argument that wecan no longer say the only
problem with excessive is themasking of a B12 deficiency.
We have to be looking at it froma biochemical point of view.
What does it do to methylfolate?
What does it do to theepigenetic effect in the
(04:41):
offspring?
And so that is a completelydifferent conversation and one
that is a public healthemergency.
And I actually saw this morningon the news that one in four
children under the age of 10 arewith the NDIS for ADHD and
(05:04):
autism.
Now we have animal studiesdating back to 1998 that says if
you exceed certain levels offolic acid, the effect in the
offspring is neurodevelopmentaldisorders, including autism.
(05:25):
So it's no longer okay, let'sjust let everybody go the way
we're going.
We as a as an probably one ofthe most important things to
come out of this is we have todefine what excess is.
And that's not only insupplement use, but also in red
(05:45):
blood cell folate and serumfolate.
We need to define it, and thatis the most important thing, I
think, that's come out of this.
Because as you know, at a lowlevel, 200, 300 micrograms, it's
probably not an issue.
But we have uncontrolledvoluntary fortification, and so
(06:08):
these young kids are gettingexcessive levels even without a
supplement.
And I don't think parentsunderstand that.
I don't think public healthpolicy understands that.
And it is a real problem.
SPEAKER_00 (06:28):
Absolutely.
And I'm so glad you said that,because indeed the folic acid
issue is largely, not solely,but largely from food
fortification.
And it would be, it would bereally interesting to look at um
those countries that did notfortify foods with folic acid
and to see what happens withtheir neuroatypical um
(06:51):
prevalence.
Um but you know, I I guess oneof the issues is you know, with
a with a a B vitamindeficiencies, you know, palagro
or something like that, you seethe issue.
You know, with a B12 deficiency,you will feel the paresthesia.
With a folate issue and an overan excess, what do you see?
SPEAKER_01 (07:15):
Anxiety is probably the number one.
Anxiety and pain.
And when you consider howstressed out everybody is, I
honestly believe that most youngkids suffering from anxiety have
this problem.
Because we know that if we canclinically reduce that folic
(07:36):
acid or folate getting blocked,that that block that we've
always spoken about, thenusually their anxiety will come
down.
And I think the folic acid,there's no question that at an
excessive level it is causing ametal metabolic block.
So we we we need to define it,number one, but we need the
(08:00):
governments now to beresponsible because there's no
question that 800 micrograms inthe leading prenatal
multivitamin in Australia is toomuch.
And that's what this paper thatwe have coming out, hopefully
published very, very soon.
It's been with the journal forsome months.
(08:22):
It basically says, well, youknow, all the governments
recommend 400 to 500.
It seems sensible, 400micrograms, if you don't have an
MTH4 polymorphism and you don'thave problems with metabolizing
your folate through othergenetics, but not 800.
No.
So it looks like anything over400 is is problematic from a
(08:46):
supplemental point of view.
So why are we allowing theleading prenatal to have 800?
Yeah.
So I think things like that needto be looked at.
And in a preconception andpregnancy perspective, we did
find in our paper that waspublished in 2022 that that
excessive level of a thousandmicrograms is always due to
(09:11):
supplements in preconception andpregnancy.
SPEAKER_00 (09:14):
Right.
SPEAKER_01 (09:14):
So this is but but the general population probably
doesn't always take amultivitamin.
And so you're right, from theirperspective, if it's going to be
excessive, it will be from food.
But if someone takes a uh amulti, it's probably 400
micrograms.
We don't have manymultivitamins, as far as I know,
(09:36):
with folic acid above 400micrograms in this country, but
we do have a prenatal.
And so I think we also need toreview that.
SPEAKER_00 (09:46):
So in in your reviews of um serum folate, uh
folic acid, I should say, uh,did you find indeed that
disparity with regards to foodversus supplements?
Did you find that food wouldonly give you um this amount,
food fortification of folicacid, not green leafy vegetables
(10:08):
with the active folates, um, butfor food fortification would
only give you that, butsupplements would bump you up to
this?
SPEAKER_01 (10:15):
Yes.
So in that, in that particularpaper where we evaluated how
much folic acid um or or indeedfolate, because we did look at
natural food sources as well, weabsolutely established that
women are not getting enough,they're not getting nearly 400
micrograms from food alone.
(10:37):
However, there was some that hadthat typical um Western diet
where they wake up in themorning, they have breakfast
cereal, then they have, youknow, a sandwich for lunch, and
they've got a lot of packagedfoods.
Some of them were getting over800 micrograms in their food.
So that's very problematic ifyou then add a supplement on top
(11:01):
of that.
So it depends, but I think thepeople that are most at risk are
the pregnant and prenatal womenthat are taking these 800
microgram plus um multivitamins,but it's the young kids, and and
if it's a neurodevelopmentaldisorder because of the
(11:23):
epigenetic effect, then it'severy newborn if mum has taken
excessive levels of folic acid.
Of folic acid.
And so that's that's a that is apublic health thing that we need
to address.
We need to have the cautionaround how much is too much, and
(11:47):
we don't know the answer tothat.
SPEAKER_00 (11:50):
When you're start talking about governments being
responsible and you know, publichealthcare messages and things
like that, we've seen it beforewhere you know there's a real um
uh protection, let's say aprotection of what's gone
before, you know, and then thethe slow change, if you like, so
that those people that areaffected by one um policy issue.
(12:13):
We could talk about asbestoshere.
So, you know, asbestos isoutlawed at a certain point, and
it took decades for any legalrecourse to happen, by which
time many of those victims hadalready passed on.
We're seeing this with PFASissues, with um um, you know,
(12:34):
aviation support people aroundairports.
Um anyway, blah, blah, blah,that sort of thing, you know.
Yeah.
So we're seeing this lag time ofthose people affected where they
encounter health issues.
That generation, if you like,dies out, and therefore it's
like, oh, yeah, we knew that.
Um now it's a real big issue,sort of thing.
(12:54):
Um you know, I I'm forgive mefor being so negative, but I
just I can see governments justgoing, nah no, nothing to see
here until bang.
Three generations later, whenthings have changed, they'll go,
oh, sure, we knew about that.
SPEAKER_01 (13:11):
Yeah, look, I I don't think it's an easy thing
because you're talking about aworldwide public health policy.
And we're not saying that folicacid is a no-go zone.
What we're saying is we now haveclear evidence from animal and
human studies that there is aproblem with excessive levels.
(13:33):
So let's define it.
If we're saying that 400micrograms is the recommendation
worldwide, then we need tocounsel women that they
shouldn't exceed that.
We also need an alternative.
So if someone does have problemswith methylation or they've got
an MTHR polymorphism or they'vegot other genes in that folate
(13:56):
pathway, then the sensiblealternative is the methylfolate,
which doesn't build up.
And so I think the problem, partof the problem is we have this
one size fits all.
And I think we need to be moreindividualized in our
prescriptions.
And I think we can't assume thatmore is better when it comes to
(14:19):
folic acid.
I think has it done its job frompreventing neural tube defects?
Yes, but it was only ever meantto contribute 100 micrograms per
100 grams of flour.
We're way beyond that.
Way beyond that.
Some breakfast cereals have 400.
(14:39):
So this is part of the problem.
It's it's we've got thisattitude that more is better,
let's just get more, more, more,more, more.
And you know, there's someresearchers in the UK that are
actually proposing we nowsupplement our food with a
thousand micrograms.
It's insanity, absoluteinsanity.
(15:00):
We can't wait, which is theaverage of research to the
population, 20 years.
We can't wait 20 years for thisto be resolved.
We need to be looking at thisexcess level now, and we need to
say, okay, for the majority ofthe population, there's no
problem if you're under 400micrograms of combined food and
(15:24):
supplements, which means we'vegot to drastically change what
people are having access to onthe supermarket shelf.
But then we also need to be ableto say, okay, if you do have
MTHFR, or we do know that youhave problems with not
metabolizing that folic acid,you might have a DHFR,
(15:44):
dihydrofolate reductasepolymorphism as well.
We think the better option foryou is methylfolate,
particularly in recurrentpregnancy loss.
And I'm really, I think that'sone of the things that I've come
out of this definitely saying ifyou've got recurrent pregnancy
(16:04):
loss, I don't think there's anyoption other than to swap to
methylfolate and really go at ahigher level.
SPEAKER_00 (16:14):
So let's just say, let's just dream for a second
that governments listened andsaid, okay, we're going to swap
to the methylfolate, which isone of the ones, one of the
active folates found in food,normal food, not fortified food.
Um, is it stable if they decidedto fortify with methylfolate?
(16:36):
And not at the end point.
Right.
SPEAKER_01 (16:40):
This is the biggest problem we have.
And I look, I don't think thatthere's any, I don't think
there's any chance that you willget a complete change in swap to
methylfolate.
I think where we we need to goinitially is say, okay, we're
still saying that folic acid isgenerally fine for the
(17:01):
population.
We'll stick it at 400micrograms, but we have to
minimize the voluntary folicacid.
I think if we could actually umdelete a voluntary folic acid
fortification and say we're onlysticking with the mandatory, you
(17:22):
can easily then guess how muchsomeone is getting from their
food.
Right.
And then say, okay, we want youto have a total of 400
micrograms to support thepregnancy.
Therefore, you you can have asupplement of 200 micrograms.
And then say to those peoplethat are having problems or
having recurrent pregnancy loss,we think that we need a
(17:45):
personalized prescription foryou, and we don't think
methylfol the folic acid is theright way to go.
Let's go with methylfolate.
And I think if we if we plan itout as a slow transition, I
don't think there's any chancethere will be a complete swap.
Because we do have problems, andthis was one of the things
(18:07):
unfortunately that came up inthe trial is that we did have
stability issues with themethylfolate product, which I
think did absolutely affect theoutcomes.
So the stability of methyl fromethylfolate is problematic, and
as yet, the one of the I thinkone of the reasons it hasn't
(18:28):
been approved for foodfortification is that it's not
stable.
And it's only in certaininstances that you could improve
that stability.
So I think it is a problem, andwe we probably need to just say
keep the methylfolate in thesupplements.
But then, given what we wentthrough, stability is key.
(18:53):
And I have to question a lot ofthe research that's come before
that's used methylfolate andhasn't found it to be
therapeutic, particularly infertility and with MTH of R,
whether that's part of theproblem, because they didn't
check most of I don't know ofany other study that actually
did test stability of theproduct.
SPEAKER_00 (19:15):
Wow.
Okay.
So what about I um introducingthe halfway measure, the folinic
acid?
Where does that sit in thepopulation versus a personal
sort of issue?
Somebody with SNPs on it versusa population basis.
Food fortification I'm talkingabout here.
SPEAKER_01 (19:32):
It's definitely stable.
And that's one of the hugeadvantages of folinic is it is
stable and it is, you couldabsolutely put it in food
instead of folic acid with noproblem.
And would that be a good interimstep?
Probably, particularly for foodfortification.
SPEAKER_00 (19:49):
Yeah.
SPEAKER_01 (19:49):
It's still in my mind, though, not the ideal,
particularly for those peoplewith MTH VAR who have got
recurrent pregnancy loss.
And also for to prevent ifyou're using it in
fortification, yes.
Um, but in terms of preventingthe epigenetic effect, you still
(20:11):
need that methyl folate.
So that would depend on aconversion issue.
It would um be anindividualized, I think,
approach.
But from food fortification,yes, it's so stable.
And it and it would be a verygood choice.
SPEAKER_00 (20:28):
From a healthcare policy and costing um issue, uh,
A, would it be viable?
B, if you're thinking aboutsub-populations that might be
affected by a methylation SNPand would require methyl folate
more than just the folinic acid.
Um, and then you've got to thinkabout the testing.
I mean, at the moment, anybodytrying to get a um a methylation
(20:52):
SNP tested, you've got toqualify uh by basically having a
um, what is it, a cleft palletor a baby with cleft pallet
previously or something?
Yeah.
Um so it's almost like you haveto have been proven to have had
an issue with your pregnancy,not just no pregnancy.
SPEAKER_01 (21:11):
It's it's a really Well I I really think that all
women with recurrent pregnancyloss should fit into that
category.
You've had a problem, let's makesure that we're doing something
differently.
Because what our research found,and it was just a small
subsection of the women from theum pilot study, where we
(21:34):
interviewed them about theirexperiences in the medical
system with their recurrentpregnancy losses.
And there's a real there'sthere's a lot of different
problems when we we look atthese this recurrent pregnancy
loss situation because thesewomen are not pregnant, but
they're not not pregnant.
(21:54):
They're getting pregnant usuallywith no problem whatsoever.
They ring their GP and they say,I'm having a miscarriage, and
the GP says, well, go to theemergency, I can't do anything.
The emergency center puts themin the maternity ward to have
their miscarriage, and thenthey're told go home and keep
(22:14):
trying.
So there's this loss of thislack of appreciation of what
they've gone through, and justcan, I guess, thinking about it
from a physical point of viewand not an emotional point of
view, it's very lacking.
And these women are saying, hey,we don't fit into the system.
(22:35):
We're not we're asking what wecan do differently, we're asking
how we can prevent it, andthey're told nothing, go home
and keep trying.
So I think there's real issues.
And if we could come back tothese women, and that's why they
love to see us in clinic,because we say, Yes, we actually
believe there's a lot you cando.
First of all, get rid of thefolic acid out of your diet.
(22:57):
Second, let's move you to methylfolate, let's test you for
MTHFR, let's increase the folateif it's warranted, and let's
look at all the other.
And if they say there's nothingphysical, that's when I say,
great, perfect.
And you know, 80, 85% of thetime they will get pregnant
naturally.
(23:18):
So I think there's a lot we cando if we're a bit more
individualized in the approach,and we we put these women that
are having recurrent pregnancyloss not into the mainstream
medical system, but we'resaying, okay, we accept that
what we need to do for you isactually very different.
And let's do that protocol,let's change you to methyl
(23:41):
folate and see if you get animproved response.
And they probably would.
SPEAKER_00 (23:47):
Can I ask the question about uh dosage and I
think you've sort of answeredthe question, so forgive me for
asking it again if I've um justre-asking, but with regards to
what you saw with unmetabolizedfolic acid in supplemented
individuals versus unmetabolizedum folic acid in those people
(24:09):
just on uh quote unquote uhstandard Australian diet, sad.
Um is the issue just that,simply that, solely that they're
taking folic acid, and if theystopped that intake of folic
acid, their folic acid levelswould drop to normal, i.e., the
issue of high folic acid isquote unquote supplementation of
(24:33):
some form, whether that be froma tablet or food.
Is that the issue, or doesunmetabolized folic acid remain
an issue after cessation offolic acid intake?
SPEAKER_01 (24:47):
The there's previous research, not mine, that that
basically says if you live in acountry of fortification and you
are eating a normal, what theycall a normal diet, you will
have levels of unmetabolizedfolic acid.
Every single person in asupplemented country that has
bread or breakfast cereals oranything in a packet absolutely
(25:10):
will have unmetabolized folicacid.
One of the things we found inthe trial, though, that was very
exciting, is that the women onthe folic acid had really high
levels of unmetabolized folicacid.
The women on the methylfolatedid not.
It was really low.
SPEAKER_00 (25:27):
Well, hang on.
So that would that wouldindicate, therefore, that the
issue is supplementation, i.e.
tablets, not food fortification.
SPEAKER_01 (25:33):
We took them all off.
Every single person in the trialwas off folic acid-based foods.
And that was what was totallyunique about this trial is that
it was one of the only trials inthe world to take people off the
food fortified with folic acidand also to include the male
partners.
And what was really interestingis that the male partners were
(25:57):
the ones mostly with thehomozygous MTH of R.
SPEAKER_00 (26:01):
Right.
SPEAKER_01 (26:02):
Not the women.
And yet we do nothing for men.
We don't tell them to take anyfolate, we don't counsel them to
take, well, we do, but mostpractitioners don't.
Um, so what the women did in thetrial, the men did too.
They had to go off the folicacid foods, they had to take
their prenatal multivitamin, um,and they did exactly the same.
(26:25):
But it was really interestingthat it was the men.
And we know from previousresearch, there is a lot of
research around how folic acidaffects sperm.
And those people, those maleswith MTH of R polymorphisms have
been shown to have azoospermia,oligosoospermia, and
(26:49):
infertility.
And there's multiple, multiplestudies that reinforce that and
back that up.
SPEAKER_00 (26:55):
It's it raises a really interesting question
regards the regarding theprevalence of neuroatypical um
issues, disorders, if you like,in young children, male to
female prevalence.
SPEAKER_01 (27:06):
Yeah.
SPEAKER_00 (27:07):
Wow.
SPEAKER_01 (27:08):
Absolutely.
SPEAKER_00 (27:09):
I know yet again.
SPEAKER_01 (27:10):
Yeah, it's it's but it's so interesting.
And I guess what I'm, you know,what I I've got to really sit
down now is pull all thistogether in a sensible way.
Because as I said, I just don'tthink there's any hope in public
health policy changingovernight.
It's just not going to happen.
(27:32):
But but if but if we're saying,hey, 400 uh micrograms is the
recommendation, then why are weallowing more than that?
You know, we we have to, and andwe can't have this attitude that
more is better with folic acidbecause we know it's not.
SPEAKER_00 (27:50):
Is part of it also balance, i.e., we're seeing an
issue with B6, you know, vitaminB6.
It's being, you know, uh, in myopinion, um, a little bit
lamb-based in that we're seeingtoxicities, but is it largely?
Um, is it solely?
I don't know.
But um I don't know of anaturopath who would use massive
(28:13):
doses of B6 solely for anextended period of time without
supplementing with other Bvitamins, preferably activated.
Indeed, it was the the naturalhealth practitioners in this
country that sort of lobbied,and and the companies which
lobbied for the activated uh Bvitamins to be to be listable.
SPEAKER_01 (28:31):
Um you know, you know why I think that is
happening, the whole B6 issue?
SPEAKER_00 (28:35):
Tell me.
SPEAKER_01 (28:36):
So we need B6 has a lysine residue in it, right?
So to metabolize B6, you needlysine.
We have come off five years of ahigh viral load.
And everybody, in my opinion, islysine deficient.
(28:57):
We have proved hundreds of timesin clinic if we give lysine, the
B6 comes down instantly, likewithin weeks.
SPEAKER_00 (29:08):
Wow.
SPEAKER_01 (29:09):
So I believe this whole issue is a lysine
deficiency and has nothing to dowith B6 toxicity.
SPEAKER_00 (29:19):
That's a big statement.
SPEAKER_01 (29:20):
I but I do because how can you then explain that
you give someone lysine forthree weeks and their B6 comes
back to normal?
And they're still they're notnecessarily and we put them back
on the B6, keep the lysine in,and there's no toxicity.
Because you need lysine tometabolize your B6.
SPEAKER_00 (29:42):
Yeah.
Wow.
Wow, that's an interestingcomment.
I didn't look into that.
SPEAKER_01 (29:47):
Yeah.
SPEAKER_00 (29:47):
So because if you look at if you look at the the
Australian Bureau of Statistics,the ABS, and you look at their
nutrient sort of deficienciesover lifespans, you know, B6 in
young women and and uh I'm gonnasay middle age women, but you
know, the sort of mature woman.
Um, they're huge.
Yeah.
Um wow.
(30:10):
I need to think about that tothink even of questions I can
ask.
SPEAKER_01 (30:13):
Well, I've I've been I've been doing that in clinic
for probably eight years.
If I see B6 elevated, I givelysine, it comes straight back
down.
SPEAKER_00 (30:23):
Wow.
Cool bananas.
Okay, uh, let's go back to yourresearch because um you said
earlier about your attitudetowards changing folic acid and
things like that.
Is there any other messages thatwe need to heed that you've
learnt along your journey withyour research?
SPEAKER_01 (30:40):
Yes, I I'm I'm more absolutely 100% determined to
ensure that men are included inpreconception care across the
board.
I mean, we when you look at theall the policy recommendations,
um, all the protocols thatdoctors are following in regards
(31:03):
to recurrent pregnancy loss, menare pretty much nigh absolutely
ignored.
And so I think we can't expectall these women to be pin
cushions in IVF and doing allthe right thing and taking all
the supplements and beinginjected with hormones and
everything else, and then justignore them in and go, oh well,
(31:25):
it's not your issue.
We need to really be looking atDNA fragmentation rates across
the board.
We need to be checking them forMTHFR, we need to be putting
them on the same diets.
We we did in the um practitionerresearch that we've just had
published last week, that wasone of the things that really
stood out when we asked them howmany actually included males in
(31:50):
preconception care, was 11%.
SPEAKER_00 (31:53):
Wow.
SPEAKER_01 (31:55):
11% of fertility specialists, midwives, GPs, um
rates, 11%, and that can'tcontinue because what what is
this?
Do men a do we not teach kids inschool that they're involved in
making a baby?
(32:16):
Two, do men have no idea that50% of their DNA is
contributing?
I mean, the amount of times thatmales say men say this has
nothing to do with me, it'slike, oh my goodness, I wish I
had a daughter for every time.
So, and then because we're notaddressing it from a public
health perspective, we needmessaging out there for men, and
(32:39):
it's got to start at school.
Hey, you're 50% responsible.
So what your wife does, you do,or what your partner does, you
do.
And that was a big eye-opener,particularly when we found in
the trial that it was the menthat had the MTH pharaoh
polymorphisms homozygous.
(33:02):
So that raises the wholequestion is why do we only
consider that the woman has hasthe problem?
And the amount of times thatwe've seen, you know, these
women in clinic that havestruggled and struggled and
struggled to get pregnant, andall the time it was their
partner.
(33:22):
Yeah.
So I think I mean, mostnaturopaths would absolutely
address the um the male, butit's not happening at the front
line.
It's not happening with GPs andit's not happening with
fertility specialists on thewhole.
So we really need to change thatwhole dimension that, hey, we
(33:44):
need protocols for men as womenand women, not just women.
SPEAKER_00 (33:50):
What about things like other B vitamins, e.g.
B12?
You know, like I I never everused to give folic acid in my
younger days.
Um, I never used to give folicacid without giving B12, just
wouldn't do it.
SPEAKER_01 (34:02):
Yeah.
SPEAKER_00 (34:02):
Um what have we learned?
What what sort of other issueshave you learned with
generalized nutrition?
Uh ID deficiency, for instance.
Are you seeing this being aconcordant issue?
SPEAKER_01 (34:15):
Yes.
I mean, I think I think theproblem is now that our food
doesn't supply us with what wethink it should.
And I think a lot of um GPsstill have the attitude that
it's food is fine when you'repreparing for pregnancy.
And I just don't think we cansay that anymore with the
processing and everything.
(34:36):
So all the things that we knowwe've got to check, B12 is
critical when it comes to folateabsorption.
Absolutely critical, because youcan't absorb your folate without
B12.
And so if we consider that folicacid does mask a B12 deficiency,
anyone taking folic acid is athuge risk.
(34:58):
And so I think we've got to bechecking those absolutely.
And as a general rule, we don'tgive isolated B vitamins without
the whole package.
So I think that's alsoimportant.
But we did see that in thepractitioner's survey where they
were giving off-the-counterproducts that just had folate
and iron in it, because that'sthe recommendation.
(35:20):
So I think the recommendationsneed to be broadened to say we
do need multi-Bs in formulas.
Um, and when you look at thoseformulas on the shelf, the
amount of B12 in there isabsolutely pathetic, except for
practitioner-only products,which they're really good.
I mean, you're talking sixmicrograms.
(35:42):
Like it's it's insane.
So I think there's, yeah,there's a lot of a lot of
issues, but we're not gonnasolve all those overnight.
But we can only try, can't we?
SPEAKER_00 (35:53):
We're gonna need to clone you for the next
generation, Carolyn.
So you've got the next we needmore.
And and flowing on from that,what's next with your research?
What's happening now?
So um, okay, you'll have yourPhD done hopefully by the end of
2025.
Um, what's it's Dr.
(36:13):
Carolyn Ludowski?
SPEAKER_01 (36:15):
Oh, well, it's a really good question.
And I I'm not sure yet.
I would I like to do someteaching?
Yeah, I would.
I think I'd really like to teachthe next generation of kids
that, hey, this is a reallyimportant topic, and for us to
understand that biochemistry andhave the attitude that we need
to be more individualized in ourprescriptions.
(36:37):
I think that's really important.
There's so much research, andI'm I'm in the process now of
writing the implications forfuture research, and there's so
much future research around thiswhole thing.
Maybe supervising some other PhDstudents that can continue this
work would be awesome.
(36:58):
Um, so I don't there's a lot ofoptions.
I'm not sort of wedded toanything, or a book.
Yeah, absolutely.
I do want to write a book nextto you.
That's one of the things on mylist.
Um, but it's there's a lot, andI think well, I've only looked
at it from a recurrent pregnancyloss, but as I said in the very
(37:19):
beginning, I think autism, Ithink definitely neurological
disturbances across the board isa very, very big part of the
picture.
And I think cardiovascular,there's so much.
Um, mental health, depression,anxiety, there's a lot that
(37:40):
could be addressed throughfuture research.
And I think I think, yeah, justI'd like to get to public
department, you know, healthdepartments to start presenting
the results to at least opensome conversations to say, hey,
wouldn't it be great if we couldbe the first in the world to
(38:02):
actually look at what excessmeans and how we define it and
what we do?
I think that would be great.
SPEAKER_00 (38:09):
I think, I think part of what you're asking,
though, and uh we can only hopethat somebody in authority
within the healthcare system,within politics, the you know,
that sort of echelon of ourgovernance in Australia, um,
whether it be medical orpolitical, has the fortitude to
(38:30):
change policy with regards topublic health, that more is not
better.
We got it wrong.
We need to change.
We've we've we've done itbefore.
I don't think they're gonna saywe got it wrong.
SPEAKER_01 (38:42):
No, I don't think, but but I do think the first
step could absolutely be we'renot changing our policy.
We're just saying that webelieve that 400 micrograms is
the upper limit.
So we're gonna restrictsupplements, we need to tamper,
we're gonna reassess voluntaryfortification, and by the way,
(39:03):
we're gonna acknowledge thatthere is a subset of the
population, like those havingrecurrent pregnancy loss, that
we might look at changing whatwe give.
unknown (39:12):
Yeah.
SPEAKER_01 (39:13):
If we could do those three things, that would be
major.
SPEAKER_00 (39:18):
Yeah, but not just with those women that are losing
the baby with their partners whoare give donating the DNA.
Yeah.
SPEAKER_01 (39:26):
Absolutely.
I think that would be absolutelyphenomenal if those three things
could at least be started tosay, okay, we acknowledge
there's an upper limit.
We don't know what it is yet,but let's let's just stick to
the worldwide recommendation,which is four or five hundred
micrograms.
Let's not allow any supplementto have above that.
(39:48):
And by the way, yeah, we thinkthe people are probably getting
too much.
So let's cut out a voluntaryfortification and just stick to
our mandatory.
That would be major if we coulddo that.
SPEAKER_00 (40:01):
I I am so impressed by your your incredible focus,
but also your care because it'snot just care about the topic,
because you're a clinician, youcare for patients, you care for
women and men who are sufferingissues, not just pregnancy and
loss and things like that, butneurological issues you have
done for decades.
Um, I'm so impressed that youare finalizing your PhD now
(40:26):
because it's going to give youthat extra piece of credential
to say, no, no, I've reallylooked into this.
You know, um, you really, youreally have a message that's
worthy of being listened to.
I just I thank you so much forthe work that you've done, not
just for patients, but forfuture practitioners and the
care of their patients.
Well done to you, CarolynLudowski.
And I will I will preempt thisby saying, uh, what do we say?
(40:50):
PhD candidate, but you know, Ican't wait for the day where I'm
able to say Dr.
Carolyn Ludowski.
SPEAKER_01 (40:56):
Oh, thank you.
That's really kind of you.
Yeah, it is look, it isexciting.
And as you said, I I've beenpassionate about this for 15
years, but I it was justsomething that I was determined.
That was part of the reason I Idid the research.
One, I found, and it's sad, uh,but I did find as a naturopath,
(41:17):
I didn't have a voice in thisarea.
I and I really needed to have avoice.
I needed to basically try andget other people to see what I
could see in clinic.
And so that was the real movebehind doing the doctorate, was
to not only get research wedidn't have, but also have a
(41:40):
voice at the end of it that Icould say, yeah, I have the
credentials to be able to say toyou, I think we've got a
problem.
And so if that means then that Ihave to do 500,000 presentations
next year, I'll do it.
But it just means that we've gotto open some doors.
And I think as a doctor, I'vegot more chance of opening doors
(42:05):
where I couldn't open a doorbefore.
And it's really sad to say that.
But I think what comes with thedoctorate is people say, Well,
you've got to know your topic.
SPEAKER_00 (42:16):
Yeah.
Yeah.
And I can see that you'll be indemand the world over.
Well done, Carolina Ludowski.
It's been great chatting withyou again.
Yeah, and thank you so much forsharing.
This is like it's such importantwork that you're doing.
So well done, seriously, forwhat you've done.
Beautiful.
Thank you.
And thank you, everyone, forjoining us today.
Of course, we will put up asmuch as we can with Carolyn's
(42:39):
research.
There will be some that we can'tthat will be embargoed until
it's published, but um, watchthis space.
We'll put up the relevantdetails for when they become
available.
And of course, you can watch theother podcasts on the Designs
for Health website.
I'm Andrew Whitfield Cook, andthis is Wellness by Designs.
Welcome back to Wellness by Designs.
I'm your host, Andrew WhitfieldCook, and joining us again today
is Carolyn Ludowski, nearly Dr.
Carolyn Ludowski, who's anaturopathic practitioner,
clinician, researcher whospecializes in methylation
issues.
And today we're going to bediscussing indeed that and her
(00:32):
research.
Welcome back to Wellness byDesigns, Carolyn.
How are you going?
SPEAKER_01 (00:36):
I'm well, Andrew.
Great to be back again.
SPEAKER_00 (00:40):
Great to be speaking with you again.
This is such a it's a vitalpiece of research that you're
doing.
Um, because there were some sortof hints along the way, but I
think we should get into it.
And and I should say for allthose people who might not have
listened to Carolyn's previouspodcasts, listen to those as
well because you'll learn a heckof a lot of the backstory that
(01:03):
we're going to be talking abouttoday.
So we've spoken about yourresearch before.
Um, can you give us an update onwhat's happening with that and
where it'll be lying with yourPhD project?
SPEAKER_01 (01:15):
It's very nearly at the end, Andrew.
I'm very pleased to say.
Um it's it'll be the finalsubmission in December.
So at the moment it's head down,12 hours a day writing and just
pulling it all together, whichis is it's very, very exciting.
So, yes, it's been a long fouryears, but I would be very glad
(01:38):
to get to the end of it.
SPEAKER_00 (01:40):
I I gotta say though, four years, like you, I
mean, you are a machine.
Anybody who's worked with you,anybody who knows you you're a
machine, but this has takenother people, not this, but you
know, other people's PhDprojects can take, you know,
four, five, seven years.
You've done a heck of a lot infour years.
What is this based on withregards to the research, though?
(02:03):
Have you seen this exponentialincrease in what we're going to
be talking about today?
SPEAKER_01 (02:08):
Look, it's really interesting, and and as my PhD
supervisor, one of Amy Steelesaid to me, you know, you you
had so much knowledge about MTHfar and methylation and folic
acid and methylfolate cominginto this.
So it may not be that I havelearned more.
(02:29):
I certainly have aboutmethodology, I certainly have
about how you approach theresearch, because at the very
beginning she said to me, youknow nothing, you have to let
the research guide you.
And so that is a very difficultprocess for a practitioner who
(02:49):
knows clinically the effect thatshe can get from methylfolate as
opposed to folic acid,particularly infertility.
So it is a completely differentskill set to actually start at
the very beginning and say, youknow nothing, the research must
guide you.
And so that's a reallyinteresting process that, as a
(03:13):
researcher, you go through.
And what's very exciting is theresearch has guided to the point
that I'm not as fanatical as Iwas.
I'm a lot more balanced, but Ihave still the very strong uh
(03:34):
opinion, and now backed up byresearch, that if you exceed
certain levels of folbic acid,it's definitely problematic.
And what we don't know, which ishas to be established with
further study, is what is excessand what does it look like?
(03:56):
Because the Institute ofMedicine in the United States
back in 1998 said, well, it's athousand micrograms, but that's
only based on it masking a B12deficiency.
It has nothing to do with thebiochemical way that folic acid
(04:17):
is processed.
And this is my argument that wecan no longer say the only
problem with excessive is themasking of a B12 deficiency.
We have to be looking at it froma biochemical point of view.
What does it do to methylfolate?
What does it do to theepigenetic effect in the
(04:41):
offspring?
And so that is a completelydifferent conversation and one
that is a public healthemergency.
And I actually saw this morningon the news that one in four
children under the age of 10 arewith the NDIS for ADHD and
(05:04):
autism.
Now we have animal studiesdating back to 1998 that says if
you exceed certain levels offolic acid, the effect in the
offspring is neurodevelopmentaldisorders, including autism.
(05:25):
So it's no longer okay, let'sjust let everybody go the way
we're going.
We as a as an probably one ofthe most important things to
come out of this is we have todefine what excess is.
And that's not only insupplement use, but also in red
(05:45):
blood cell folate and serumfolate.
We need to define it, and thatis the most important thing, I
think, that's come out of this.
Because as you know, at a lowlevel, 200, 300 micrograms, it's
probably not an issue.
But we have uncontrolledvoluntary fortification, and so
(06:08):
these young kids are gettingexcessive levels even without a
supplement.
And I don't think parentsunderstand that.
I don't think public healthpolicy understands that.
And it is a real problem.
SPEAKER_00 (06:28):
Absolutely.
And I'm so glad you said that,because indeed the folic acid
issue is largely, not solely,but largely from food
fortification.
And it would be, it would bereally interesting to look at um
those countries that did notfortify foods with folic acid
and to see what happens withtheir neuroatypical um
(06:51):
prevalence.
Um but you know, I I guess oneof the issues is you know, with
a with a a B vitamindeficiencies, you know, palagro
or something like that, you seethe issue.
You know, with a B12 deficiency,you will feel the paresthesia.
With a folate issue and an overan excess, what do you see?
SPEAKER_01 (07:15):
Anxiety is probably the number one.
Anxiety and pain.
And when you consider howstressed out everybody is, I
honestly believe that most youngkids suffering from anxiety have
this problem.
Because we know that if we canclinically reduce that folic
(07:36):
acid or folate getting blocked,that that block that we've
always spoken about, thenusually their anxiety will come
down.
And I think the folic acid,there's no question that at an
excessive level it is causing ametal metabolic block.
So we we we need to define it,number one, but we need the
(08:00):
governments now to beresponsible because there's no
question that 800 micrograms inthe leading prenatal
multivitamin in Australia is toomuch.
And that's what this paper thatwe have coming out, hopefully
published very, very soon.
It's been with the journal forsome months.
(08:22):
It basically says, well, youknow, all the governments
recommend 400 to 500.
It seems sensible, 400micrograms, if you don't have an
MTH4 polymorphism and you don'thave problems with metabolizing
your folate through othergenetics, but not 800.
No.
So it looks like anything over400 is is problematic from a
(08:46):
supplemental point of view.
So why are we allowing theleading prenatal to have 800?
Yeah.
So I think things like that needto be looked at.
And in a preconception andpregnancy perspective, we did
find in our paper that waspublished in 2022 that that
excessive level of a thousandmicrograms is always due to
(09:11):
supplements in preconception andpregnancy.
SPEAKER_00 (09:14):
Right.
SPEAKER_01 (09:14):
So this is but but the general population probably
doesn't always take amultivitamin.
And so you're right, from theirperspective, if it's going to be
excessive, it will be from food.
But if someone takes a uh amulti, it's probably 400
micrograms.
We don't have manymultivitamins, as far as I know,
(09:36):
with folic acid above 400micrograms in this country, but
we do have a prenatal.
And so I think we also need toreview that.
SPEAKER_00 (09:46):
So in in your reviews of um serum folate, uh
folic acid, I should say, uh,did you find indeed that
disparity with regards to foodversus supplements?
Did you find that food wouldonly give you um this amount,
food fortification of folicacid, not green leafy vegetables
(10:08):
with the active folates, um, butfor food fortification would
only give you that, butsupplements would bump you up to
this?
SPEAKER_01 (10:15):
Yes.
So in that, in that particularpaper where we evaluated how
much folic acid um or or indeedfolate, because we did look at
natural food sources as well, weabsolutely established that
women are not getting enough,they're not getting nearly 400
micrograms from food alone.
(10:37):
However, there was some that hadthat typical um Western diet
where they wake up in themorning, they have breakfast
cereal, then they have, youknow, a sandwich for lunch, and
they've got a lot of packagedfoods.
Some of them were getting over800 micrograms in their food.
So that's very problematic ifyou then add a supplement on top
(11:01):
of that.
So it depends, but I think thepeople that are most at risk are
the pregnant and prenatal womenthat are taking these 800
microgram plus um multivitamins,but it's the young kids, and and
if it's a neurodevelopmentaldisorder because of the
(11:23):
epigenetic effect, then it'severy newborn if mum has taken
excessive levels of folic acid.
Of folic acid.
And so that's that's a that is apublic health thing that we need
to address.
We need to have the cautionaround how much is too much, and
(11:47):
we don't know the answer tothat.
SPEAKER_00 (11:50):
When you're start talking about governments being
responsible and you know, publichealthcare messages and things
like that, we've seen it beforewhere you know there's a real um
uh protection, let's say aprotection of what's gone
before, you know, and then thethe slow change, if you like, so
that those people that areaffected by one um policy issue.
(12:13):
We could talk about asbestoshere.
So, you know, asbestos isoutlawed at a certain point, and
it took decades for any legalrecourse to happen, by which
time many of those victims hadalready passed on.
We're seeing this with PFASissues, with um um, you know,
(12:34):
aviation support people aroundairports.
Um anyway, blah, blah, blah,that sort of thing, you know.
Yeah.
So we're seeing this lag time ofthose people affected where they
encounter health issues.
That generation, if you like,dies out, and therefore it's
like, oh, yeah, we knew that.
Um now it's a real big issue,sort of thing.
(12:54):
Um you know, I I'm forgive mefor being so negative, but I
just I can see governments justgoing, nah no, nothing to see
here until bang.
Three generations later, whenthings have changed, they'll go,
oh, sure, we knew about that.
SPEAKER_01 (13:11):
Yeah, look, I I don't think it's an easy thing
because you're talking about aworldwide public health policy.
And we're not saying that folicacid is a no-go zone.
What we're saying is we now haveclear evidence from animal and
human studies that there is aproblem with excessive levels.
(13:33):
So let's define it.
If we're saying that 400micrograms is the recommendation
worldwide, then we need tocounsel women that they
shouldn't exceed that.
We also need an alternative.
So if someone does have problemswith methylation or they've got
an MTHR polymorphism or they'vegot other genes in that folate
(13:56):
pathway, then the sensiblealternative is the methylfolate,
which doesn't build up.
And so I think the problem, partof the problem is we have this
one size fits all.
And I think we need to be moreindividualized in our
prescriptions.
And I think we can't assume thatmore is better when it comes to
(14:19):
folic acid.
I think has it done its job frompreventing neural tube defects?
Yes, but it was only ever meantto contribute 100 micrograms per
100 grams of flour.
We're way beyond that.
Way beyond that.
Some breakfast cereals have 400.
(14:39):
So this is part of the problem.
It's it's we've got thisattitude that more is better,
let's just get more, more, more,more, more.
And you know, there's someresearchers in the UK that are
actually proposing we nowsupplement our food with a
thousand micrograms.
It's insanity, absoluteinsanity.
(15:00):
We can't wait, which is theaverage of research to the
population, 20 years.
We can't wait 20 years for thisto be resolved.
We need to be looking at thisexcess level now, and we need to
say, okay, for the majority ofthe population, there's no
problem if you're under 400micrograms of combined food and
(15:24):
supplements, which means we'vegot to drastically change what
people are having access to onthe supermarket shelf.
But then we also need to be ableto say, okay, if you do have
MTHFR, or we do know that youhave problems with not
metabolizing that folic acid,you might have a DHFR,
(15:44):
dihydrofolate reductasepolymorphism as well.
We think the better option foryou is methylfolate,
particularly in recurrentpregnancy loss.
And I'm really, I think that'sone of the things that I've come
out of this definitely saying ifyou've got recurrent pregnancy
(16:04):
loss, I don't think there's anyoption other than to swap to
methylfolate and really go at ahigher level.
SPEAKER_00 (16:14):
So let's just say, let's just dream for a second
that governments listened andsaid, okay, we're going to swap
to the methylfolate, which isone of the ones, one of the
active folates found in food,normal food, not fortified food.
Um, is it stable if they decidedto fortify with methylfolate?
(16:36):
And not at the end point.
Right.
SPEAKER_01 (16:40):
This is the biggest problem we have.
And I look, I don't think thatthere's any, I don't think
there's any chance that you willget a complete change in swap to
methylfolate.
I think where we we need to goinitially is say, okay, we're
still saying that folic acid isgenerally fine for the
(17:01):
population.
We'll stick it at 400micrograms, but we have to
minimize the voluntary folicacid.
I think if we could actually umdelete a voluntary folic acid
fortification and say we're onlysticking with the mandatory, you
(17:22):
can easily then guess how muchsomeone is getting from their
food.
Right.
And then say, okay, we want youto have a total of 400
micrograms to support thepregnancy.
Therefore, you you can have asupplement of 200 micrograms.
And then say to those peoplethat are having problems or
having recurrent pregnancy loss,we think that we need a
(17:45):
personalized prescription foryou, and we don't think
methylfol the folic acid is theright way to go.
Let's go with methylfolate.
And I think if we if we plan itout as a slow transition, I
don't think there's any chancethere will be a complete swap.
Because we do have problems, andthis was one of the things
(18:07):
unfortunately that came up inthe trial is that we did have
stability issues with themethylfolate product, which I
think did absolutely affect theoutcomes.
So the stability of methyl fromethylfolate is problematic, and
as yet, the one of the I thinkone of the reasons it hasn't
(18:28):
been approved for foodfortification is that it's not
stable.
And it's only in certaininstances that you could improve
that stability.
So I think it is a problem, andwe we probably need to just say
keep the methylfolate in thesupplements.
But then, given what we wentthrough, stability is key.
(18:53):
And I have to question a lot ofthe research that's come before
that's used methylfolate andhasn't found it to be
therapeutic, particularly infertility and with MTH of R,
whether that's part of theproblem, because they didn't
check most of I don't know ofany other study that actually
did test stability of theproduct.
SPEAKER_00 (19:15):
Wow.
Okay.
So what about I um introducingthe halfway measure, the folinic
acid?
Where does that sit in thepopulation versus a personal
sort of issue?
Somebody with SNPs on it versusa population basis.
Food fortification I'm talkingabout here.
SPEAKER_01 (19:32):
It's definitely stable.
And that's one of the hugeadvantages of folinic is it is
stable and it is, you couldabsolutely put it in food
instead of folic acid with noproblem.
And would that be a good interimstep?
Probably, particularly for foodfortification.
SPEAKER_00 (19:49):
Yeah.
SPEAKER_01 (19:49):
It's still in my mind, though, not the ideal,
particularly for those peoplewith MTH VAR who have got
recurrent pregnancy loss.
And also for to prevent ifyou're using it in
fortification, yes.
Um, but in terms of preventingthe epigenetic effect, you still
(20:11):
need that methyl folate.
So that would depend on aconversion issue.
It would um be anindividualized, I think,
approach.
But from food fortification,yes, it's so stable.
And it and it would be a verygood choice.
SPEAKER_00 (20:28):
From a healthcare policy and costing um issue, uh,
A, would it be viable?
B, if you're thinking aboutsub-populations that might be
affected by a methylation SNPand would require methyl folate
more than just the folinic acid.
Um, and then you've got to thinkabout the testing.
I mean, at the moment, anybodytrying to get a um a methylation
(20:52):
SNP tested, you've got toqualify uh by basically having a
um, what is it, a cleft palletor a baby with cleft pallet
previously or something?
Yeah.
Um so it's almost like you haveto have been proven to have had
an issue with your pregnancy,not just no pregnancy.
SPEAKER_01 (21:11):
It's it's a really Well I I really think that all
women with recurrent pregnancyloss should fit into that
category.
You've had a problem, let's makesure that we're doing something
differently.
Because what our research found,and it was just a small
subsection of the women from theum pilot study, where we
(21:34):
interviewed them about theirexperiences in the medical
system with their recurrentpregnancy losses.
And there's a real there'sthere's a lot of different
problems when we we look atthese this recurrent pregnancy
loss situation because thesewomen are not pregnant, but
they're not not pregnant.
(21:54):
They're getting pregnant usuallywith no problem whatsoever.
They ring their GP and they say,I'm having a miscarriage, and
the GP says, well, go to theemergency, I can't do anything.
The emergency center puts themin the maternity ward to have
their miscarriage, and thenthey're told go home and keep
(22:14):
trying.
So there's this loss of thislack of appreciation of what
they've gone through, and justcan, I guess, thinking about it
from a physical point of viewand not an emotional point of
view, it's very lacking.
And these women are saying, hey,we don't fit into the system.
(22:35):
We're not we're asking what wecan do differently, we're asking
how we can prevent it, andthey're told nothing, go home
and keep trying.
So I think there's real issues.
And if we could come back tothese women, and that's why they
love to see us in clinic,because we say, Yes, we actually
believe there's a lot you cando.
First of all, get rid of thefolic acid out of your diet.
(22:57):
Second, let's move you to methylfolate, let's test you for
MTHFR, let's increase the folateif it's warranted, and let's
look at all the other.
And if they say there's nothingphysical, that's when I say,
great, perfect.
And you know, 80, 85% of thetime they will get pregnant
naturally.
(23:18):
So I think there's a lot we cando if we're a bit more
individualized in the approach,and we we put these women that
are having recurrent pregnancyloss not into the mainstream
medical system, but we'resaying, okay, we accept that
what we need to do for you isactually very different.
And let's do that protocol,let's change you to methyl
(23:41):
folate and see if you get animproved response.
And they probably would.
SPEAKER_00 (23:47):
Can I ask the question about uh dosage and I
think you've sort of answeredthe question, so forgive me for
asking it again if I've um justre-asking, but with regards to
what you saw with unmetabolizedfolic acid in supplemented
individuals versus unmetabolizedum folic acid in those people
(24:09):
just on uh quote unquote uhstandard Australian diet, sad.
Um is the issue just that,simply that, solely that they're
taking folic acid, and if theystopped that intake of folic
acid, their folic acid levelswould drop to normal, i.e., the
issue of high folic acid isquote unquote supplementation of
(24:33):
some form, whether that be froma tablet or food.
Is that the issue, or doesunmetabolized folic acid remain
an issue after cessation offolic acid intake?
SPEAKER_01 (24:47):
The there's previous research, not mine, that that
basically says if you live in acountry of fortification and you
are eating a normal, what theycall a normal diet, you will
have levels of unmetabolizedfolic acid.
Every single person in asupplemented country that has
bread or breakfast cereals oranything in a packet absolutely
(25:10):
will have unmetabolized folicacid.
One of the things we found inthe trial, though, that was very
exciting, is that the women onthe folic acid had really high
levels of unmetabolized folicacid.
The women on the methylfolatedid not.
It was really low.
SPEAKER_00 (25:27):
Well, hang on.
So that would that wouldindicate, therefore, that the
issue is supplementation, i.e.
tablets, not food fortification.
SPEAKER_01 (25:33):
We took them all off.
Every single person in the trialwas off folic acid-based foods.
And that was what was totallyunique about this trial is that
it was one of the only trials inthe world to take people off the
food fortified with folic acidand also to include the male
partners.
And what was really interestingis that the male partners were
(25:57):
the ones mostly with thehomozygous MTH of R.
SPEAKER_00 (26:01):
Right.
SPEAKER_01 (26:02):
Not the women.
And yet we do nothing for men.
We don't tell them to take anyfolate, we don't counsel them to
take, well, we do, but mostpractitioners don't.
Um, so what the women did in thetrial, the men did too.
They had to go off the folicacid foods, they had to take
their prenatal multivitamin, um,and they did exactly the same.
(26:25):
But it was really interestingthat it was the men.
And we know from previousresearch, there is a lot of
research around how folic acidaffects sperm.
And those people, those maleswith MTH of R polymorphisms have
been shown to have azoospermia,oligosoospermia, and
(26:49):
infertility.
And there's multiple, multiplestudies that reinforce that and
back that up.
SPEAKER_00 (26:55):
It's it raises a really interesting question
regards the regarding theprevalence of neuroatypical um
issues, disorders, if you like,in young children, male to
female prevalence.
SPEAKER_01 (27:06):
Yeah.
SPEAKER_00 (27:07):
Wow.
SPEAKER_01 (27:08):
Absolutely.
SPEAKER_00 (27:09):
I know yet again.
SPEAKER_01 (27:10):
Yeah, it's it's but it's so interesting.
And I guess what I'm, you know,what I I've got to really sit
down now is pull all thistogether in a sensible way.
Because as I said, I just don'tthink there's any hope in public
health policy changingovernight.
It's just not going to happen.
(27:32):
But but if but if we're saying,hey, 400 uh micrograms is the
recommendation, then why are weallowing more than that?
You know, we we have to, and andwe can't have this attitude that
more is better with folic acidbecause we know it's not.
SPEAKER_00 (27:50):
Is part of it also balance, i.e., we're seeing an
issue with B6, you know, vitaminB6.
It's being, you know, uh, in myopinion, um, a little bit
lamb-based in that we're seeingtoxicities, but is it largely?
Um, is it solely?
I don't know.
But um I don't know of anaturopath who would use massive
(28:13):
doses of B6 solely for anextended period of time without
supplementing with other Bvitamins, preferably activated.
Indeed, it was the the naturalhealth practitioners in this
country that sort of lobbied,and and the companies which
lobbied for the activated uh Bvitamins to be to be listable.
SPEAKER_01 (28:31):
Um you know, you know why I think that is
happening, the whole B6 issue?
SPEAKER_00 (28:35):
Tell me.
SPEAKER_01 (28:36):
So we need B6 has a lysine residue in it, right?
So to metabolize B6, you needlysine.
We have come off five years of ahigh viral load.
And everybody, in my opinion, islysine deficient.
(28:57):
We have proved hundreds of timesin clinic if we give lysine, the
B6 comes down instantly, likewithin weeks.
SPEAKER_00 (29:08):
Wow.
SPEAKER_01 (29:09):
So I believe this whole issue is a lysine
deficiency and has nothing to dowith B6 toxicity.
SPEAKER_00 (29:19):
That's a big statement.
SPEAKER_01 (29:20):
I but I do because how can you then explain that
you give someone lysine forthree weeks and their B6 comes
back to normal?
And they're still they're notnecessarily and we put them back
on the B6, keep the lysine in,and there's no toxicity.
Because you need lysine tometabolize your B6.
SPEAKER_00 (29:42):
Yeah.
Wow.
Wow, that's an interestingcomment.
I didn't look into that.
SPEAKER_01 (29:47):
Yeah.
SPEAKER_00 (29:47):
So because if you look at if you look at the the
Australian Bureau of Statistics,the ABS, and you look at their
nutrient sort of deficienciesover lifespans, you know, B6 in
young women and and uh I'm gonnasay middle age women, but you
know, the sort of mature woman.
Um, they're huge.
Yeah.
Um wow.
(30:10):
I need to think about that tothink even of questions I can
ask.
SPEAKER_01 (30:13):
Well, I've I've been I've been doing that in clinic
for probably eight years.
If I see B6 elevated, I givelysine, it comes straight back
down.
SPEAKER_00 (30:23):
Wow.
Cool bananas.
Okay, uh, let's go back to yourresearch because um you said
earlier about your attitudetowards changing folic acid and
things like that.
Is there any other messages thatwe need to heed that you've
learnt along your journey withyour research?
SPEAKER_01 (30:40):
Yes, I I'm I'm more absolutely 100% determined to
ensure that men are included inpreconception care across the
board.
I mean, we when you look at theall the policy recommendations,
um, all the protocols thatdoctors are following in regards
(31:03):
to recurrent pregnancy loss, menare pretty much nigh absolutely
ignored.
And so I think we can't expectall these women to be pin
cushions in IVF and doing allthe right thing and taking all
the supplements and beinginjected with hormones and
everything else, and then justignore them in and go, oh well,
(31:25):
it's not your issue.
We need to really be looking atDNA fragmentation rates across
the board.
We need to be checking them forMTHFR, we need to be putting
them on the same diets.
We we did in the um practitionerresearch that we've just had
published last week, that wasone of the things that really
stood out when we asked them howmany actually included males in
(31:50):
preconception care, was 11%.
SPEAKER_00 (31:53):
Wow.
SPEAKER_01 (31:55):
11% of fertility specialists, midwives, GPs, um
rates, 11%, and that can'tcontinue because what what is
this?
Do men a do we not teach kids inschool that they're involved in
making a baby?
(32:16):
Two, do men have no idea that50% of their DNA is
contributing?
I mean, the amount of times thatmales say men say this has
nothing to do with me, it'slike, oh my goodness, I wish I
had a daughter for every time.
So, and then because we're notaddressing it from a public
health perspective, we needmessaging out there for men, and
(32:39):
it's got to start at school.
Hey, you're 50% responsible.
So what your wife does, you do,or what your partner does, you
do.
And that was a big eye-opener,particularly when we found in
the trial that it was the menthat had the MTH pharaoh
polymorphisms homozygous.
(33:02):
So that raises the wholequestion is why do we only
consider that the woman has hasthe problem?
And the amount of times thatwe've seen, you know, these
women in clinic that havestruggled and struggled and
struggled to get pregnant, andall the time it was their
partner.
(33:22):
Yeah.
So I think I mean, mostnaturopaths would absolutely
address the um the male, butit's not happening at the front
line.
It's not happening with GPs andit's not happening with
fertility specialists on thewhole.
So we really need to change thatwhole dimension that, hey, we
(33:44):
need protocols for men as womenand women, not just women.
SPEAKER_00 (33:50):
What about things like other B vitamins, e.g.
B12?
You know, like I I never everused to give folic acid in my
younger days.
Um, I never used to give folicacid without giving B12, just
wouldn't do it.
SPEAKER_01 (34:02):
Yeah.
SPEAKER_00 (34:02):
Um what have we learned?
What what sort of other issueshave you learned with
generalized nutrition?
Uh ID deficiency, for instance.
Are you seeing this being aconcordant issue?
SPEAKER_01 (34:15):
Yes.
I mean, I think I think theproblem is now that our food
doesn't supply us with what wethink it should.
And I think a lot of um GPsstill have the attitude that
it's food is fine when you'repreparing for pregnancy.
And I just don't think we cansay that anymore with the
processing and everything.
(34:36):
So all the things that we knowwe've got to check, B12 is
critical when it comes to folateabsorption.
Absolutely critical, because youcan't absorb your folate without
B12.
And so if we consider that folicacid does mask a B12 deficiency,
anyone taking folic acid is athuge risk.
(34:58):
And so I think we've got to bechecking those absolutely.
And as a general rule, we don'tgive isolated B vitamins without
the whole package.
So I think that's alsoimportant.
But we did see that in thepractitioner's survey where they
were giving off-the-counterproducts that just had folate
and iron in it, because that'sthe recommendation.
(35:20):
So I think the recommendationsneed to be broadened to say we
do need multi-Bs in formulas.
Um, and when you look at thoseformulas on the shelf, the
amount of B12 in there isabsolutely pathetic, except for
practitioner-only products,which they're really good.
I mean, you're talking sixmicrograms.
(35:42):
Like it's it's insane.
So I think there's, yeah,there's a lot of a lot of
issues, but we're not gonnasolve all those overnight.
But we can only try, can't we?
SPEAKER_00 (35:53):
We're gonna need to clone you for the next
generation, Carolyn.
So you've got the next we needmore.
And and flowing on from that,what's next with your research?
What's happening now?
So um, okay, you'll have yourPhD done hopefully by the end of
2025.
Um, what's it's Dr.
(36:13):
Carolyn Ludowski?
SPEAKER_01 (36:15):
Oh, well, it's a really good question.
And I I'm not sure yet.
I would I like to do someteaching?
Yeah, I would.
I think I'd really like to teachthe next generation of kids
that, hey, this is a reallyimportant topic, and for us to
understand that biochemistry andhave the attitude that we need
to be more individualized in ourprescriptions.
(36:37):
I think that's really important.
There's so much research, andI'm I'm in the process now of
writing the implications forfuture research, and there's so
much future research around thiswhole thing.
Maybe supervising some other PhDstudents that can continue this
work would be awesome.
(36:58):
Um, so I don't there's a lot ofoptions.
I'm not sort of wedded toanything, or a book.
Yeah, absolutely.
I do want to write a book nextto you.
That's one of the things on mylist.
Um, but it's there's a lot, andI think well, I've only looked
at it from a recurrent pregnancyloss, but as I said in the very
(37:19):
beginning, I think autism, Ithink definitely neurological
disturbances across the board isa very, very big part of the
picture.
And I think cardiovascular,there's so much.
Um, mental health, depression,anxiety, there's a lot that
(37:40):
could be addressed throughfuture research.
And I think I think, yeah, justI'd like to get to public
department, you know, healthdepartments to start presenting
the results to at least opensome conversations to say, hey,
wouldn't it be great if we couldbe the first in the world to
(38:02):
actually look at what excessmeans and how we define it and
what we do?
I think that would be great.
SPEAKER_00 (38:09):
I think, I think part of what you're asking,
though, and uh we can only hopethat somebody in authority
within the healthcare system,within politics, the you know,
that sort of echelon of ourgovernance in Australia, um,
whether it be medical orpolitical, has the fortitude to
(38:30):
change policy with regards topublic health, that more is not
better.
We got it wrong.
We need to change.
We've we've we've done itbefore.
I don't think they're gonna saywe got it wrong.
SPEAKER_01 (38:42):
No, I don't think, but but I do think the first
step could absolutely be we'renot changing our policy.
We're just saying that webelieve that 400 micrograms is
the upper limit.
So we're gonna restrictsupplements, we need to tamper,
we're gonna reassess voluntaryfortification, and by the way,
(39:03):
we're gonna acknowledge thatthere is a subset of the
population, like those havingrecurrent pregnancy loss, that
we might look at changing whatwe give.
unknown (39:12):
Yeah.
SPEAKER_01 (39:13):
If we could do those three things, that would be
major.
SPEAKER_00 (39:18):
Yeah, but not just with those women that are losing
the baby with their partners whoare give donating the DNA.
Yeah.
SPEAKER_01 (39:26):
Absolutely.
I think that would be absolutelyphenomenal if those three things
could at least be started tosay, okay, we acknowledge
there's an upper limit.
We don't know what it is yet,but let's let's just stick to
the worldwide recommendation,which is four or five hundred
micrograms.
Let's not allow any supplementto have above that.
(39:48):
And by the way, yeah, we thinkthe people are probably getting
too much.
So let's cut out a voluntaryfortification and just stick to
our mandatory.
That would be major if we coulddo that.
SPEAKER_00 (40:01):
I I am so impressed by your your incredible focus,
but also your care because it'snot just care about the topic,
because you're a clinician, youcare for patients, you care for
women and men who are sufferingissues, not just pregnancy and
loss and things like that, butneurological issues you have
done for decades.
Um, I'm so impressed that youare finalizing your PhD now
(40:26):
because it's going to give youthat extra piece of credential
to say, no, no, I've reallylooked into this.
You know, um, you really, youreally have a message that's
worthy of being listened to.
I just I thank you so much forthe work that you've done, not
just for patients, but forfuture practitioners and the
care of their patients.
Well done to you, CarolynLudowski.
And I will I will preempt thisby saying, uh, what do we say?
(40:50):
PhD candidate, but you know, Ican't wait for the day where I'm
able to say Dr.
Carolyn Ludowski.
SPEAKER_01 (40:56):
Oh, thank you.
That's really kind of you.
Yeah, it is look, it isexciting.
And as you said, I I've beenpassionate about this for 15
years, but I it was justsomething that I was determined.
That was part of the reason I Idid the research.
One, I found, and it's sad, uh,but I did find as a naturopath,
(41:17):
I didn't have a voice in thisarea.
I and I really needed to have avoice.
I needed to basically try andget other people to see what I
could see in clinic.
And so that was the real movebehind doing the doctorate, was
to not only get research wedidn't have, but also have a
(41:40):
voice at the end of it that Icould say, yeah, I have the
credentials to be able to say toyou, I think we've got a
problem.
And so if that means then that Ihave to do 500,000 presentations
next year, I'll do it.
But it just means that we've gotto open some doors.
And I think as a doctor, I'vegot more chance of opening doors
(42:05):
where I couldn't open a doorbefore.
And it's really sad to say that.
But I think what comes with thedoctorate is people say, Well,
you've got to know your topic.
SPEAKER_00 (42:16):
Yeah.
Yeah.
And I can see that you'll be indemand the world over.
Well done, Carolina Ludowski.
It's been great chatting withyou again.
Yeah, and thank you so much forsharing.
This is like it's such importantwork that you're doing.
So well done, seriously, forwhat you've done.
Beautiful.
Thank you.
And thank you, everyone, forjoining us today.
Of course, we will put up asmuch as we can with Carolyn's
(42:39):
research.
There will be some that we can'tthat will be embargoed until
it's published, but um, watchthis space.
We'll put up the relevantdetails for when they become
available.
And of course, you can watch theother podcasts on the Designs
for Health website.
I'm Andrew Whitfield Cook, andthis is Wellness by Designs.
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