For a while, anyway.
Hi. I’ve missed you.
It’s been a long time since I’ve posted. For the last several months, I’ve had my nose to the grindstone in my philosophy program, and holy crap, I’ve never been happier. I love what I do so much I think my heart might explode.
That isn’t to say it’s all been puppies and candy canes. I’ve had several of those “aha! I’ve finally figured it out!” moments with respect to my acne and my PCOS, and it’s been frustrating to continually realize how wrong I was. I’m here writing a lot because I’ve continued to learn a lot over the last several months, and I think it’s important that I get as much information out there as possible. All that said, I’ll be on Jimmy Moore’s podcast in February, and I’m going to be contacting some other paleo bigwigs about paleo and PCOS. I probably won’t have time to write all that much after this brief stint, but I’m going to do everything I can to reach out to the PCOS community in the upcoming weeks.
So posts about PCOS are forthcoming. I also have one thrown together that I’m really excited about, summarizing what I think are the most important factors and tips in dealing with disordered eating. These’ll all be out within the week.
For a personal update, in case you’re interested, what follows is a brief play by play of my own health from the point at which we left off this summer.
You’ll recall that I left this summer, around July, experimenting with stress and carbohydrates. I had thought that adding some carbs in would ease any cortisol issues I had, and would help increase leptin signalling to my hypothalamus (which it probably did), but ultimately I had very little success. I was still getting acne, too. WTF? What I did find, by the end of the summer, was that eating meat and chicken was causing me acne. I ended up realizing that land-raised, conventionally farmed animals are injected with hormones. I discovered, moreover, that scientists are divided on whether these levels of hormones are significant. I conducted a controlled experiment. They certainly make a difference for my acne.
I went to Boston eating vegetables and fish. Through experimenting with a couple of Clif bars and some tofu I realized that soy was a big problem for me. It gave me acne, too. This didn’t make sense: my problem was a lack of estrogen. Everything on the internet says that eating soy would help with that problem. Why didn’t it help me? I didn’t understand.
Another thing I ate for a while was legumes. I enjoyed lima beans and peas in particular. After a week of feeling really good on them, I got a big break out and panicked and never ate them again.
Then I learned about BPA and eliminated it from my diet as much as I could. This meant I’d stop microwaving my plastic mug, but I also had to cut back on canned fish, my only source of protein. It was hard times for a woman who ate nothing but vegetables and fish. At points, avocadoes were 80 percent of my calories.
I read that cruciferous vegetables were good for liver health. I increased my intake of those. Things seem to be going decently, now, with my acne much diminished, but with no other indicators of hormonal health returning. Finally, I turned to medication.
After doing some reading, I realized that my hormone system might be too messed up to fix itself on its own. The first drug I seriously considered was Metformin, which is designed to increase insulin sensitivity. This has the added bonus of lowering testosterone production in the ovaries. I decided to try it. I felt great for a week, then woke up with a big cyst on my face and cried and cried and cried like I never have. I didn’t know, at the time, that it was clinical depression.
A week later I decided to try the Metformin one more time. Any number of variables could have messed it up the first time. After two days, taking the lowest dose prescribed, I experienced the biggest breakout of the most painful cysts I have ever had, and plunged into a depression that lasted for an entire week. I barely had the motivation to pick up my phone and text a friend to come take care of me. WHAT. Why didn’t this innocent, never-anything-but-helpful drug work for me?
I was maybe a little bit frustrated.
The thing is that I think it did work. I think the Metformin worked really well. It seems as though it made me ovulate. During ovulation, testosterone levels (the ones that make acne) peak, and estrogen levels fall. I already had low estrogen and high testosterone, so perhaps that just made it worse. It’s good that I ovulated, despite all the nasty side effects I experienced, but I didn’t have a period.
I came home for the holidays and got a blood test and learned a lot more. My testosterone was decent but my estrogen was lower than ever, as was my thyroid. Clearly I wasn’t doing well “naturally” and “on my own.” (Guys, don’t try this at home. Don’t be a moron. Get blood tests. Know what’s going on. Take care of yourselves.) After doing a lot of reading, this is what I’ve deduced:
Phytoestrogens such as soy and legumes act as estrogens, but not in precisely the same way. They can ease the pain of menopause symptoms such as hot flashes, but they are not true estrogen, so they won’t help with my ovaries or with pituitary signalling. They don’t fit quite right in the receptors. They are, in fact, harmful, and decrease levels of true estrogen. This is why legumes, soy and BPA (similar to a phytoestrogen, but not quite the same) are so nasty for PCOS.
Cruciferous vegetables are “good” for liver health, but they increase the activity of a cytochrome that clears estrogen from the blood stream. By eating pounds of them each day, literally, pounds, what else was I going to eat?, I may have been lowering my estrogen to dangerous levels.
My thyroid has always been low, but now it is lower than ever, possibly because of natural decay, or maybe because of all of the goitrogens I was eating. In any case, supplementation with T3 (I have plenty of TSH and T4) has resolved problems I have had my whole life that recently got a whole lot worse, and that I never really thought about: the low, gravelly voice that prevented me from singing in the last couple years has been replaced by a high, smooth, natural one; my perpetually frozen feet are now perfectly fine in the house, even though it’s winter time and normally that gives me sores from the cold; I no longer have to wear jackets inside; and my food cravings have decreased, too. My doctor says this will also help with my skin. Most importantly, treating hypothyroids almost always makes an anovulatory woman ovulate.
Another medication, called Spironolactone, is another class of testosterone blocker and might be a better medication for me than Metformin. It prevents androgens from binding to receptors, and also blocks some of the production of androgens, such that it is virtually a miracle cure for hormonal acne. Which is what I’ve been experiencing, huzzah! I was only on Spiro for about 36 hours before I started seeing improvement. Also, spironolactone lowers blood androgen levels over time. It makes PCOS patients ovulate. Double win.
Since the summer, I have taken a turn for medications, and I couldn’t be happier about it. But more importantly, I have begun taking the intricacies of the endocrine system seriously. I’ve studied texts. Many. And come to appreciate that there aren’t always easy answers. Whatever answers there are, I’ll be sharing over the next few posts. In the meantime I am happy to be back.Tweet