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Unraveling PCOS and Fertility: Debunking Common Misconceptions with Dr. Tara Harding

Unraveling PCOS and Fertility: Debunking Common Misconceptions with Dr. Tara Harding

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Unraveling PCOS and Fertility: Debunking Common Misconceptions with Dr. Tara Harding

New Frontiers in Functional Medicine® with Dr. Kara Fitzgerald

Gear up for an enlightening dive with Dr. Tara Harding, a vanguard in the realm of women’s health and fertility. Renowned for her exceptional work as a family nurse practitioner and fertility coach, Dr. Harding brings a wealth of knowledge from her battle against infertility and medical gaslighting, all while breaking barriers and fostering a supportive community for those navigating the complex journey of infertility. This conversation not only highlights innovative diagnostic tools like Mira, but also delves into the nuances of managing conditions like PCOS and endometriosis. Dr. Harding’s personal and professional journey is a beacon of hope and empowerment, underscoring the significance of comprehensive care in women’s health. Prepare to be inspired by her dedication to revolutionizing fertility care and advocating for patient empowerment.

Unraveling PCOS and Fertility: Debunking Common Misconceptions with Dr. Tara Harding

In this episode of New Frontiers, Dr. Kara Fitzgerald and Dr. Tara Harding examine the escalating crisis of infertility, exploring the multifaceted approaches to diagnosis and treatment. Dr. Harding, fueled by her personal encounter with infertility, illuminates the subject with a blend of professional insight and heartfelt dedication. The discussion unveils the promising capabilities of Mira, a pioneering diagnostic tool, alongside a thorough examination of conditions like PCOS and endometriosis. Dr. Harding’s innovative strategies for tackling these complex issues, combined with her advocacy for mental health and holistic care, offer a comprehensive roadmap for clinicians and patients alike.

In this episode of New Frontiers, learn about:

  • The alarming global increase in infertility rates and its profound impact.
  • Dr. Tara Harding’s personal and professional journey, driving her dedication to women’s health.
  • The revolutionary diagnostic tool, Mira, and its role in personalized fertility solutions.
  • The impact of common diseases, as well as stress, long COVID, and concussions (and more) on fertility.
  • Comprehensive strategies for identifying and managing PCOS and endometriosis.
  • When to use, and not to use, ultrasounds.
  • The significance of lifestyle, diet, and mental health in fertility treatment.
  • Discussion of standard lab panels and diagnostic tests used in clinical practice.
  • Exploration of low-dose naltrexone (LDN) and its potential role in fertility treatment.
  • The importance of patient empowerment and education in navigating healthcare.
  • Innovative approaches to fertility treatment, including the use of Mira for hormonal monitoring.

Dr. KF SPONSORED CONTENT

I am eternally grateful to our sponsors who, by blogging, podcasting and advertising with us, enable me and my team to devote energy and time to writing and publication. All the companies who sponsor us are companies that I trust for myself and my patients and use regularly in my clinical practice. Please check out their websites! – Dr. KF

The Full Transcript

Dr. Kara Fitzgerald – Hi, everybody. Welcome to New Frontiers in Functional Medicine, where we are interviewing the best minds in functional medicine. And of course, today is no exception. We’re going to be doing a dive into infertility, into PCOS, it will be very solution driven. We’re going to be talking about a pretty exciting lab test, actually, that we’re adopting in our clinic and I’m just excited to introduce it to you.

Dr. Kara Fitzgerald – We’ll also dive into a little bit of the problem of infertility that we’re seeing globally. But before we do all that, let me introduce you to my interviewee today. Her name is Dr. Tara Harding (Brandner). She’s a distinguished family nurse practitioner, fertility coach and medical advisor for Mira. She’s known globally for her expertise in women’s health and infertility and combating medical gaslighting, gaining recognition through her educational content on TikTok with over 15 million views per video, that’s so crazy to me Tara, and her widely downloaded podcast Hopeful Hints. Dr. Tara has also been featured in notable publications like BuzzFeed and Today’s Parent. Her unique blend of professional knowledge and personal experience, coupled with her commitment to empowering patients, has made her a guiding force in the healthcare community, especially in navigating personal health challenges and providing tailored women’s health and fertility solutions. Dr. Harding, welcome to New Frontiers.

Dr. Tara Harding – Hey, thanks for having me.

Dr. Kara Fitzgerald – Listen, I just want to ask you one prelim question. What’s your story? I mean, like what? What what’s your own personal experience that has made you so passionate about this topic?

Dr. Tara Harding – Yeah. Like so many individuals out there are doing great things in women’s health and fertility and just the medical field in general, there’s usually a little bit of a personal story attached to it. And mine was going through infertility as a medical provider. I actually was living in rural North Dakota, so that puts some barriers to a lot of things too, but just as a provider moving through the “system” I was just caught off guard in so many areas. And there were so many things done wrong that when I came out on the other end, which I did have to go through IVF, but I was like, what just happened? I remember holding our six-week-old son and I was just like, this is ridiculous. From cost, to process, to the mental health, just why? I had no answer. I had unexplained infertility in the beginning and I was not okay with that as a medical provider. I’m like, you can’t just be like, oh, sorry, I’m not sure here. Carry on.

Dr. Tara Harding – We’re just going to keep pushing forward. I felt like I was just getting pushed forward with things and no answer, and that not knowing drove me nuts. And so, it eventually transformed into… I start with a non-profit. So, I started the first and only non-profit in North Dakota and South Dakota for those with infertility. There was just no support. And then I started driving legislation to advocate for insurance coverage for the disease, which I’m still, six years later, working on that, but we’re making big progress with that. And then it, of course, led into me being a fertility coach first. Being an entrepreneur in the medical field is just a whole thing they don’t ever teach you anything about. And then that grew into this telemedicine in three states, and now I’m brick and mortar offering IUI (intrauterine insemination) services. So, it’s really just grown and all from my own story and my own working as a provider. How was I treated and how would I have liked to be treated? And how should women and couples, how should really anyone just in healthcare, be treated the moment they walk into your office through their whole process, and being believed, and again, mental health always being forefront of things too.

Dr. Tara Harding – And that came from… I was met by a provider saying, “Well, when you’re crazy enough, let me know and we’ll move on to the next step.” So that was just like I’m already-

Dr. Kara Fitzgerald – Brutal, brutal

Dr. Tara Harding – Yeah, after miscarriages and going through things, it’s like, “Ma’am, I’m sorry, but you don’t say that to people, but I’m already in counseling. Little did you know.” So, it’s all really just from, again, my personal experience and then having students and really wanting them to follow me and be like, here’s how you actually should talk to your patients, and here’s how their options should look, and letting the patient drive their entire process from start to ending.

Dr. Kara Fitzgerald – Wow, that is such a powerful story. What a powerful testament.

Dr. Tara Harding – I later found out she was going through her own stuff too. And I’m just like, okay, I get that. But at the same time, I’m just like, we all go through stuff every day. We can’t let that bleed out to our patients. We have to just watch our words.

Dr. Tara Harding – And that’s really what I try to teach students to, is how to keep your personal bias or things out of it, too, and let that patient just, again, drive every conversation. So, it’s ironic that you had that too, because looking back, I had found that out later as well. It’s kind of crazy.

Dr. Kara Fitzgerald – Well, yeah, we’re the safe space. We have the opportunity to be the safe space. We have the opportunity. And to your point, we absolutely have the responsibility to extend that safe space. That is, I think for me, the fundamental joy of practicing. I mean, of course, being a functional medicine provider, and being very solutions-driven, and being able to really walk with people on their healthcare journey, like every aspect of it, is rewarding, but being able to actually extend somebody the opportunity to have a safe space, I think is probably the most powerful thing we’re able to do.

Dr. Tara Harding – Absolutely. Absolutely

Dr. Kara Fitzgerald – Wow. Okay. I did not quite expect us to start in that very powerful and personal way. Wow. Okay. Well, thanks for your courage. Really.

Dr. Tara Harding – Oh. You’re welcome.

Dr. Kara Fitzgerald – That’s incredible. Okay, so we started on the infertility conversation. This is our topic today, and again, as I said earlier, we’re going to be very solutions-driven. This is a conversation mostly for clinicians, but there’s plenty of savvy non-clinicians listening. We’re in an infertility epidemic, so if you can speak a little bit to that, like what we know as contributing, and then we’ll move into what we do about it. But if you can give me contributors and maybe if you’ve got epidemiological data – I don’t want to say that I would love to know, because it’s actually pretty disheartening, but yeah – Let’s talk about that.

Dr. Tara Harding  – It is. Yeah, so we know that infertility rates, across the world this number is one in five. And I’m looking back at when I started my nonprofit it was one in eight. There was a study done about two years into that, so about 2020 or 2021, they kind of changed how they did the data on that and we already knew it was one in six and now worldwide, we know it’s one in five. And we know that like 55% of those going through this, it’s more stressful than unemployment. We have found it to be a leading cause of trauma in women. We know that 73% of people experiencing infertility reported that it impacts their work. That’s huge. And we know from some other data, too, that it’s actually comparable, when you go through and compare infertility to the grief and the anxiety and depression and all that of losing a parent, or it’s just as stressful as cancer.

Dr. Tara Harding – So we have all of these comparisons that this disease is, and yet it’s things like insurance saying that it’s not medically necessary so we’re not going to cover it. And then you have individuals being stuck with high cost and there’s no affordable solutions, or very minimal affordable solutions, and they’re just kind of having to pick. I also work with a lot of fertility preservation patients too, and they’re in that time crunch of do I, you know, teens, 20s, 30s, maybe they don’t even have a partner or a significant other yet and they have to decide; am I going to preserve my fertility or quickly move forward with treatment due to cost. And so, cost is always such a number one issue to the word infertility as well. And there’s only like 500 infertility clinics that exist nationwide, lab tests are expensive, you have to have these in-person appointments for things, or every clinic wants to have you come there for stuff like that.

Dr. Tara Harding  – 33% of first round of IVF cycles are unsuccessful, and those are $19,0000 to 20,000, a pop too. So, these are not little things. When you get stuck with that diagnosis there’s so much that goes into it. It’s not like, “Okay, go see your local provider down the street and see what they’ve got to say.” There’s just so much that goes into it on top of that, such as why. Why do you have infertility? Who? Is it one of you? Both of you? The man gets forgotten so often too. That’s a whole rant I could go on too, but there’s just so much that goes into that “why”.

Dr. Kara Fitzgerald – Well, I mean, just to bring the men into the conversation for a minute. Well, first of all, let me just point out that you launched your nonprofit, you said in the beginning, six years ago, and already our numbers are worsening in fertility just in your short jog. And by the way, folks, sidebar we’ll link to these resources from Dr. Harding. They’re awesome, and maybe we’ll link to your crazy popular TikTok. I’m really never on TikTok, but I’m super curious about it.

Dr. Tara Harding – I’m wearing these glasses. You have to go watch. The ones that were all me doing this. So, I’ll just do that right now to trigger everyone to come over to take a look.

Dr. Kara Fitzgerald – Yeah. So, the stats are just getting worse at a pretty breakneck pace. And yeah, I know that the sperm count has meteorically declined, really in lockstep with what we’re seeing in women. What do you think? What do you put your finger on as causal to both. What are your thoughts? What have you read? What are you seeing in practice?

Dr. Tara Harding – A lot of it is the lack of understanding basic disease processes and how to diagnose them from the medical community.

Dr. Tara Harding – PCOS is missed all the time. Endometriosis, male factor infertility, thyroid conditions.. Just straight up missed. I don’t know if it’s that they’re not comfortable giving it. It’s almost like they feel like they’re giving them a cancer diagnosis or something if they say you have PCOS. And it’s blazingly obvious. It’s not even like anything- I don’t do anything majorly different than should be done to diagnose some of the stuff initially. And it’s like, “Did you look at the patient?” You know, basic understanding of the disease, but environmental for sure goes into this too. And I will even say I have seen viral illnesses and Covid and things like that truly impacting sperm, or long Covid impacting a lot of my male patients, too, and having to really work on that when it comes to male factor. Stress – holy moly, we are just a stressed-out world, and it just gets foofooed and dismissed. Instead of addressing cortisol and really working with patients to figure out how they can best work that into their life they just say, go change this, do this, whatever, or it’s not even an issue.

Dr. Tara Harding  –  They think the stuff that I use to treat cortisol is like foofoo. Really, this is so basic, but I don’t know if health care providers understand ovulation and a menstrual cycle and a fertility cycle. If they really took the time and looked at patients’ data that they have right there on their smartphones nowadays, you would see right away this individual has a hormone imbalance. This individual is not ovulating. This individual has something going on. And they’re just like, “Nope, here’s your IUI.” And after so many IUIs, “Here’s your IVF, carry on.” They’re just getting kind of brush through the system and not working with nutrition and movement and sleep. People need to sleep. I don’t know how many times I’ve put on a patient’s chart in a week insomnia, weight gain, fatigue, things that are just really looking at their external environment and family history.

Dr. Tara Harding – So one of the first things I do when I talk to my patients, very first day, yes, there’s family history, but when I’m talking about a menstrual cycle, I try to make it a light conversation. If you know, can you share with me, at the holidays are we having conversations with mom, sisters, cousins, about our hormones and hysterectomies? And I try to make it a light conversation, but I can ping endo and PCOS from a mile away within the first ten minutes of talking to them by looking at their high school period intake. So, tell me about your period. How old were you when it started? What was it like when it started? Were you missing school? Why did you get put on birth control? That’s like a dead giveaway too, for a lot of stuff. When I’m asking like why they got put on that and really looking at the historical side and family genetic side of that too, as well as being a possible-

Dr. Kara Fitzgerald – I want you to just speak to some of those really obvious clues. And if you can distinguish PCOS from endometriosis, like, what are what are some of those clues? I mean, you got you’re going to have to color this in. People are asking.

Dr. Tara Harding – So acne. If someone’s like, I got put on it for acne, or I was always the female who was a little bit overweight, or I was in six sports and I couldn’t lose weight, and I was gaining weight in high school already, or if they were the female who went to college and again, whether they were athletic or not, and they gained weight out of nowhere, I’m thinking PCOS. If they have a mom or a sibling with a hysterectomy, endometriosis and adenomyosis is at the forefront of my mind. There’s data out there now too, showing any young female with a painful period is endometriosis until proven otherwise. And the earlier we can catch that, man, like things can be significantly different for her going forward and not being placed on birth control.

Dr. Tara Harding – If they’re placed on birth control for heavy, painful periods, heavy, heavy, heavy, I’m bleeding all the time, I’m missing school because of it – endometriosis. And to just dispel any myths right off the bat, you can most certainly have PCOS and endometriosis and or thyroid disorder going on at the same time at. That’s been brought up; can I really have both of them? And never dismiss a female who comes you even if they’re- And we’re going to focus in on fertility and stuff-  but if they’re coming to you in their 40s and 50s and they’ve had chronic pain, my other new finding in my office, I feel every female with fibromyalgia needs to be talked to and looked at for endometriosis being the cause of that with inflammatory lesions throughout. Fatigue can go both ways. I find fatigue can be PCOS. Insulin resistance, everyone who’s fatigued and having daytime fatigue and/or afternoon crashes or feeling crappy after they eat – insulin resistant, every single one of them.

Dr. Tara Harding – This weight gain, libido change, hair loss, making sure we’re checking for iron deficiency anemia and looking at all their stores. It all goes into that fertility picture, too. But don’t be scared to give someone a PCOS diagnosis, whether they have hirsutism or not. Don’t be looking for just an outside appearance is probably my other thing I like to always share. A lot of women, you can look at them as I’m air quoting and be like, “Oh, they look like PCOS.” But then you have your really lean, athletic female who is not gaining weight and she could eat a whole burger times five in a day and she’s not going to gain weight, but she has no libido, her progesterone, when you’re looking at her charts and stuff is really off and things like that too. Weight isn’t always the indicator of PCOS. They might not always have the “look” to them. But looking at their data and we’ll talk about this later too, but really looking at their hormones is going to really help you navigate. Estrogen – is it high all the time? What’s their progesterone doing? That kind of thing.

Dr. Kara Fitzgerald  – And I’m just curious, in your experience, how often are you seeing cysts in PCOS?

Dr. Tara Harding – I’m so happy you brought that up. How could I forget? That’s the horse that I ride on. You don’t need an ultrasound. I don’t know the last time I ordered an ultrasound in my practice. Here’s a fun story- But when I did order one, if they can time it specifically, usually around ovulation is where you’re going to see some actual cysts going on. If you can time it to this – Oh yeah. It’s usually on this time of the month, I have this pelvic pain, one sided, both sided, etc.- time it towards that. I had a teenager and she liked to ride horses and she’s like, “It seems like only certain times when I ride.”

Dr. Tara Harding – And we really took it next level and I had her time it out. We had her come in specifically when she was feeling it and that’s how we caught it. But I don’t know the last time I even ordered one. You do not need that. And I’m actually using AMH (anti-Müllerian hormone) levels now. So AMH of four or higher, 3.7 I did use the other day, but four or higher is PCOS. And you can pair that, of course, with your DHEAS and testosterone, but that’s a new actual guideline that came out is that we can use AMH levels now too, and that’s been super fun because it’s like obvious all the time. It’s a great marker to use that I’ve kind of flipped over to adding into their lab work along with all the others; insulin, lipids and all the other hormones that I already was doing, is AMH levels. But yeah, not very often will I catch a cyst being the “There it is! Good to diagnose it now.” Now people are coming to me because they had ultrasounds that did not show a cyst and they still have PCOS.

Dr. Kara Fitzgerald – Of course. Yeah.

Dr. Tara Harding – Yeah, I’m glad you brought that up.

Dr. Kara Fitzgerald – Well and AMH- Actually, let me just have you define some terms. You can define that one just for any listener who’s not in clinical medicine, IUI, IVF.

Dr. Tara Harding – Yeah. AMH is anti-Müllerian hormone, IUI is intrauterine insemination, which is typically the- I should say oral medications are usually used first for a timed cycle for conception, if you’re going to roll into like thin fertility treatments. And then next is that intrauterine insemination, or IUI, where that sperm is washed, and there’s various different methods of doing that. And then the female has her cycle timed and possibly, more than likely, a trigger shot given, so we know the exact hour that she’s ovulating to time that IUI. And then IVF is in vitro fertilization, and then, of course, that’s taking the actual sperm, perfect sperm, injecting it into the egg in a timed process as well, but you’re taking multiple eggs and multiple sperm and creating that embryo outside.

Dr. Tara Harding – And then, many, nowadays are doing the genetic testing and freezing and all of that process too, that goes along with IVF. And you can also have egg donor, sperm donor, embryo donor, and then surrogacy, of course, goes along with all of that too.

Dr. Kara Fitzgerald – What’s the age range that you’re working with in your population? Are you working with pretty young women dealing with PCOS and then you go on into fertility work

Dr. Tara Harding – I would have said yes about two years ago, but now I’m working with young teens. I would say 12 is probably the youngest so far where we’re talking about period care, all the way up to 63- to 65-year-old women. I’m starting to, of course, go into the perimenopause and menopause. But endometriosis in 40-year-old women is very significant nowadays too. And they might even have had a hysterectomy and they’re still having ongoing symptoms because that hysterectomy takes care of adenomyosis, where those growths are on the muscular part and the actual uterus itself, but no one took care of the lesions of actual endometriosis that live everywhere throughout the body, essentially, but in those areas as well, causing chronic pain, chronic fatigue, mental health. Oh, that’s a whole thing too. That goes along with all of these, with PCOS, endometriosis, and infertility in general. But a lot of that, when you resolve root cause issues and the cause of everything, you can see great improvement in everything. But it’s kind of grown, my age range has grown and changed and shifted because as the-

Dr. Kara Fitzgerald – As the issues evolve, right?

Dr. Tara Harding – Exactly.

Dr. Kara Fitzgerald – And the time they present is probably changing in somewhat of a disturbing way. So, like precocious puberty and then sort of profound hormonal imbalances extending out much further.

Dr. Tara Harding – And women being told nothing’s wrong with them, that there is nothing going on with them. And they continue for years. I’m usually probably anywhere from the third to eighth provider, which is really a challenge in itself, sometimes too.

Dr. Tara Harding – It’s like, well, what makes you any different? I’m a nurse practitioner. I’m not a naturopathic doctor. So, they like, “You take insurance and you’re a nurse practitioner. Surely, you’re just like everybody else we saw.” And really, I have that nice blend of integrative and you know, and so I’m like, “No, I’m different. You’re safe here.”  And the first visit they see that right away, but I had a patient, she was a third grader and got her period. It’s just like, yeah, mind boggling. And it’s like, how did all these providers miss that? There’s such obvious stuff going on here from the history standpoint.

Dr. Kara Fitzgerald  – Well, let me just ask you this, because people are thinking about it, including me. I’ve got a lot of questions actually. So, standard American diet, crappy diet, pesticides, organopesticides, metallotoxins, mercury, lead, etc., you mentioned stress, you mentioned sleep… So, these exposures, just all of this… I know that you’re an in-the-trenches clinician working with patients. I get that that’s your vantage point. But any thoughts on this environmental piece? And you mentioned viruses, you mentioned Covid, but any thoughts on this? And just the presentations that you’re seeing and the change in the epidemiological data, like earlier onset, continuing later on in life, etc.

Dr. Tara Harding – Yeah, I think it’s hard to dismiss that at this point, whether people want to acknowledge it or not. I think you can see it and you can see that also in the decline in population rates. I think there’s been some data that’s come out on that too, that said general conception and population in this state is down, and the country is down compared to this country, and you can just see all that. And when you look at how other countries eat in general, their sort of lifestyle, their environment, their day to day from wake to sleep, just how different that is from America.

Dr. Tara Harding – It’s hard to deny the data that’s there with that. So we are, you know, in my practice and I just think everyone should be really incorporating approaching things and changes and acknowledging that because it’s obvious and there is stuff, of course, to back that as well. But you can’t be like, here, let’s just treat this arm. I say this a lot too. Your head is connected to your chest is connected to your arms, is connected to your uterus. If you have joint pain in your knees and they’re red and inflamed, it’s not bypassing your uterus or your ovaries or your testicles. Like, hello! That’s inflammation in your entire body. You need to be addressing that. Or you can’t expect, if you’re eating this way, or, you know, lifestyle, or alcohol, tobacco… Oh, my goodness. If my men- I absolutely will not do an IUI or any treatment if they’re on nicotine of any sort vapes, anything.

Dr. Tara Harding – We cannot be having that because it has a huge, huge impact on sperm. And I’ve seen that because I will put them on enclomiphene or medications to try and override that, and I cannot get it to budge for many of them, or it’s very slow to budge. You’ve got to change your lifestyle and your environment and what you’re exposed to on a day to day, you know rigamarole, to have that adequate fertility goal.

Dr. Kara Fitzgerald – Yeah, yeah. What about antecedent variables? You did talk about genetics and you get a really careful family history. What about early exposure to antibiotics or chronic exposure, or medications or, I don’t know, a lot of allergies or other illnesses. Yeah. Yeah.

Dr. Tara Harding – Concussions. Yeah. I started asking a lot about concussions. And so, I’m seeing a lot of elevated prolactin levels in males and that impacting sperm. I think I’ll use a male example a lot because again, “Oh, his sperm was fine. There’s only just a little bit off or just a few things are off.” But they weren’t worried about it. and I’m like okay, no, no. And I do the same, take it from the top from my men too. But I am asking, you know, men, women to concussion histories and that significantly changes cortisol as well. I know a lot of my naturopathic crew goes more into that antibiotic side of it, but I ask about gut health. I’m asking about nausea, heartburn, indigestion, bloating, diarrhea… I’m going through the symptoms, and if they’re sparking something in me, I’m all about team building. So, I’m not like, I’m going to be the one-stop shop. And I just think it’s almost like dangerous medicine sometimes if providers think they can do it all. It is, “Hey, let’s grow your team.

Dr. Tara Harding – Let’s get you into acupuncture, let’s get you in and get some gut health testing done because it’s significantly important for your fertility.” I believe that. I just might not be the one to be running all the tests on them. I am growing my practice to that, but I’m not quite there yet, but I 100% ask about any recent antibiotic use or did your symptoms start after you took an antibiotic or even if it was like, oh yeah, I did fertility treatments and they put me on antibiotics, that kind of thing too. It’s just kind of crazy what I’m kind of finding by going down that road. There’s a common variable there, for sure.

Dr. Kara Fitzgerald – Well, yeah. And I don’t have any attachment to zeroing in on that, I was just curious about the different antecedents. But you know what? I 100% appreciate having a collaborative care team.

Dr. Kara Fitzgerald – I mean, we just need to. And you get to be really good as you are in your area. So, there’s two lines of inquiry that I’m eager to go with you. One is I want to talk about labs, what you’re doing. I want to talk about the standard lab panels that you’re thinking about. In your practice. And I want to talk about this really cool product that we’ve been excited to learn about in our clinic, Mira. So, we can go down the lab avenue or- Well we’re going to go down both – or we can start with the intervention avenue. Maybe it makes sense to start with the lab avenues and some of what you’re seeing and then maybe layer in interventions.

Dr. Tara Harding – Yeah. Yeah. So, it’s funny because I said earlier, I was like, I don’t get why other health care providers are just missing this. Because if you pull up like Epocrates or UpToDate, these tests are spelled out clear as day and they’re not being done.

Dr. Tara Harding – So that’s where I’m like, there is a huge issue just with the system itself, I think, in wanting to make some of these diagnoses. Or thinking, oh, I’ll do an ultrasound on somebody and either catch PCOS, or worse, claim they can catch endometriosis on that and using imaging and stuff, which you cannot. But for PCOS, I’m running prolactin, 17-hydroxyprogesterone, DHEAS, insulin, glucose, lipids, CBCs. I’m usually doing iron panels along beside all of that too. They just all, you know, whether it’s heavy cycles, hair loss, heat, or cold intolerance, you name it, we’ve got to look at that side and it gets missed all the time too. Androstenedione, like I said earlier, testosterone of course, total and free. And then if they come to me and they want to go deeper, I do run DUTCH tests and other tests like that as well.

Dr. Kara Fitzgerald  – What about thyroid? I’m sure you’re looking at thyroid.

Dr. Tara Harding – Oh yeah. Thyroid. And this was like, oh I had a thyroid panel done. It was normal. It’s like no, no, no you did not. I do antibodies all the time. Everyone gets antibodies. Sure enough, there’s usually the culprit to the problem. But yeah, free T4, free T3, TSH, doing all of that. I looked, just last week, I was like, okay, show me your chart. They’ll pull their chart up on their phones and they did thyroid, and every time, they just have a TSH, maybe a T3 done and that’s all they’ve had done. So, I always have to tell my patients, and would encourage this of others saying, “You know what? I’m so glad that they did something on you. I like to go deeper. Are you willing to let me do my panels on you?” And I just leave it at that and try to just order the other things or redo it if it’s been within six months.

Dr. Tara Harding – Like I said earlier, I don’t do ultrasounds unless they’re having actual pelvic pain, or irregular bleeding that’s not matching up, or just ruling out other things. What else am I doing? I’m trying to think… I’m usually ordering, if we’re going fertility and that male’s never been checked, there is a home test that I’ll do as well. I’ll run a Yo Sperm Test on them. If they are very hesitant and resistant, perhaps work is not allowing them, a lot of farmers or just men in general, getting them to usually do that is easier if I’m like, there’s a home test you can do. Or at that time I’m sending an order to their lab to have it done on them as well, because, again, they’ve probably never had it done. If they’ve never had a fertility workup, I’ll do the FSH, the LH, time it to the cycle, things like that too. And then of course, I do always talk about, okay, there’s some home kits we can do as well, and bringing that in.

Dr. Kara Fitzgerald – How do you time your labs?

Dr. Tara Harding – Yeah. Day three through five, if I’m doing the FSH, the LH, the estradiol. Otherwise, go in the morning before 10 a.m. and go fasting because it’s sometimes a matter of just getting them in there to do it is the hardest part and I’m not going to sit and wait around for a cycle.

Dr. Kara Fitzgerald – Yeah that’s right. That makes sense. Yeah. You just got to get it done. You’re right.

Dr. Tara Harding – Yeah exactly. They’re busy, cortisol, stress, we’re talking. But for cortisol, speaking along those lines, I’m doing a lot of treatment just based on symptoms. And if they really want to know or I really want to know what’s going on, I use a Dutch test to capture that and see what’s going on there.

Dr. Kara Fitzgerald – Just give me a quick rundown on symptoms that are going to flag you.

Dr. Tara Harding – Not sleeping, waking up in the middle of the night, daytime fatigue, if they’re just sluggish, not feeling rested when they’re waking up or at any point having daytime fatigue. Neck, and shoulder tension is a huge one. Any headaches, usually, aside from the like- and even if they have migraines, I’m still kind of convinced that that’s cortisol, too and I’m bringing in my treatment for that. But a lot of that neck, any joint pain, like, do you have any joint pain, joint swelling, swollen fingers, or rings can come off, sock indentation at the end of the day, that kind of thing as well. Mood: I’m really talking about mood or irritability. And again, when I’m taking a history, I’m always talking about mental health and tell me about high school, tell me about college, and I’m looking back at that timeline for mental health, too, because it goes hand in hand with a lot of these diseases.

Dr. Tara Harding – But cortisol, you’ll see that agitated, moody, kind of anxious, just that daily, high-functioning, stressful individual is cortisol.

Dr. Kara Fitzgerald – Yeah. No, that makes sense. All right, talk to me about the home kits and talk to me about how you’re using- Introduce Mira, let’s get a little background on it and then how long have you been using it? And how has it shifted your practice?

Dr. Tara Harding – Yeah. So, Mira was founded by Sylvia Kang. She was a scientist, and, of course, motivated by her own fertility challenges, like a lot of us. She faced it herself and her peers and her friends around her, and it led her, thankfully, to creating Mira because she saw too, 80% of people with hormone imbalance and 30% of couples getting this “unexplained” infertility diagnosis, which was me. And I sat there, and I was like, this just doesn’t make any sense.

Dr. Tara Harding – There’s got to be something going on. So, she created it because of people’s fertility journeys needing accuracy, peace of mind and cost. Cost was always on the forefront of the creation of this device too.

Dr. Kara Fitzgerald – Let me just ask you – save that where you use it. Is she here in the States?

Dr. Tara Harding – I think California.

Dr. Kara Fitzgerald – Is she? It’s interesting. We’ll link to her background because I’m super curious what her focus is, what her PhD is. But fascinating. So she had her own struggle.

Dr. Tara Harding – Yeah, had her own struggle and saw a lot around her, especially with PCOS. That’s the main diagnostic factor that drove this because it’s so hard for individuals with PCOS to just use these over-the-counter, take-a-picture device type of thing. It’s not effective. Another really cool thing, too, is I know they’re expanding their machine to include other things, so we’re going to be able to see cortisol, testosterone, ketones, all sorts of other general health stuff coming too. So, that’s kind of what got me into it too. I was like, okay, you’re not going to just use this during your fertility phase. It can be used into menopause and for other aspects of our life, too, instead of just this blip in time as well.

Dr. Kara Fitzgerald – And what is it? What is Mira? And you don’t happen to have it I mean, I know it’s-

Dr. Tara Harding – No, mine is literally in my bathroom at home because I’ve been using it. I should have brought it. I don’t have any in clinic here. But yeah, it looks like a little egg. It’s like a little egg, a little circular egg, and it comes with this fantastic- You know, I was like, what do I pee into? Do I get a plastic container from under the cupboard? No.

Dr. Tara Harding – It comes with a nice little cup and these easy-to-use sticks. And I always tell my patients I’m like, “Okay, I’m going to add you. We’ll talk about this through the back-end portal. But I get to be in the bathroom with you.” You know, usually like I’m like, “This sounds really creepy, but, like, I’m in the bathroom. You just tell me whenever you want me to look at your chart, and I’ll be in the bathroom with you checking your hormones right beside you.” But I just roll out of bed, I leave mine on the counter, lay everything out the night before, and it’s just super easy to use, but it’s like, really true quantitative technology too, and this fancy lab technology, it’s palm size, people travel with them, but you get that lab accuracy at home and you don’t have to go in and get blood draws. And every “body” is so different that you can’t just “Okay, day 21…” You know, come in and do that. And not everyone wants to be doing the expensive fancy testing too. We need something cheap or a low hanging fruit that they can enter into and use FSA and HSA money and all that stuff too.

Dr. Kara Fitzgerald – That’s awesome. So, it’s this little egg, and the reason you don’t have them in practice is because they’re just dropshipped directly.

Dr. Tara Harding – Yeah, they’re dropship directly. Yep.

Dr. Kara Fitzgerald – Yeah. So, you don’t have to stock them. But it’s this little egg at home, they pee on their little dip, and then pop it in the egg, and then you get the data and you have it presented to you, as we would read it as clinicians. What are the analytes that Mira is looking at right now? What are the analytes on there.

Dr. Tara Harding – Yeah. So FSH, LH progesterone, estrogen, and you can even link basal body temperature devices to it as well, so, it’s really a great full stick.

Dr. Tara Harding – One stick can get all of that. You’re not in there doing multiple sticks. One stick can do that. And then if you want to save them money, they do have some different options. Like for example, you can do just a progesterone stick as well. So sometimes I’ll tell my patients, okay, once we see this happen, we can move on to just that progesterone if you want to save some money too with that.

Dr. Kara Fitzgerald  – Do you think they’ll hook it up with wearables? You know, speaking about cortisol, like having HRV data (heart rate variability) and beyond basal body temperature. I mean actually, this does have some temperature data, but it has like, pulse ox and obviously my sleep data. That would be fascinating.

Dr. Tara Harding – That would be so awesome. I’m here for that. Come on, Sylvia, you can do it.

Dr. Kara Fitzgerald – That would be super. Really interesting. I mean, you could publish on your observations, seeing the sleep connection. Really interesting. Okay. So, you’re using the Mira with some of your patients. Who’s the ideal patient? Obviously, we’re talking about PCOS, but what kind of data are you able to pull? And then how does that guide your interventions. And let’s talk a little bit about your approach.

Dr. Tara Harding – If I had a magic wand, I would tell women to do this before, you know, if you want to get really, really into it, I don’t care if you’re not even dating somebody, if you just want to know about your health, I would love to have teens do it. Especially if they’re coming in with signs. You’re going to see some of this stuff happening on the back end, you know, hormones, and she’s moody during this time. Let’s see what her estrogen is doing.

Dr. Tara Harding – Let’s see what her progesterone is doing. Is it cliff diving? Is the day she’s just a “snotty teenager”, is that when she’s having these cliff dives, as I call it? There’s a reason people are feeling that way.

Dr. Kara Fitzgerald  – Amen.

Dr. Tara Harding – PMDD (premenstrual dysphoric disorder), gosh, we could catch so many things with that, too. And just, is there something going on hormonally during that time? Like, if you’re just wondering if there’s something hormonal, aside from all the other reasons for mental health and other symptoms, but is there a hormone correlation going on? I really want to encourage women to really get a hold of any concerns they have before they meet their true love, because usually when you or, you know, maybe you’re engaged. So, I even set up my clinic vendor show one time at a bridal show because I’m thinking, women need to be thinking about, if they want to start a family, or they have concerns, whether they realize it or not.

Dr. Tara Harding – Just a general preconception workup should be on the forefront of mind, because we don’t want to wait until you’re ready and then find it. And now it’s taking months and months for you and maybe even him to have things resolved. And so, it’s really just the earlier the better. There’s no wrong time, I think, to kind of know what’s going on.

Dr. Kara Fitzgerald  – How early could a girl start using it? If she’s getting, I mean we see these changes, particularly the emotional changes, happening in girls before their period starts. And of course, periods are getting, you know, we’re seeing more and more precocious puberty. Would this be something that could be useful in that arena?

Dr. Tara Harding – I do believe so, yes. I think it could give us some insight into what is there. Are they flatlining with their hormones? Did they really cycle? Are they cycling and just not bleeding? Are they having peaks in LH and estrogen and things like that going on too? And then it’s like, fun because your mom can use it too. They can both use these devices at home together. It can be something that we’re doing together as a mother/daughter to figure out what is going on.

Dr. Tara Harding – There’s a why. There’s a “why” to things. If you’re not smooth sailing – “I hardly know I have a period. I get it every month at the same time, life’s fantastic, I’m feeling great all the time.” If that’s you, you can maybe wait a little bit. But if you have any red flag, if you do not feel well and you’re concerned and you’re not getting answers, there’s nothing, it’s not your thyroid, you don’t have anemia, everything else has been kind of ruled out, this is an easy thing that you have the power in your own home to do and utilize.

Dr. Kara Fitzgerald – Really interesting. So cool, so cool. All right. So, let’s talk about some of the interventions that you’re using. Maybe let’s start with PCOS or just the treatment approach. And then let’s touch on endometriosis as well.

Dr. Tara Harding – Yeah. So, for PCOS of course, and for all of them, I’ll just start with what I do for all of them I’m looking at lifestyle. Sleep, and if they’re not sleeping, why? And really making sure, you know, dark room, sound machine, cool temperatures, checking melatonin levels, if I have to. I’ll get into my unicorn dust, as I call it here in a second. I’m looking at nutrition. Are they eating enough? Because we know too, from studies, 1200 calories or less can really be harmful to hormones too. I’ve even switched to say, “Hey, are you taking a bite or a drink of your protein and your fiber first? And when they are eating, changing the order of their food, and really optimizing their levels of insulin and glucose. What are they doing for activity? Are they so tired they can’t even get off that couch? Like, they’re crashing. Then I’m looking at cortisol here that I do as well.

Dr. Tara Harding – I’m teaching them how to meal prep, how to plan. I just brought in a service that delivers it to my door lately because I, myself am not eating enough. Are you fasting all day and it’s backfiring? You know, really revamping things. again, growing the team if they need to have a nutritionist or dietitian or some other specialty come in to help with that or doing that. Do  they need a personal trainer? You know, that kind of thing, too. I hate saying the word stress because I’m just like, it’s cortisol and it’s life, but what are areas in your life that you can change or adjust? Are you at this awful job that you’ve been at with night shifts and shift changes for ten years and you do have an option to switch? Because shift work goes negatively towards fertility. We know that from studies too, for men and women. But shift work can greatly impact that. What are external factors that can be fixed? Do we need to add counseling and therapy as well?

Dr. Tara Harding – Hypnosis. I love hypnosis, meditations, things like that into our daily routine as well. Environmental stuff, products that they’re using and really reviewing that as well. Are you using plastic still? What are you reheating your stuff up in the microwave in? I still always talk about that basic stuff, too, because it gets forgotten about. And then I love, love, love- I started to really use low dose naltrexone in my practice, and it has been instrumental. I take it myself to really help with that cortisol drop. But there’s a lot coming out on fertility with that and general inflammation in the body and it helping with that. And then of course getting them set up with supplements, the myoinositols, NAC, berberine, Macha, and then the herbals. I usually have acupuncture, I offer acupuncture. It’s really cool. A lot of acupuncturists are even implementing Mira into their practice because they can time acupuncture, based on levels and things like that too.

Dr. Tara Harding – So I’m always growing their team. Do you want a cold plunge? That’s the latest thing right now, and infrared saunas, and acupuncture, and other fun things like that too. Gut health – It’s not me, but let’s grow your team right now and let’s figure that out if you have those symptoms. It’s really working on all of those symptoms they’re having as well and bringing in outside resources and getting them to eat more is just something very basic. Looking at what does their plate look like when they’re eating, and I’m asking, tell me about your day. Tell them about daily intake for you and things like that as well. And then what format of supplement are they taking? Are they like choking on six pills a day or ten pills a day and saying, I’m like, you know, we can get this in the powder format and really working with maybe they already have implemented something and it’s not working.

Dr. Tara Harding – We can kind of adapt and shift. Don’t quit it all together and give up on things. It’s like, what else can we do to optimize great supplements and other things too, if they’re not liking what they’re doing.

Dr. Kara Fitzgerald – You’re using hormones in this population, I would assume. Do you want to speak to that in PCOS? I mean-

Dr. Tara Harding – Yeah. So for fertility, sometimes I will use ovulation induction medications, like Femara (Letrozole). I go to that first before going to Clomid. It’s better on estrogen levels and side effect-wise. And then if we’re doing IUI, we’re doing the trigger shot, things like that as well. Progesterone is something that gets forgotten too. It’s such an easy- You know, if they want a baby yesterday, and we’re doing all the other things to naturally try to support their hormones and progesterone, what I try to do is oral progesterone three days post ovulation, or when I see the Mira fertility kit kind of peak and show me that they’ve ovulated or they’re about to ovulate, I bring in that post-ovulation, day three oral progesterone.

Dr. Tara Harding – And then at time of conception I will bring in suppositories. A lot of people are just like complaining about the ooey gooey goopyness of it, you know, and that kind of thing, but sometimes I’ll bring in suppositories as well. A lot of my patients, I’m finding, have PMDD, premenstrual dysphoric disorder, that’s missed all the darn time. And I’ve really shifted to troche progesterone for that. So, a lot of them are on it during that phase and that time anyway. So it’s helping that progesterone for conception and things as well. And then supporting it with supplements. My patients will have fish oil, vitamin D, are they deficient in their B vitamins, and looking at some deficiencies as well that they might have going on alongside supporting the PCOS, just really supporting their general minerals and other things like that too, that they might be deficient in naturally.

Dr. Kara Fitzgerald – Unicorn dust. Is that LDN? (low-dose naltrexone)

Dr. Tara Harding – That’s my LDN, my low-dose naltrexone. LDNResearchTrust.org is such an amazing website on it. I don’t know why some providers are so scared to use it, but really work with a compound pharmacy that is skilled on it. And I am very, very lucky that the pharmacy I use has a tracking system. They track patients’ symptoms, they follow up with them, they check on them, they help dose it. They really make it easy to use and really hands-off as a provider to, you know, they help take care of any side effects, which are usually minimal, and patients, usually what we’re treating with a dose change, will get worse, a headache, joint pain, fatigue gets worse within the next day. You drop it back down to previous dose and they’re doing well on it. So, it’s really underutilized and can just, like you’ll be the hometown hero if you start using that stuff.

Dr. Kara Fitzgerald – That’s great. That’s great to know. And who’s your compounder. Are they local or are they national.

Dr. Tara Harding – It’s called Irsfeld Pharmacy. They do other states as well, but they are the ones with the tracking program in place, and really help patients. Just like, how is a pharmacy so nice? Like, they care about me too. Again, that growing your team includes a pharmacy in my practice. And they just have next level of care that’s hard to beat. They do mail to other states though too.

Dr. Kara Fitzgerald – You’re focused on fertility in your practice, but are people coming to you on birth control? And are you having to taper them? I just want you to talk a little bit about that journey, because that can be tough with PCOS.

Dr. Tara Harding – Definitely. So, I do there’s a big trend of that. People want to get off, and what I will do is, because it’s really limited what you can draw to some extent when they’re on hormone replacement, you can’t do a lot of testing.

Dr. Tara Harding – That’s where tapping into their high school, college, pre-birth control, timeline to figure out is this endo? Is it PCOS? Now a lot of things can overlap. You’ll have your good herbals that can really help with both. But I will put people on myoinositol, NAC, for sure, maybe some magnesium, even B… I’ll put them on stuff and I’m like, okay, give me probably 2 to 3 months on this before we take it off, if you can, and then let’s take it off. They do so much better with symptoms and stuff-

Dr. Kara Fitzgerald – When you stop.

Dr. Tara Harding – LDN, I’ll even bring in low-dose naltrexone. The supplements-

Dr. Kara Fitzgerald – Before-

Dr. Tara Harding – Before. Yeah. Before stopping it and you will have much better results. And unless of course, they wanted it out yesterday, they’re done with it or they stopped it already. I’m like, okay, just give me 90 days at least. Like really commit up front. Like, this is going to take a little bit of time. Hirsutism is so slow; hair loss is so slow to come back.

Dr. Tara Harding – I think when implementing things, it’s not this quick fix, like the mood, the anxiety, will go away like this within days of starting low-dose naltrexone. I will also wean SSRIs a lot in my practice with utilizing low-dose naltrexone. Of course, hormone balancing and figuring out the “why” too. Well, every case is individual but with supportive, the counselors and other professionals on hand too and having good systems in your practice, you can wean people off of other medications, chronic pain meds, all sorts of things too when you bring in and fix that cortisol issue.

Dr. Kara Fitzgerald – Dr. Kelly Brogan once, many years ago, advised using liquid SSRIs for the taper, so that you could just really do a micro taper.

Dr. Tara Harding – Yeah. Those are hard. They’re hard.

Dr. Kara Fitzgerald – Yeah. They can be really, really hard. What else did I want to say about this? It’s fascinating. Okay. So, somebody is on OCPs (oral contraceptive pills), they’ve been on for a long time, maybe they were prescribed as soon as they had a difficult menstrual cycle like from age twelve. What are we looking at for the fertility journey with long-term OCP? Does it always have to be difficult? I mean, what are your thoughts on that.

Dr. Tara Harding – No, it doesn’t have to be. The PCOS ones are maybe, I would say, a little bit easier, I don’t know if that’s even the right word to say. But if they’re on that and they weren’t ovulating and you pull them off, in my practice, then I will see some months of a good cycle and then it tapers off. You’ll have two or three months, four months, five months of a of a “Oh! Good cycle. You ovulated”, and then it tapers off If you don’t bring something else in,

Dr. Tara Harding –  Or they’ve already done that data collection upfront, like “I came off and I was doing good. And now, look, there’s nothing.” They’ve kind of captured that themselves for you to see. And then you know you need to target things that will induce ovulation and bring ovulation back. And I think another thing that goes amiss all the time is insulin resistance. We are not checking for that enough and treating it enough. And I will say in my practice, I have started to use some injectables in this case, because when I’ve run every test under the sun, and I’m implementing everything, and there’s a team approach to this, and I can’t get that insulin to move, and they are not getting a period, when I bring in the semaglutides, the tirzepatide, they are starting to cycle, mucus is coming back, androgens are dropping, levels are dropping, hirsutism… Everything is dropping.

Dr. Tara Harding – But I’m talking on day one, about our exit strategy. You know, we’re not doing this for life. We’re going to get this so that the fifty-pound weight that’s preventing you from eating and cooking and exercising goes away and then we can taper our dose, or decrease it, or get you ovulating, get fertility and get other things working. I call it unsludging, or getting them unstuck, and then talking about weaning that off. So, it is kind of an interesting thing I found in my practice is like, I’m doing everything and this woman is not getting a period. I’m talking 90 to 100 days of no period and I bring that in and we’re getting a period,and cervical mucus, and ovulating. It’s hard to not want to go that way for a little bit to help these people out so they don’t need IVF, and they don’t need IUIs, and things like that, if they’re willing.

Dr. Tara Harding – And I keep a close eye on them. They’re in my office every 6 to 8 weeks, and we’re doing lab work. This isn’t like a med spa where you’re just getting your shot for high dollar. It’s a program that they have to enroll in and we have a lot of firm things put in place to make sure that they are getting checked and coming back in and things like that too.

Dr. Kara Fitzgerald  – And what are some of the other, and then I know we have to wrap up, but you’re just jogging a lot of questions in my head. This is such a great conversation. But like, what are some of the pre-GLP-1 (Glucagon-like peptide-1) interventions you might do to stoke ovulation? In addition to the lifestyle and the supplements you’ve already talked about, is there anything else you’re using or looking.

Dr. Tara Harding – Walking! Oh my gosh, if I can just get these people even walking after their meals or just walking during the day it is huge for that. You’ll see that feel good, and the insulin, there’s some studies that came out too on movement, even if it’s just for 10-15 minutes after eating that meal or changing, like I said, a little bit earlier, the order; putting fiber and protein in your mouth first. And then don’t eat the whole chicken breast or don’t eat the whole serving of veggies, but just flipping a few bites.

Dr. Tara Harding – There’s data coming out on that, too, showing to be really effective for insulin resistance. But the other thing, when you start those GLPs, the biggest thing is the constipation. And patients don’t want to stop or adjust their dose because they’re getting good results, but they have this. And so, it’s really honing them in and being like, “I cannot have you constipated.” So, it’s really tracking those symptoms and working with that. There’s aloe juice, and probiotics, prebiotics, and making sure they’re on all of the gut stuff too going into it, or tracking them and not letting the side effects and symptoms get out of control when they’re on those medications. And then I always like, “Okay, what’s our goal, and our goal weight number and a feel good, or you’re going to the gym now, or you’re walking more, or you’re doing this.. Like, what are the goals that we’re going to start weaning at and cutting back on this at?

Dr. Tara Harding – And it’s, of course, a needle issue too, that some have, if they don’t want that. But good ole insurance is getting a teensy-weensy bit better about coverage with this too, if we do our good old prior authorizations and stuff like that, where these individuals are candidates for it. And again, talking about exit strategy on entry strategy. But just knowing that it is an option and it’s really helping with fertility.

Dr. Kara Fitzgerald – Yeah. Well listen Dr. Harding, it was just great to meet you and to hear about the good work that you’re doing, both in your own journey, and what you’ve brought forward in the world of infertility. I mean, from your nonprofit to your current clinical practice to your TikTok rock star status.

Dr. Tara Harding – Yeah. I have some fun with that.

Dr. Kara Fitzgerald – Which you guys, she told me, was almost entirely random and happy. It’s kind of a funny story, but we’ll link to as much as we can so people can track this down. But really, you’ve given us a lot of just incredibly useful information. And we’re thrilled about the advent of Mira and it’s really nice to see with your years of experience with it, how useful it’s been for you.

Dr. Tara Harding – Yeah. Thank you for having me. And it is. It’s super helpful. It makes it so easy. Just go on to your provider portal on the back end and you’re in the bathroom with them. Like I said, there it is. There you are.

Dr. Kara Fitzgerald – That should be their tagline. We’re in the bathroom with you.

Dr. Tara Harding – I have such a, you know, joking… I have such a good connection with my patients too, that of course, it’s a funny thing. But it’s like, yeah, how cool it is. You can be right there beside them.

Dr. Kara Fitzgerald – Yeah, yeah. All right, my dear. Well, thank you so much for joining me. To be continued. Ciao ciao.

Dr. Tara Harding – Thank you.

Dr. Tara Harding DNP, FNP-C and Medical Advisor at Mira

Dr. Tara Harding (Brandner), DNP, FNP-C, is a distinguished family nurse practitioner, fertility coach, and medical advisor for Mira. She is known globally for her expertise in women’s health and infertility and combating medical gaslighting. Gaining recognition through her educational content on TikTok with over 15 million views per video and her widely downloaded podcast “Hopeful Hints,” Dr. Tara has also been featured in notable publications like Buzzfeed and Today’s Parent. Her unique blend of professional knowledge and personal experience, coupled with her commitment to empowering patients, has made her a guiding force in the healthcare community, especially in navigating personal health challenges and providing tailored women’s health and fertility solutions.

Mira: partnership@miracare.com

Dr. Tara: hello@simplyyouclinic.com (social media: @tarabfertility or @simplyyouclinic)

From PCOS to Parenthood: Strategies to Natural Conception

Show Notes

Dr. Tara Harding

Mira

Mira’s Backstory with Sylvia M. Kang

Hopeful Hints Podcast

Buzzfeed article: “Clots During Your Period Are Not Normal”: This Nurse Practitioner’s TikTok Is Going Viral, But There’s More To It Than You Think

Today’s Parent article: Can Pregnant Women Swim in a Chlorine Pool?

Everlasting Hope – Dr. Harding’s non-profit group

Dr. Tara Harding on TikTok

YO Home Sperm Test

Sylvia Kang

LDNResearchTrust.org

Irsfeld Pharmacy

Mira Brochure for practitioners/providers

Mira Leaflet for patients/customers

Mira Research Studies

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