Wednesday, July 9, 2014

Starting From Scratch

Previous fertility post: IUI or IVF?

Okay, here's what I know... or at least what I think I know, at this point in time about things affecting my fertility:

I have a hormonal imbalance. Duh. My whole hypothalamic-pituitary-ovarian axis with all the associated hormones aren't working quite right. There's a disruption happening somewhere, but it's hard to say what's a cause and what's a symptom. It's all connected. So, I need a comprehensive plan to achieve normal hormonal balance. And advice like, "You should just try primrose oil/ acupuncture/ chaste berry/ etc." will make me roll my eyes. It's way more complicated than that. (Note: I'm just annoyed with people who don't have a clue and are Miss Fertile over there popping out babies without a problem who like to give me advice from something that worked for a friend-of-a-friend or whatever... I actually don't mind advice in general in my nice infertile community, cuz I'm still learning! :) )

My thyroid is under functioning, but it's not terrible. Right now it's in a very broad "normal range," but still not where I or the doctors want it to be. I've tried 3 different thyroid medications, trying to figure out what works best for me (a ratio of T3 and T4)... and I've learned that I absolutely cannot increase the dose of my thyroid meds rapidly or it very quickly brings on a panic attack. That is scary, but now that I know what it feels like, I can recognize it quickly and go back down in dosage. Zay has been super understanding when that has happened (which has only been twice) and drops everything to make sure I can rest and recover. Over time I do need to increase my dose, but I need to do it veeeeerry slowly. So, I'm gonna have to find a pill cutter rather than trying to freehand it with a razor so that I'm getting more accurate dosages consistently. That way I can increase it slowly by cutting the smallest pills in half. I really have to increase it in super duper baby steps. I get my thyroid levels checked with a blood draw 10 weeks from now and we'll see how things are going. Also, I learned this tidbit from my doctor: thinning near the outside of the eyebrows is a sign of a thyroid condition. Hmm. Did not know that. Many women in my family have thin eyebrows...

I'm insulin resistant and I have high testosterone (due to PCOS). I'm taking Metformin to help with both of those, although I hate Metformin. That's another medication that doesn't appear to work for me unless it's in a super high dose, but getting up to that dose is a pain in the you-know-what. Literally. It destroys your stomach. So I'm increasing my dose veeeerry slowly. I increased it too much once (on doctor's orders - to his credit, he asked me if I thought my stomach could handle it and I said yeah, ha ha) and I ended up vomiting all over the place and then devouring a huge stack of pancakes (with syrup and whipped cream, lol) because I felt like my blood sugar dropped super fast and I was gonna faint. No good. So, baby steps on increasing the Metformin. Many have found success in restoring ovulation on a regular basis with it, so I'm gonna stick to it and let it get in my system and not give up when it gets hard.

I could stand to lose a few pounds. I'm over the BMI line for "overweight." Laaaame. My ideal goal weight loss total was 37 lbs and I'm down 12... so 25 to go! Slow changes in my diet and making time for exercising (which I love, but sometimes takes a back burner to other things) are what's gonna do it for me. More baby steps. My doctor told me to think of "HALT" when I'm headed to the kitchen to eat something... am I Hungry, Angry/Anxious, Lonely/Bored, or Tired? If I'm tired, go take a nap. If I'm lonely/bored, get out of the house and play with friends. If I'm emotional, deal with those emotions and what's really causing them. If I think I'm hungry, am I hungry enough to eat an apple? No? Then I'm not really hungry. If I really am hungry, drink a tall glass of water first and then eat sensibly. As for exercising, he wants me doing 30 minutes of moderate exercise 5 days a week. No excuses. That's not too hard. I just have to make time and find that motivation that I had 2 years ago.

I do not ovulate because I don't have a normal menstrual cycle. I found the word for it! All these years I didn't know it had a name: amenorrhea. I've been doing a ton of reading about hormonal imbalances that disrupt the normal menstrual cycle and I Google a lot of things like "primary amenorrhea" and "chronic anovulation" and "cyclical progesterone hormone replacement." I do A LOT of reading. What I've decided is the best approach to this problem right at this very moment is that I need to have a cycle. Right now. Whether I actually ovulate or not at first, I need to teach my body that cyclical rhythm of a regular menstrual cycle. So I'm taking bioidentical progesterone pills (I decided against the cream, because I just don't like the messiness of it and worrying if it's rubbing off on other people) for 14 days on, 14 days off... then 14 days on, 14 days off, etc. I'm not positive what this will do for me in the long-term. (I haven't found any studies on the long-term effects of bioidentical progesterone replacement/supplementation yet, but the potential benefits are GREAT and I've read a lot of personal stories where women hail bioidentical progesterone as the miracle for them.) In the short term, I'll be having a period every 28 days, which is healthy and is something I need to get used to. It'll also be introducing my body to a hormone it does not make on a regular basis - progesterone. Which is something my body needs! Maybe it'll jumpstart my own production of progesterone. Maybe I can wean myself off it some day. Maybe the regular cycles will remind my body that it should be ovulating too and do that. Maybe it'll only benefit me while I'm taking it, but go back to irregular cycles when I get off it. Maybe it'll only give me a period but not assist in me ovulating. I'm not positive about what it'll do for me, but I'm hopeful and I'm going to give it at least a year to see what it's really helping with. After a few weeks since starting it, I sleep much deeper and my acne is freaking out (lol) and I got my period right after stopping the pills - just as expected. That's all I know right now.

For my overall health, my doctor told me how to conduct a candida yeast infection self exam. Basically, you just spit in a cup of water right when you wake up... and see if your spit grows little "tentacles" or if it just sits on top. If it grows little legs or sinks, it's a positive sign for candida yeast overgrowth in the gut. And of course, my test was positive. The answer to that is to find a really good pro-biotic. I've been taking one but I'm going to research a better one. A friend recommended ProBio5 by Plexus, so I'm thinking of checking that one out. Another thing I should do on top of that is a low-carb, low-sugar diet for 3-6 months. Ugh. Maybe. Not now. But maybe.

Possible food allergies: I personally don't think I'm allergic to any foods, but my doctor wants to rule out any sensitivities (like gluten) and wants me on an elimination diet to see... but I've been having a hard time sticking to it for any length of time. I love my gluten. I decided I could give up milk, but I love my cheese. I'm afraid if I do the elimination diet and find I'm allergic or sensitive to something, then I'll have to give it up. And I don't wanna! Ha ha. So, I'm avoiding finding out. I'll work on this one after I get some of the other things down first.

I just did a cortisol test and am waiting to hear back the results from that. I would NOT be surprised if I had elevated cortisol levels. That's the stress hormone. Failed adoptions have made my stress level dramatically increase and I've been working on ways to calm myself down over the last few months. I think I'm getting back into a good place, but I sure wouldn't be surprised if my body says otherwise. I've been reading a lot about something called Cushing's Syndrome that mimics PCOS and occurs when your body has/ is exposed to high cortisol levels and part of me wonders if I have it. I know I shouldn't even bother with researching something caused by high cortisol levels before I even get my cortisol test back! But that's what I do. We'll see what those results are in the next week sometime.

Stress-related: The last time I went to the dentist, I got the wonderful information that I needed an extra deep cleaning (not as pleasant as it sounds, I found out) and a twice daily gum disease rinse. Ugh. I never have teeth problems and now all of a sudden I do. I asked what can cause that so quickly and the dentist told me that stress could do it. Well, that's just great. I also had 2 fillings done and my last wisdom tooth extracted (did 3 of them a few years ago, but left one that was completely sideways) and am still recovering from that. So, with all that money spent and all that pain and annoyance, it taught me that I really need to pay extra close attention to my teeth and take care of them. More than I already do. And, I really really need to lower my stress level because it's affecting my health. Even down to my dang teeth. That's ridiculous. So I'm paying attention and making good habits.

So... that's where I am right now. I want to be healthy and treat my body like it's a temple. I can't ignore big obvious symptoms/diagnoses of a health problem (infertility... anovulation... insulin resistance... polycystic ovaries... hyperandrogenism... hypothyroidism... PCOS) and not do something about it. For my health, not just for future possible babies. I think this is the right approach.

Next fertility post: Attempting to Achieve Hormonal Balance

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