How I Managed Hashimoto’s During Pregnancy

hashimoto's pregnancy

This was the last picture taken of me before I gave birth to my daughter May 2016.

 

One of the most frequent questions I receive these days is, “How did you manage your thyroid while pregnant?” This is a poignant question because pregnancy and post-partum is infamous for sending the thyroid awry whether or not you have Hashimoto’s disease.

 

my back story…

I was diagnosed with Hashimoto’s at age 19 (10 years ago) and have been on some form of thyroid hormone replacement since then. In our community, we tend towards anti-medication but in the case of many autoimmune diseases, supporting the body through medication AND dietary and lifestyle changes is a true holistic approach.

 

My body requires supplemental hormone because the disease has significantly destroyed my thyroid prior to diagnosis and dietary changes. Once thyroid tissue is destroyed through autoimmunity or radiation, it will not produce the necessary thyroid hormone required for optimal metabolic function. This requires supplement through medication and it is incredibly important to adhere to your doctor’s advice regarding medication while pregnant.

 


A quick note on which thyroid medication I take:

I am one of the rare people who has a severe autoimmune attack to porcine thyroid hormone (Armour, Naturethroid, for example). In fact, the last time I took it, I launched into a 12-month long flare that ended during pregnancy. You will also likely find autoimmune disease remission during pregnancy as the immune system down regulates to protect the body from seeing your baby as an invader.

Instead, I do best on a synthetic combination of T4 (Tirosint) and T3 (liothyronine). Yes, I’ve tried compounded medication with a functional practitioner and my numbers do not stabilize well. No, I have not tried and will not try to go off my medication. Tirosint is a great option for those of you looking for additive-free synthetic thyroid medication. Ask your insurance if they will cover it.


 

My story with infertility is long, and I won’t be talking about it here. Instead, let’s start with conception to keep this focused. 

 

I went into pregnancy in the middle of that autoimmune flare mentioned above. Women with Hashimoto’s do have an increased risk of pregnancies not being carried to term (I don’t like the word “miscarriage”). As a woman with Hashimoto’s, I knew I needed to be an educated self-advocate during pregnancy and beyond.

 

I did not let these statistics scare me though. Sure I had my moments of worry like most moms, but I trusted and supported and loved my body extra during this time. When I needed to calm my mind, I used prayer, meditation and journaling to comfort me.

 

I am sharing with you the process I put into place the moment I found out I was pregnant in August 2015 to best ensure a healthy mom and a healthy baby.

 

GET TESTED AS SOON AS YOU TEST POSITIVE

 

I found out I was pregnant in Hawaii on our way from moving from Chicago to Austin. I didn’t have an OBGYN in Austin let alone a general practitioner.

 

The day I found out I was pregnant, I called my health insurance company from our Kauai Airbnb to get the number of a gynecology group in Austin under our plan. I knew they may not be the perfect fit, but I needed to establish care as soon as possible so I could get my thyroid tested immediately.


But what if I don’t have diagnosed Hashimoto’s? Should I still get my thyroid tested?

My answer as a thyroid patient is YES. If you have suspected Hashimoto’s or hypothyroidism or have a family history, get your thyroid tested early in the first trimester. There is absolutely no risk to you to get this done but it can be risky to NOT know what your thyroid is doing in those formative weeks.

In fact, some thyroid experts advocate thyroid testing for every pregnant woman.


 

The office requested I only schedule my first appointment between 8 to 10 weeks pregnant, but I had done enough research on early pregnancy and Hashimoto’s to know I needed to get in sooner.

 

I was able to schedule my first appointment for 6 weeks. I would have preferred 5 weeks but they did not have availability. I requested a blood thyroid panel including TSH, free T4, free T3. I even got to see my baby as a little dot on a quick ultrasound (and hear her heart beat) during that appointment.

 

Backing up, I had a full panel done around the time of conception and knew my TSH, T3, and T4 were normal even though my antibodies were high from the flare. Just four weeks later at 6 weeks pregnant, my TSH increased from 1.0 to 9.0 and my T3 and T4 dropped.

 

The increased demand on your thyroid during the first trimester is no joke. If you have a damaged thyroid due to Hashimoto’s, your thyroid may not be able to keep up with this increase demand. Test early, test often, and test fully.

 


Test early, test often, and test fully.


 

We increased my thyroid dosage by about 50% to stabilize my numbers. At this time, I was only on T4 and not T3. In fact, during pregnancy, I could not find a practitioner to prescribe me T3 since it has not been studied in pregnant women. You may have a different experience with that depending on your practitioner. I got on T3 within a few weeks of giving birth. Even without supplemental T3, I was able to keep my T3 in the 50% range and had bounds of energy throughout pregnancy.

 

 

FIND THE RIGHT PRACTITIONER

 

Many thyroid patients will agree that finding the right practitioner, one knowledgeable in full thyroid panels and optimal levels (not just “in range” levels) is a necessity. Pregnant women especially must feel they are in good care with their medical team. Your OBGYN, midwife or general practitioner will likely be the one in charge of monitoring your thyroid while pregnant. 

 

You’ll likely encounter a physician who doesn’t believe in testing T3. I did several times (endocrinologists are notoriously the worst about this ironically). I essentially “fired” those physicians but not before providing information on why testing T3 is so important for their thyroid patients. This topic is worthy of more than just a quick paragraph here.

 

Rather than having an endocrinologist follow my thyroid throughout pregnancy, I trusted my gynecologist. We worked together to establish a plan of care that included frequent testing, monitoring of symptoms, and extra care to ensure that Grace was growing adequately. Since mothers with unmanaged Hashimoto’s can have babies with low weight as well as an increased risk of pre-term labor, we wanted to monitor closely.

 


How I Self-Advocate with Physicians

Whenever I move to a new city or visit a new doctor, I am very clear about a few things. I tell them I am a seasoned thyroid patient, I know how to read my lab numbers, and I know when I need a change in medication. I have lived this and researched it for a decade, and I would like to be treated that way.

 

The only physicians who have responded negatively to this are endocrinologists so I refuse to see them anymore. Am I being harsh about endocrinologists? It may seem that way. But over ten years, I’ve had the exact (it’s eery) same experience with over a dozen of them. It angers me to see so many thyroid patients often poorly managed by these specialists.

 

Being this upfront may not be easy, especially in a world where we believe medical practitioners are above us. Remember, no one knows you better. Trust yourself, your experiences and your intuition. Your doctor is your teammate not your boss.

 


 

MONITOR & ADJUST FREQUENTLY

 

My doctor felt most comfortable testing my thyroid every 4 to 6 weeks throughout pregnancy to ensure stabilization. I informed her at my first appointment at 6 weeks that I tend to have a volatile thyroid that struggles with stress and hormonal changes (so prevalent in pregnancy and post-partum!)

 

This is another instance of self-advocacy in the hierarchical medical model. Speak up for yourself. Don’t be complacent with your physician. You know your body way better than they do. They know textbooks, they know previous patients. They do not know you. Help them get to know you.

 

Thankfully, I only had to adjust my medicine once during pregnancy in the first trimester and was able to maintain that dosage throughout. Your doctor needs to be well-informed on the thyroid ranges for pregnant women as they do differ from non-pregnant women. For example, the TSH range is quite a bit tighter than for non-pregnant women, and it also changes slightly the first to the second trimester.

 

Most providers will want your TSH below 2.5 for the first trimester and below 3.0 for the second and third trimester. My TSH stayed around 2.0 throughout my pregnancy, about twice as high as when non-pregnant. I was not concerned with this number after researching the increased demand on the thyroid. It makes sense my pituitary was sending out a “produce more thyroid hormone” signal to my thyroid.

 

That being said, be aware of your hypothyroid symptoms even if your numbers are in range, especially if they are at the higher end of the range. For example, I could barely walk up the stairs my first trimester. This symptom (what I call “stair fatigue”) is a classic hypothyroid symptom for me. I knew I needed to give the increased dosage a couple weeks to kick in before my symptoms would reside though. Once the meds kicked in, my fatigue quickly dissipated.

 

It’s important to know your body in this way. Get a sense of what it feels like to be hypothyroid and to feel well. Note those hypothyroid symptoms so that if and when they appear, you can get yourself to your doctor for testing.

 

 

SUPPORT YOUR THYROID WITH DIET & LIFESTYLE

I started the autoimmune protocol in 2014, about 18 months before getting pregnant. In fact, it was key in helping me reverse my infertility diagnosis. I didn’t use pregnancy as an excuse to go wild on cravings though. If there’s ever a time in your life to treat your body with respect, it’s during pregnancy and post-partum.

 

The nutritional and energy demands of a woman’s body during this time are astounding. I made a pact with myself to stick as closely to the principles of the autoimmune protocol as possible during pregnancy and post-partum. Note that I said the principles of the protocol and not the elimination phase of the protocol.

 

For me, this meant including foods I knew I tolerated well such as soaked organic white rice cooked in broth, dark chocolate, seed spices and treats like store-bought coconut milk ice cream. This allowed me to focus on nutrient density while still having fun with food and listening to my body.

 

I would be lying if I said I ate “perfectly healthy” my entire pregnancy. I am not a diet perfectionist by any means. My food choices stem from my intuition, my mood, the social setting and frankly what’s in my fridge. While I ate dark chocolate most days, I also never skipped a meal. I had three balanced meals each day that included protein (a must!), leafy greens (folate!), starchy veggies (glucose!) and fats like avocado or coconut. I wish I still ate like that post-partum!

 

I personally do not believe in attempting low carb and ketogenic diets during pregnancy. I only mention this because they are trending hard right now. I am so happy for all the people these diets heal and bring happiness. If you naturally eat low carb (and you’re being honest with yourself about it being natural), then continue to listen to your body.

 

But if you are truly craving sweet potatoes, dried mango or a bowl of freakin’ cereal, then YOU get to decide if you eat that or not. Not a diet guru. In fact, I had gluten-free cereal several times during pregnancy. I also distinctly recall eating a bowl of rice with coconut aminos at 3 am because I woke up craving it and was starving (2nd trimester hungry, if you know what I mean).

 

My pregnant body craved SPECIFIC foods like citrus, mango, berries and sweet potatoes. And I don’t blame this on being a “sugar-burner” (so many opinions on that terminology, by the way). These are common food cravings for pregnant women for good reason – our bodies demand all of that folate, vitamin C and glucose they’re asking for. WE’RE BUILDING A HUMAN. Be easy on yourself but also treat your body with respect and let that be reflected on your plate, with your sleep, your stress management, your movement and your relationships.

 

 

It is my goal one day to provide a more inclusive guide of managing autoimmune disease during pregnancy. Until then, I hope this article provided you with some helpful, actionable information to protect your thyroid health during pregnancy. 

 

 

ADDITIONAL RESOURCES

Hypothyroid Mom is an excellent resource for additional information on fertility and pregnancy. Dana Trentini is also the author of Your Healthy Pregnancy with Thyroid Disease. You can also order your own full thyroid panel with a coupon code on her website.

 

Looking for post-partum support? I found Dr. Jolene Brighten’s book Healing the Body Naturally After Childbirth helpful.

 

I also have written an article on Balancing Hormones for Fertility. You can read more about my story of reversing infertility here.


 

Disclaimer: I am not a medical practitioner, and I will not be able to answer specific questions regarding your health state. I am here for emotional support and to provide hope. The information in this article is based on my personal experience and research. 

 

What the F is EFT (Emotional Freedom Technique)?

 

 

I couldn’t resist titling this article “What the F is EFT?” I can’t tell you how many people have asked me this very same question when I started talking about my experiences with the Emotional Freedom Technique (EFT) last year. And I said the same thing when I first heard of this interesting form of therapy myself.

What the F is EFT?

EFT is a therapeutic emotional tool implemented by practitioners all over the world that combines the principles of acupressure (tapping along meridians with your fingers), talk therapy and replacing current thought patterns with positive affirmations in order to move energy around your body and nervous system. In a way, it has similarities to acupuncture which uses needles along known energy meridians to re-circuit the body’s qi (another word for energy). 

 

I have come across several different philosophies behind EFT, so rather than explaining the who’s, why’s, and how’s… I’m going to share my personal experiences so you can get a more unique look inside an EFT session. I do encourage you to reach out to a local EFT practitioner if you have one in your area, if this sounds like it may be beneficial for you. I received great benefit from my sessions + much, much, much better results than a traditional therapeutic approach or even hypnosis (I tried that too). It’s VERY woo-woo at first, but once I saw benefit, I put my initial judgments aside and just went with it. 

 

Humans tend to bury the things that frighten us the most deep, deep, deep into our cells. Our cells, our mitochondria, are responsible for giving us life and controlling every bodily process you can think of… including how we think. Our immune system. Our brains. Our guts. Our cortisol response. When our cells are contaminated with a personal history of fear, trauma, abuse, and invalidation, a switch turns on.

 

This switch could be the trigger that pulls the gun for autoimmunity that was already loaded by your genetic and environmental toxins. Or it could be the switch that keeps you from living life in your truest form and achieving true happiness and fulfillment. Don’t you find life’s greatest moments result when you just drop expectations? For EFT to “work”, you really have to become as non-judgmental as you can be and not overthink it one bit.

 

Think of it this way. Most humans are walking around on earth tightly wound up like a spring. Everyday experiences continue to load that spring until it gets tighter and tighter and smaller and smaller, so that it no longer feels, looks, or acts like itself.

 

Until we release the tension caused by all of these experiences, we are going to stay tightly wound, our cells starved for new flow of energy. This didn’t totally make sense to me until I tried EFT with a very skilled practitioner in Austin. I no longer live in Austin but I continue to use what I learned from my therapist to cope and thrive in my everyday life. 

 

How does it work?

Ideally you learn to self-administer EFT tapping with an experienced therapist in a quiet and safe setting. It’s important to trust your EFT therapist because you will likely be talking about your deepest concerns, fears, and anxieties. Some people use EFT to calm headaches, allergic reactions, back pain, bloating, constipation, rashes, etc. I started EFT after hearing what an effective treatment is can be for someone with PTSD, emotional trauma, and anxiety. I wanted to change my thought patterns because I knew if I changed those, other things in my life would naturally fall into place to make me a happier and whole being. 

 

EFT is applicable to pretty well any physical, emotional, or cognitive issue or ailment you are experiencing. While I haven’t used EFT on more than two occasions for physical illness (an exposure to an allergen), I have used it for the last 6 months to successfully heal emotional wounds that I have carried with me from birth, childhood and young adulthood.

 

One could argue that the trauma we carry with us may have caused enough stress to trigger our autoimmune diseases. Now it’s time to unload the gun so that if the trigger is pulled by a daily event, it’s not going to harm us.

 

Okay, so here’s how it works…While narrating your thoughts, you tap along designated acupressure points in a calming pattern. Top of the head, above the eyebrow, the side of the eye, under the eye, under the nose, on the breast bone, across the chest, under the ribcage, side of your body, along your forearm, hand, and fingers. It’s important to really let the thoughts flow and to not judge them. If you need to vent about your ex-husband, mother-in-law, the girl who stole your treadmill at the gym, or the guy who rear-ended you this morning in a non-judgmental space, this is the place to be.

 

EFT doesn’t encourage you to pretend everything is roses + pack away your real feelings. Remember, it’s about the good, bad and the fuuuugly. I’ve learned that to cope in life, we need to be aware of our reactions first and foremost. I have less to cope with now since EFT has changed my outlook so dramatically on people and events. 

 

My Personal Experiences with EFT

I find the subtle drumbeat of tapping vibrating through my body INCREDIBLY calming, and will now even start tapping in public subconsciously if something is stressing me out. For example, the other day a car drove by my daughter and I while we were walking in my neighborhood way too fast.

 

My cells immediately wound up in anxiety, my heartbeat faster, and I started to sweat. To calm this cortisol response down quickly, I started tapping, tapping, tapping, and within a few moments, I felt level again and ready to appreciate the beautiful morning for what it was. In the past, that event would have set up me for anxiety all day, heightening my adrenal response, lowering my digestion, and stimulating my immune system. 

 

During our first session, I felt what I can only describe as a ball of energy form in my throat, almost choking me, and certainly uncomfortable. I consider that the first and largest release of energy from my body that was keeping me sick and unhappy. My body gathered up energy in my throat likely for a few reasons: I have a diagnosed thyroid disease and the energy was right where my thyroid is located. I have felt my voice was squashed for so long… I used to hide my diagnosis (especially my infertility diagnosis) from friends and peers, even my family. I’ve also always had a fear of choking or of anyone touching my neck. It makes complete sense that this is where my body’s energy expulsion targeted. My therapist said some people burp, pass gas, become sleepy, or feel other odd sensations during EFT sessions.

 

We continued to tap along the meridians of my body, me following the lead of my therapist. The room had lowered lights, soft music playing, and my therapist encouraged me to keep speaking my inner thoughts. The ones I had pushed deep into my cells for so long. That ball of energy slowly started to release into the top of my throat, near my mouth, and suddenly it was gone. I no longer felt like I was choking or couldn’t breathe. I didn’t burst into tears (this session), it just went away. And the issue we were talking about truly stopped bothering me. It was an issue that was rooted in a past relationship. That’s some heavy stuff to work through that quickly. Other topics took several sessions for us to work through, though, so even if you don’t feel completely resolved after one session, don’t give up yet.  

 

Of course I was incredibly curious to return for more sessions once I had that effective initial experience. And each subsequent session we focused on whatever was on my mind that week. One week it was my birth experience, another week it was about missing deceased family members, another week it was to combat anxiety I was experiencing in anticipation of having six weeks straight of visitors when Grace was a few months old. We also discussed past relationships and experiences (like a scary experience I had walking home by myself in college as well as the tragic death of two friends).

 

On top of the fear and trauma that results from those situations is blame and an unwillingness to make ourselves vulnerable… for fear it may happen again. Or maybe it’s embarrassment for others to know. Either way, neither fear, invalidation or embarrassment are creating a positive flow of energy in your body and are negatively impacting your efforts in healing. Wrapped up in my past trauma is years and years and years of living a life of someone who was unwell and had lost her zest for life. 

 

The guilt, shame, fear, pain, sorrow, and hopelessness that many of us that have been diagnosed with a chronic illness or infertility comes as a package with our diagnosis. We have to unwrap that package, stare at it, examine it, question it, and then decide how we’re going to address it. Do we want to hold those emotions in our cells, keeping us from leading the life we were meant to live? Or do we want to release those emotions + clear our energy meridians so we can instead bring them true emotional and physical nourishment?

 

I lived in these negative emotions far too long, especially with my infertility diagnosis. I can say with confidence that my diagnosis of Hashimoto’s would not have been nearly as devastating to me if it hadn’t come along with an infertility diagnosis a year later. After the birth of my daughter, the greatest gift I could have ever received, I decided enough was enough. I wasn’t going to raise my daughter as a tightly-wound emotional spring, off-gassing my trauma on her. She deserved better and so did I. I had to face my own demons, the ones that were keeping me in a place of emotional restriction and possibly from reaching my full healing potential. That may sound strange to you depending on your own spirituality + openness to new ideas. But I fully believe that what we carry with us affects those around us.

 

Haven’t you been around someone who just made you feel off? There was a girl in my occupational therapy program who literally gave me the heebie jeebies… there was something in her energy that was so negative, it made my stomach twist and turn when I was near her. I had to work closely with her during the time of a Hashimoto’s flare and the days we were together, I felt so exhausted and sick. I wish I had known about EFT back then because I could have better protected myself in that situation. 

 

So what have I gained from EFT?

  • In a rather short time, I have increased my coping abilities dramatically. I go through my day with greater ease.
  • I have further accepted my body for what it does, what it looks like, and what it may do in the future. I don’t live in fear of autoimmune flares or fear of situations I cannot control.
  •  I have stopped blaming myself for everything. I’ve stopped worrying and “but what if-ing” everything.
  • I have stopped trying to control the future so much but rather live and stay in the present.
  • I feel healed from past traumas and aware of the healing that still needs to occur.
  • All of these tendencies and behavioral/thought patterns were rooted in anxiety and that anxiety was flowing through my cells like the Colorado River. We disrupted the flow.
  • Shifted my cognitive patterns using an almost trance-like state that is consciously tapping… and it really changed my outlook on the world and my place in the world.

A Serious & Honest Look at Why Periods are So Important for Health

Periods… I’ve always wondered why they are called that. They aren’t the “end” of something. Menstruation should be a never-ending cycle until we start winding down our reproductive capabilities in our 4th and 5th decade of life. But why are more and more women in their teens, twenties, and thirties going to their doctors with menstrual irregularities and hormonal symptoms? I wanted to explore this topic a little deeper with you guys in my typical bulletpoint article style flecked with sarcastic commentary meant to lighten up a pretty heavy (no pun intended) topic!

 

First, I will say when I lost my period after going off birth control in 2009 I was not upset. I historically was riddled with cramps so bad they required prescription-strength pain relievers and usually a day or two off school or work. There was something amazing about going through life never worrying about if I would start bleeding in the middle of a meeting, but that joy wore off pretty quickly once I stopped feeling like a woman. My weight dropped dramatically, my breasts went from a full C to a AA, and I lost my ability to cry. Seriously, I could NOT cry and my mood was the same all the time. Even puppies living in sad conditions could not make me shed a tear, and if you know me at all you know I am incredibly passionate about animal wellness. I just didn’t feel like myself but some androgynous creature floating through life with this fantastic benefit of never having to wear a bra (that part I miss). 

 

 

  • Why getting a period is a sign of health
    • I know we all gripe about it, oh approximately every 4 weeks, but if you have a regular and healthy menstrual and ovulation cycle, consider yourself fortunate. It likely means that you have a lot of your health ducks in a row. Of course there are many people in a diseased or malnourished state that still get their periods as their bodies have a different threshold of perceived threat to a fetus, but overall when your brain and endocrine system are synced up, it’s likely that you’re doing something right. That is if you don’t have any hormonal imbalances hiding behind your regular monthly cycle such as estrogen dominance or anovulation (lack of ovulation).

 

 

In order to truly appreciate the beauty of the female reproductive cycle, I think you need to understand the orchestra of hormonal harmony your body must create before the blood bath begins… 

 

 

What happens to hormones during a menstrual cycle

  • Day 1 of your cycle starts on the day you begin  your period which usually lasts anywhere between 3-7 days for most women
  • During the follicular phase before ovulation progesterone is staying stable but estrogen, is rising and peaking up until ovulation. Initially, your libido may be non-existent but it often ramps up towards ovulation as your body prepares for making babies.
  • As estrogen rises, another hormone, the follicular stimulation hormone (FSH), is also rising and signaling to your body to start readying those eggs for release
  • Luteinizing hormone (LH) rises and peaks dramatically, stimulating ovulation and the release of an egg which will travel to the fallopian tubes.
  • After ovulation, progesterone rises steadily (along with another smaller surge of estrogen) and drops off before your period begins again. Generally around ovulation, women tend to feel their “best” – breasts start to become fuller, mental clarity is highest, and you will probably perform better in the gym too! But the closer we get to our next period, the more bloated and tired we feel and the more carbs we crave due to a drop in serotonin (one of your mood-boosting neurotransmitters) and a rise in cortisol. You may also feel HOT! No, not sexually attractive, but physically overheated. One of the best indicators of a successful ovulating cycle is an increase of about ½ a degree in body temperature that is sustained during weeks 3 to 4.

 

That’s a lot of hormonal ups and downs and you can see how a typically healthy individual is already on a hormonal roller coaster each month! Now throw in autoimmune disease, thyroid dysfunction, adrenal burnout, and inflammation, and you have got yourself a party. A party of screaming drunk girls fighting over who copied who’s statement coral lipstick trend.

 

But what if you aren’t one of the lucky ones with predictable cycles or heck, you can’t even remember the last time you had one?!

 

Common Causes of Irregular or No Cycles

    • STRESS
      • Emotional: Difficult life stressors such as moving, break ups, the onset of new disease symptoms, a death in one’s family, etc can be enough of a stressor for the body to put a stop to potential fertility. Our cortisol production is part of the HPA axis which is the feedback loop between the hypothalamus, pituitary, and adrenals. When one of those systems goes awry, it can affect the stimulation and production of another gland’s master hormones such as FH and estrogen. This can happen fairly quickly and you can go from a lifetime of normal periods and the next month (or months and years) of amenorrhea (lack of periods) unless the cycles have been regulated. Unfortunately our bodies are very good at prioritizing certain functions over others so if you’re constantly revving the sympathetic nervous system (“fight or flight”) and not spending enough time in a relaxed state, your production of cortisol is likely going to be high. High cortisol generally results in low DHEA (commonly seen in the first stages of adrenal fatigue) which is like the first stop on the production line of female hormones before you make a baby. Breakdowns with cortisol and DHEA can mean that your body shuttles its energy towards staying alive rather than making lives.
      • Physical: Most of my readers know this well! Chronic autoimmune disease that has not been addressed from a gut health perspective is a constant underlying stress on the body. We think of sitting in traffic and paying overdue bills as typical life stressors, but I would count those more under the “Emotional” stress category. Physical stressors such as a leaky gut, low-level infection, chronic inflammation, active autoimmune disease, and endocrine imbalances are the physiological stressors we cannot see or tangibly address each day but they are big contributors to a lack of menstruation or ovulation. These physical stressors shuttle your body’s energy towards keeping those systems functioning – if you have low thyroid function, your body is obviously not going to be able to support the stress of pregnancy or carry your child to full-term (although that does sometimes happen but it can result in an exhausting pregnancy and possible birth defects!)
    • Malnutrition
      • Poor absorption of nutrients is very common in those with autoimmunity due to increased intestinal permeability and funneling of energy towards other processes
      • B vitamin deficiencies may lead to anemia and both can affect the regularity of your menstrual cycle
      • New research has been exposing a link between low Vitamin D levels and irregular periods but further studies need to explore this in a controlled human subject design
    • Low body weight
      • Yes, those thin, lithe models you see in magazines and the perfectly dressed petite girls on the beach wearing crop tops and jean shorts with not a hint of cellulite…. They’re probably not getting their periods. Yes, I said it. What we as a culture deem as healthy, vibrant, and beautiful usually is a cover-up for some serious female hormone issues. It’s sad. It really is. How the media has turned the curviness, roundness, and fullness that should be a female’s body (unless by pure genetics you are one of those lithe individuals who still gets her period every 28-32 days) into something that needs to be “fixed”. I wish I had a percentage I could give you for how many young American women are walking around with diet-induced amenorrhea, but if my social circle is an indication then my guess is over 50%. Not at any one point in time, but I would not be surprised in the least if over half of young American women have experienced disruptions in their menstrual cycle due to the diet and exercise choices they make so they can be thin and fit into our socio-cultural definition of beauty. It’s disturbing. What’s covering up this problem even more is the overuse of hormonal birth control which overrides your body’s production of female hormones with man-made versions that tell your brain it does not need to do its job anymore. I know MANY women walking around on low calorie diets, exercising their butts off (literally) for 60-90 minutes a day, who religiously take their birth control and have no idea that once they go off the pill, it’s likely their body has “forgotten” how to make its own estrogen and progesterone. More on that in a little but there’s some food for thought in the meantime.
    • Premature ovarian failure affects up to 1% of the female population under 40 years old, according to recent research. It usually results in irregular or absent cycling and some menopausal-like symptoms such as decreased libido, hot flashes, vaginal dryness, and painful sex. There’s no solid cause for premature ovarian failure but it has been linked to X-chromosome genetic diseases, chemo and radiation treatment, autoimmune ovarian disease (where your body produce antibodies directed at your ovaries), and inflammation. It affects fertility greatly, but instance of women conceiving do occur through hormonal support designed to stimulate ovulation.

 

Okay, Alaena, get off your soapbox of sarcasm and tell me how I can fix this darn mess?

 

Ways to Support Regulation Of Menstruation

  • Cease birth control: When you were put on birth control by your gynecologist (oh, say around 17-19 years old), you were probably sold on lighter, less painful periods, clearer skin, and the freedom to sleep with whomever you want without the risk of having a baby with that frat guy Jim from the glow-in-the-dark bubble party last Saturday. It’s very freeing in that way! You can even control WHEN you have your period! Oh, huge tropical vacation coming up? I’m just going to skip that week of placebos and be blood-free for 6 weeks straight! Sounds wonderful, it really does, but what about when you want to start having children? Or if you just are curious if your body is even capable of menstruating without pharmacological assistance at a $10 price tag? What doctors DON’T do when they put you on the pill is tell you how it can affect your cycle once you go off of it. It is not uncommon for women to not start a natural period for up to 6 months after going off or even years (like in my case). YEARS. That was the scariest situation I have gone through in the past decade, and that is saying a lot considering my health journey has been a little rough. What’s even worse is that when you do go off the pill and don’t get your period, what does your doctor suggest you do? Go BACK on the pill to “regulate” it. If you ever get that advice, run. Run fast. And knock down the display of NuvaRings on your way out the door.
  • Eat a nutrient and calorie-rich diet: It isn’t folklore that a diet high in fat and calories (as long as they come from the right foods in the absence of a sedentary lifestyle) is an excellent way to support natural hormone production. If our bodies view us as starving, which they do when we are cutting calories while exercising vigorously, it is not going to set itself up for carrying a fetus who is going to need a good amount of our nutrient store to develop healthfully. Particularly, Omega-3 rich foods are useful for contributing to a healthy menstrual cycle. My favorite sources include wild salmon and other fatty fish, high quality soy-free egg yolks, flax and chia seeds (if tolerated), fish eggs, and basil (in higher amounts). Don’t count calories – how many times do we have to hear that before it clicks? Not only is counting calories stressful (hey cortisol, what’s up?) but it can limit our intake of the vitamins and minerals our bodies are craving. It’s OKAY to crave carbs sometimes – just get them from potatoes, sweet potatoes, white rice, carrots, parsnips, and other starchy vegetables rather than cereal and pizza. You’re still a good person if you eat carbohydrates. I promise.
  • Reduce stress: I think I mention this in every article I have written for the blog, but it is the root of many hormonal imbalances. You need you find a way to calm down. Oh, you think you’re calm? Next time you’re getting ready in the morning for work, stop for a second and let yourself hear and feel your heart rate. I have a feeling you’re going to be like “Why does my heart think I’m running up the stairs and I’m only brushing my teeth?” It’s unfortunate but most of us live in hectic, schedule-filled states that don’t allow much breathing room. My favorite stress reduction techniques are going for long walks, meditating (the Headspace App is amazing!), coloring, painting, and playing with animals. If going to CrossFit is your “stress reduction” then please remember that your “stress reduction” is actually spiking your cortisol…

 

Well, that was about as brief of an article I could write on a monster of a topic! But I have been wanting to address health of the reproductive system for a long time since I have such a long history with it. I spent my entire twenties back and forth between doctors trying to figure out why I wasn’t “normal” anymore, and I’m really glad I never took “you just aren’t” as my answer! Remember, the body is amazing at prioritizing what it sees as most vital for survival, but you can tweak it’s to-do list by supporting your hypothalamus, pituitary, thyroid, and adrenals by leading a low-stress lifestyle focused on eating nutrient-rich whole foods, making plenty of time for playing in the sunshine, and developing a strong social circle of people you can rely on when stress gets the best of you!