low estrogen + amenorrhea

purelaur

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background:

At age 14 I was diagnosed with hypothyroid and put on Synthroid. I was a chubby kid that grew into an overweight teenager, though I was more of an academic than an athlete and I surely liked my food. Anyway, bouts of extreme fatigue and coldness led my doctor to test me. I was taking increasing doses of Synthroid daily until age 18 when I left for university (by this time I was also on a birth control pill). Frustrated, overweight, and with low self-esteem, my emotional teenage self adopted a restrictive vegan diet, which eventually turned into an outright eating disorder that left me underweight and obvious lasting psychological impacts. I took myself off of synthroid because I was convinced it wasn't doing anything (it wasn't). I took the next year off from university and worked with a dietician, psychologist and took antidepressants. Slowly but surely gained weight the "vegan" way -- lots of soy, lots of nuts, moderate grains (I've always been a carb-phob, my own issue, working on it) and subsequently bounced around the different sects of veganism -- fruititarian + distance running (almost passed out because of extremely low sodium and low blood sugar), low fat, high fat, etc. I tried it all. Frustrated by my lack of commitment and my still highly restrictive diet (I was still pretty underweight at this time), I decided to commit to "full recovery" which in the vegan sense meant lots of nuts and calories. I regained menses (last December) at a comfortable weight. ( I don't want to bring weight into this but I am naturally a small-frame, athleticly built person. I have a straight shape with narrow hips). I continued on the high nut/legume diet and continued gaining weight to an unsightly amount. Something wasn't right. Freaked out, I began the "Insanity" workout (dumb) and started cutting calories. The following few months I successfully put myself into adrenal fatigue, continued to gain weight, but lose my period again. I continue to see my endocrinologist but she is convinced that my thyroid problems "never existed" and that I'm the predicament I'm in is because of my restrictive dieting (possible -- but the thyroid problem is was sparked the dieting in the first place, so it's unfair to say that my health issues are solely the cause of my "dieting")

Frustrated with results and in light of the paleo-fad I coaxed myself into eating seafood again (salmon), and eventually became full-carnivore. I started the "bulletproof" thing, low carb, high fat, though occasionally had carb "refeeds". Cut back on exercise. No change, started experimenting with veganism again. Cut out soy and ultimately began meshing the two together, I guess a "normal" gluten-free diet.

I began adding dairy back in (greek yogurt, I love it) and noticed myself slowly losing weight. I had moved back to university at this time and I was more active on a daily basis just walking more around campus. I began running again, but only 3-5 miles in the mornings a few days a week, nothing compared to the distances I used to run. I began to stumble across Peat followers and reading about their diets and started making small changes in my own, though it is nowhere near perfect-Peat.

However, I'm having bizarre symptoms:

I've lost a lot of weight, specifically from my upper body. I'm slim all over, but particularly bony on top. I store fat in my inner thighs.
I'm panicky-- maybe about my health, and I might be bringing it on myself (my doctor described it as the chicken-or-the-egg phenomena)
I still eat a pretty restrictive diet because I don't have a huge appetite. Cooking things in coconut oil/butter helps me to get an overall higher caloric amount but I probably don't eat "enough" but there is no definitive answer to what "enough" is, and I really don't like to eat when I'm not hungry
Cold hands and feet -- always, throughout my life
Thinning outer eyebrows (also always throughout life)
and this is new: ringing in my ears, pretty constant for the past month or so
Foggy- lightheaded, disoriented feelings

my doctor checked my blood work and I have low estrogen, high rT3

my diet now consists mostly of:
pastured eggs (2 or 3 a day)
greek yogurt
milk
cheese (hard cheeses and feta)
fruit (mostly apples and oranges because they're in season now)
raw honey
pasture raised chicken/turkey
grass fed beef
gelatin/ collagen
white fish, occasionally salmon
tomatoes, cucumbers, some lettuce, carrots
squashes, sweet potatoes (I'm eating more of these now)
occasionally rice
butter, coconut oil, occasionally avocado


I take my temperature each morning and I am consistently 98.4
I still run but it's usually just shorter, intense bursts (2-5 miles, only a few days a week)
I started light strength training daily
I supplement 4000 IU vitamin D every day and do get outside in the sun for at least 20 minutes daily

I need help. Physically I feel very, very, very off and it is interrupting my productivity. I feel almost like I did when I was eating highly restrictive though I am eating MUCH more than I have ever before. Could it be that I turned my thyroid hyper? (I'm not warm though-- though it is the middle of winter in new england)
 

HDD

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:welcome2 purelaur!

It is my understanding that low blood estrogen means high estrogen in your tissue. Are you eating a carrot salad daily? This can help balance your hormones. Your liver needs plenty of quality protein and sugar to detox estrogen and to make the active thyroid hormone, t3. Are you trying to get 80 grams of protein daily? Using cronometer.com can help track your nutrients. Orange juice is highly recommended for your sugar.

If I recall correctly, the highest your basal temperature should be is 98.2. Does your temperature rise after breakfast? Sometimes stress hormones can cause a higher basal temperature and eating will bring it down.

Are you taking a thyroid supplement now?

On the forum there are interview transcripts that are very helpful. You might want to check out the ones titled "Thyroid".
viewtopic.php?f=73&t=5322
And
viewtopic.php?f=73&t=5413

Actually they are all packed with useful information. You also might want to read Ray Peat's articles about estrogen on raypeat.com.
 

charlie

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purelaur, :welcome
 
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purelaur

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:D thank you all

I have an appointment with a new endocrinologist tomorrow. I guess that's obvious re: the estrogen thing, though I am under the assumption that high estrogen is associated with being overweight, low estrogen = underweight? Except I'm not underweight, just slim (albeit disproportionately so in the upper-body, I do not understand why) Would GAINING weight, per typical "eating disorder recovery protocol", resume menses? I'm convinced that that is not so as I had previously resumed menstruation, then put myself in adrenal fatigue, then lost it again. As far as I'm concerned, my eating disorder history is part of who I am, yes, but I am not actively restricting energy intake. Now at 22 I am just trying to function as an adult woman and I feel very weakened and panicky about the state of my health.

I eat carrots daily, but not a full carrot salad -- I'll start grating/prepping a proper one in the future.

In terms of my diet, I'd estimate my total caloric intake is around 1700-1800 calories per day, which I think is average for someone my size. I don't measure anything precisely, and I consume quite a bit of fat (cheese, butter, coconut oil). My carbs are probably around only 150g. Protein is above 100g -- I forgot to add that I quite like grassfed whey shakes (I know they're anti-peat, but I buy high quality grassfed whey, and it's an easy quick snack when blended with banana and a bit of coconut oil). I'll note that the days that I feel I've "overdone it" (christmas/new years, cleaning the cheese plates ;-)), I am finding myself waking up leaner, not bloated.

Also, I notice at the same time monthly, even though I am not menstruating, I tend to break out and "bloat" and my blood sugar gets a little crazy, kind of like PMS, minus bleeding. I'm assuming this is my body getting in gear.

Are there any recommendations that can be made? I really really want to feel better.
 

Faymus

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Hi, hope you don't mind me coming in on your chats but I'm in desperate need of some advise I really worried.... I will start from the beginning....
1. I'm 33 years old and came off the pill in June 2014 after 15 years due to boyfriend and I wanting a baby
2. Didnt track dates of first 3 periods but they did happen.
3. Went to the doctors with cystic acne
4. Was then going to go doctors with headaches but the subsided a little after drinking more.
5. I was very dizzy in the morning but subsided more by the afternoon
6. Next 3 periods I tracked and dated and were pretty normal except the middle one stopped and started over 6/7 days
7. December period never started negative pregnant test.
8. Went to the doctors and she sent me for blood tests said she was testing for early menopause and thyroid etc etc.
9. Panick kicked in with me and played on my mind ALL over Christmas
10. Went to another doctor for my blood results. He said all bloods came back clear apart from my estrogen levels were low -
"I would expect these levels from a lady in her 40s/50s going through her menopause!!!" He said. "Although it could be your body regulating itself after coming off the pill after being on it for so long".
IM 33!!!!!! He sending me to a specialist!!!!
11. Was due on 6 days ago again and still not had that period either.
12. I've been having hot swear during day and during night but not sure if it's due to worry and panick attacks.
13. I've not been able to stop crying since being to the docs. I'm so worried that my chances of having children have gone!! My family are worried about me coz I'm worrying so much so trying to hide it from them so they stop worrying. I've not felt myself today. Very lightheaded and just feeling under the weather.
I so want a baby of my own.
What do you think? Do you think I'm Early menopausal?
I would really appreciate your time to tell me your view. Thankyou.
 

Jennifer

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Faymus said:
IM 33!!!!!! He sending me to a specialist!!!
13. I've not been able to stop crying since being to the docs. I'm so worried that my chances of having children have gone!! My family are worried about me coz I'm worrying so much so trying to hide it from them so they stop worrying. I've not felt myself today. Very lightheaded and just feeling under the weather.
I so want a baby of my own.
What do you think? Do you think I'm Early menopausal?
I would really appreciate your time to tell me your view. Thankyou.
I'm sorry to hear what you've been dealing with, Faymus. I'm 33 too and have dealt with hormonal issues as well. I too had low estrogen and was considered menopausal at age 27 so my doctor put me on a combination of bioidentical estrogen and birth control without ever checking my progesterone level. I took myself off the estrogen/birth control after I became suicidal.

Did your doctors also check your progesterone level? It should be about 10x that of your estrogen level, if I remember correctly. Have you looked into progest-e? It, along with a change in my diet, helped get me out of menopause. I no longer have hot flashes or night sweats. I haven't had them in a couple of years so yes, you can definitely get yourself out of menopause if you are in fact menopausal. We're far too young for that. :)

So please try not to worry, okay!? You are not broken or incurable. I know you know this because with as worried as you are, you've probably spent a good amount of time researching, but one of the number one things that can halt conceiving is stress. Relaxing is SO important.

I'm always hearing about those couples that try desperately to conceive to the point that it feels like a job to them, only to end up still childless. They go on vacation to get away from the stress, come back and find out that they're expecting. I hope I'm not being too forward when I say this, but please try not to worry or let conceiving become a job and instead have a good time loving and connecting with your boyfriend and try to let things happen organically. It's amazing what can happen when we stay in a state of just allowing. :)
 

Faymus

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Hi Jennifer, Thankyou so much for your time. I'm driving myself crazy worrying that I'm going to go to the specialist and say sorry you aren't working anymore - no babies. :-( I'm making myself I'll over it so your feedback makes me feel so much better that someone else has been through the same thing and is now ok.

He never mentioned my progestrogen levels. I don't know if that was because he never tested me or they are normal. So Thankyou for that info I will ask him at my next appointment.

I have started taking evening primrose, flax seed and clover (something or other) supplements to try to increase my levels. I've still to look into the diet Thankyou.

I've read that estrogen levels can be low between 100 and 40 but anything below 40 is menopausal low. That's all I can presume the doctor is look at when he said "it's at a level of a woman in her menopause" that's what is concerning me.

The other thing is is that I've had 6 cycles since I came off the pill why suddenly stop?

I've had hot flushes (none throughout last night though which is good, could be due to supplements), feeling dizzy and off balance. Mum keeps reassuring me that that could be just due to the imbalance not necessarily due to menopause.

Sorry for talking so much but this is how I stop myself from going under so much by talking.

As you say I won't conceive if I'm worried that will just stop everything so I need to calm down. I've taken kalm tablets and they seem to be working so fingers crossed I will have a period soon and get back on track and NOT menopausal (fingers and toes crossed).

How are you now? Are your hormones balanced out now? 33 is way too young to be worrying about things like this.

Thankyou again for your time it's helped me a lot. You have given me some questions I need to ask my doctor. Thankyou.
 

tara

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purelaur said:
:D thank you all

I have an appointment with a new endocrinologist tomorrow. I guess that's obvious re: the estrogen thing, though I am under the assumption that high estrogen is associated with being overweight, low estrogen = underweight? Except I'm not underweight, just slim (albeit disproportionately so in the upper-body, I do not understand why) Would GAINING weight, per typical "eating disorder recovery protocol", resume menses? I'm convinced that that is not so as I had previously resumed menstruation, then put myself in adrenal fatigue, then lost it again. As far as I'm concerned, my eating disorder history is part of who I am, yes, but I am not actively restricting energy intake. Now at 22 I am just trying to function as an adult woman and I feel very weakened and panicky about the state of my health.

I eat carrots daily, but not a full carrot salad -- I'll start grating/prepping a proper one in the future.

In terms of my diet, I'd estimate my total caloric intake is around 1700-1800 calories per day, which I think is average for someone my size. I don't measure anything precisely, and I consume quite a bit of fat (cheese, butter, coconut oil). My carbs are probably around only 150g. Protein is above 100g -- I forgot to add that I quite like grassfed whey shakes (I know they're anti-peat, but I buy high quality grassfed whey, and it's an easy quick snack when blended with banana and a bit of coconut oil). I'll note that the days that I feel I've "overdone it" (christmas/new years, cleaning the cheese plates ;-)), I am finding myself waking up leaner, not bloated.

Also, I notice at the same time monthly, even though I am not menstruating, I tend to break out and "bloat" and my blood sugar gets a little crazy, kind of like PMS, minus bleeding. I'm assuming this is my body getting in gear.

Are there any recommendations that can be made? I really really want to feel better.

:welcome Purelaur
If you are only eating 1700-1800cals, I would think you probably need more to recover from the damage of an eating disorder. You are effectively still restricting. As long as you are restricting, you probably can't know what your healthy set point is. If you are not menstruating, that could well be the reason. You most likely need more calories than that on a regular basis for your body to trust the food supply enough to crank up reproducive hormones again.
Have you seen Gwyneth Olwyn's youreatopia site? It is not the same a Peat's view, but I think her take on calories, metabolism and hormones are largely consistent with his ideas, though she recommends PUFAs and Peat strongly recommends avoiding them (I'm with Peat on this). Gwyneth recommends at least 3000 cals every day for young women under 25 in recovery, and to eat much more than that if hunger tells you to.
If you do increase calories, you may well gain weight, but my guess is that's your best bet at improving health including reproductive health.

http://www.youreatopia.com/blog/2011/9/ ... ories.html
http://www.youreatopia.com/blog/2014/7/ ... repro.html
http://www.youreatopia.com/blog/2012/11 ... order.html
http://www.youreatopia.com/new
There's a thread on this forum discussing it, too: viewtopic.php?f=11&t=4028

I'd also recommend going to Peat's site and start reading his articles on progesterone and estrogen:
http://raypeat.com/articles/

Endocrinologists don't always get things right, so it's good to start to learn to understand your body yourself. If they prescribe estrogen supplements, take it with a grain of salt and read up here and on Peat's site first.

Protein at 100g day may be enough, though some people do better on a bit more - lots of cheese is great, with calcium as well as protein - it sounds like that works for you. I wouldn't hold back if you feel like more.
I would suggest increasing carbs - if you double your current 150g to 300g you'll likely be closer to meeting your needs?
Can you swap the whey for milk?

I recognise the premenstral blood sugar wobbles - I get serious munchies.

That's my take, others may have other suggestion.
Good luck. :)
 

tara

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PS. It might be worth cutting the running - it might be messing with your hormonal recovery.
 
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purelaur

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Hi Tara, thanks for your response!

While I disagree with some of Gwyneth's recommendations in regards to eating disorder recovery, I did follow a similar trajectory during the initial weight restoration phase of my eating disorder (lots of calories and no exercise.) since then, however, my autoimmune hypothyroid symptoms have flared up (probably in response to the PUFAs I was eating, in addition to my vegan diet) and my endocrinologist who has been treating me for the past 8 years completely disregarded my preexisting condition and now sees me as a recalcitrant anorexic... which I am not. I am the result a medical industry that shamed me as an obese kid. I was in an emotionally abusive relationship that caused me to value my self-worth on my body shape. I have sat through the cognitive behavioral therapy and I have made leaps and bounds on working on fixing myself from the ground up.

As a hypothyroid individual, I handle stress very poorly. My stress hormones are out of control, which I believe is causing my amennhorrea. I am a full-time student with a challenging courseload and am at a very critical point in my personal and professional life and I feel as though the world is on my shoulders. Since increasing my sugar intake, I have felt a little better in regards to keeping panic at bay. Exercise is constructive stress to me as it makes me feel better about myself, but I am focusing on yoga and light strength training now, I am otherwise sedentary as I spend most of my time studying.

I'm relieved now that my current endocrinologist sees me as more than my eating disorder. It's a very small part of me now, and eating intuitively has helped me more than shoveling in calories that makes me feel uncomfortably full. My appetite naturally tapered as my hypothyroidism increased and I maintain my weight as I eat to appetite. Implementing RP-style eating has stimulated my appetite and I find I am eating more but still maintaining my weight.

TLDR; I am weight restored. My weight is not the underlying issue.
 

tara

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I agree that you are of course more than an eating disorder. There may well be other things going on, but undereating is probably one of them. Weight is not the only significant indicator, though I'm glad you are out of the immediate danger of extreme low weight. Hopefully your appetite will increase enough now to help get all the hormones going again, along with the other changes you are making. The PUFAs could well be an important factor. I disagree with Gwyneth about recommending nut butters etc.
 
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purelaur

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Thank you Tara. I must say, my appetite really has skyrocketed and my exercise tolerance has decreased (it has been decreasing. I don't know how I used to run so much before) but my perfectionist tendencies are making me a little nutty in deciding what to eat. I know Ray recommends a 50/25/25 calorie split but I find myself needing a little higher fat and protein. I'm not sure if it's due to the years of veganism and not digesting any protein at all but I'm usually at around 120-130 grams before I'm completely satisfied. And milk. I've been craving milk. I never used to care for it but now I'm craving glasses of it between meals. I've been drinking 2%. I've been trying to choose fruit over starch but I think I'm going to eat more potatoes. Are white or sweet potatoes better? I love a baked sweet potato with fried eggs and feta cheese... so delicious. I avoided starch today but didn't have any digestive issues, so that's good. Is the 50/25/25 just for weight loss? I am most satisfied and energized with a more balanced micronutrient ratio of carb + protein + fat.

TMI but my usual "routine" is upon waking to drink a large glass of water followed by black coffee. That usually gets my bowels moving. Since I cut out the black coffee, however, I'm finding it hard to "go" in the mornings. Is that cup of coffee that bad? I eat breakfast soon after.
 

tara

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purelaur said:
I know Ray recommends a 50/25/25 calorie split but I find myself needing a little higher fat and protein.
Hi, If you are wanting 130g protein, I'm surely not going to talk you out of it - you may well need it. I don't think the 50/25/25 split is set in stone - people here vary quite a bit on that. You may well be needing that milk fat too, while rebuilding. Carbs are good fuel because they produce more CO2 than fat when they are efficiently oxidised, and the CO2 is really important for keeping many aspects of metabolism running well.

purelaur said:
TMI but my usual "routine" is upon waking to drink a large glass of water followed by black coffee. That usually gets my bowels moving. Since I cut out the black coffee, however, I'm finding it hard to "go" in the mornings. Is that cup of coffee that bad? I eat breakfast soon after.

Peat would not recommend coffee without fuel - first thing in the morning fasting, stress hormones are likely high. Adding coffee to that will likely raise them even more - it helps burn your fuel more efficiently, but you've got to have some fuel there to burn, or it will just raise stress hormones more. If you can start your day with carbs and protein and a little fat, and then follow that with coffee, the coffee will likely do you more good. Or put a lot of milk, sugar and cream in your coffee.
 
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purelaur

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got my blood work back. don't have the exact numbers but TSH was horrendously high, like 4.2, t4 was high-normal and t3 was low, as well as high antibodies, consistent with Hashimotos. doctor prescribed t3 which I will start tomorrow (5mcg on an empty stomach in the morning... is this correct?)

female hormones- low progesterone, but estradiol was normal as well as LH/fsh

she said it looks like I'm "stuck" in follicular phase and t3 should give me the push to luteal

I'm on my phone now trying to type this but are there any recommendations?
 

HDD

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freyasam said:
HDD said:
:

It is my understanding that low blood estrogen means high estrogen in your tissue.

HDD, do you have a source for this statement?

My understanding that you referenced above came from reading others posts on the forum. Possibly Peatarian or Rayser. I will research it more. The following is stating it somewhat but not exactly.

"The concentration of a hormone in the blood doesn't directly represent the concentration in the various organs."

"The amount of estrogen in tissue is decreased when progesterone is abundant. In the absence of progesterone, tissues retain estrogen even when there is little estrogen circulating in the blood."

His crucial observation was that the difference in estrogen concentration between tissue and blood was lowest in the luteal phase, when progesterone is high:

“The tissue/plasma ratio of E2 [estradiol] ranged from 1.45 to 20.36 with very high values in early follicular phase and the lowest in mid-luteal phase.” This means that progesterone prevents the tissue from concentrating estrogen. He made similar observations during pregnancy, with tissue estrogen decreasing as blood progesterone increased, so that there is less estrogen in the tissue than in the plasma. But in women who aren’t pregnant, and when their progesterone is low, the tissues may contain 20 to 30 times more estrogen than the plasma (in equal volumes).

http://raypeat.com/articles/articles/ti ... ogen.shtml
 

tara

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I have read that starting at too low a dose of progest-e can sometimes cause a worsening of symptoms, which can be avoided by the recommended higher staring dose: 3 drops 5x/day, reducing later as less is needed.
 
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purelaur

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cytomel says to wait 4 hours before taking calcium or iron supps -- does that mean supps, or should I avoid dairy?

I've been searching online and most people say to avoid calcium within 4 hours of taking it -- how does this interfere with RP's recommendations??
 
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