Whole30 is helping Thin PCOS -- where do I go from here?

[smallsoprano]

I’m currently on Day 22 of my first Whole30, and I’ve had some great results already. I don’t have blood sugar crashes in the afternoons, I’m eating more vegetables than ever, and best of all, my Thin PCOS symptoms seem to be sorting themselves out. For the first time, I had the unmistakeable sensation of mittelschmertz, and then 14 days later I got my period. 

 

My cycles can be anywhere from 6 to 12 weeks long, and I often have to take Provera to induce bleeding when I hit the 12 week mark, so this is huge, huge news for me. For whatever reason, my body seems to love this Whole30 diet. 

 

When I am finished with the 30 days, I am going on a vacation for a couple weeks. Ideally, I know the 10 days after the Whole30 would be devoted to reintroducing foods and noting how they affect my body, but I don’t want to ruin my vacation by obsessing over dietary stuff all the time. I’m thinking that when I get back from vacation I ought to do another Whole30, and then reintroduce foods and monitor their effects. 

 

I’m glad I have embarked on this journey, but I’m scared about the reintroduction phase. If this way of eating regulates my cycle, then why would I want to add foods back to my diet that would compromise my health? I was gluten-free for about a year and a half a few years ago, and that diet did not regulate my cycle. So I know it's more than just eliminating gluten that's helping. Or maybe it wasn't gluten at all, and eliminating sugar has been the real key. Or maybe it's that this diet is less carby overall, since there are no grains or legumes. 

 

I wish I knew whether it was a specific food sensitivity, the overall macro ratio, the exclusion of sugar . . . but I hate that I'd have to mess around with my healthy diet to pinpoint the cause. And how would I even know whether something was affecting my PCOS or not? For what it's worth, I've always had a weak stomach, but my digestion has been fantastic on the Whole30.

 

 Where do I go from here? 

[jmcbn]

I'm so glad to here that you've seen improvements with Whole30 already.

Where you go from here is entirely up to you.

If it were me I'd go down the slow roll reintro route given that it may well take longer than the two days in standard reintro for the excluded foods to effect your PCOS./cycle. You don't ever have to reintro any of the foods you've currently excluded if you don't want to, but actually going through the process of trially each one that you feel you may want to eat in the future will arm you with the knowledge of just what your maintenance plan needs to look like going forward. What effects you, what doesn't, what is worth the tummy cramps you might get for indulging on a special night out in good company at your favourite restaurant.... Knowledge that will allow you to have a little more food freedom.

Given that you've already got a holiday in the pipeline I'd say your plan of doing a second whole30 on your return would be a good one. Use the time to think about what you might like to introduce, and get set for round 2.

Bear in mind, also though, that you're only on day22 and your thoughts on life after Whole30 may change in the next 8 days.

[TrayS]

Though I've never had a formal diagnosis of PCOS I have always had irregular periods as well. However, my last three cycles (I've had four since I miscarried in December) have been pretty regular and I'm really really hoping to ovulate again in the next few days (around CD 14-15)... and I think it's likely I will because I take my basal body temp daily and my temps are super steady currently, where they always swing wildly when I'm having an anovulatory or late ovulating cycle.

 

This is my fourth Whole 30 since mid-2012, and during the interim between W30s I've stuck to the meal template and on-plan foods, with some periods of too much wine, and then I went grain-crazy for the three months I was pregnant and never really got out of that mode after the miscarriage. Hence the current W30 to get back on track, I'm now on Day 20 and LOVING how I feel after several months of making excuses for myself and consequently feeling like crap.

 

I can't say I've ever really been able to pinpoint what foods did or did not affect the regularity of my cycle. I've analyzed it to death, but I just don't know. My best guess is that the overall nutritional content of my diet, eating ENOUGH food, stress control, and adequate sleep all play huge roles. My cycle was at its worst when I was undersleeping due to work (pre-Whole30 days) and it's at its best now that I've been eating nutrient-dense food regularly for 3 years. During that time I also started on a low dose of T4, which may have made a difference too. Overall, the changes I've seen in myself are trends as opposed to a clear cause-effect.

 

Regarding eating enough food - Chris Kresser posted an article a few days ago where he discusses symptoms of undereating. I've always been a bit overweight so I never thought this could be the case with me, until I read it and realized he was describing me. (Irregular periods are one of the symptoms.) Might be worth a read: http://chriskresser.com/are-you-an-under-eater-8-signs-youre-not-eating-enough/

 

I think you have the right idea in realizing that you'd have to mess with your healthy diet to pinpoint the cause, and how would you even know? Perhaps how you would know is by eating clean for a long period of time and seeing if things regulate. I think that with Whole30 you're certainly on the right track.

[smallsoprano]

jmcbn -- Thank you for your response! I like the idea of doing a second Whole30 when I get back from my trip (it's actually a belated honeymoon, and part of it will be in Ireland. If you've got any dining out recommendations for paleo folks going to Dublin, I'd love to know  ). Summer seems like an ideal time to be eating this way, since there is so much beautiful produce in season. 

 

TrayS -- PCOS is no fun. I'm so sorry about your miscarriage -- if you are trying to conceive, I wish you a healthy pregnancy sooner rather than later! Smart of you to be monitoring temperature, and so useful to have made that connection with your ovulatory/anovulatory cycles. I have only just begun learning about this stuff -- I downloaded the Fertility Friend app last week, and I look forward to reading TCOYF while we're traveling. 

 

As far as getting diagnosed formally, I think it's a good idea. Seeing the ultrasound of my ovaries with their classic "string of pearls" of enlarged follicles was scary, but I'm glad to know more about what's going on in my body. As I stick with this template for eating and incorporate more of the Whole9 lifestyle principles into my life, I'd love to go back for another ultrasound down the road and see if there is any improvement or change. 

[TrayS]

TrayS -- PCOS is no fun. I'm so sorry about your miscarriage -- if you are trying to conceive, I wish you a healthy pregnancy sooner rather than later! Smart of you to be monitoring temperature, and so useful to have made that connection with your ovulatory/anovulatory cycles. I have only just begun learning about this stuff -- I downloaded the Fertility Friend app last week, and I look forward to reading TCOYF while we're traveling. 

 

As far as getting diagnosed formally, I think it's a good idea. Seeing the ultrasound of my ovaries with their classic "string of pearls" of enlarged follicles was scary, but I'm glad to know more about what's going on in my body. As I stick with this template for eating and incorporate more of the Whole9 lifestyle principles into my life, I'd love to go back for another ultrasound down the road and see if there is any improvement or change. 

 

Thank you. Yeah I've been tracking my bbt on Fertility Friend for 2.5 years and the insight I've gained is fantastic. I've gotten to know my temperatures so well that just a 0.2 degree increase above what I knew to be my "normal" post-ovulation temperature prompted me to test at 9 dpo when I found out I was pregnant. Knowing when or if I've ovulated has also helped me not to waste pregnancy tests (or mental energy wondering if I am or if I'm not). I always know.

 

I aparently don't have polycystic ovaries. During my pregnancy at my 8 week appointment (which was perfect, strong heartbeat, baby measuring exactly on schedule) the doctor looked at my ovaries and they appeared normal. I also had transvaginal ultrasounds the day of my D&C at 13 weeks, and my follow up appointment after, and all looked good. I've had bloodwork done in the past, but the doctors I'd been to kind of gave up on pursuing answers once they got my bloodwork back (which I now recall they never tested free T, just LH/FSH and not even on day 3) and until recently I didn't have the awareness to push back. But my lifelong struggle with weight and tendency to pack it on the middle, a bit of hirsutism, hair thinning on my head, and my extremely irregular periods are clinical evidence.

 

But it's possible that I've been misinterpreting my symptoms (I am not a medical professional) because all of the symptoms I've had don't fit into a neat box. Upon reading the Kresser article I linked above I realized that my past bloodwork was indicative of Euthroyd Sick Syndrome (the problem is that most doctors will look at TSH only, and many who will take a more in-depth panel don't know how to interpret it, as my doctor apparently didn't). A very tiny dose of T4 was all they were willing to put me on with TSH within the (erroneously wide) reference range, but it did help ease some symptoms, however did not correct my low T3. Only since I started eating paleo has my T3 reached a normal level. I also was diagnosed about four years ago with "probable Sjogren's" because I had elevated inflammatory markers and extremely dry eyes. My dry eyes are about 90% better since I went paleo, really a night-and-day differnce. Eating nutrient dense food really does help the body function correctly!

 

I agree it is good to know as much as you can about what's going on in your body. Scheduling another ultrasound for down the road is a great idea. If you set a date in your mind, say, 6 or 9 months or a year from now, that can also help you stay motivated in the long term. Maybe you'll see improvments in your cycle in the meantime.

[ThyPeace]

I'm no expert on PCOS, but do have a cousin who has it.  She found that a whole-foods, no-grains diet (not Whole30, but far healthier than the SAD nonetheless) regulated her period completely.  She said she had a fleeting thought that she should get some form of birth control (she's never needed it before) and the next thing she knew, she was pregnant.  It caused some financial hardships for her and her husband, but the baby is one of the cutest boys I've seen in a very long time.  All in all, we all agree it's a good trade.

 

ThyPeace, notes that metformin also helped her cousin considerably when she got pregnant with her first baby.  Something worth talking to your doctor about.  Better yet, a reproductive endocrinologist.