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amenorrhea mystery--with labs!

Answered on August 19, 2014
Created December 12, 2012 at 12:32 AM

I've been paleo for some time. Almost 3 years ago, before I went paleo, I lost my period. I am 5'11"; at the time, I was maybe 155lbs. I have since lost a significant amount of weight (I'm about 135lbs now). However, since I lost my period when I was at a higher (and stable) weight, I don't think that is the cause.

I have a myriad of symptoms like headaches, craving salt, and being cold.

My lab results don't really make sense to me. Many seem to be subclinically low. My most recent labs are as follows:

ASL and ALT are high (these are liver enzymes. they have been high for at least 2 years. I feel like it might be related?)

Slightly low LH, estradiol, prolactin

Free t3 and free t4 aren't low, but they are at the low end of the "normal" range

High cortisol

Any advice on what is going on (hypopitutiarism? hypothyroidism?) and what to do about it would be extremely helpful!

A3c56c85290f748410a6f340ddd552b3

(321)

on January 02, 2013
at 06:05 PM

For less cost than an office visit, I'd recommend you purchase and devour Stefani Ruper's PCOS eBook. Agreed that there do not necessarily need to be detectable cysts for a PCOS-like situation to exist (and be treatable). My only tie is that I've met Stefani and think she's doing good work.

930d02c6cf3fb783f15d22e3b49e0490

(250)

on December 12, 2012
at 03:08 AM

Maybe you should address the weight thing + elevated liver enzymes first, before you go in for more labs. That'll normalize endocrine function - so any abnormal lab values causing amenorrhea will really stick out.

E0113315a1e96e127b7126755ca33bd2

(0)

on December 12, 2012
at 02:55 AM

Around 155. Which is the weight that I was for YEARS. Probably from age 17-26.

3491e51730101b18724dc57c86601173

(8395)

on December 12, 2012
at 02:46 AM

Not everyone with PCOS has cystic appearing ovaries, so their absence, alone, does not rule out PCOS. Some doctors don't know this and will mistakenly rule it out when other symptoms are present. Better tests are LH/FSH ratio, C-peptide (looking for insulin resistance) free testosterone levels. But there are many causes of amenorrhea, besides PCOS.

930d02c6cf3fb783f15d22e3b49e0490

(250)

on December 12, 2012
at 02:43 AM

Higher than 155, or higher than 135?

E0113315a1e96e127b7126755ca33bd2

(0)

on December 12, 2012
at 02:36 AM

Even though I was heavier when I lost my period? My last 2 periods were shorter and heavier than usual, and for maybe 6-8 months after I lost it, I would get CRAZY moody and needlessly emotional around "that time" of the month...but that ended long ago.

93eea7754e6e94b6085dbabbb48c0bb7

on December 12, 2012
at 01:59 AM

Right... but eating paleo low carb could exacerbate it as well. How are your stress levels?

E0113315a1e96e127b7126755ca33bd2

(0)

on December 12, 2012
at 12:55 AM

I had a pelvic ultrasound and it was normal, so I couldn't have PCOS, right? I was also NOT on a paleo diet when I lost my period, so I don't think that low carbs is the issue either. :/

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4 Answers

2
930d02c6cf3fb783f15d22e3b49e0490

on December 12, 2012
at 01:56 AM

From a clinical perspective, you're almost underweight. I don't think that is healthy in the long run, nor is it sustainable.

People who are young, not insulin-resistant, and have no serious hormonal issues tend to remain within a certain weight range which is healthy for them. The human body is amazing at keeping homeostasis. If, on the other hand, you lose enough weight, your cortisol shoots up. It's why dieters tend to regain weight - and why it happens in their bellies first.

The elevated liver enzymes are also classic hallmarks of being underweight.

Sources: http://www.ncbi.nlm.nih.gov/pubmed/8912046 http://onlinelibrary.wiley.com/doi/10.1002/%28SICI%291099-0968%28199903%297:1%3C28::AID-ERV274%3E3.0.CO;2-U/abstract

Same goes for the cold intolerance, amenorrhea, headaches, and euthyroid sick syndrome.

More sources: http://www.aafp.org/afp/2003/0115/p297.html

E0113315a1e96e127b7126755ca33bd2

(0)

on December 12, 2012
at 02:36 AM

Even though I was heavier when I lost my period? My last 2 periods were shorter and heavier than usual, and for maybe 6-8 months after I lost it, I would get CRAZY moody and needlessly emotional around "that time" of the month...but that ended long ago.

E0113315a1e96e127b7126755ca33bd2

(0)

on December 12, 2012
at 02:55 AM

Around 155. Which is the weight that I was for YEARS. Probably from age 17-26.

930d02c6cf3fb783f15d22e3b49e0490

(250)

on December 12, 2012
at 02:43 AM

Higher than 155, or higher than 135?

930d02c6cf3fb783f15d22e3b49e0490

(250)

on December 12, 2012
at 03:08 AM

Maybe you should address the weight thing + elevated liver enzymes first, before you go in for more labs. That'll normalize endocrine function - so any abnormal lab values causing amenorrhea will really stick out.

0
2006ccb2b60f9cc5ba5e8eff8a7abc46

on January 28, 2013
at 01:29 AM

is your life stressfull or how do you respond to stress? do you exercise? if so how much. what is your sleep schedule like? what do you eat? how much? what are your energy levels like? morning, noon, night?

0
9529c6f7aa64b2820a6a715a8958f75b

on December 12, 2012
at 03:16 AM

I am experiencing the same thing. I lost my period two years ago (not paleo at the time). I have seen many doctors and had blood tests- no PCOS, LH is a little low but the ratio is fine. My estrogen levels are low though so they put me on an estrogen patch but that didn't help. I am 5'10 135lbs 19yrs old. I am desperate for answers that nobody seems to have. Now I am just trying herbal supplements that promote fertility and working on stress reduction because the doctor says that stress is the only reason she can think of to explain a random disappearance of menstruation.

0
93eea7754e6e94b6085dbabbb48c0bb7

on December 12, 2012
at 12:36 AM

In the same boat. I'm sorry. Go see a naturopath. They offer some different insight than the standard MD (not that they don't help too but it is good to hear other opinions). It could be PCOS. It could just be lack of carbohydrates-- works for some to increase, hasn't worked for me yet :(.

E0113315a1e96e127b7126755ca33bd2

(0)

on December 12, 2012
at 12:55 AM

I had a pelvic ultrasound and it was normal, so I couldn't have PCOS, right? I was also NOT on a paleo diet when I lost my period, so I don't think that low carbs is the issue either. :/

3491e51730101b18724dc57c86601173

(8395)

on December 12, 2012
at 02:46 AM

Not everyone with PCOS has cystic appearing ovaries, so their absence, alone, does not rule out PCOS. Some doctors don't know this and will mistakenly rule it out when other symptoms are present. Better tests are LH/FSH ratio, C-peptide (looking for insulin resistance) free testosterone levels. But there are many causes of amenorrhea, besides PCOS.

93eea7754e6e94b6085dbabbb48c0bb7

on December 12, 2012
at 01:59 AM

Right... but eating paleo low carb could exacerbate it as well. How are your stress levels?

A3c56c85290f748410a6f340ddd552b3

(321)

on January 02, 2013
at 06:05 PM

For less cost than an office visit, I'd recommend you purchase and devour Stefani Ruper's PCOS eBook. Agreed that there do not necessarily need to be detectable cysts for a PCOS-like situation to exist (and be treatable). My only tie is that I've met Stefani and think she's doing good work.

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