Paleo Diet and Paleolithic Diet Questions & Answers

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So i found a relatively good doctor to communicate with out of TX. Long way from me but whatever. I cant afford doctors visits and hormonal/blood work ups so this is what i got. Anyways I talked to him about my past. FWIW, i suffered anorexia and have gained weight in recovery and restored weight and been messin around with paleo/primal trying to find what makes me feel best since. my hobby is the brain, love studying it and obviously nutrition. so yes, before its said, i know eggs and all the yum cod liver oil and sat fat is good for fertility. same with starch, been eating plenty of food. its not anything i ever took out of my diet(besides when actively anorexic..) but the point remains i have gone 7 years without a period. so anyways, the doc told me this:

"I can tell you that amenorrhea can be caused by suppression of pituitary function from excessive cortisol or psychological stress. Basically, the pituitary shuts down some of it's output, and in the case of amenorrhea, shuts down output to the gonads. To really find out you'd need a complete functional neurological and functional medicine work up."

guessing this is about where i stand... anyone got some information, advice, ideas? i need help with sleeping, im up all night- sweaty mess around 3(cortisol? low blood sugar?). i workout once a week, other days walk in the sun/stretch/meditate. been reading primal wisdom, ray peat and rosedale recently and everything is getting confused because each seems to 'make sense'

edited Feb 21 2012 at 20:53

Primordial
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asked Jul 21 2011 at 17:30

Mallory
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can you turn the title into a one-sentence question that summarizes your dilemma? It helps people find relevant questions. Thanks!! – Bread-Eating Beelzebub Jul 21 2011 at 17:34

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I don't want to turn this into a Peat revolution or anything - but his latest KMUD podcast on kmud.org/… (go to the dropdown menu Friday Night Talk find the third Fri in July -) That show was about hair but a caller asks about bulmia/anorexia recovery and hair loss. Ray addresses the cortisol issues. – none Jul 21 2011 at 17:41

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+1 for being confused, because when you're confused you're on the path of wisdom. I am impressed. You have in the past seemed so certain in your statements. – Thomas Seay Jul 21 2011 at 17:41

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Be careful who you believe and read. Reading tons and absorbing/following little is of no use. – ben61820 Jul 21 2011 at 17:44

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I don't understand why so much research is necessary, not to be rude but looking at photos on your blog it looks like your body fat might still be too low to support fertility, even if you are in recovery. Am I wrong? – Olivia Jul 21 2011 at 18:13

show 11 more comments

chirocaveman · Answer 1 · 2011-07-21 18:05:59Z UTC

I think that your doctor is right (I guess that's why he's a doctor!). Amenorrhea resulting from anorexia is called functional hypothalamic amenorrhea, and is the same type that athletes are prone to develop.

There are some drug therapies that have been found very helpful, but seeing as you are paleo, I'm sure you would like to avoid that at all cost. It sounds like you have recovered amazingly well from such a debilitating illness, and are living a very healthy paleo lifestyle. Unfortunately, there is not much data on how well people with this type of amenorrhea recover from restoring proper exercise and diet, so there is no telling what will happen as of right now.

If you're trying to conceive, and this is a time-sensitive issue, I would suggest seeing a reproductive endocrinologist. This doesn't mean going on drugs, but he could help and guide you in attempting to treat your amenorrhea naturally. If things go well, your experience could potentially add to the case study literature and help other women who are going through similar issues.

If you are truly unable to see a physician regarding this, I would give the paleo diet some time to balance out your system. Women who have been on Depo-Provera shots for any length of time require over a year for their endocrine system to balance back out. Years of damage often take just as long to repair. Best of luck, and hopefully there will be some good input on this issue from other paleohackers!

In the meantime, here is a good article from NEJM about functional hypothalamic amenorrhea.

turkeytyme · Answer 2 · 2011-07-22 04:23:40Z UTC

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The waking up sweaty sounds like you are low on estrogen. The best doctors for straightening out hormonal issues, I've found, are traditional Chinese medicine doctors. Acupuncture, herbs and diet worked wonders on my hormones. My periods were more like monthly spotting when I started, but now they are full, normal flow. I remember eating a lot of leafy greens helped too.

answered Jul 22 2011 at 4:23

turkeytyme
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	Ditto! It is amazing what a TCM practitioner can do! – Marie Jul 22 2011 at 4:39
	again, i have no money whatsoever – Mallory Jul 22 2011 at 15:29
	Mallory, go to a local TCM school. They have sliding scales for treatment costs, and you'll probably just be charged for herbs ($15). Your case is a GREAT case for their students as your symptoms are a "classic" case of hormonal distress. – Marie Jul 22 2011 at 15:37
	i serrrriously doubt Mississippi has TCM schools haha – Mallory Jul 25 2011 at 15:39

dorchid11 · Answer 3 · 2011-07-21 18:10:25Z UTC

I have trouble sleeping when I suffer from information/stimulation overload. This book had easy, efficient methods to help me stay focused when I had low motivation and also to calm me down when I was too anxious. If you have a history of mental illness, it's worth it to find tried-and-true methods that help keep you grounded and moving beyond your old compulsive tendencies. This is why I can see an anorexic person more likely to become orthorexic than someone without that history.

Find Your Focus Zone by Lucy Jo Palladino http://www.amazon.com/Find-Your-Focus-Zone-Distraction/dp/1416532005

Marie · Answer 4 · 2011-07-22 04:38:17Z UTC

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I highly recommend looking into Chinese Medicine. A good practitioner can do amazing things with a couple of needles and some herbs. I've had AMAZING success with TCM w/r/t my hormones...even when I didn't ask for anything to be "fixed", which was a great "convincer" for me.

answered Jul 22 2011 at 4:38

Marie
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	Hmmm...Care to explain that down vote? Read any research on TCM and fertility treatments? Nope, probably not. FWIW, TCM has a long, well documented success rate regarding hypothalamic-pituitary-ovarian axis issues. – Marie Jul 22 2011 at 11:02
	haha so go check out primal wisdom, start eating lentils/beans/buckwheat and go the herbal medicine route?? wont lie, i am intrigued. i just dont see how it works – Mallory Jul 22 2011 at 15:30
	Ha, no lentils or beans. My L.Ac practitioner was the first one to comment that my diet was "not appropriate for sustainable health" when I was a veggie. She also knew I was not eating "cooked orange veggies", and a number of other, VERY specific things which were quite shocking to hear during that first 90 minute appointment. TCM is much more Paleo than one would think from listening to the common media. It is less about needles, more about diet, with herbal concoctions thrown in to encourage the body to find it's balance point. – Marie Jul 22 2011 at 16:09

Ambimorph · Answer 5 · 2011-07-22 14:58:27Z UTC

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It's complex, and not well understood, and I don't have much specific advice for you, though I wish you the best of luck in your searching.

I think body fat plays a role, and I've seen the figures 20-22% quoted as necessary to recover fertility, but it isn't a guarantee, either.

Here's a comparison from Leigh Peele:

alt text

I'm thinking you look closest to the middle one at 15%, just as Kamal placed you.

Cortisol does seem to play a role in predicting who will resume menses when weight is recovered. See: Predictors of menstrual resumption by patients with anorexia nervosa

answered Jul 22 2011 at 14:58

Ambimorph
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	thanks, yes i have used those same pics on my website but def dont think i am 15%bf – Mallory Jul 22 2011 at 15:31
	do you have full text to that study? – Mallory Jul 22 2011 at 15:31
	Yeah, I couldn't confidently guess your BF from photos. I'm sure you have a better idea than I do. I'm sorry, I don't have the full-text. Do you have a medical school near you? You could use their library. – Ambimorph Jul 23 2011 at 0:23
	medical school? like college? – Mallory Jul 25 2011 at 15:40
	Yeah. I'm not sure exactly where you are, but university libraries are usually open to the public, and you can go to the periodicals section and browse hard copies of the journals. If your local U has a medical program, they're more likely to carry copies of medical journals, and they should have archives of all the back issues. I've resorted to this in the past, especially back before you could get anything online. – Ambimorph Jul 25 2011 at 16:55

Mallory · Answer 6 · 2011-07-22 15:35:20Z UTC

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also, i have VITEX and have heard good things about it. anyone know about it? supposedly it works to naturally balance hormones, its also called chasteberry

answered Jul 22 2011 at 15:35

Mallory
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Mallory · Answer 7 · 2011-07-22 16:13:58Z UTC

this is pretty interesting too...

Circulating leptin concentrations showed two peaks; one coincides with the maximum fat accumulation prior to winter dormancy, whereas the second shorter peak coincides with late pregnancy. The in vivo study in S. heathi showed that the increased circulating leptin level during winter dormancy coincides with the decreased expression of ovarian steroidogenic acute regulatory (StAR) protein, and low circulating estradiol (E2) level. At the same time, increased circulating leptin level coincides with increased expression of ovarian insulin receptor and high circulating A4 level. The low circulating leptin level during preovulatory period coincides with the increase in StAR protein but decrease in insulin receptor protein. The in vitro study confirmed the in vivo observations of inhibitory effect of leptin on LH induced StAR expression and E2 production, whereas the stimulatory effect of leptin (high dose) on LH induced expression of insulin receptor protein and A4 production. However, pharmacological dose of leptin produced inhibitory effect on the expression of insulin receptor protein. The results of the present study thus suggest that high circulating leptin level during winter dormancy promotes adiposity and impairs ovarian activity by suppressing StAR-mediated E2 production as well as by enhancing insulin receptor-mediated A4 synthesis thereby contributing anovulatory condition of delayed ovulation

Mallory · Answer 8 · 2011-07-22 21:19:53Z UTC

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http://donmatesz.blogspot.com/2011/07/diet-and-female-hormone-balance.html

umm....any help?

answered Jul 22 2011 at 21:19

Mallory
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Amenorrhea Advice/Info Appreciated!

8 Answers