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Baby Ian is now 6 months old and I am JUST starting to get my life back in order again in terms of meeting my long term health goals.  I promised myself when I first started this experiment that I would not abandon my health and wellness goals once I was no longer seeking pregnancy.  I’ve been enjoying reading back through this blog to remind myself all of the wonderful meals I created and lifestyle choices I made to get the fertility results I was after.  As it turns out, I don’t think they are all that different from what my new, “post baby” health plan should be.  After all, I still have PCOS and Celiac Disease, and will for the rest of my life.  It’s time to start thinking about my health for the long term and how to stay trim, healthy, happy, and vital as I age.  I recently saw an interview with Deborah Szekely, one of the founders of the health and wellness movement, who just turned 90 years old this week.   Not only did she look great, but she was as eloquent and vivacious as someone half her age.  What a testament to practicing what you preach, but really, what an inspiration!  I’m 35 now, and so I will set my health goals at living to 100+ years old.  That leaves 65 years, or 780 months.  I hear-by rename this blog, My 780 month PCOS Experiment.  To christen the name, I’m going to round-up and share all of the new health/wellness information I’ve come across recently as this passion of mine has slowly emerged in importance again in my post pregnancy life.

1) A more nutritious and PCOS friendly gluten free bread

I’ve often been dismayed at how refined and lacking in nutrition most commercially available gluten free breads are.  And when you look at the carbohydrate content, it’s not something a woman with PCOS should be eating either.  After some searching around, I came across a woman’s website, http://www.elanaspantry.com/, who has developed many gluten free baking recipes using primarily almond flour.  She also uses coconut flour and several types of alternative sweeteners that I’ve grown to like.  I’ve taken her “Paleo” bread recipe and adapted it for myself and I’m really happy with the results.  It is packed with protein and has almost no carbohydrates.  It’s easy to make, nutritious, and filling.

2) Grain Free Diet

The woman I mentioned above, Elana, is a celiac, but she also has Multiple Sclerosis, and has developed her own grain-free, healing diet that keeps her symptom free.  I was not aware before reading her website that many people with Celiac Disease and other kinds of auto-immune disease do better with no grains in their diet, in addition to avoiding the gluten producing ones.   I also found out on her site that both Celiac Disease and Diabetes have the same gene in common and so it makes a lot of sense that I have insulin problems/PCOS AND Celiac Disease.   The diet that I followed at the beginning of this experiment was primarily grain free, as well as low carb and low sugar and obviously I did very well with this way of eating, so I am going back to it, but with renewed vigor as I now better understand the hows and whys.  I do want to mention that it is not a “Paleo” diet though.  I eat dairy and beans and probably all sorts of other things that are not allowed on the Paleo diet.  It’s simply a diet that I have tailored to my own, particular health needs.

3) Xylitol

Xylitol is a natural sweetener that is primarily derived from birch trees (and the fiber of other fruit and vegetables).  It’s low in calories and carbs unlike sugar and it also does not affect blood sugar the same way sugar does.  I’ve been a big fan of agave nectar in the past as my alternative sweetener of choice, but with the recent studies showing a correlation between fructose and high triglycerides, I have decided to limit my use of it, as it is a “high fructose” product.  I am REALLY picky about my sweeteners, as I cannot stand that weird artificial aftertaste that many, even natural, sweeteners have.  I don’t use stevia for that very reason.  Xylitol tastes very much like cane sugar to me.  Xylitol has many other health benefits though that I am also very interested in.  When ingested, it creates an environment in your mouth that is not welcoming to the bacteria that cause plaque and so it can do wonders for one’s oral health if used in sufficient quantities over time.  In fact, it can help remineralize your teeth, virtually healing them from within.  It’s been shown to do the same things for bones too.  There is also research that shows that it prevents ear and respiratory infections.  It’s amazing to me that there is such a product out there that I am only recently hearing much about.  My whole family is using it now with great results.

4) Unsweetened, unflavored protein powder

I’ve been looking for a protein powder that I can add to baked goods and smoothies to boost protein without adding a flavor (vanilla for example) or any sweetness (such a stevia).  Both hemp and pea protein powders were recommended by Dr Frank Lipman.  I found hemp powder at my store, and I can say that so far I am really happy with it.  It has a very mild and pleasing natural flavor and I like the green color too – it just “looks” healthy!  I use it in my new bread recipe as well as smoothies to replace the yogurt that baby Ian can’t tolerate right now while breastfeeding.  I can see lots of ways to use it in the future as the package says that it can be used replace up to 25% of the flour in a recipe.

5) Dr. Frank Lipman

I mention Dr. Frank above, and for good reason.  He’s an MD who practices “Functional Medicine” in NYC, and a wonderful source of health and wellness information.  He gives truly sane, well researched, and highly usable advice to stay on the cutting edge of health.  After reading his website, I can wholeheartedly recommend him as a valuable guide to health.  I love his site and his Facebook presence.  The best thing I can say about him though is that I trust him.

6) Misclaneous – Here’s a list of some of the other things that I’m still doing regularly (or have resumed doing recently) to help treat my PCOS:

-cooking with and making salad dressing with organic apple cider vinegar

– having green tea every morning

– having sufficient protein with each meal and snack

– taking a multi-vitamin, B-multi, vitamin C and D, calcium, magnesium, omega 3s/fish oils, and probiotic.  I’m keeping my supplement list quite simple right now since I’m breastfeeding.

– deep, mediative breathing any time I can

– avoiding toxins and chemicals in my cleaning and personal care

– eating whole, mainly organic foods

– avoiding sugar, most grains, and things with a high carbohydrate and glycemic load

– eating lots of healthy fats (unrefined olive and coconut oil, pastured butter, avocado, nuts/seeds, fish/sardines)

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Life can surprise you sometimes.  The day after I wrote and posted the previous conclusion I got a positive home pregnancy test!  I had my blood test today and everything looks good.  Can I owe any of this wonderful news to this experiment?  There is no way to know for sure, but I would like to think so.  If you remember my story, I did two Femara cycles last summer after a few months of Metformin and I did not conceive on either one.  Flash forward 5-6 months and I am pregnant with only one round of Femara and no Metformin.  Perhaps I just needed a few more months for my body to recover from breast feeding.  There’s no telling.

So, the real conclusion to this experiment is ambiguous, but who the hell cares?  I am pregnant with minimal intervention and I did not have to take horrid Metformin to get this way.  I can’t see it any other way but a total and complete success!

I seriously cannot believe another month has passed since the last time I wrote a monthly report!  I’m not going to write a long report in the usual format since I am in the middle of a medicated fertility cycle and I cannot differentiate between actual progress and the possible effects of the medications.  What I will say is that I have remained true to the basic tenants of this experience –  I have eaten well, continued to exercise often, taken my daily supplements, and have seen my acupuncturist weekly with no changes or deviations.  My weight is slightly lower than last month and very stable.  I am not going to do body measurements because I am having some wavering abdominal bloating as I approach ovulation, but based on my appearance and how clothing fits, I would guess there has been very little change.  My acne is quite bad, but I am actively messing with my hormones by taking fertility drugs and this is a very common side effect for me while on them.  Emotionally, I am a little short of temper, but I have yet to feel any depression or major psychological upheaval, which is sometimes the case during a medicated fertility cycle.  My energy level has been a bit low the past week or so (again, normal for this point in a medicated cycle), and so I have started doing a Fertility Yoga DVD that I’ve owned for several years, but had only done a few times before.  Even though it’s a step down from the more ambitious exercise I usually do 3-4 times a week, I still feel like I get a decent strengthening and stretching work-out, and it’s better than simply doing nothing and letting my conditioning dissolve away.  I have also added a nightly abdominal and lower back massage using a blend of essential oils (mixed in apricot seed oil) that are beneficial for PCOS and infertility. The oils are Clary Sage, Geranium, and Rose – all with specific medicinal benefits for balancing hormones, increasing circulation and general stress reduction.  All in all, this has been the easiest medicated fertility cycle I have even gone through in terms of physical and emotional side effects.  I have also been able to achieve follicle growth without the use of Metformin, and that is a first for me.  All of this speaks volumes for what I have achieved in doing this PCOS experiment.  The proof is in the pudding though, as they say, and the proof for me will be to conceive a healthy baby.  I won’t know if I ovulated for a few days still and won’t know about pregnancy or not for two weeks after that, so lots of watching, waiting, and testing with baited breath to go, but I feel very positive about it all and that’s the best I can hope for.

Four months of this experiment have now come and gone!  This has seemed like the fastest month by far, probably because this lifestyle change has become a habit that I don’t think about it as much as I did in the beginning.  I just keep a general framework in my mind and try my best every single day to work within it.  I am spot on for a few days and then I may not get the chance to exercise for 2-3 days in a row.  Instead of trashing the whole endeavor, I just start right back up and make up for lost time.  It’s making good choices most of the time that makes the difference.

‘Tis the season for all manner of diet blunders, but I have been successful in resisting the temptation to fall off the wagon.  I enjoyed Thanksgiving without so much as an added pound, which I did, not by turning down the delicious meal, but by remaining moderate in my food choices and continuing to work-out, even when out of town.  I used to be fairly frustrated about the fact that I have not lost many actual pounds, despite lots of effort, but I now know that each pound lost is backed up by lean muscle gain and is stable, meaning the scale does not fluctuate wildly anymore.  When I lose a pound now, I’ve really lost it.  Because of this, I no longer feel like a slave to the scale or a rigid diet that cannot include an occasional treat (within reason).  I trust myself and my body.

My supplements have changed quite a bit this month with the addition of D-Chiro-Inositol, myo-inositol, and a weekly prescription of Chinese herbs.  I have not been taking any of them long enough to report much change yet, but I am very hopeful.  I sincerely wish that I could report today that I have recorded an ovulation, or even gotten a spontaneous period, but more time is needed it seems to get those kind of results.  Here’s a link that details my supplements and all of the changes that have been made along the way.

Despite feeling impatient at times in regards to my progress this month, I generally feel such gratitude for the positive changes this experiment has made in my life and for my husband and baby as well.  I look great, but better than that, I feel great too.  My interest in life is filled to the brim and I feel my creative juices flowing again.  I periodically catch myself smiling, almost giddy with happiness and excitement for the year ahead of us.  I am feeling more confident about being able to handle the responsibility of having two children.   I am actually just starting to feel ready to be pregnant again. This goal, I am confident, will be met in 2011.

So, I guess we should take a look back at the original success criteria for this 6 month experiment, noting my progress since last month:

1) Ovulation and Menstruation – It had been a while since my last period, and I began experiencing some signs of Estrogen Dominance (constant fertile cervical fluid, ferning on ovulation microscope every day).  I started an oral natural progesterone supplement called Progon B, and 8 days later I started spotting and got a very light period lasting about 4 days.  I have since started Chinese herbs and acupuncture to stimulate ovulation, but no rise in basal body temps. yet.  This goal is still a work in progress, but I have never felt closer to this goal than now since it was with Chinese herbs that I was able to regain my cycle back in 2006. Very hopeful to see what the next few weeks bring.

2) Stable weight and body measurements –  I am wearing clothing that I have not been able to in many years.  I once had a pretty remarkable wardrobe from my fashion design days in NYC, and thankfully I kept some of my more timeless pieces.  The clothes not only fit, but they look really good.  This thrills me to no end!  The big news is that I now have a waist!  I have not been able to wear anything that accentuated it in many years.  I actually pulled out a belt and wore it over a dress for the first time in as long as I can remember.  I have been fighting a puffy Insulin Resistance belly since childhood.  I still weigh myself most days and I hover around 112-113.5 lbs with very little fluctuation.  This goal has been met and exceeded!  See my body measurements below.  Despite not losing many more pounds, my measurements keep going down.  YES!

3) Little or no acne – Similarly to last month, I have had some success and failures this month in regards to my acne.  Myo-Inositol has helped me fight the urge to pick at and scrutinize my pores, but I have since screwed with the dosing too much and so the jury is still out as to if it can help my OCD-type preoccupation with my skin/acne for the long haul, enough to make a lasting difference in my face.  I was hoping that I would know something more by the time I wrote this, but I’m still not sure enough to make any grand declarations.  Hopefully the picture, and my face, will become clear enough to make an accurate report.  This goal is still a work in progress.

4) Stable and positive emotions – I’ve had some resumption of some roving anxiety that I have suffered with in the past on several occasions this month (likely low blood sugar from new supplements), but for the most part I have felt very even keeled and happy.  I feel confident and much more take-charge than maybe ever before.  I’m not shying away from things that used to intimidate or scare me.  I’m ready to take on more responsibility in my life.  This goal has been accomplished yet again!

Body Measurements:

1) Natural waist:
a- 27″ on 10/7
b- 26″ on 10/23
c- 25″ on 11/23
d- 24″ on 12/22

2) Lower abdomen (around fattest part of tummy):
a- 32″on 10/7
b- 29 1/2″ on 10/23
c – 28 1/2″ on 11/23
d- 27 1/2″ on 12/22

3) Lower hips (around largest part of butt):
a- 35 3/4″ on 10/7
b- 35″ on 10/23
c- 33 3/4″ on 11/23
d- 33 1/4″ on 12/22

4) Individual thigh circumference (around thickest part of one thigh):
a – 20 3/4″ on 10/7
b – 19 3/4″ on 10/23
c – 18 3/4″ on 11/23
d – 18 1/2″ on 12/22

Three months are now completed in this PCOS Experiment!  This month the experiment went from a highly regimented plan to a sustainable way of life.  I’ve been so self-disciplined since this experiment began that I no longer felt the need to record my progress daily, and so I ditched my daily format.  I was feeling stressed until I could stop and type out everything I had eaten for the day, and with a toddler, finding the time was getting tough.  The new, free-form blogging is much better suited to where I am in my progress.

I decided to take my exercise requirements down just a slight notch, from 5-6 days a week to working out every other day, alternating cardio and strength/resistance training.  I also started adding in a little bit more complex carbohydrates in the form of gluten free rolled oats a few mornings a week.  I made these changes in the hopes that I will be able to not only finish this six month experiment, but to keep it going for the rest of my life.  I’ve been afraid of burning out as things in my life become more complicated and prevent me from adhering to a strict lifestyle.  I have only seen the scale go down since I made these amendments to the original plan.  I started the month a solid 115 lbs and now I’m seeing the scale hover around 113 lbs most mornings.   I’ve continued to find my clothing slowly getting looser and more comfortable.   I just did my body measurements since the last monthly report and I have dropped more inches (see below).  Wow, that is satisfying to see!

Since last month I’ve noticed my weight being less vulnerable to restaurant meals and changes in my diet.  This weight stability gives me a lot of confidence when we do have a family dinner out or I want a glass of wine or a square of dark chocolate as a treat.  I might have seen the damage to the scale a few months back, but I have come far enough now that it’s no longer a problem.  I’m assuming it’s because I have raised my metabolism and healed a fair amount of insulin resistance.  The other more noticeable change since last month is the appearance of my face.  I have a quite naturally fleshy/full type face and even at times of being thin, it looked chubby, especially in photos.  I can see the reduction in puffiness and fullness in the mirror and can see it in photos too.  What an awesome and unexpected side effect of this experiment!

Since I am not reporting on my diet and lifestyle daily anymore, I want to give a synopsis of the things I am still currently doing on a weekly basis to help control my PCOS symptoms and to help my body heal.  I continue to add a splash of apple cider vinegar to every glass of water I drink.  I have half a grapefruit several days a week.  I drink green and spearmint tea once or twice a day.  I work out every other day, doing both cardio and strength training.  I go to acupuncture once a week.  I try to reserve a few minutes a day for a relaxing bath, usually with Epsom salts and essential oils.  I’m still eating very cleanly, with an emphasis on low carbohydrates and whole foods.  I eat small snacks that contain protein in between meals to keep my blood sugar stable.  I take a wide range of daily supplements prescribed by my acupuncturist to help my body heal my PCOS.  I record all info about my supplements here, including changes as they occur, and there is lots of change monthly.

So, I guess we should take a look back at the success criteria for this 6 month experiment, noting my progress since last month:

1) Ovulation and Menstruation – This month I started having almost daily fertile signs and symptoms which has lead both my acupuncturist and myself to believe that I am now experiencing some Estrogen Dominance (a build up of estrogen that is never balanced by progesterone because of the lack of ovulation).  I started experimenting with a saliva microscope and it shows that I am in the presence of increased estrogen every time I use it.  A week ago, I started back on Symplex F for two weeks to try to stimulate ovulation.  I had my first high temperature this morning, so this is not proof of ovulation, but a girl can hope.  Suffice it to say, this goal is an ever evolving work in progress.

2) Stable weight and body measurements – Overwhelmingly, this goal has been met and exceeded!  I started this experiment at 117 lbs, went down to 115 lbs for a while, and I’m now around 113 lbs consistently.  My abdomen is pretty darn flat and not reactive to eating.  See my reduction in body measurements below.

3) Little or no acne – I’ve experienced both total clarity and an upsurge in acne at different points this month.  I had not experienced a completely clear face at any point in the months prior, so I would say that I have had at least some success in this department.  When I don’t fuss about and pick or squeeze on my face and keep it clean and doctored up with my various acne preparations, I can now have relatively clear skin.  Even with that though, I still had some breakthrough pimples that surfaced no matter what I did to prevent them.  This goal, while I’ve seen moderate improvement, is still a work in progress.

4) Stable and positive emotions – Like my acne progress I spoke about above, my emotional health has been both very good and wavering at times as well.  I’ve had some mild depression and reduction in motivation in regards to this experiment during this month, but I really think I solved this problem by changing the parameters of this experiment as I mentioned earlier.  My self-assurance and confidence has been quite good and I have felt more like reaching out to people and less introverted.  I am going to call this goal accomplished for now, especially since I’m no longer dealing with rocky emotions on a daily basis, just in isolated drips and drabs.

Body Measurements:

1) Natural waist:
a- 27″ on 10/7
b- 26″ on 10/23
c- 25″ on 11/23

2) Lower abdomen (around fattest part of tummy):
a- 32″on 10/7
b- 29 1/2″ on 10/23
c – 28 1/2″ on 11/23

3) Lower hips (around largest part of butt):
a- 35 3/4″ on 10/7
b- 35″ on 10/23
c- 33 3/4″ on 11/23

4) Individual thigh circumference (around thickest part of one thigh):
a- 20 3/4″ on 10/7
b- 19 3/4″ on 10/23
c – 18 3/4″ on 11/23

Even since the time change a few days ago, I’ve felt like a chicken running with it’s head cut off.  I was so tired from the weekend that I almost talked myself out of exercise today, but I had some green tea instead and got my butt moving anyway.  I am really going to have to work on my motivation to get through the rest of this experiment.  My routine has really been trying to run off course lately and I keep nudging it back, trying to salvage it.  Jude is requiring more and more from me – I feel like I’m running in circles most of the day just to keep up.

Had a tiny more bit of spotting and felt bloated after dinner for the first time in months.

Exercise – did about 3/4 of Crunch: Burn and Firm Pilates DVD with 3 lb. weights

Mind/Body – Had a very brief few minutes to soak in the tub and read while Jude watched a video.  He did end up joining me within a few minutes to splash his arms in my bathwater, so my time-out was shortly over.  Good while it lasted.

Diet – 114 lbs

Breakfast – large iced green tea with milk, 2 fried eggs, 2 chicken breakfast sausages, 1 scoop of cottage cheese

Lunch – leftover butternut squash bisque, collards with black eyed peas, braised red cabbage,  and about 1/2 cup cottage cheese for protein

Dinner – Half a grilled NY strip, half a roasted acorn squash with butter/honey/cinnamon, leftover braised red cabbage, and a wedge of iceberg with homemade blue cheese vinaigrette dressing

Snacks – green tea with milk, half a grapefruit and a handful of raw almonds

Feeling a bit sluggish on the second day of no exercise.  With everyone in town, plus trying to stick to this experiment, plus getting things done on a usually busy weekend, and I’m running in circles all day.  Started spotting a tiny bit again and boy, oh boy, my acne is HORRID!  What the hell is going on with my hormones??  A period, ovulation, or just plain screwed up??  I wish I knew.

Exercise – took the day off

Mind/Body – Got to hang out more with my friends from out of town and see their miracle babies.  Due to the time change, I got a few extra minutes at the end of the day for a relaxing bath and some reading time.

Diet – did not weigh

Breakfast – black/green/spearmint tea with milk, 2 fried eggs, 2 chicken breakfast sausages, 1 scoop of cottage cheese

Lunch – leftover butternut squash bisque and about 1/2 cup cottage cheese for protein

Dinner – Chicken Parmesan cutlet topped with marinara sauce and mozzarella cheese with sauteed portobello mushrooms/thyme/butter/sugar snap peas, and lima beans on the side. very small glass of red wine

Snacks – green tea with milk, red grapes and a handful of raw almonds

When we began in earnest to try to conceive Jude with fertility treatments (early 2008), I became part of an internet support group for thin women with PCOS who were also trying to get pregnant.  Over the years most of us have remained friends and have shared the ups and downs of our pregnancies, births, and our adventures in mommy-hood together.  We arranged a little get together this weekend in Austin for four of us and our babies (plus 3 husbands).  It was so weird and wonderful to finally get to meet everyone after sharing so much online.  What a miracle to see all of the babies after some of us had such a hard time getting them here.  I know I will eventually meet everyone in the group in real life because these women are my true friends – friends that were really there for me through some of the hardest times in my life, and continue to be there during the happiest.

Exercise – took the day off

Mind/Body – I had such a good time getting to meet and visit all of my friends and their babies.  It was good for the heart and soul.  Also got a badly needed date with my husband where we were able to talk, laugh, and have fun.

Diet – 114 lbs.

Breakfast – small latte and one black bean, bacon, cheese, and avocado breakfast taco on a corn tortilla

Lunch – did not feel great so only had an almond Bumble Bar

Dinner – date night out – tortilla chips and salsa, 3 mini al pastor tacos, and a few bites of refried black beans. One top shelf margarita on the rocks!!

Snacks – iced tea

I forgot to mention that at my visit this past week, my acupuncturist wanted me to try halving my Gymnema dose to only one tablet, 3 times a day rather than 2 tablets, 3 times a day.  I wrote about Gymnema in depth here, but in a nutshell it helps regulate sugar metabolism and makes me have virtually no sugar cravings despite eating low carb and almost no sugar, except for in fruit.  I started feeling sugar cravings by the end of the first day with the reduced dose (11/2/10).  I tried to fight the urge the next day, but I decided that I needed to up my dose again and just modify it a little.  Since I eat almost no carbs at breakfast, I will not take any after that meal.  I will take 2 after both lunch and dinner.  So far this seems to be working.

Exercise – Crunch: Super Slim Down DVD

Mind/Body – Got a quick and very hot bath where I was able to lay back and meditate for a short while.  It really helped to both relax and invigorate me at the same time.

Diet – 114 lbs.

Breakfast – black/green/spearmint tea with milk, 2 fried eggs, 2 chicken breakfast sausages, 1 scoop cottage cheese (which Jude ate most of)

Lunch – leftover red cabbage, collards/black eyed peas, and a scoop of cottage cheese for a little protein.

Dinner – Roasted butternut squash/veggie soup (pureed) topped with cheese and cilantro chicken sausage

Snacks – half an apple and a handful of raw almonds, green tea with milk, small juice glass of raw milk

Still feeling a little scatterbrained and slightly anxious.  Not sure where this is coming from, but I don’t like it.  I’ve enjoyed so much focus the last few months so I hope this is not a trend.  At least I physically feel strong and well, unlike earlier in the week.

In better news, Jude’s verbal communication is really taking off again after not hearing much during his teething crisis.  I’ve been in a constant state of amazement in him nearly all day.

More breakouts today.  Blahhhh!

Exercise – Self: Slim and Sleek Fast DVD – about 40 minutes with 3 lb. weights

Mind/Body – Got a very nice soak in the tub today after my workout and I enjoyed a great chapter in my book.

Diet – 114 lbs.

Breakfast – black/green tea with milk, 2 fried eggs, 2 chicken breakfast sausages, 1 scoop cottage cheese

Lunch – Part of a can of organic tomato soup and a piece of GF high fiber bread, toasted with a tablespoon or so of roasted almond butter

Dinner – 6 huge sea scallops pan seared with pasture butter and parsley and collard greens sauteed with slow cooked black eyed peas and truffle oil.

Snacks – small bunch of red grapes and a handful of raw almonds, 1/2 a small grapefruit and a handful of raw almonds, green/spearmint tea with milk, chai tea with milk, 1 mini Reeses peanut butter cup