Showing posts with label hypothalamic amenorrhea. Show all posts
Showing posts with label hypothalamic amenorrhea. Show all posts

Tuesday, 22 July 2014

Quinoa confusion - Paleo or not? Healthy or not?

What an exciting week it has been! In case you missed it, I had the amazing honour of sharing my journey with hypothalamic amenorrhea and body image on The Huffington Post! Seriously a dream come true! 

OK back to quinoa. It’s the high-protein darling of the vegan and vegetarian world. It’s the hip new pseudo-grain (it’s actually a fruit). And it seems to be somewhat of a grey area for Paleo folks – some love it (using said “fruit” defense, because God-forbid they eat a grain), and some are downright against it (if it walks and talks like a duck, (or grain), then…).

So who is right? Is quinoa the super-food it’s made out to be, or is it just another dodgy grain-like cereal?

Apparently Quinoa is a girl on pinterest who is well
 into her fashion…and hates pleather.
Just a little weird.

About 4 years ago, I was diagnosed with coeliac disease. My symptoms were not pretty – fat and protein malabsorption (which translates to chronic diarrhea, that kind of also feels like constipation – fun, right?), nutrient deficiencies, low energy and a rash that was spreading all over my body. The treatment for coeliac disease is simple – follow a gluten free diet.

So I switched my beloved oat-based porridge to quinoa porridge. It was a simple switch, and tasted pretty good, too. Unfortunately, just going gluten free didn’t cut it. I still had my symptoms some 6-9 months later. That’s when I decided to try this crazy “Paleo” thing that my hubby was doing (despite my dietitian brain being completely against it). Lo and behold my symptoms disappeared…..quite rapidly, in fact, with the high fat, low carb diet I had adopted.

Fast-forward to last year when I was diagnosed with hypothalamic amenorrhea and hypothyroidism, which my low carb diet probably played a large role in. I was tasked with adding in more carbs, and there is only so much sweet potato a girl can eat, especially with the exorbitant prices in NZ! Cue quinoa. I thought – why not throw it back in the mixer and see what happens?

This time, however, I made sure that I soaked my quinoa seeds overnight, rinsed and rubbed them in the morning, THEN cooked them (more on why I did this later). Success! No adverse reaction, no tummy upset. I felt great. Hurrah! Quinoa porridge is now a regular breakfast for me, and I love it!

I tell this story to highlight the fact that there is no one diet for everyone, and what might be right for you now, might not have been OK a while ago, or in the future. It’s all about experiementation!

So why does quinoa get such a bad wrap? Well, the quinoa seed contains a few “anti-nutrients”:
Check out those soapy saponins after soaking quinoa overnight
  • Saponins – as the name suggests, these are soap-like substances, which can cause problems with digestion and potentially increase intestinal permeability (AKA “leaky gut”)
  • Phytates – or “phytic acid” can bind up minerals, such as iron, zinc and magnesium, preventing their absorption and utilization by the body
  • Protease inhibitors – “proteases” are enzymes that break down proteins into their smaller constituents, amino acids, which can then be absorbed through the intestinal wall and used by the body to build new proteins. The body is clever, right? Protease inhibitors, as you might have guess, can inhibit the action of these enzymes, thus disrupting the ability to digest proteins 

Well crap. That all sounds pretty unhealthy. Why would I even consider eating such a food?

Here’s the thing – soaking, rubbing, rinsing and cooking reduces the content of these anti-nutrients by 50-100%, making them less problematic, and the vitamns and minerals contained within (think calcium, magnesium, folate, iron, phosphorus, vitamin Bs and vitamin E), more bioavailable. Brilliant!

All that said, if someone is suffering from a health condition, especially if it is digestion-related, I would suggest cutting out quinoa and going quite strict Paleo for a period of 30 days. Then you can start to reintroduce foods and see how you go. That sounds fair, right?

Now just because I love you, I have decided to share my yummy brekkie recipe. Enjoy!

Warming Quinoa Porridge


  • ¼ cup quinoa
  • ½ cup water (plus extra for after cooking)
  • ¼ cup coconut milk (plus extra for after cooking)
  • 1 ripe banana, mashed
  • 1 tsp cinnamon
  • 1 tsp maca powder (optional, but is great for hormonal balancing)
  • 1 small handful of nuts (chopped) and/or seeds
  • 1 small handful of coconut flakes (optional)
  • Sometimes I also add a sprinkle of Great Lakes Beef Gelatin (flavourless) for extra gut-healing goodness

Method
  1. Soak the quinoa overnight and rinse thoroughly in the morning, massaging the seeds as you rinse. This removes “saponins” and improves the digestibility of the quinoa
  2. Add quinoa, water and coconut milk to a small saucepan over med-high heat until just boiling
  3. Turn the heat down to low and put a lid on the saucepan for around 10 minutes or until most liquid is absorbed
  4. Meanwhile, mash the banana and chop the nuts
  5. Add everything together (quinoa, banana, nuts, maca, coconut flakes, cinnamon) and add extra water and/or coconut milk until it reaches your desired consistency
  6. Enjoy slowly!




Tuesday, 1 July 2014

Hypothalamic Amenorrhea and How To Exercise

I get asked this question A LOT. Especially since Sarah Wilson kindly posted my story on her blog. I think, inherently, we are all a little voyeuristic. A little pervy. Wanting to know the intricate details of other peoples’ lives. Or perhaps we just want a little guidance or confirmation that we are doing the right thing. Either way, I have decided to share how I approached exercise as I was healing from hypothalamic amenorrhea.

Peeping Toms in Tokyo, 1951. Image via pinterest by sahua d
First, know this: hypothalamic amenorrhea (also referred to as the Female Athlete Triad) is often a result of over-exercising and/or under-eating, which leads to an overall negative energy balance for an extended period of time. The body senses that you are, essentially, starving and says “Righteo, no energy for reproduction, then” and bids farewell to your monthly lady holiday.

So, taking this into account, you can see that exercise is perhaps contraindicated in the treatment of hypothalamic amenorrhea. Right? Right! 

Chronic exercise = no good. BUT movement = good!

Prior to actually deciding to do something about my infertile situation, this is what my exercise looked like: 
  • Monday: Body Attack (1hr) followed by Body Pump (1hr). I might have walked ~1/2 -1hr too
  • Tuesday: Maybe a walk, maybe a weights session (maybe both), maybe a cardio session
  • Wednesday: Body Attack (1hr)
  • Thursday: Body Step (1hr), ½-1hr walk
  • Friday: Body Attack (1hr), weights (1hr)
  • Saturday: Body Step (1hr) – every second Saturday
  • Sunday: Body Step (1hr)

Holy crap. I am exhausted just looking at all of that! So much time wasted in the gym! Granted, it was my job, which made it more “legitimate”, I suppose, albeit no less damaging to my health and fertility.

I realised that this was unsustainable and would leave me in my infertile state if I were to continue. 



Yes, thank you for your wisdom, Albert. For a while, I was insane. I thought I could just throw herbs and vitamins at the situation and it would sort itself out. But, after spending thousands of dollars (literally), I realised this approach was no bueno. So here is what I did…

I progressed quite gradually, and it helped that it coincided with my dietetics placement, so I had an excuse to no longer teach a lot of my classes.

Stage 1
  • Monday: Body Pump
  • Tuesday: Walk
  • Wednesday: Weights (functional training 1hr)
  • Thursday: Yoga
  • Friday: Weights (functional training 1hr)
  • Saturday: Body Step (every 2nd weekend)
  • Sunday: Body Step

 A considerable change, but probably not enough. Cue stage 2.

Stage 2
  • Monday: Body Pump
  • Tuesday: Walk/yoga
  • Wednesday: Weights (8 minutes – YES, you read right EIGHT minutes – 8 sets of 3 clean and presses; sets 1 min apart)
  • Thursday: Walk/yoga
  • Friday: Walk/yoga, maybe a Tabata session (4mins of cardio)
  • Saturday: REST
  • Sunday: REST

Although it was tough (mentally), I stuck to this routine for quite some time (until my period returned), gradually adding in more yoga (vinyasa/yin/hatha NOT bikram/ashtanga) and taking out the Body Pump. As I have previously mentioned, I found the yoga incredibly beneficial to the healing process as it allowed me to focus more on my body’s ability, rather than its aesthetics.

So, now that my cycle is getting back on track, how do I exercise? Well, it depends. I try and get outside as much as possible for a gentle walk/hike, as I now live in the nature-lover’s playground:

Image by Lake Wanaka Tourism
But if it is raining outside, and I feel really good, and my stress levels are low, my week might look like this:
  • Monday: Weights (1hr - 10 min mobility warm up, 30 min weights, 20 min stretch/yoga)
  • Tuesday: 1hr yoga
  • Wednesday: Body Pump
  • Thursday: Tabata
  • Friday: 1hr yoga
  • Saturday: Hopefully the rain has stopped by now and I can go for a hike!
  • Sunday: Rest

Note: I do at least 30 minutes of yoga every day in the morning. It grounds me and sets me up for an awesome day.


Now please note, this was MY journey. This gives you a general idea of what worked for me. It may or may not work for you. Listen to your body. If you have exercise/stress/lack of food-induced amenorrhea, then you probably need to pull right back on the exercise to start with, then take baby steps along the way, depending on how everything is tracking along.

If this is all too overwhelming for you, I get it. My hubby (who is a PT and peak performance coach) helped keep me on track. Everyone needs someone. Feel free to shoot me through an email via my website if you would like to book a consultation for some more structured, personalised guidance that will help you get your sexy back.


Final note – as always, be kind to yourself. x

Tuesday, 10 June 2014

How I got the body I've always wanted

This past weekend, I turned 30. Officially in the dirty thirties now. And I feel great. Fantastic, in fact.

My awesome hubby took me on a helicopter flight for my b'day!
It has been 1 year since I wrote my postabout putting on weight to restore my fertility. It has been 3 years since I lost my period due to under-eating, over-exercising, taking the birth control pill and being a stressed-out, maniacal perfectionist. It has been an interesting 30-year journey of progressing from someone who was constantly trying to change her body to meet some unrealistic ideal, to someone who actually loves the skin she is in. And I am not just saying that. For the first time in my life, I actually really love my body.

I have been wanting to write this post for a while, but putting it off. Not sure why. I guess we all have a fear of being judged in a negative light. So I ask you to please, if you have nothing nice to say, then say nothing at all. OK here goes...

For reference purposes, here is my before and after pic to show my progress. Please excuse the hair in both shots – one was scraggly beach hair and the other sweaty post-workout hair. But it’s not about the hair (although it is thicker and more lustrous nowadays). Let’s take an objective view here, simply looking at the change in body shape.


On the left, you will see “Check out my 8-pack, you think I'm healthy and fit , but my fertility is in the shitter” Kate. I showed this to a friend the other day and she said “Oh wow! What were you training for?”. Nothing. I was training for my illusive “dream body”. Pfft.

On the right, you will see “Check out my boobs, I look healthy and feminine and my internal state reflects this” Kate. There are just two things that I do not like about this pic – 
1)My lack of tan (although I have that many layers on here in Wanaka that a tan would not even get noticed) and 
2)The selfie pose. I hate bathroom-half-naked selfies. It makes you look like such a wanker. I apologise. I am doing this for reference purposes, not to show off or entice more Instagram followers.

OK, so aside from having boobs (seriously, I’m still obsessed with them), what is so great about my new body? Probably best if I list out the reasons, as I tend to do. As always, feel free to just read the bolded text to get a general gist:
  1. I have unbelievable energy. I used to have to take regular naps throughout the day, just to make it through. Now, I can soldier through, completely sans-caffeine. Funny what happens when you start to eat enough
  2. The whites of my eyes are crystal clear. They used to be constantly bloodshot and my vision was blurry. I relied on ClearEyes, and I wasn’t even getting stoned!
  3. My skin is clear and wrinkle free. Previously, it would look kind of dry and lackluster
  4. My nails are thick and strong. For the first time in my life, my nails are not snapping off as soon as a little bit of white appears. I used to have vertical ridges (signs of adrenal fatigue) and horizontal ridges (signs of thyroid issues). These ridges are almost non-existent now
  5. My gray hairs have disappeared. Now this one I find quite odd, and did not think it possible. I used to have quite a few gray hairs, and my hairdresser can vouch for this – she kindly pointed out a patch of grays on my head that I would have otherwise been unaware of. Thanks Leigh. Those grays – all gone! Bizarre, right?
  6. My cycle is getting back on track. Thank God, because that’s the whole reason I headed down this road. It’s not perfect – about 40 day cycles, but compared to the nothingness of about 6mths ago, this is a pretty significant improvement
  7. I can do crazy yoga shit. Seriously – handstands and backbends and balances and all sorts of awesome stuff. I am loving it! I would never have gone down the yoga path if I wasn’t forced to sort out my stress and pull back on the chronic cardio that I was doing
  8. I am so much more in tune with my body now. I listen to how it feels and I respond with understanding and respect, rather than saying “Harden up! It’ll be worth it”, because more often than not, it won’t be worth it.
  9. My hubby thinks I am sexy and tells me this all the time. I know what you are thinking – he has to say that. Maybe, but he could just say nothing at all. I asked him if he preferred me the way I used to be and he said “Honestly, you were almost too skinny for me”. Interesting. I find the male response to this whole thing very intriguing. Any males out there who want to chime in on this, please do – obviously not telling me I’m sexy (unless you want to), but just commenting on the whole female body thang.
  10. I am now in the position to be a positive role model for other females, both young and old. My previous body was unrealistic and unattainable for most. It took a lot of hard training and strict eating, and wasn’t even healthy. I was practically a male! No boobs, no period, no hips. Sounds pretty masculine to me!

So how did I do it? How did I go from hating my body at 57kg (172cm tall, 'cos I know you were wondering) to loving it at around 62-64kg (not exactly sure what my weight is – I broke up with the scales a while ago)? Well, it wasn’t easy. I didn’t just suddenly wake up and go “Hurrah! I am woman, hear me roar!”. These are the things that were invaluable to complete body image backflip:

  1. Support. Lots and lots of it. From loved ones, and from you folks through the interwebs – thank you!
  2. The knowledge that I might be helping others in a similar situation – this was a massive driver! I truly hope I can help others, even if it is just one person
  3. The realisation that menstruation is a sign of fertility. Fertility is a sign of health. Body fat is needed for menstruation. Ergo body fat is healthy.
  4. Self-love. I know this sounds really woo-woo, but it truly helped me understand the underlying thoughts I had about my body and how to change them. Gabrielle Bernstein’s May Cause Miracles, and Louise Hay’s You Can Heal Your Life are invaluable resources. Get them both. NOW!
  5. Yoga. Yes, I am well and truly a hippy now. I even have crystals throughout my house. Candles too. But back to yoga. Aside from being able to bend and balance my way into poses that I was once only dreamed of doing, yoga taught me how to focus on my body’s ability, rather than it’s aesthetics.
  6. The realisation that those who really matter in your life could not give a flying fuck (sorry - I was overdue for a swear word) if you are a size 8 or a size 14
Image via care2.com
This is my body. In your eyes, it may not be perfect. I have cellulite. I have stretch marks (in fact, I had cellulite and stretch marks before putting on weight). I don’t have abs. Or a thigh gap. But in my eyes, what I see and how I feel, for the first time in my life, I am completely and unashamedly happy. This is 100% me. I am not a replica of someone else, nor am I trying to be. I am confident and I am healthy, and I hope that I have sparked the desire in you to love, accept and appreciate your body exactly as it is. xx

Wednesday, 21 May 2014

Are you eating enough?

It is rare that I will get a client who is eating too much food. Often, it’s the other way around. Which makes sense, given what we have been taught about weight loss. It’s simple, really: 

“Eat less. Exercise more”.

Hmm. OK. My job (in terms of weight loss clients) really should be obsolete then, right? If it really were as simple as eating less and exercising more, most of my clients would be Kate-Moss-thin. But they aren’t. Some have just a little bit of stubborn fat that they would like to lose (for aesthetic reasons), others have more that they need to lose (for health reasons). All are exercising their butts off. Too much, in my opinion. All are not eating enough.

So simple, yet so easily forgotten. 
I was taught at university that if an overweight person comes to me and their food record shows they are consuming fewer calories than they are burning, then they must have been lying, because they should be losing weight. How f-ing arrogant of us to assume this. It truly breaks my heart to see people who are literally broken from trying so hard to lose weight using the traditional “eat less, exercise more” dogma”.

I agree. Ridiculous indeed.
So why is fat loss so hard?

Well, it is complicated, and I am the first person to admit that I do not have all the answers. As I mentioned, if weight loss were easy, we would not have an obesity epidemic that is running out of control.

What I do know is that when you consume too few calories, shit is going to hit the fan. Let’s back up a little for some weekly science….

Your resting metabolic rate (RMR) is an estimate for how many calories you would burn if you lay in bed all day (sans hanky panky). Your RMR represents the minimum amount of energy required to keep your body functioning – your heart beating, your lungs breathing, your reproductive system functioning, your thyroid gland humming along nicely, controlling your metabolism and body temperature. Let’s put this into practice and see what some numbers look like:

To calculate your RMR, you can use something called the “Schofield Equation”. While this equation does have some flaws, it provides a pretty decent estimate.

For me (and any other female in the 18-30 age group), the following equation would be used to get my RMR:

{(0.062 x weight (kgs)) + 2.036} x 1000 = 5,942kJ per day (divide by 4.28 to convert to calories)

So my minimum calories that I should consume, based on me staying in bed all day is 1388. MINIMUM! This is not taking into account any sort of exercise, folks.

Let’s say I decide that I am going to walk a little each day. My estimated energy requirements then go up to 2,082kcals per day! Just to do a little wandering here and there.

What is really concerning to me is that I have clients consuming around 1300-1500 kcals per day who are training at high intensity, for long durations, every day of the week. A rest day for them would involve a slow run, rather than a fast one. And this is not just females, it’s the fellas too.

What’s the problem with eating too few calories?

Image by Sara Thurley via Pinterest
When you have insufficient calories on board to fuel basic bodily functions, those functions will slow down. Your brain will recognise this lack of fuel and signal to the thyroid gland (in your neck) that energy needs to be conserved and to slow everything down.

Your thyroid gland controls all of your metabolic processes and your body temperature. If it slows down production of thyroid hormones, your metabolism will slow down, your heart rate will drop and you may struggle to keep warm. What happens when your metabolism slows down, people? You guessed it! Weight loss resistance!  If you are, essentially, starving, do you really think your body is going to give up its fat stores easily? Or do you think it is going to hold on to every last morsel to feed your vital organs (and to keep you warm). (PS have you checked out the Thyroid Sessions yet? They are awesome!)

If this wasn’t bad enough, your adrenals are probably going to kick into gear to help you survive (especially if you are doing high intensity exercise and don’t have enough carbs in your diet). This means cortisol is going to ramp up and give you a nice little pooch around your tummy that you can’t shift, no matter how many crunches you do (as a side note, crunches are not the best exercise for a lean mid-section, so just stop it).

In my opinion, troubles with weight loss are the least of your worries if you are chronically under-eating and over-exercising. I have spoken (at length) about how this can lead to Hypothalamic Amenorrhea (click the labels below this post to read more about this topic), but what about the other consequences, not just impacting the ladies:
  • Compromised bone density
  • Brain fog and inability to focus
  • Decreased performance (in all forms of exercise, including the bedroom)
  • Vitamin and mineral deficiency
  • Low energy
  • Increased risk of heart problems
  • Poor memory
  • Skin breakouts
  • Hair loss
  • Cracked and brittle nails 

Not pretty, right? Moral to the story – eat more and eat well! Or, exercise less. You choose. But don’t do nothing, or you could end up in some ugly (literally and figuratively) places. It might be useful to track your daily food and exercise, using something like “My Fitness Pal” to get a better picture of whether you need a slap in the face with a juicy steak.

Thanks, Ryan. Much appreciated.