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Ask Stefani: PCOS Edition

Posted by on Jan 28, 2013 in Blog, Disordered Eating, Hormones, PCOS | 5 comments

Ask Stefani: PCOS Edition

More questions about PCOS this afternoon!   No surprises here.  Below are some thoughts on endometriosis and PCOS, quinoa, feeling restricted, allergies, and moving forward with hypothalamic amenorrhea.

If you find that a question you asked me is below and I have not stripped it enough of your personality to post it here, please let me know.

 

Help!  I have both endometriosis and PCOS.  I don’t understand– I thought endometriosis was a condition of high estrogen levels, and PCOS a condition of low estrogen levels.  What gives?

 

There are two ways to answer this question.  First, PCOS patients can have high estrogen levels, and in fact many of us do.  For this reason, you can have both endometriosis and PCOS without rocking the boat of your theory.   On the other hand, I also believe it is entirely possible to have endometriosis and to have low estrogen levels.  This is because endometriosis and endometrial pain is related to high estrogen levels, but there are a variety of other factors in the development of endometriosis.  Having an impaired immune system and inflammation are two big ones on the list.  Once those things happen together, and you plant endometrial tissue somewhere in your abdomen (and in all likelihood aided by having high estrogen levels), then you have endometrial tissue that is going to be very difficult to weaken.  That is just the nature of the tissue.  It does not just shed off effortlessly.   In this time period your estrogen levels can drop and your immune system can improve, but your tissue may still cause you pain.  This is how you can have low estrogen and endometriosis.  The solution is to mitigate the problems as best you can, reducing stress and inflammation, healing your gut, boosting your immune system, and eating a hormone balancing diet such as the paleo diet.

I wrote about endometriosis at great length here.

 

I stumbled upon your website researching the Paleo lifestyle and was pleasantly surprised to see the tie in to PCOS! I’m sure you’re wondering why I’m commenting on this article but being an avid consumer of marijuana, I had to click and read. Admittedly, I was quite disappointed in what I read not about marijuana but more about seeds, nuts and quinoa. I was under the impression that quinoa was NOT a grain but rather a seed. I’ve successfully omitted all grains, beans, soya from my diet and this was a major bummer to read.  I am feeling very deprived right now thinking of the possibility of having to omit this as well. Thank you for the great article however and keep up the great work.

 

Quinoa is in fact not a grain.  It is called a “psuedo cereal” because it does not come from grains or grasses, but is rather the seed of a plant.  It is gluten free.  That being said, it also has many properties that seeds do, such as having a relatively high amount of phytoestrogen content (and will contain many of the phytates inherent to legumes, beans, and grains all).  Phytates are also a bit of a problem for PCOS because they have the potential to limit calcium and magnesium absorption– two ions quite crucial for the development of healthy and fertile corpus lutea.  All of which is to say that seeds are not great for PCOS, but unless you are eating buckets they will not make or break your case.  Probably, at least, in my opinion.

My thoughts about restriction are of course always complicated.  If quinoa is something that is necessary for you to feel good about food and your body, then I advocate keeping it in your diet at least for a while.  Clean up as much as you can, and relax into your food choices.  Try eating less whenever it seems easy to do so.  If it’s a battle, don’t fight it.  Just phase it out only as you can let it go with peace.  This will happen over time with patience and with love.  And if it does not, I really think that’s okay, too.  Take care of your brain first and foremost.   It is going to be your most important tool by far for taking care of your body for the rest of your life.

 

I have question. I had a hysterectomy in May 2012. I struggle with endometriosis, hashimoto’s, Sjögren’s syndrome & celiac. I’m on estrogen therapy & the autoimmune protocol but my allergies are getting worse! I eat meat, non starchy vegetables & fruit. I can’t tolerate any spices or starches & my allergies continue to worsen. Any suggestions?

 

You may wish to try eating a GAPS diet to heal your gut further.   Allergies are not my specialty– but I highly recommend first doing everything you can to assist your immune system, since this is where allergy problems are rooted.  This includes reducing stress, getting as much sunlight and/or vitamin D as possible, eating organ meat often–I’d advocate at least once each week–getting as much sleep as possible, and potentially getting your micronutrient levels checked to see if you have any deficiencies that are hindering immune function.    Boosting immune function will help your immune system react appropriately to foods without leaping into panic mode.  It also depends very much on what your allergies are and how you are reacting to them.   Are they definitely allergic reactions, or are they food intolerances?  This is a crucial difference.  An allergy is rooted more in immune issues and food intolerance is rooted more in the gut.  Allergen-specializing docs are probably the best place to go for troubleshooting this sort of issue.   You also want to make sure you are taking care of your hypothyroidism appropriately — are you supplementing with thyroid hormone?  because with Hashimoto’s you may need to be, so speak with your doctor about it — because thyroid hormone is crucial for immune function, for cellular repair, for probably energy usage, and just about everything else cells do.

 

I have had HA since february, since I stopped taking the birth pill. I am really underweight (5’10 and 100#). I lost a lot of weight when I started crossfit and doing a low-carb diet for two years. I am now trying to conceive.   My hormone levels are all very low.  I haven’t worked out for several months.   I only walk daily for one hour. I started seeing a therapist about my anxiety, who is helping me gain weight.   She makes me track my calories in order to gain weight. I have to eat more than 2,000 calories but rarely go over.  I am a bit scared of carbs.  Gaining weight is not working although I eat more and stopped working out. I keep counting the carbs and feel bad having potato chips and a cookie (too much carbs).   I do eat a good amount of fat (teaspoons of coconut oil, nut butter bacon, greek yogurt etc…).   What should I do?

 

Since your primary concern– and biggest obstacle– in getting pregnant is convincing your body that you are fed, you want to err on the side of eating more rather than less.  This should be the case all of the time.  Also, I recommend that you eat whatever you want.  Anything you want. I personally eat a very high carobhydrate for extended periods of time to zero ill effect. Do your absolute best to stay within the range of non-toxic foods (ie, skip the gluten, deep fried foods) and eat heartily. The more frequently you can hit your 2000 mark, or even better, go over, and the less you obsess, the faster you’ll regain hypothalamic health.

I cannot stress to you how much all of the factors of relaxing, reducing your anxiety, and gaining weight are all important for your ability to conceive.  This takes a lot of work.  You are going to have to have patience, and to forgive yourself as much as possible for all of the difficulty you are having moving forward.  The thing is that it is not your fault.  You have become inordinately thin as a result of psychological pressures put on you by an external environment, and now you are stuck with fighting that.  Keep your chin up and move forward as lovingly as possible.  Accept yourself as a natural body with natural needs.   When you look in the mirror, don’t obsess.  As a matter of fact, don’t look in the mirror.  It is way too easy to start seeing ourselves as bigger than we used to be– and even while we need to gain weight to be and even look healthier, by the simple fact of being “bigger” we think we look huge.  Don’t let your brain trick you into such radical subjectivity.   Do your best to put your evolutionary need and your fertility at the front of your mind, and be excited when you see yourself put on a bit of weight.  Do it slowly and make sure to protect your brain in all of this, but embrace your needs.  You are a woman with some strong ovaries and the power to carry children.  Nourish yourself as your body is crying out for, and take as much pride in that as possible.   Being thin doesn’t make you worthy.  Being a badass and tackling these problems with as much love and determination as possible does.

Eat carbohydrates!!!!  Carbohydrates a) do not make you overweight, they just don’t, period, and b) are supremely healthful for you, especially in a state of metabolic distress.   Start eating them slowly and learn bit by bit the lessons I am telling you.  You will see that they make you feel and look better without making you balloon in some ridiculous fashion.  They are just food, same as fat and protein.  Period.  Eat them whenever, however, and however much of them as you want.

Be patient, however, love.  These things can take time depending on how much damage has been done and how diligent you are about allowing some weight gain and calorie intake.   Increase what you are doing as much as possible, and make sure that you are erring on the side of nourishing yourself more rather than less.  Believe it or not you have already made radical progress.   You have started therapy– something most women never do!– and you have admitted that you need to work on some of these issues.  And you have really cut back on your exercise, and you are working on eating more and gaining weight.  These are all awesome things.  You are doing it, and you have so much to be proud of moving forward.  You will get there, especially with love, forgiveness, and harmony with your natural body on your side.

 

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You can read more about my work and opinions and plans for PCOS in the manual PCOS Unlocked.

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5 Comments

  1. for the third question friend, trying to conceive …… may i suggest reading “the diet cure” by julia ross?? she talks about overcoming the fears of eating more calories. but, she also advocates amino acids to help with imbalances … hormone or mood or cravings, etc. there is also some evidence that yoga can help with conception, and, of course, anxiety! :) just my two cents. happy tuesday. hugs.

  2. Hi Stefani!

    I’m thin and non-IR and have PCOS. I’m going Paleo very soon. I have some scalp issues that makes it scaly and rarely oozes clear liquid. Doctor diagnose it as mere dermatitis but I think there is more to it. I suspect eczema or psoriasis.

    I belong to India and there is very little awareness of Paleo diet here. So, I have limited options here and following auto-immune protocol will make my diet quite restrictive. I’m yet to start full-fledged Paleo. So, before starting I would want to ask if I should follow the autoimmune protocol in it, if I suspect something about the scalp issue?

    Thanks…

  3. Hi Stefani, my name is Lindsey I’m a 17 year old girl who has been fighting PCOS for the past two years now but was diagnosed in August, 2013. Just today I found this blog and the book you wrote “PCOS Unlocked”. I have been trying to heal myself naturally but I have been struggling majorly, and I had lost all hope until I saw your blog today. I’m going to buy your book! I want just to say thank you for existing! Because if u didn’t I might not anymore!

    • A bit dramatic :) , but I understand nonetheless. Please feel free to check out my one-on-one stuff @ http://paleoforwomen.com/consultations… you get a discount if you own PCOS Unlocked. :) I am so excited for you on your journey! Onward and upwards!

  4. Dear Stefani, my main problem is hirsutism. I’ve done it all possible tests of hormones, visited all the experts, but everyone has their own opinion. Idiopathic hirsutism, PCOS because of high fsh/lh ratio on 21. day of cycle, insulin resistence..I do not know any more how to deal with and what is the real cause of my hirsutism. That is why I am sending you my test results and ask you for help. I do not know what to eat, which tipe of PCOS do I have..I am really confused.
    There are my test results:

    s-estradiol 178,5 pg/mol
    s-dhea 8,1 nmol/L
    progesteron 7,89 ng/ml
    prolactin 26,29 ng/ml
    testosteron 0,402 ng/ml
    kortizol 571,6 nmol/L
    LH 16,56 IU/L
    TSH 2,12 mlU/L
    T3 5, 01 pmol/L
    T4 16,80 pmol/L

    And the results of tests in the hospital last year also on 21 day of cycle: estradiol 0.71 nmol / L, 17-OH progesterone 7.92 nmol / L, progesterone 30 nmol / L IGF-289 (units not specified), LH 17, 7 IU / L, 4.2 FSH IU / L, s-DHEA 10.7 nmol / L.

    Also I have to mention I am on spironolactone 100 mg daily for last one year with no effect. Probably because the level of testosterone and androgens are ok? And my glucose was 6,29mmol/L. I hope it is not to much for you.

    Please, any advice? I would be very grateful.

    Michelle

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