Nourishing My Soul – Healthy Hormone Series!

So one of my biggest challenges on the journey to recovery from amenorrhea is understanding what specific foods to incorporate into my diet. One GIANT lesson learned was in relation to soy – soy products mimic estrogen, so they can help boost your estrogen levels, but they can also be detrimental to your thyroid function. I have learned to strive for balance when it comes to incorporating foods into my diet.

Here are my top 5 foods that I make sure to incorporate into my daily diet, in moderation, to make sure that my hormones are happy and healthy. Please not that these foods have several other health benefits, but I will be focusing on how they augment your hormone function:

1. Brazil Nuts

Hormone Benefits: Brazil nuts are a great source of Selenium, which plays an important role in healthy thyroid hormones and function.

Nutrition: 1 kernel has 33 kcal, and is an excellent source of good fats (just what your amenorrhea needs to heal), omega-3, and magnesium.

Use: I suggest eating these raw, or even chopping them up to sprinkle over a salad, or add to a wrap – I really like how they taste with chicken!

Brazil nuts| nutrition facts and health benefits

Image Source: https://s-media-cache-ak0.pinimg.com/736x/a3/63/19/a36319875ec034b814a36249d193b1dd.jpg

2. Pumpkin Seeds / Pepitas

Hormone Benefits: Pumpkin seeds help lower your Cortisol (stress hormone) levels, and can help balance your Progesterone and Estrogen levels.

Nutrition: 1 tbsp has 56 kcal, and is an excellent source of good fats (just what your amenorrhea needs to heal), iron, zinc, copper, manganese, magnesium, and potassium.

Use: I have started replacing my granola with 1 tbsp of pumpkin seeds, but you can also eat them raw or sprinkle them over a salad / wrap. They add a delicious crunch to grains, like quinoa and oats, as well.

Image Source: https://www.ourskinny.com/media/blog/post/Blog_Pumpkin.png

3. Cacao Nibs

Hormone Benefits: cacao helps lower your Cortisol (stress hormone) levels, and can help balance hormonal mood swings.

Nutrition: 1 tbsp has 60 kcal, and is an excellent source of omega-3, iron, antioxidants, fiber, manganese, magnesium, and potassium.

Use: I usually add 1/2 – 1 tbsp of cacao nibs to my smoothie bowls – both acai bowls and greek yogurt berry bowls.

Candied Cacao Nibs

Image Source: https://s-media-cache-ak0.pinimg.com/736x/b6/4c/8a/b64c8ae483a8e0319d21e933c533ac68.jpg

4. Dark Chocolate

Hormone Benefits: like cacao, dark chocolate helps lower your Cortisol (stress hormone) levels, and can help balance hormonal mood swings.

Nutrition: below is my NEW FAVORITE brand, Pascha 85% dark chocolate, which has 125 kcal in 5 pieces (the image below shows the chocolate chips bag, which I am desperately looking for. Dark chocolate is an excellent source of omega-3, iron, antioxidants, fiber, manganese, magnesium, and potassium.

Use: I usually snack on this plain, but I recently combined a few pieces with a KIND Caramel Almond Sea Salt bar and it was HEAVENLY. One of my coworkers also sprinkles some dark chocolate on her Greek yogurt!

5. Bee Pollen

Hormone Benefits: bee pollen has a whole host of health benefits and is often used for allergies, but it is fabulous for fertility and aids in balancing your reproducing hormones, especially estrogen.

Nutrition: there are 15 kcal in 1 tsp of bee pollen. If you want the added benefit of an allergy remedy, then be sure to source your bee pollen locally. WARNING – some people have bee pollen allergies, so test out a few grains first, or check with your healthcare provider.

Use: I usually add 1 tsp to my smoothie bowls – both acai bowls and greek yogurt berry bowls – but I recently started sprinkling them over plain bananas, and they add a great texture to the fruit!

Those of us who suffer seasonal allergies will definitely be giving bee pollen a chance! How Bee Pollen Could Cure Your Allergies

Image Source: https://s-media-cache-ak0.pinimg.com/736x/0f/40/97/0f4097dac0f39cf15f652d11e7bb60dd.jpg

Note: I buy all of the above foods organic, and try to source locally when possible (and if it’s not too much more expensive).

Let me know if you end up adding any of these to your diet and enjoy them – I personally found that I have a lot more energy after incorporating these foods into my daily diet.
Happy healing!

Girl Guilt-Free

Hospitals, Health, and Healing – My New Life!

Free Thankful Quote Printable from Mommyish

Image Source: https://s-media-cache-ak0.pinimg.com/736x/63/fa/1e/63fa1ee0605af33d63d2f12b72130df9.jpg

If you’ve read my previous posts, you know that the past few weeks have been a wild ride, health-wise. However, they have been a blessing in disguise because I have truly redefined what ‘living’ means to me.

Pituitary Update

As some of you know from my previous post, I was working with doctors to determine whether I have a pituitary dysfunction that is causing my amenorrhea. The last few weeks involved an MRI scare – they found a little formation on my pituitary gland, the exact classification of which was TBD – followed by several blood and urine tests (delightful, I know).

The doctors were trying to determine whether I had a pituitary adenoma – a collection of cells that form a benign (non-cancerous) tumor, which often secretes some sort of hormone – or a Rathke’s Cleft cyst. A Rathke’s Cleft cyst is also a benign condition, but unlike a pituitary adenoma it does NOT secrete anything – it is likely something I was born with and is completely harmless, unless it grows in size (and affects my vision by putting pressure on the optic nerve), which is extremely unlikely. According to my doctor 1 in 5 people have this condition and it goes un-diagnosed; people with the cyst live completely normal and healthy lives, and it is often only discovered in an autopsy.

Now let’s come back to pituitary adenoma’s and how blood / urine tests are used to diagnose an adenoma vs. a cyst. There are 4 types of pituitary adenomas:

1. Prolactinoma – secretes prolactin (hormone that produces breast milk)
2. Growth hormone-secreting (IGF) pituitary adenoma
3. Cushing’s Disease (ACTH-secreting pituitary adenoma) – ACTH produces cortisol (the stress hormone)
4. Thyrotropinoma (TSH-secreting pituitary adenoma) – TSH is a thyroid hormone

The Results 

AMAZING NEWS – turns out I don’t have a pituitary adenoma:

1. NOT a Prolactinoma – normal prolactin levels
2. NOT a Growth Hormone-Secreting pituitary adenoma – normal IGF levels
3. NOT Cushing’s Disease (non ACTH-secreting pituitary adenoma) – normal ACTH and urine cortisol levels
4. NOT a Thyrotropinoma (TSH-secreting pituitary adenoma) – normal TSH

So the diagnosis is a cyst – it is benign and, thank GOD, will not affect me at all! I feel so INCREDIBLY blessed and grateful!

AND EVEN MORE GOOD NEWS – my estrogen and FSH levels are up, which means that I am making significant progress on the amenorrhea front too, and hope to get my period back soon!

My Life Forward

I have now learned to take a step back and put things into perspective. About a week ago, I weighed myself after a VERY long family vacation and no exercise. I was still eating between 1800 – 2000 calories per day, but had more variations – for example, I had one day of 2600, and another of 1450. I was pretty happy, because I take that this is what normal eaters do – intuitive eating with the occasional indulgence and no guilt.

However, the guilt came – I weighed myself and the scale showed 131.5 (I am about 5’6 and 3/4). Now granted (and I know this is TMI), but I have been a tad bit constipated, and fly weekly for work, so this number could have reflected water retention, but obviously I was upset. I had been maintaining at 127 for a while, and then saw a jump to 129 prior to my vacation, which I had made peace with. I did not take the 131.5 well!

That’s when I took a step back and replayed the past few weeks through my head – I had just experienced the scariest, potentially life-threatening, medical finding of my life. I had to be grateful for my normal pituitary results, and for the fact that I had made progress on the female hormone front. Sure, I’ve gained weight, but y’know what, I am NOT fat. Some people’s bodies just CANNOT handle low weights – we’re all so, so different! So I am happy; happy, grateful, and rejuvenated with positivism.

Lessons on Eating

I think I can finally say *knock on wood* that I am transitioning to becoming a ‘normal’ eater – I have days where I eat close to 2200, and others where I eat about 1600. I am LISTENING to my body and eating intuitively, without depriving myself. I am conscious of satisfying cravings when they hit, and luckily I never crave junk – my excess calories are usually from a Kit’s Organic Bar, 85% raw cacao dark chocolate, Greek yogurt, or nuts!

Here’s to being grateful for all that you have – you only have one body, so please love and respect it!

Happy healing!

Girl Guilt-Free

The Scariest Experience of my Life

A week ago, I experienced the most intense emotional roller coaster of my life.

Flashback 2 weeks – 

I scheduled an MRI – this was a precautionary test that my doctor had requested, just to make sure that my amenorrhea is not a result of any pituitary disfunction. My doctor was almost certain that my amenorrhea was a result of female athletes triad – restrictive eating and over-exercise – but she wanted to be safe.

I was not worried about the MRI – my family was in town, and it was just precautionary. I went into the lab center and, to my surprise, was told that they would be injecting a dye into me halfway through the MRI. Immediately I began to panic – no one had warned me of this!

Now, I do not get claustrophobic, but let me tell you that the MRI almost pushed me over edge – you’re basically in a confined space, with a weird plastic contraption and white sheet over your face (to hold your head still) for 20 minutes.

Anyway, the dye injection turned out to be painless (though it made me a tiny bit nauseous), and I walked out of the MRI center as my usual self.

Flash forward 1 week – 

My family had just flown out (they live overseas), and I received news from my doctor (via email) regarding my MRI results – turns out she had tried to call me, but I was at work and had missed a call.

THEY FOUND SOMETHING.

My doctor’s email said that the MRI indicated a very small Rathke’s Cleft Cyst. I was absolutely devastated, and spent the rest of the night oscillating between fear, sadness, despair, and anger.

I immediately scheduled follow-up visits and blood tests with my doctor, and scheduled an appointment with my endocrinologist. I was FREAKING out at the thought of a brain tumor – What did this mean for me? Would I be able to live a normal life? Would I need surgery? Would I be able to have children?

The Endocrinologist – 

Long story short, I went in to see the endocrinologist who put me at ease – turns out 20% of the population has some sort of pituitary growth / tumor / cyst (whatever you want to call it), and most people spend their entire lives without even knowing and without any health complications as a result of it. However, one thing did confuse me – the endocrinologist diagnosed the MRI reading as a Pituitary Adenoma.

Pituitary Adenoma vs. Rathke’s Cleft Cyst – 

Now, to my understanding (the doctors kind of confused me), a rathke’s cleft cyst is usually a liquid-filled, bubble (if you will), which is something that you are born with. It is harmless unless it expands and starts putting pressures on other structures in the brain, such as the optic chiasm, which can cause your peripheral vision to decrease. THANK THE LORD that in my case, the structure on my pituitary gland poses no threat.

By contrast; however, a pituitary adenoma is essentially a collection of cells. While both a pituitary adenoma and a cyst are benign (non-cancerous, and will not spread to the rest of the body), adenoma’s can sometimes secrete hormones. This prompted my endocrinologist to order some more blood tests in order to make sure that no extra hormones were being secreted.

Blood Test Results

Now, I am a results-oriented person, so my blood work speaks volumes. Two takeaways:

My estrogen levels are up to 19 (up from 14 last time) – this is a FABULOUS sign because this means my body is able to increase my levels on its own and that the pituitary adenoma / cyst is not causing my amenorrhea.

My cortisol levels (stress hormone) were super high (29 – normal range is 20-25 in the morning). While my doctor has ordered follow-up tests for this, she thinks the emotional roller coaster that I went through after learning about my MRI results is was prompted this spike in stress levels.

What I have learned –

My biggest takeaway from this crazy experience (as cliche as it may sound) is that life is short! It is SO important to take the time to be grateful for everything that we have – otherwise you have to learn it the hard way, when something goes wrong. I am so, incredibly grateful to be (generally) healthy, have a strong support system of incredible family and friends, and to be able to share my learning with you all!

If any of you have any questions, are experiencing a similar situation, or just want to talk, then please do not hesitate to reach out to girlguiltfree@gmail.com!

Stay happy; stay healthy!

Lots of love,

Girl Guilt-Free

Recovery through healthy indulgence – my ethnic food fiesta

I am an avid foodie, and this was the reason why I was extremely overweight for the majority of my life. In an effort to lose weight, I found myself giving up a lot of the foods that I loved. Eventually, I just stopped going out to explore new cuisines and restaurants – I had a fear of overeating, so employed the “all or nothing” mentality and just boycotted eating out.

My journey to recovering from HA has taught me a lot about self control and really listening to my body – this is called intuitive eating. Because I am no longer depriving my body of calories and nutrients, I am able to enjoy the foods that I am craving without over-indulging. I still track my calories, only because I want to prevent the tendency to binge!

For all you lovely ladies on the road to recovery, indulge in some middle eastern delights for fresh tasting, flavorful, and nutritious foods. Here are some of my favorites:

1. Lebneh – this is a delicious yogurt dip that is packed with protein, healthy fats, and calcium. It is also packed with probiotics to keep your gut healthy!

Image Source: http://food52.com/blog/4547-homemade-labneh

2. Tabouli – this parsley – based salad is super refreshing, and parsley is a herb that is often used as a natural remedy to treat amenorrhea!

Tabbouleh is a refreshing salad made with bulghur wheat, cucumbers, tomatoes, parsley, and mint. If you haven't tried it yet you're missing out! It's delish!

Image Source: http://food52.com/recipes/29842-my-mother-s-lebanese-tabbouleh

3. Hummus – this olive oil and chickpea – based dip is a great tasting source of healthy fats and protein!

Image Source: http://alldayidreamaboutfood.com/2011/03/spicy-chipotle-hummus.html

3. Babaganoosh – this is an egg plant-based dip, and I recommend ordering the yogurt based version (if available), which packs in a healthy kick of calcium, protein, and probiotics, along with phenomenal flavor.

Grilled Baba Ghanoush

Image Source: http://food52.com/recipes/6574-grilled-baba-ghanoush

“Do Whatever Makes You Feel Good”

Source: http://refinedside.com/wp-content/uploads/2015/01/f4fee40929ff27bfd378f605df0313e7.jpg

Sometimes I catch myself feeling guilty about blogging – I should be using every free moment I have (when I am not working) to study for my GMAT, right? (Ah yes, forgot to throw in that little detail about myself, haha). But, you know what? To hell with saying “should” – it is not about what you “should do,” but what you “want” to do, and what makes you feel good.

Blogging is cathartic for me; blogging lifts a huge load off of my chest, and actually makes me feel as though I am making an impact in the community by spreading awareness and maybe helping someone else in the same situation. So that’s the though of the day folks – “do whatever makes you feel good,” and I firmly believe that you will see things fall in to place. 🙂

Stay happy, stay positive!

Happy healing,

Girl Guilt-Free

A Grain of Salt and Reading Between The Lines – My Blood Test Results

If you’ve had a chance to read my previous blog post, then you will remember that I had my second set of blood tests (as a follow-up for my Hypothalamic Amenorrhea)done last Friday (June 5th). The doctor was testing to see if my hormone levels, specifically estrogen, had increased as a result of changes to my diet and exercise routine.

I received an email from my Doctor this morning, and all it said was that my estrogen levels “are still low,” and that she would be requesting a bone density test (per my inquiry), and an MRI to check my pituitary function “to make sure there is no structural reason” why I am not getting my period.

My reaction to the news was as follows: worry; despair; sadness; crying; frustration, and eventually a “k sera sera” mentality that has left me feeling happy again.

A Grain of Salt

Perhaps this section could be more appropriately named as “finding the silver lining.” It is natural to assume the worst when a doctor wants to test for different types of diseases (my “pituitary tumor” alarm bells were ringing loud). Word of advice – DO NOT GOOGLE YOUR SYMPTOMS and let the results leave you distraught. Unfortunately, you will likely come away thinking that you have cancer, or another seriously, life-threatening condition. While, this is always a possibility, realize that your doctor may just be requesting tests as precautionary measures – requesting tests DOES NOT CONFIRM that you have a certain disease.

So, that’s how I overcame my absolute terror regarding the MRI request.

Reading Between The Lines

So my doctor told me that my “estrogen levels are still low;” however, I asked her to release the specific blood test results to me regardless. I then loaded the data in to Excel, and did my own analyses to find the following:

March June
Estradiol (this indicates my estrogen levels) <12 14
FSH 4.4 4.9
LH 0.2 0.8

Now, what the doctor failed to mention, was that there WAS AN INCREASE in my hormone levels, albeit relatively small. For those of you wondering what these numbers mean, here are some guidelines:

ESTRADIOL Reference Range (female):
Prepubertal:
Post-menopausal:
Follicular phase: 20-100 pg/mL
Mid-cycle: 80-400 pg/mL
Luteal phase: 30-220 pg/mL
FSH Reference Range:
Follicular phase: 2-8 mIU/mL 
Mid-cycle: 6-23 mIU/mL 
Luteal phase: 1-6 mIU/mL 
Post-menopausal: 21-106 mIU/mL 
Prepubertal Children: 1-6 mIU/mL 
Pregnant:
LH Reference Range: 
Adult Female: 
Follicular: 2-15 mIU/mL 
Mid-cycle: 10-91 mIU/mL 
Luteal: 1-15 mIU/mL 
Post-menopausal: 16-63 mIU/mL 
Prepubertal Children: 1-3 mIU/mL

Clearly, my increased caloric and fat intake, weight maintenance, and reduced exercise were working – YAY! The fact that my doctor had failed to mention this had sent me down a rabbit hole worries for no reason. Granted, is slow progress, but hey, it’s still progress.

Now, another thing that I found was that my white blood cell count had decreased slightly from my last blood test, as had my T3, which is a thyroid hormone. My doctor has not mentioned this either, so naturally I started panicking again. Naturally, Googling these symptoms freaked me out even more, so I paused and started to think about all of the dietary changes I had made in an effort to increase my estrogen.

Soy – BINGO! Through research, I had found that increasing soy intake can increase estrogen, so I went from drinking no soy milk, to drinking a soy latte every day. Remember what I had said about extremes and how maintenance and balance are key? Well, I may have just whacked my body out with the excess soy consumption. And my research confirmed this – soy, specifically the processed kind, can reduce white blood cell count through reduced zinc levels. Decreased zinc levels can also be reflected through decreased T3 levels – AHA!

Staying Positive

My plan forward? I am going to stay positive 🙂 NOTHING IS WRONG RIGHT NOW, and why should I worry about something that is not final? I am going to cut out soy for now, and just focus on maintaining a balanced diet – maybe I’ll have the occasional soy latte, but certainly not everyday. I was going to talk to the nutritional therapist (who now wants $90 for a 30-minute phone conversation), but I realized that would just stress me out more because she never references my blood test data points, and never actually gives me tangible advice other than “just keep eating more fats; keep doing what you’re doing.” I’m sorry Doc, but for that much money, I need to be getting a little more than half-hearted validation.

Happy healing!

Lots of love,

Girl Guilt-Free

First Steps to Recovery

Today I received an email from a beautiful young girl who wanted some advice. I realized that the questions she asked are likely questions that a lot of other lovely ladies may have, so I wanted to share my response.

So, you think you have Hypothalamic Amenorrhea, and you have NOT been on the pill, so you don’t think this is the cause. What should you do?

First Things First

Congratulations on commencing your journey to recovery – acceptance is the first step. I recommend that you start by seeing your primary care provider and having blood tests done. The doctor will check your Estradiol, LH, and FSH levels. You may also want to ask to have your thyroid function checked via the blood tests to make sure that thyroid issues are not the root cause of the amenorrhea. Vitamin D levels would also be good to get checked. Vitamin D helps our bones absorb calcium. In women with amenorrhea, the low levels of estrogen can prevent our bones from absorbing adequate calcium, making us more susceptible to osteoporosis.

What’s The Cause?

It is important to know that Amenorrhea can be at 4 levels:

1. Hypothalamic

– This is where my amenorrhea is rooted. Excessive exercise and restrictive eating cause our hypothalamus (the part of our brain that regulates hormone function) to panic. It essentially enters ‘survival mode’ due to lack of nutrition, and shuts off all ‘unnecessary functions’ in order to make sure the body survivors. Unfortunately, reproduction is not a function that is essential to our survival, so my hypothalamus just told my body to stop producing Estradiol, LH and FSH.

2. Pituitary / Thyroid

3. Ovarian

4. Uterine
Start With Your Doctor – Blood Tests
Starting with a blood test will help your doctors confirm that your amenorrhea is rooted in the excessive exercise and restrictive eating. I don’t want to scare you at all, and just want you to be aware, so it’ important to get the blood tests done to make sure that nothing else is the root cause – does that make sense? Honestly, when I went in, my doctor just checked for everything:
– Vitamin D 25 Hydroxy
– Estradiol
– Follicle Stimulating Hormone
– Luteinizing Hormone
– CBC and Platelet Count
– Lipid Panel
– Prolactin
– DHEA Sulfate
– Testosterone Total Free
– Hemoglobin A1C
– TSH with Reflex FT4, FT3
– Comprehensive Metabolic Panel
If you’re scared of blood tests, don’t worry, all of these tests were conducted with one sample set i.e. I did NOT have to get my blood drawn multiple times.
What You Can Do
Nutrition
Caloric Intake
If you have been restricting caloric intake, I would start by slowly increasing. I know a lot of HA blogs say “increase to 2500+ per day,” and as someone who has been so conscious about their weight, I know that’s hard. For example, i am about 5’7, and weigh between 125 – 129 lb. I was restrictive at 1200 for the longest time. I started by increasing by 150 per day, every week, so that after about 4 weeks I got close to 1900. I now eat between 1800 – 2000 (I still log, because it makes me feel less stressed) and I try to LISTEN to my body and hunger levels.
Macro-Nutrients
It is really important to make sure you are getting at least 60g of healthy fats per day. Incorporate nut butters, avocados, and seeds in to your daily intake. I also started taking a few supplements, which you can find on my blog. 🙂 I did NOT take a calcium supplement, because some research indicates that these can increase your risk of heart-disease. Instead I increased my intake of greek yogurt and dairy, and tracked my calcium intake using My Fitness Pal.
Estrogen-Boosting Foods
I wrote a post on my blog about this, so feel free to reference that!
Your doctor will likely refer you to a nutritionist or nutritional therapist. The one my doctor referred me to was SUPER EXPENSIVE, and basically did not tell me anything I did not know – limit exercise; eat 1800-2000; increase fat intake. However, what she did tell me is that I DON’T have to worry about gaining weight – I just need to maintain. She has also helped me transition towards being a normal eater. I plan to share these insights on future blog posts because I don’t want other girls to have to worry about paying $160 / hour like I did.
Keep in mind, don’t scare yourself, or let anyone scare you in to thinking that you “HAVE TO GAIN WEIGHT.” Let’s not worry about the weight part for now – I certainly have not. Getting your period back is about showing your brain what ‘balance’ means, and so for now i am focusing on maintaining my weight, and incorporating healthy fats in to my diet, along with an increased caloric intake.
Exercise
I would suggest taking a few weeks off from exercise. If this is really hard – you mentioned just walking has been really hard – then limit exercise to 3 times a week. I have a post on my blog about what exercises I do as well. Definitely lay off high-intensity cardio.
This journey requires patience. I should also let you know that it is COMPLETELY normal to have emotional fluctuations and breakdowns – in fact, this can be a sign that your hormones are kicking in. Don’t let your emotions scare you – let them out!
Happy healing!Lots of love,

Girl Guilt-Free