Ep. 23: Understanding Blood Sugar & Fertility with Dr. Brittannie Chester, PhD, RDN, CDES
Caitlin:
Welcome to the woven well podcast. I'm your host, Caitlin Estes. I'm a certified fertility care practitioner with a master of divinity degree. Each episode we'll cover a topic that helps educate and empower you on your fertility while honoring the deep connection your fertility has with your faith. Let's get started.
Caitlin:
Today. I have the pleasure of speaking with Dr. Brittannie Chester. Dr. Chester is a registered dietician and certified diabetes educator, who is the director of the didactic program in dietetics at Tuskegee University. She's the owner of Chester nutrition counseling and the first lady of St. Mark Baptist church in Huntsville, Alabama. She received her PhD from Auburn university's nutrition program and has been a dietician for eight years. She specializes in diabetes and heart disease prevention and management. And I am super excited to talk with her today because if you heard our recent episode on an RD's approach to P C O S, then you heard us touch, just touch, on blood sugar regulation and how important it is for all women and their reproductive health specifically. So today we're gonna be able to dive into even more detail with an expert in the field, and I just really couldn't be more excited. So, Dr. Chester, thank you so much for joining us.
Dr. Chester:
Thank you for having me. I'm really excited.
Caitlin:
Me too. Me too. So let's start off with a big picture question. What is blood sugar and why does it matter for our overall health?
Dr. Chester:
Sure. Yeah, so blood sugar, we used to kind of think only diabetes <laugh>, but now we're really seeing it in multiple different conditions and diagnoses. So we really are paying more attention to blood sugar now, I think than ever. And, big picture is really the balance of it. So not too high, not too low is really what we need to maintain for hormonal balance and a lot of areas for complications that come into the mix and dealing with fertility. A lot of those complications can lead to having a little bit more trouble getting pregnant and just fertility issues in general, in addition to eye damage, kidney damage, blood flow to the limbs, you know, all of those things. Diabetes doesn't tend to hurt. High blood sugar doesn't tend to hurt typically. So it can kind of go unnoticed if your blood sugar can be high or too low. So really just being aware of what your glucose levels are are very, very important.
Caitlin:
So you already mentioned several reproductive health issues specifically. So how, or why does blood sugar directly impact our reproductive health so much?
Dr. Chester:
So when you think about blood sugar, we're really dealing with the hormone insulin being able to control that blood sugar. So we have that insulin, (some people don't, so that of course is your type one diabetes). So you may have seen someone that has to inject insulin every time they eat their body doesn't produce any insulin at all, but any other type of blood sugar issues or conditions, whether that's insulin resistance, type two, P C O S, anything that bothers that blood sugar balance insulin is really what we're looking at. And insulin is a hormone. So when it comes to how our body is regulated, insulin a lot of times in our blood sugar is really just a balance of what's going on with other hormones, and you'll notice other things can be off. So when it comes to fertility, insulin is one thing that we really have to be mindful of, and we really don't test it a lot. Unfortunately, we kind of just look for blood glucose. We look at hemoglobin A1C. You know, often we just really don't notice is that person producing too much insulin, you know, or what's really going on with deeper than just their blood sugar, because you could catch somebody's blood sugar on a good day and it be normal, you know, so really getting to know what's going on is really hard. But really if you know that blood glucose, if you know the hemoglobin A1C, which is your average blood sugar over the past three months, that can really give us an idea of what's happening. And if you're trying to get pregnant, if you are pregnant, or after you've had a baby, controlling that blood sugar is going to be a big part of your overall health,
Caitlin:
That is so well explained. And thank you for doing that because I think for many, the concept that our blood sugar is important, even if we aren't diabetic, is new. That's a new concept to think about, because we aren't taught a ton about blood sugar in school or by our doctors. And, you know, sometimes you mentioned A1C as long as that's okay, you know, within a good general range, then that's all we know. But it really does have an impact on our overall health and our overall reproductive health. And many women do have issues with regulating blood sugar, whether that is insulin resistance or negative effects from having those drastically fluctuating blood sugar levels. But it can be hard to know if you have blood sugar issues. So let's talk about that for just a minute. Many, you know, may be familiar with what you mentioned about the A1C levels to test for diabetes, or even maybe if they're prediabetic, for insulin resistance, you can have a glucose tolerance test to see how your body responds, both with glucose and insulin after drinking one of those sugary drinks. You know, you do that two hour test. But what are some every day signs that our blood sugar maybe is not being very well balanced? Are there certain things that we can look for in our bodies and how we feel that can give us an indicator of how well we're balancing our blood sugar?
Dr. Chester:
I love the word balanced because we'd love to just say, oh, we need low blood sugar, but it's like, no, on the other end too low can also be a problem. So having blood sugar that's too low or too high, sometimes we see similar symptoms, whether that's blurry vision, somebody being very, very thirsty or having to urinate a lot, or your appetite changes, or just a lot of fatigue or even tingling or numbness in your feet or hands. A lot of times that can be a sign that your blood sugar may be a little high or a little low. If it's too low, you may notice like you just get a fog almost of just, you're not quite sure what's going on or you're dizzy. So we have a lot of those emergency things that we do if your blood sugar is too low. But the other side of that, oftentimes you're not getting a hemoglobin A1C test but maybe once a year, and the doctor never looks again if it was normal, once that they saw you. So you really have to ask, Hey, what was my blood glucose level? And can I have a hemoglobin A1C? Because if it's normal, they don't tell you if it's been creeping up over the years. So sometimes we're able to see a trend that, Hey, it may not be prediabetes yet, or it may not be diabetes yet, but every year you've been in, it's been a little bit higher every time. So that's why it's important to really know your numbers, know your blood pressure, know your blood sugar, know those cholesterol levels. But blood sugar, if it's normal, they kind of just say, oh good.
Caitlin:
That is such a good point. And our listeners are not new to the concept of needing to advocate for themselves. So that's a very good point that even if it's within the normal range, that could slowly be changing over time. And that's an indicator to you about the changes going on in your body and that,that needs to be looked at. And I'll add too that with charting your cycles, you're also able to see some of those changes over time as well. Something like a change in mucus production. Suddenly a woman is seeing far more, you know, continuous mucus production or in other hormone, reproductive hormone labs, maybe there's an inverse FSH to LH ratio. That's sudden a change. All these could be signs that there's an issue with insulin or glucose. So we can even sometimes see the effects of this in our cycle charting too. So all of these ways that our body is giving us these hints that it needs a little bit of help.
Dr. Chester:
Yeah, absolutely.
Caitlin:
So if you suspect that you have blood sugar issues, whether that's full blown diabetes or insulin resistance, or you just think you maybe have some of these signs of nitial blood sugar dysregulation, what can you start doing today to help improve that blood sugar balance?
Dr. Chester:
Yeah, so we are so fortunate to be able to have kind of down pat what to do with diabetes. You know, there's a few other things, of course, individualized. We have to kind of be careful if there's other comorbidities going on, but when it comes to blood sugar and diabetes, we know that carbs are that main source of our food group that directly is related to our blood sugar. So this is where I say, we're not saying avoid carbs. That's not what we're saying. <laugh>
Caitlin:
Thank you for just clarifying that!
Dr. Chester:
I have to say that, because if I point out carbs, I have to say, I'm not saying eliminate them completely, but you'd be surprised how much we're taking in on a daily basis. And one thing that I just usually off the bat, if I get an initial consult with someone for prediabetes or diabetes, I ask, what are you drinking? You know, I say, what's your go to drink that you're drinking throughout the day. If it's sweet tea, if it's lemonade, if it's fruit juice, you could maintain what you're doing eating wise, cut back on those sugary beverages and you will see a big change just there. The sugary drinks that we drink, it's a lot, and when you deal with blood sugar, I mentioned low blood sugar's not good as well, we actually use sugary drinks as emergency, you know, lift your blood sugar because that's how fast it's gonna affect your blood sugar.
Caitlin:
You know what that makes me think about something about that glucose drink that you have to drink for the glucose tolerance test. I read somewhere once, and you can tell me if this is wrong, but the sugar in that, which we all think about as being this huge amount is something like a Grande white mocha.
Dr. Chester:
Mmhmm, pretty close. I mean, some people are like, you could down a sunkist, a Fanta soda, you know, Starbucks drink, you know?
Caitlin:
So we feel like, oh, it's this huge sugar intake, but actually we've gotten so conditioned to taking in sugar that we don't even realize it as much anymore. And I think that's a wonderful point about the drinks. Okay, so just cutting out the drinks, we may notice, the sugary drinks specifically, we may notice a huge difference.
Dr. Chester:
Yeah, absolutely. If you can make that shift to water, that's what I ask first. I'm in the south, so typically they're gonna say I'm not drinking unsweetened tea and I understand because that is a big shift, but if you could do something that's diet. Which, you know, we all have those, you know, balance between we could have a whole conversation about sugar, alternative sweeteners, all of those things because there's pros and cons to those as well. But in the diabetes world, if I have somebody that is addicted to mountain Dew, like it is their bread and butter, switching to diet mountain Dew cuts out the sugar.
Caitlin:
It's a first step.
Dr. Chester:
It's a first step because versus them getting 50 grams of sugar every time they drink one to zero, that's a step they're gonna start feeling better. They're going to possibly lose some weight. That may encourage them to say, let's make the switch to water or let me add fruit to my water. Let me do something a little bit different. If somebody's totally against getting any of the alternative sweeteners in their system, any aspartame any of the alternatives, which is totally, I have a lot of clients that are that way because of course we understand that scientific results tell us things about those as well. We have the switch to water. We try to do lemon in the water, lime in the water, but it's a big thing about being a dietician is you're individualizing plans based on someone's likes and dislikes. We want you to enjoy food. So we try to find a way for you to get what you enjoy and then partner it with how you need to eat for your condition. So based on what you prefer, we would help you make those switches. But cutting out on the drinks that actually have tons of sugar, that is a big place to start because if we really were to think about it, we teach 45 to 60 grams of carbs per meal, which is a really good balance. You know, you get plenty. I mean there's 15 grams of carbs in a slice of bread. So, you know, that's enough per meal, but when you drink 50 grams of your carbs in your can of soda, you're drinking over your limit for the day. So we really just teach balancing them out per meal. And really for people that are just like, I can't change my food right now, we just focus on the drinks and really just talk to them about exercise, starting to walk Walking lowers your blood sugar naturally. We talk about cutting back on the sugary drinks. Those are our first two that we focus on because they do have such a drastic change from before and after with your blood sugar.
Caitlin:
Those are so doable. It can feel overwhelming, I think, for some...gosh, I have to change everything about how I eat!
Dr. Chester:
Or I have to count carbs. Like how, you know, that's sometimes just mind blowing for people to have to do that. And it's overwhelming.
Caitlin:
And so knowing that it is doable and there are things we can start doing today, I think is encouraging. So that's, that's great. It really sounds like the major components to getting started are awareness, first of all, realizing that what we put into our bodies really does make a difference. And then that individualized approach that you were talking about. It's not going to be the same for one person versus the next person. It doesn't matter if they're both female. It doesn't matter if they're both the same weight. It doesn't matter if they both happen to have, you know, P C O S or some other condition. They're unique individuals and they need a unique approach.
Dr. Chester:
Absolutely. Absolutely. And we're finding out more. I will say, a lot of my clients have gluten sensitivities and dairy sensitivities, and that's an individual thing. We don't just automatically tell somebody to switch to a gluten-free diet. We're looking at how does your body react to certain foods? Are you noticing a bloating sensation after you eat a certain type of food? And that tells us. Hey, I mean, some people that's broccoli and we would love to tell everybody to eat vegetables, right? But if broccoli is making you bloat, then broccoli may not be the vegetable for you. But that it allows us to understand like, Hey, good food, "bad food," whatever we are putting in those categories. It's like, no, what is your body? How is your body responding? And that's something a dietician will help you do is really pinpoint where. Like a coach that comes in and is like, Hey, I know your body, you know, let's partner that and find out what foods can we help you to eat or cut back on that will really help you to feel better. A lot of my clients are just like, I just want to feel better because having high blood sugar just drains your body, you know? And they just want to have the quality of life, they're not thinking about, I wanna be a size five or a size six, you know, they're like, I wanna feel better, right? I wanna be able to get up and walk and enjoy my life. And cutting back in those little areas is the first step to feeling better. Maybe if you can go exercise, add in a walk, you know, three to five times a week, lowers blood sugar tremendously. So we've seen great results on making those small changes. And exercise, really making, I mean, people can get off of their medication if they're on diabetes medication, if they're making those choices. Catching it early is really our biggest, biggest thing. Prediabetes, those numbers have changed because we wanna catch people before it gets too high. Because we know that we can shift that person back to normal blood sugar if we catch it early. Some people are even being put on diabetes medications earlier, just so we don't get too high into those complication ranges. So the sooner you know what's going on, the sooner you can get in and make those changes.
Caitlin:
Absolutely it is worth doing the work earlier because you have such better long term outcomes for your overall health. I know we talk about reproductive health specifically a lot, but overall health, as well as you mentioned, quality of life. And I will say this is such, this has been such a great overview for everyone. Just getting started with understanding the important role of blood sugar in the body and in reproductive health. So for anyone interested in learning more about how to naturally regulate their blood sugar and see improvements overall, the best thing to do, I think my personal opinion, would be to work with a registered dietician who's trained in this. So if someone were interested in working with you specifically, what would be the best way for them to reach you?
Dr. Chester:
Sure. The best thing that I love, because I specialize in diabetes, I became a provider with blue cross blue shield or any Medicare. A lot of these, if it's blood sugar related, it can be free for my clients, which I love. And for me, I can be emailed at bchestertcnc@gmail.com. And I'm also on Instagram at @Chester.nutrition. And I mean, I've been fortunate to work with an OB GYN and all of these other areas because it matters helping regulate cycles with your blood sugar being improved and just overall health. It's just great to be able to learn and maintain. So a dietician can help with that.
Caitlin:
Wonderful. Well, if anyone's interested, I really encourage you to reach out to Dr. Chester. She's great. So thank you so much for joining us, I really appreciate it.
Dr. Chester:
Thanks for having me.
Caitlin:
Yes, listeners. I hope this has been as enlightening of an episode for you as it has for me. I'm learning more and more every day about the importance of this holistic approach to our overall health. And I hope this episode has given us even more insight into that today. As always thank you for listening as we continue to explore together what it means to be woven well.