two week followup with the vag

May 25, 2012

illness, pregnancy

Heading now to the reproductive endocrinologist with my mother in tow. Or rather, she’s got me by the hair and is dragging me there now. Will report the findings after my 11am appointment. I wonder if this premature menopause is caused by a gluten intolerance. One of my best friends in Austin considers the gluten-free diet a panacea. She sends me articles on the links between premature menopause and gluten intolerance almost daily. I will bring this up to the endocrinologist.

The endocrinologist didn’t give me a good vibe. At all. He just struck me as someone who was familiar with women who desperately wanted to get pregnant but knew very little about managing menopause, especially with regard to premature menopause.”You’re out of eggs,” he said. “It unquestionable. You’re not peri-menopausal or pre-menopausal. You’re in full blown menopause, or postmenopausal, there’s really no difference.”

For the record…
LH 37.7
FSH 75.8 (Postmenopausal is 25.8 – 134.8)
Prolactin 9.0
Estradiol 17.9

Roche ECLIA methodology
Thyroxine (T4) 11.9 (Normal is 4.5 – 12.0)
T2 Uptake 26 (Normal is 24 -39)
Free Thyroxine Index 3.1 (Normal is 1.2 – 4.9)
TSH 1.770 (Normal is 0.450 – 4.500)

Thyroid Antibodies
Thyroid Peroxidase (TPO) Ab  10 (Normal is 0 – 34)
Antithyroglobulin Ab <20   (0-40)
Siemens (DPC) ICMA Methodology

Anti-Mullerian Hormone (AMH) <0.16 (Reference Range for adult females: <6.9)

CEA 2.1 ng/mL Normal is 0 – 4.7

Creatine Kinase, Total, Serum  43  (Normal is 24 – 173)

Vitamin D, 25-Hydroxy 39.7 (Normal is 30 – 100)

Since I’m moving to New York, I want to hold off on doing HRT until meeting with a premature menopause specialist in New York. This doctor today, when I asked him about the risks of bioidentical vs traditional hormone replacement therapies, specifically bringing up the information that the mayo clinic has cited bioidentical HRT as being riskier, given the specialized compounding, he simply shrugged and said, “I disagree,” adding no… “Here’s why I disagree.” When I asked him what form he recommended in terms of HRT delivery (cream, suppository, capsule, tablet, etc.), he said only that it was really just a matter of preference. Except I had read that the cream or a patch were preferable because they needn’t be processed by the liver. Why didn’t he mention this? Why? Because this just isn’t his bag, and it should be right? As a reproductive endocrinologist? Shouldn’t he know this stuff? I feel so disheartened.

So, here’s my plan. I’m going to go gluten free for the next month, no cheating. Just to see if a period comes. He assured me that it wouldn’t, that I’m “Simply out of eggs.” He said there was no cause, no thyroid issues, no auto-immune things going on. I asked if he thought I should see a non-reproductive endocrinologist, and he believed “This is simply the amount of eggs you were born with. There’s likely nothing that caused this.”

Bottom line, I didn’t like how clueless he seemed about this. When I brought up my concern about the lack of studies of HRT on young women, he actually SHRUGGED. He had nothing to say other than, “Well, this is what I recommend.” He didn’t speak of a single side effect, of any of the risks, nothing. Doesn’t seem very responsible to me. So, now I’m on the hunt for a NY doctor and for some sushi. Without wheat or flour, there will be a whole lot of sushi in my future.

 

34 Responses to “two week followup with the vag”

  1. southpengirl Says:

    I found out I had Celiac disease after my son was born 2 years ago. I went on a gluten free diet and have felt like my whole system works better, digestive, reproductive, etc. I don’t think you need to have Celiac to reap the benefits of going without wheat and gluten. A book called Wheat Belly gives good reasons to give up wheat even if you don’t have an intolerance.

    Reply

  2. Amy Says:

    I have seen Rogerio Lobo at Columbia Center for Reproductive Health, he was very good as well as Michael Guaranaccia (I think you will prefer the latter.) http://www.columbiaobgyn.org/services/infertility/ I liked the whole practice they were lovely.

    Good luck with all of it.

    Reply

  3. Sue Says:

    With gluten – question everything. It resides in a whole lot of foods that you would never suspect — like some sushi ( http://newhope360.com/blog/sushi-not-gluten-free-who-knew ) *sigh* Thinking of you!

    Reply

  4. Gitt Says:

    That whole “simply out of eggs” thing isn’t necessarily true. It does drop down to zero as there are fewer and fewer eggs left, but even that low result doesn’t mean NO eggs are left. A very close friend of mine (who is dealing with infertility and attempting pregnancy) had an AMH of 0.03. She produced 6 eggs on her first round of stimulation meds. Not that this changes much of anything, since there are so many other factors involved, but perhaps this doc is a fan of…. exaggeration.

    Reply

  5. green Says:

    See someone in NY. My parents live in FL now, and my mother is always saying how there are no good doctors there. It almost seems like your doctor was lazy. I’m sorry you had the experience you did.

    Reply

  6. Carol (middle-aged-diva) Says:

    So are eggs like brain cells? You get a certain number and that’s it? Sounds like a terrible doctor. Thank goodness you’re going to NY where you’ll have a better choice. Good luck!

    Reply

  7. Meredith Says:

    Before you give up the gluten get tested. Find an intuitive healer type (mine happens to be a chiro) who can test for food sensitivities. Ask them to test as many as they can – soy, corn, gluten, dairy, egg, etc. The issue is you HAVE to have those in your system to see if you have an issues. The test is gross. You have been warned. If it is not gross, you have the wrong one.

    I find modern medicine does not tend to think gluten sensitivities exist, but I have labs that show improvements and the ONLY change in me is gluten. So, go with someone open to finding the issue and not just prescribing hormones.

    Then when you give it up, my dear foodie, realize it is in so much. Soy sauce, marinades, and on and on and on.

    Also be prepared for physical reactions after you clean yourself out and you gluten yourself. I was miserable for 6 months while trying to figure it out. But now? 2+ years later I barely register the gluten issue unless at a party or restaurant.

    Good luck!!

    Reply

  8. Victoria Says:

    I’m so happy you’re heading back to NY. A while ago, I gave you the name of my doctor in the city who is one of the leading experts in bioidenticals. I’ve taken them for years and they truly have given me my health back. It’s important to make informed decisions and here in the city, you have the best doctors to help you in your journey.
    Wishing you much health and happiness.

    Reply

    • Chris Says:

      Do you mind posting the name of the doctor in new york city that is the leading expert in bioidenticals? I am also looking for reproductive endocrinologists in NYC. Thanks!

      Reply

  9. Carole Says:

    Sounds like the Florida doctor has a bit of a God complex. On to New York!!

    Reply

  10. Arli Says:

    That doctor sound like a complete jerk. He may be right, or he may be lazy and uninformed, but you won’t know until you see another endocrinologist and perhaps do the gluten-free thing. Sorry I don’t have a name for you, but it’s good that you’re heading back to NYC where I’m sure you’ll find a more competent doc. Good luck.

    Reply

  11. Suzanne in Austin, Texas Says:

    Having to go gluten free is a challenge but not the end of the world. but it takes very conscientious planning. I did it 5 years ago this month when I was diagnosed with gluten intolerance and my eldest son was diagnosed with celiac disease. Doing so changed our lives in so many ways. This is my favorite GF website: http://glutenfreegirl.com/ Shauna is a fantastic writer with an amazing outlook on life and is married to a chef so she shares great recipes too. This is another helpful site: http://www.celiaccentral.org/ Good luck!

    Reply

    • Stephanie Klein Says:

      I miss running into you too!!! Thanks for this. I’ve actually looked through one of their cookbooks. There is something not quite right. I’ve been 100% gluten free for 10 days now. I think it’s been 10, no cheating. Checking every single label. And I am terribly bloated, distended, miserable from eating gluten-free alternatives like Pamela’s and Glutino. I’ve never felt worse! Doesn’t make a lot of sense, does it?

      Reply

      • Suzanne in Austin, Texas Says:

        For many packaged GF products to taste good and hold together, there are other ingredients that can make one feel this way. For me personally, GF flours like teff make me terribly gassy and bloated. The Glutino original style NY bagels had a terrible effect on me last week but the ingredients include dairy which I had been avoiding and didn’t think to look for on the package so maybe that was it. Shauna, the GF girl determined that xanathan and guar gums were a big problem for her and they’re in a lot of prepared GF items. Here is a link to where she discusses her reaction to them, very similar to yours. http://glutenfreegirl.com/gluten-free-whole-grain-muffins/ My suggestion would be to eat as much fresh prepared, whole foods, fruits/veggies, protein and grains (rice or quinoa) as you continue. Good luck!

        Reply

      • CJ Says:

        I’m a lurker so you don’t know me and I feel weird being all in your diet and all but please consider /dropping/ /grains/. Not ‘gluten-free substitute foods’. Just no wheat or rice. The products you mention have OTHER grains in them, ones you are not used to but, and this is interesting, you are reacting to.

        I recommend trying whole30 or primal for a month or two rather than toss-one-grain-try-another! Good luck.

        That doctor sucked. You should report him because he’s not doing his patients any favors.

        Reply

  12. GP Says:

    For what it’s worth, my Ob/Gyn told me that the research that has been done on bio-identicals vs. traditional HRT was inconclusive.

    By the way, I hope your doc mentioned this to you, but I was told by at least two docs that the minimum level of estradiol to protect the bones is 50. So you are definitely on the right track in investigating HRT.

    It can feel like a never-ending nightmare trying to sort through all the misinformation, ulterior motives, and shrugging doctors. Been there, done that! It sounds like you are determined to figure out what’s right for you, and that’s a very good thing.

    Good luck!

    Reply

  13. Lisa Wynn Says:

    My friend had this very same problem and found out that she had preovarian failure – just catching the start of this thread so not sure what they have tested you for.

    As for gluten – heres my fav and a popular site by an amazing guy named Jeff SanGeorge. http://goodwithoutgluten.com/

    Good luck and I will follow!

    Reply

  14. Lisa Says:

    When you are back in NY go see dr Liccardi at NYU. He is a RE. It takes a couple months to get apps, so you might want to call now. Good luck.

    Reply

  15. mcatgirl Says:

    I am so sorry the doctor gave you such a bad vibe. It sounds horrible! Just sounds like a horrible experience. I hope that your next doctor experience will be more compassionate and that you can have a true conversation with them. You are smart to hold off until New York.

    Hang in there, Stephanie. Sending you good thoughts. Good luck with your move.

    Reply

  16. Cyndi Says:

    You might try vitex/chaste tree supplements. Seriously. I use the chaste tree from peoples pharmacy by Mediherb. My numbers were way worse than yours– FSH 90, Estradiol less than 5. I was told the same thing — that I am post menopause and out of eggs at age 40. No need to use birth control. I didnt want kids anyway but was struggling with the same concerns as you about hrt. I tried a week of hrt (bio-identical) and it made me feel really bad so I stopped. An acupuncturist gave me the chaste tree and two months later I had a period. My FSH and Estradiol numbers were then completely normal on 2 separate tests a month apart and NOW 6 months later I am still having periods on exact 28 days schedule. Good thing I continued to use birth control! :)

    Reply

    • Stephanie Klein Says:

      Are you 100% serious? This would be a dream if it really worked.

      Reply

      • Cyndi Says:

        I am 100% serious it worked for me. I’ll be tested again this month but I am going on month 6 where my period should start today and I can tell it IS going to (light cramping the last few days). Last year I went 5 months without a period, then 2 months, then 3 and so on… and it all changed within 2 months of taking this herb. You have to start it slow with one pill for a few days, then two, then I was up to three a day when my periods started back up and now I’m backing off slowly down to 2 a day and being extra careful because chaste tree is a fertility herb and I do not want children. I am not using any hormones at all. And contrary to the name it did not affect my sex drive in a bad way at all.
        I dont know if it will work for you but it is worth a try. I tried many other things holistic and traditional — this was the only thing that worked for me.

        Reply

        • Cyndi Says:

          Oh and I saw a menopause specialist here in Austin (at ADC off Mopac) and she was great, I love her, but she really couldnt do anything for me if I didnt want to take hrt and I didnt feel like being a guinea pig which is what you have to do to find out what works best for you.
          The acupuncturist I saw, that also does nutrition testing is Doug at Tigerlily. He was good in that he gave me the right herbs that worked for me but a little pricey with a hard sell. I went originally with a groupon… :)

          Reply

  17. Lynne Says:

    If you are tested for food sensitivity, keep in mind that the blood test isn’t the best one. You need to do the poop test and I’m so sorry I just wrote that on your blog.

    Good luck!

    Reply

  18. my eggs are hard boiled Says:

    wow -i am going through the same exact thing. i was diagnosed with premature ovarian failure two months ago. i’m 40 but i’ve known something was wrong for over five years (2 periods a year, mood swings, weight gain). i told my MALE gyno that i thought i was in menopause and he told me i was crazy. five years later and with a new FEMALE doctor i got all the tests done and my FSH level is 155. crazy high! i’ve been doing hrt for about a month and it’s really helped. the only issue i seem to have is the week without the patch i find myself incredibly agro – i mean like slap someone in the face agro. otherwise it’s really helped my mood, emotions, etc. i think my body was literally sucked dry of estrogen so any i get i feel so much better. i am very interested in the chaste tree therapy – i would love to hear how it works for you.

    thanks for posting this – good luck with everything! xx

    Reply

  19. Mx Says:

    Obviously this doctor sucks. I had a similar experience recently and that’s why it’s important to be empowered enough to seek other opinions. But the gluten free thing is so stupid. I know it’s the new holy water but you must remember that correlation is not causation! I would focus more on the link between emotional stress and early menopause than gluten!

    Reply

    • jeneria Says:

      Thank God someone else feels this way about the “gluten free” fad.

      Reply

    • Suzanne in Austin, Texas Says:

      Mx–The gluten free thing is NOT stupid for people who have to be or should be gluten free. Read more about it here http://www.celiaccentral.org so you can become less ignorant.

      Reply

      • Mx Says:

        Oh honey, you have no idea how un-ignorant I am. Celiac is not the same as gluten intolerant. People who have celiac get really sick if they have any gluten, life-threateningly ill. People with gluten intolerance also get sick. I am SO over people who are not celiac or g.i. adopting the diet as an ideology for weight loss or clear skin or whatever.

        Reply

        • Stephanie Klein Says:

          In my friend’s case, she was having fertility problems, couldn’t get pregnant, tried forever. Then she tried going 100% gluten free (combined with acupuncture) and she got pregnant the next month. Her second child, she had no problems getting pregnant at all. Happened right away.

          I’m trying this as a last ditch effort. It’s not my Kabalah bead trend diet. I hate doing this. I’m just trying to see if it makes any difference (I have no gluten intolerance symptoms).

          Reply

        • Suzanne in Austin, Texas Says:

          Agreed, UN-ignorant one!

          Reply

          • Suzanne in Austin, Texas Says:

            Won’t be the same as running into you at the HEB Far West discussing Passover recipes but I’d be happy to help you if you need it!

            Reply

  20. Jessica Says:

    Stephanie:

    I cannot speak to the endocrine issues, but with respect to going GF, I would try just whole foods: fruits, veggies, nuts, seeds and protein and dairy for a month (no packaged GF products or anything processed)and then add things back in one at a time (like rice that is specifically gluten free, then quinoa, then maybe some Gluntio crackers…etc) and see how you feel. I was advised to do that by my Dr. and I found, for example, that rice and I are also not friends once I started adding back in non-gluten grains, and that the gluten free packaged stuff does not agree with me for whatever reason either.

    Also, eating whole foods only for a while allows you to avoid gluten in unsuspecting places: mustard? vinegar? salami?!?!?

    Good luck — I know you will get to the bottom of this soon.

    J

    Reply

  21. Crystal Says:

    I was told I had premenopause and I had no more eggs. I was 35 at that time. I am getting hot flashes, moody, weight gain, I really need help. Tried the hrt the bio identical horemones and I had bad effects from it. I dont know what to do. I have a bad medical plan so its hard. I dont thing the diet thing will work for this situation. Thanks for any help

    Reply

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