Welcome to the Hey Mami podcast!
Our guest today is Taylor Dukes, a board-certified family nurse practitioner with a private practice in Texas. Taylor also owns a wellness center that includes everything from IV Vitamin Therapy, to saunas, to physical therapy.
She focuses on a root cause approach and uses specialty functional medicine laboratory testing to develop personalized protocols.
Taylor was first exposed to the field of functional medicine as a patient when she was really sick. Once she healed, she had the opportunity to work for Amy Myers, MD, a NY times best selling author.
Taylor is a wife and mother. She loves helping other mothers on their preconception, pregnancy and postpartum journeys.
In today’s episode we are talking about practical ways to prepare for pregnancy.
- Why Taylor does what she does
- Why is it important to avoid toxins as much as possible?
- Boosting nutrients
- Prenatal vitamins
- Prenatal blood draw
Follow Taylor on Instagram
“We can’t eliminate all of the stressors in our lives, and control all aspects. One thing that we can do is learn how to manage it.”
“If you have the means to do it, and you can prepare ahead of time, I would definitely encourage you to get on a high quality prenatal.”
016: 5 Practical Ways To Prepare For Pregnancy w/ Taylor Dukes, NP TRANSCRIPT
Dr. Maren: Welcome back to the Hey Mami Podcast. In today’s episode, we’re talking about practical ways to prepare for pregnancy. Taylor Dukes is our guest today. She’s a Board Certified Family Nurse Practitioner with a private practice in Texas. She also owns a wellness center in Fort Worth that includes everything from IV vitamin therapy, saunas, and physical therapy. She focuses on a root cause approach, and use a specialty Functional Medicine, laboratory testing, to develop personalized protocols. Taylor was first exposed to the field of Functional Medicine as a patient when she was really sick. When she healed, she had the opportunity to work for Amy Myers, MD, who is a New York Times bestselling author. That is where Taylor and I met, and subsequently became really good friends and colleagues. Taylor is a wife. She’s now a mother to a two year old boy, almost two. She has another on the way. We’re super excited to interview her today, because we’ve caught her when she’s currently 24 weeks pregnant, so everything is super fresh, right?
Dr. Maren: Yeah. You’re going through it. Alex and I have obviously been through it, but our kids are like three, or at least our youngest are. Some of this stuff is behind us, although we work with lots of patients in that preconception timeframe. Tell us about why you do what you do.
Taylor: I’m passionate about why I do what I do just because I’ve been the patient, and I think when we experience our current medical model as a patient, with chronic, or unexplained conditions, you have to advocate for yourself until you find a provider that’s willing to listen, and dig deep. I’m passionate about it just because I experienced it as a patient. Now, that I’m on the provider side of things, I’ve just seen the profound impact that a root cause approach can have on someone’s life, their fertility, chronic conditions. You can get people off with medications, sometimes medications are necessary and lifesaving, but it’s been amazing seeing the profound impact on patients. I know you guys have that experience, one-on-one, in your practices, as well.
Dr. Maren: Yeah. You know one thing, what I didn’t mention in your bio is, tell us what your background is. You started out as an ICU nurse.
Taylor: Yeah. I was an adrenaline junkie. I knew nothing about Functional Medicine. I grew up in a healthy home. Looking back, my mom definitely had an influence on me. I was a party girl in college, would drink beer, eat all the college things. I just wanted to work trauma ICU and become a helicopter flight nurse. That was my goal. Then, I had the opportunity to go abroad and do some mission work in Africa and Ecuador. After those two trips is when I really started… I got really sick. Mine happened, even though it was drops in the bucket over time, all of a sudden I was manifesting these symptoms, and I was never the sick kid growing up. I never even had acne going through puberty, any of that.
Taylor: My skin was wreck, my gut was a wreck, I joint pain, my hair was falling out. Here I was, this nurse in a medical field, going to all these different doctors and providers, everything from endocrinologists to gastroenterologists. I had colonoscopy, endoscopy. All these people were trying to figure out what’s going on. I was so convicted because here I am this nurse in the medical field, and I couldn’t advocate for myself. It wasn’t until I was introduced to Functional Medicine, as a patient, that I really believed in it. Actually I went to Dr. Ann Shippy in Austin, my parents sought her out. I was like, “That’s voodoo medicine. I didn’t learn that in school. That’s totally woo-woo.” I think I was so desperate, and on medications, I didn’t know what else to do. I went into it really skeptical, but then obviously it changed my life, and then the trajectory of my career. I’ve never turned back.
Dr. Maren: Once you see, you can’t unsee.
Taylor: Exactly. Some people that get into this field are sick. I know you have a story, you guys might have a story-
Dr. Maren: Mine is not that too dissimilar from yours. I was the same way. I was a party girl. I wasn’t crazy in college, but I was… Yeah, I was drinking beer, eating cereal at the cafeteria. These are things I would never dream of now. I would also get so hung over. I had all these little health issues. Mine crept in and in and in. In retrospect, I can see a lot of that. We weren’t born with green juice in our hands.
Dr. Carrasco: That’s for sure.
Dr. Maren: That happened over time. Cool. Taylor, one of the things I love about what you do, and your Instagram, is just that you keep things pretty practical. We’re not going to go overboard. Healthy living isn’t that far away. It doesn’t have to be this… I tell people whenever I talk about wifi, we’re not asking you to cover your house in tin foil. Suggesting some practical steps to cut back on things. You don’t have to be perfect. Let’s frame that lens around preconception, and help people understand what are the top five things that you suggest when you’re working with a patient, and that you did when preparing for pregnancy?
Taylor: I love your perspective on that, because I do feel like sometimes we get so far out in the weeds that we miss the basics, or the fundamental things. Practically, when it comes to preparing for pregnancy, I came up with five things that you can do today to implement. Some of them might feel overwhelming, but I would just encourage people to start somewhere. One of the most important things, and something that I did personally… I’ve done all these things personally, so I can speak to them. I do it professionally with patients, as well. I would say to just be mindful of your toxic exposure. Getting rid of toxins. We live in a world today where toxins are everywhere. They’re in our beauty products, our clothes, our workplace, food, household cleaners, of course, in our backyards. I get it. We may not be able to completely eliminate toxins from our surroundings, but I think that when we become more aware, and educated, about the things that we do have control about, it can have some significant impacts on not only our overall health, and our endocrine system, and hormones, but also can affect fertility. I would say focusing on getting rid of toxins, cleaning up your home, starting there.
Taylor: I know we can’t control everything in our workplaces, those of us that work at places, but the majority of time… Even I tell people, I’m like, “If you can just swap out your laundry detergent, that’s a game changer.” It’s your clothes. If you have children, your spouse, your robes, your towels, your sheets, think about how much time we come into contact with just something that’s been in a toxic laundry detergent. I would say, start somewhere, whether it’s beauty products, personal care products. Of course, I know you guys are passionate about detoxing before conception, if able. Not everybody has that opportunity. Sometimes, it’s a surprise. I think that if you can prepare, and something I did personally for both pregnancies is, I don’t advocate for detoxing during pregnancy, or breastfeeding. It’s a small window and margin of time that I think that you can really capitalize on that opportunity to do more targeted detox therapies. Just detoxing, whether that’s getting rid of products, or doing more targeted detox is something that I think is really practical, and tangible.
Dr. Maren: Yeah. For those of you who are listening, go back a couple episodes because we interviewed Lara Adler, who’s the environmental toxins nerd. We talked a lot about how to remove toxins from your environment and simple ways to do that. Then Dr. Shala Salem, who is an OBGYN, talked a lot about how those toxins actually influence reproductive health. All that should be super informative. Then, just one more thing about detox, too, we always tell patients, try to do it the further in advance you can do it from the time you get pregnant, the better. For those of you listening, try to do it early, not late. Like Taylor mentioned, definitely you don’t want to detox in pregnancy and breastfeeding. One thing I tell patients is the way that our body’s designed to detox, we detox through stool, through urine, through sweat, and through breast milk.
Dr. Carrasco: [inaudible 00:08:29].
Dr. Maren: Yeah, too. Right. Yeah. All of these bodily processes are naturally built in for us. You don’t want to upregulate when you’re pregnant or breastfeeding. What are some of your top tips? What’d you do before you detox for pregnancy?
Taylor: Yeah. I think it’s going to depend on the person, too. Some people have more toxic type symptoms. I personally, mainly I guess because I have access to it at the wellness center, but I did a lot of infrared sauna therapy. I did ionic foot detoxes, some IV vitamin therapy. If people have gut symptoms, I know it’s not necessarily a targeted detox, but getting rid of dysbiosis, pathogens, parasites, that is a form of detox. We oftentimes have pregnant patients that we’re like, “Sorry. We can’t treat this right now.” Those are some ways to detox. I would also say lymphatic drainage, you can do a therapy, massage, you can do rebounding. I remember, Christine, we were talking, I feel you were breastfeeding with your last, and you were like, “I can’t wait to be done so I can detox one day.” I think, also, too, it’s a good reminder, just getting rid of toxic chemicals in our environment. That, in of itself, is a detox. Sometimes you don’t have to pay for these really expensive therapies. Of course, I like them and enjoy them. Things like Ozone, but at same time, you can do detox baths, or armpit clay masks to detox. I think sometimes it’s just getting rid of toxic chemicals because that’s what’s accumulating your toxic burden day in and day out.
Dr. Maren: Yeah, totally.
Dr. Carrasco: Open the pathways, and also clear all the toxic exposures out, and then you end up in a more balanced and homeostatic state.
Dr. Maren: Your pathways will work better if you don’t have such a load. All right. What’s tip number two?
Taylor: Okay. Tip number two. I feel people talk about this, but it’s so, so important. I would say managing stress. I know that just sounds like, “Oh yeah. Whatever. We just live in a stressful life.” I get it. We can’t eliminate all of the stressors in our lives, and control all aspects. One thing that we can do is learn how to manage it. If you’re going through a stressful season, or things are out of your control with a diagnosis, a loss of a loved one, move in your house, you know that you’re going to be stressed, but what are the things that you can do to reset that nervous system and get you more into a parasympathetic state. Practically speaking, from a preconception and fertility standpoint, we know that cortisol can affect our HPA axis, which can affect thyroid function and sex hormones. Actually, there was a study that showed that women who felt high levels of stress during ovulation were actually 40% less likely to get pregnant during that month compared to other less stressful months.
Taylor: I think I’ve seen the profound impact of stress, even with triggering autoimmune diseases. There’s multiple contributing factors, but there was one stressful event, and that triggered the manifestation of things. Again, we can’t control everything, but I would say doing things to help mitigate, whether that’s yoga, meditation, prayer, seeing a counselor, practicing gratitude. I think when we talk about the idea of free medicine, these are all the things that we can do and incorporate, but that usually get pushed to the wayside.
Dr. Maren: Yeah. We just had a really interesting conversation with a reproductive endocrinologist who does the NaPro technology, so more natural stuff. She was talking about the adrenal subtype of PCOS, which is something I’m sure you’ve seen, too, which is this patient who’s often… She doesn’t have insulin resistance, like many of our PCOS patients do, but she has super high stress and maybe over exercising, and under eating and over-performing at work, if there’s such a thing. There is such a thing. It just goes to show, stress can even influence ovulation to a huge degree. I think that’s a really good one. All right. Take us to tip number three.
Taylor: Okay. I would say focus on boosting nutrients via nutrition. I think that we know that the mother’s health influences baby’s health in numerous ways. I would say, of course, we know that pregnancy, you’re just going through vitamins and minerals, and being depleted. It’s the beginning of that sacrificial love, even from when baby’s developing in the womb. Then you breastfeed, if you breastfeed. There’s a huge metabolic demand. I think a lot of women go into pregnancy deficient. It’s not only about eating enough foods, but I would say the right foods. I’m really passionate, just like you guys are, we’re all unified in what we believe. Just really boosting that nutrient reserve prior to conception. Some people are really mindful of their nutrition before they’re pregnant, and then some people are like, “The day I get pregnant I’ll care.” Speaking for me, personally, I don’t feel great during my first trimester. I try to load up on as many nutrients as I can prior to conception.
Taylor: Practically, high quality protein, or plant-based protein, if you avoid animal meat and things like that. If you are eating animal meat, I would encourage people to find high quality ones, that are free of antibiotics and hormones, grass fed, grass finished beef. Tons of healthy fats, which we know can affect baby’s brain development. Fiber for the liver, soluble fiber for your gut microbiome. Iron rich foods. I feel like a lot of women, and you guys probably see it in your practice, that I test, they’re super iron deficient. Going into pregnancy iron deficient can do a number on your health. Magnesium rich foods, folate rich foods. I’m sure you guys have had so many topics on nutrition and preconception health. I do think it’s a great opportunity to capitalize on eating healthy before you’re wanting to conceive.
Dr. Maren: Do you have any hacks on how to do it when you’re busy?
Taylor: Gosh. That’s the million dollar question. Everyone’s like, “How do you make time?” I’m like… Or they say, “How do you have time?” I’m like, “I really don’t.” It’s one of those things that you’ll just prioritize it when it’s important to you.
Dr. Maren: I don’t have other options, either.
Taylor: Smoothies, I feel are a great way for me to just pack in a ton of nutrients. It’s a great start to the day. I don’t always want it in the winter, obviously. If it’s cold out I want more nourishing foods. I would say, and balancing your blood sugar. That’s another one when we were talking about PCOS. My thing is being prepared. I meal prep a couple of times a week. I’ve done certain meal delivery services. My husband’s helpful, sometimes, the kitchen.
Dr. Maren: I have meal delivery coming tonight, which I’m super excited about. It’s all organic and mostly plant-based. I’m determined to have a really healthy breakfast and lunch because I am so much better. I’m a better person at night, when I have children, and I’ve had some good food during the day. Otherwise, it’s hard. You’re running a business, you have kids, we’re all in the same boat. It’s obviously a priority for all of us. We struggle just as much as everybody else sometimes. We know what to eat, we just don’t know always how to get it in our mouth.
Taylor: Mindful eating. That’s the biggest joke as a mom. I encourage it so much, but I’m like, “Got to hurry up and eat.” I feel like you guys, three kids, boss moms, own your practices. Hey Mami. How the heck do you-
Dr. Maren: Smoothies and meal delivery.
Dr. Carrasco: Smoothies and soups. Avocado.
Dr. Maren: Bone broth. Every night we make a dinner as a family, and eat a really good dinner. It’s the breakfast and lunch that can be a struggle bus over here. Smoothies are super helpful. I get sick of them sometimes.
Dr. Carrasco: Same.
Taylor: I feel like, too, with you being in Boulder, Christine, and Alex, you being in Austin, that you guys have great resources.
Dr. Maren: Yeah, we do have really great options.
Taylor: Praise the Lord for healthy restaurants when I’m on the go, that I don’t have to ask about the ingredients and quality and sourcing. Sometimes I eat out more than I care to, especially pregnant. It’s okay.
Dr. Maren: All right. What’s tip number four?
Taylor: I would say get on a prenatal vitamin ahead of time. Some people are like, “The day I get the positive pregnancy test, I’ll start a prenatal.” If you have the means to do it, and you can prepare ahead of time, I would definitely encourage you to get on a high quality prenatal. I know you guys have talked about high quality prenatals on your podcast. People can go back and listen to those episodes. I remember listening to one, was it with Sarah?
Dr. Maren: Sarah Morgan, yeah.
Taylor: That would be a great resource. I think we’re all passionate about sourcing, not getting your supplements on Amazon, making sure they’re free of allergens, fillers, chemicals, heavy metals, things like that. Then, of course, the important nutrients. You guys do such a good job of educating people. I would say a high quality prenatal that contains things like choline, and iron, and vitamin A, and omegas, and things like that. Again, it’s about boosting your nutrient reserve. I think the World Health Organization actually estimates that around two billion people are deficient in micronutrients. With women being at particular risk because of ministration, the high metabolic demands of pregnancy. Again, going into pregnancy, it’s almost like an athlete going in with a competitive advantage. We’re going to get depleted over time and be tired, but anything we can do to help boost our reserves will not only affect our health throughout pregnancy, but also babies. Babies getting our reserve, if they’re taking everything from you and you’re already on leftovers, it can effect babies development, as well.
Dr. Carrasco: That’s right.
Dr. Maren: That said, we always tell people, take your prenatal vitamin while you’re breastfeeding too. Stay on it.
Taylor: For sure.
Dr. Maren: Our last. Our fifth tip, what is it?
Taylor: All right. I would say if you’re not already working with a Functional Medicine provider, now would be a great time. Although, I realize not everybody has chronic conditions, but if you’re not working with a Functional Medicine provider, hopefully they’re doing lab draws on you, but if not, advocate for a prenatal blood draw. What I mean by that is, don’t wait until you’re having fertility issues, or don’t wait until you wonder if you’re iron deficient, go ahead and be proactive ahead of time. I realize, some people listening, you may not have that patient provider relationship where you feel comfortable. Don’t just shy away from advocating for yourself. You can check things like thyroid function, and vitamin D levels. You can check liver, kidney, blood counts, of course, an iron panel with ferritin is super important, to not just look at what is your iron levels, but what is your iron reserve look like? That’s that ferritin marker.
Taylor: Some people looking at lipids, or going more in depth looking at nutrients like RBC, magnesium, things like that can be really, really helpful. If you’re working with a Functional Medicine provider, amazing, if you can do a nutrient test. That’s something that I did prior to both babies. I was like, “What if I need to do more targeted supplementation, or if there are certain things that can be incorporating in my diet, what would that look like?” I did that testing myself to target more specific deficiencies. I realize not everyone has access to that, but even just a comprehensive prenatal blood draw that you can do through Quest or LabCorp can be really helpful and help mitigate issues, if you are anemic or have hypothyroidism.
Dr. Maren: Yeah, totally. That’s a big thing we advocate for, as well, as you know. Sometimes it’s hard, but I think they’re pretty reasonable requests when you ask for a vitamin D level, or a full iron panel.
Dr. Carrasco: Homocysteine.
Dr. Maren: Yeah, homocysteine. If you have symptoms, you might have to relate those symptoms to your doctor and say, “I feel fatigued.” Whatever else it might be, because that might be an indication to check. Sometimes when doctors don’t check, or providers don’t check, sometimes it’s because they don’t think your insurance is going to pay for it. You can address that. If you do have symptoms, make sure you communicate that with your doctor, or your provider, because then your insurance is more likely to cover it. Then again, there’s also ways that you can go order these labs on your own. It’s hard. I don’t encourage people really to do that regularly because you have to have a trusted provider who can help you interpret them.
Taylor: Exactly. All of us are passionate, we’re so like-minded. We’re all pretty much on the same page and unified, but making sure levels are not just normal, but optimal. You could be in the reference range, and it’s the same reference range for your two year old kid, and your 95 year old grandfather. It doesn’t account for age, gender, metabolic demands. That’s where working with a provider that is knowledgeable, and educated about what’s not just normal, but optimal, can be really important. I know you guys provide a bunch of resources, and I try to educate as much as I can. I do know that some people do feel lost if they don’t have a provider that knows about Functional Medicine, or Integrative Medicine. I would say, too, if someone has more targeted symptoms, a ton of gut issues, or a family history of hypothyroidism, that’s where you might want to be more proactive about specific targeted things prior to conception. These are just five good basics that everyone can take away from.
Dr. Maren: Totally. I agree 100%. Taylor, tell us where people can find you.
Taylor: They can find me online. My website is taylordukeswellness.com. That’s also my Instagram handle. Taylordukeswellness.
Dr. Maren: Awesome.
Dr. Carrasco: You’re in Fort Worth? People should check out your wellness center.
Taylor: Yes. My wellness center is in Fort Worth. It’s our little brick and mortar. It’s basically my dream day when I move. We have everything from a holistic aesthetician, to women’s pelvic floor, physical therapy, IV vitamins. It’s fun. It a dream in the making.
Dr. Maren: So awesome. Amazing. Thank you so much for being here. We have so much to catch up on, so offline we’ll just chat. It’s so fun seeing you.
Taylor: Thank y’all for having me.
Dr. Carrasco: Thank you so much.