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(Un)Happy Hormones

Monday, December 9, 2013

Gaining Weight

I went for a run and walk last Sunday (12/1). I had a much harder time than I’d been having on previous runs. Usually, the thing that limits how far I run before I slow to a walk is my breathing. It gets difficult, so I slow down and walk. Not this time. My lungs and bronchi were fine. My knees began to hurt early on. I felt like I had passed a point in all this weight gain where now it bothers my knees to hold up the extra body mass. For the first time, I could feel my thighs and butt jiggling. It was unexpected and disconcerting.

I spent the next few days thinking through what is going on with my weight. I weighed less than 130 pounds when I got married in August 2012. I felt like I was too thin, even though I kind of liked the way I looked and even though my abdomen was frequently swelling up.

As I coiled more for Bartonella and as the Lyme seemed to get less intense, I put on some weight. By spring, I weighed 135 pounds, which in the past has been my sweet spot. At that weight, I feel like I’ve got meat on my bones, my skin doesn’t seem so thin, and my body is comfortable.

In May, I started taking Vitex, an herb that helps regulate progesterone. A month later, I stopped taking Metformin, which increases insulin sensitivity, and as a result helps balance sex hormones. Since then, my weight has climbed slowly and steadily to 160 pounds.

I expected to gain some weight during the transition off Metformin. Many people lose weight when they start it. I was one of them, but everything back then made me lose another pound or two. Some people gain weight when they stop taking it. I figured I’d add another 5 pounds or so, temporarily, as my metabolism adjusted. Instead, I’ve been gaining 4-5 pounds a month, every month.

Body Positive

After so many years of being sick, I have a different relationship to my body than many women do. As a white woman in the US, I have all the cultural recordings about how being thin is more attractive. In fact, I used to console myself, back when I was underweight and frail, that at least I looked pretty good naked. For the first few years after I got sick, I didn’t purchase new clothes to fit my shrunken size, partly because I was too tired, but mostly because I assumed I would go back up to 135 pounds as soon as I started feeling well again. Wearing oversized clothes works because I could add a belt to pants that were too big. It isn’t so easy now that I’m bigger than my clothes because I can’t even get my pants on.

Gaining weight pushed my buttons at first, feeling like that skinny beauty was slipping away. In reality, when I looked in the mirror, I saw I had become stronger and sturdier. My skin wasn’t so thin. I didn’t feel like every bump and bruise hit my bones and nerves. I had a more normal amount of natural padding. Over the course of last winter, I felt like I had rounded out to a nice level, and that I would be happy at that weight.

Since June, I’ve been a little concerned. Sometimes I had to talk to myself, reminding myself that I am beautiful at any weight. I see this is true about the women I’ve known throughout my life. I was distressed by the new wardrobe restrictions, but otherwise, I could see my body was doing okay. Most of the weight was around my butt, hips and thighs, though in September, it started to become more noticeable on my abdomen as well. Each month I would tell myself, as soon as my weight levels out, I’ll get a pair of jeans that fit. Only, the number on the scale kept climbing.

Despite the weight gain, I’ve gotten stronger and had periods of higher endurance. I was able to carry my niece around and play with my nephew when I visited them. I was able to take long, slow hikes. I went for a few run/walks. So I was proud that my body had made it through so many years of chronic debilitating infection, and it was finally starting to work normally again.

The emotional give and take ended when I saw 160 pounds on the scale. I haven’t weighed this much since I was on a psychiatric drug for depression in my early 20s, one that can cause significant weight gain. For me it meant that I gain 50% of my starting weight, topping out at 165 pounds. Sometime after I stopped the drug, the weight came off effortlessly, as though my body found a new equilibrium in the absence of the drug. My recent weight stopped me in my tracks and made me think about how quickly and steadily I was gaining weight, and I started to wonder if something was wrong that I needed to address.

Hormonal Questions

Once I began to mull over the rapid and steady weight gain, my first thought was hormonal. My first question was: did my thyroid stop functioning properly? I’ve read a ton about how chronic illness can lead to hypothyroidism, which makes it a good place to investigate. But even more salient for my life, several women in my extended family have hypothyroidism usually starting in their late 40s, as they become pre-menopausal. I’m a decade early for that, but given my medical history it’s on my list.

But once I thought about hormones, I made the connection between starting Vitex to reduce PMS and help regulate my period, and beginning to gain weight rapidly. As I mentioned above, I had gained some weight after I got married, mostly because I started eating grains after 5 years not eating any. I put on 7 pounds and landed at the weight my body usually functions best at. Then I stayed at that weight until June, a few weeks into starting Vitex.

First, it is worth noting that Vitex helped at the beginning. I was just starting to show signs of low progesterone, with prolonged PMS, including cramping, fatigue and sore, swollen breasts, most of which started a day or two after I ovulated. It wasn’t fun. The month I started Vitex, it all went away. In fact, I didn’t have PMS lasting more than a day until my current menstrual cycle. A few days after I ovulated this month, breast pain and tenderness started. It hasn’t stopped yet.

Just as I hit the high weight mark, the Vitex seemed to stop working. So I did some research. First I looked at what excess progesterone can do, excess weight was definitely on the list. Then I read about other forms of increased progesterone, including birth control pills and patches, and progesterone creams. It seems that too much progesterone can cause similar problems to not enough progesterone. Then I remembered a recent news story that said that the low-dose progesterone only birth control pill becomes much less effective for women weighing more that 155 pounds. Maybe at this weight, the Vitex stopped working. Although none of these pieces of information was definitive, all signs were pointing to stopping Vitex.

I also thought about my history. I took birth control pills for two months about 10 years ago, after I had an enlarged ovarian cyst, in the hopes of preventing another one by preventing normal functional cysts that are formed prior to ovulation. At least I was willing to try this after my gynecologist insisted I “needed” to do something to prevent future cysts. (The cyst I had back then was big enough to cause pain but not big enough to remove surgically. It resolved on its own after a few months. Right after that I tried the pill.) I took a progesterone only pill that did not agree with my body at all. I think that it interacted with the tick-borne infections in a bad way. So I stopped taking it after abdominal cramps and loose stools for 6 out of the 8 weeks I was on it.

Finally, although an obvious place to have started my research, I looked up Vitex again. I had read a lot about it before taking it, but I never looked at the common side effects. That was an oversight I’d prefer not to repeat. Anyway, weight gain was listed in the side effects on Web-MD and other similar websites.

At the end of the day on December 3, I decided I was finished with Vitex. On the morning of December 4, I put the bottle away for good.

Alternate Explanations

Even though I thought I’d learned enough before taking Vitex, I don’t think I understood how it works. I’m not sure that would have changed my course of action over the past several months. But I did find an interesting summary of all the ways that Vitex modifies the hormonal balance in female users. One of the key things it mentions is that Vitex affects the pituitary gland and stimulates dopamine production.

I’ve been coiling the back of my head for Bartonella, since that is the part of my body that gives me the strongest herxes. I’ve been steadily increasing how much I coil back there. It is possible that after reducing the infection, my pituitary gland had to rebalance itself, and suddenly the Vitex became a physical stressor rather than relieving an existing problem caused by the infection. In other words, as I get rid of the infection, I no longer need the help that this supplement was providing.

Another possibility is that my body got used to the increased dopamine and I was heading towards a spiral of requiring more and more Vitex to have the same effect. That is a situation I’d prefer to cut short.

Another possibility, the one I had been considering all this time, was that my metabolism was changing as the Bartonella infection got knocked out and my food intake had become more varied.

Only time will tell whether ceasing Vitex will reverse the weight gain I experienced when I took it. At the very least, I’m hoping that I’ll stop adding a pound a week. If I don’t there are other avenues to consider.

Finding Balance

I’m sitting out this menstrual cycle, not using anything else that might affect my dopamine levels or my progesterone levels. I’ll deal with the PMS the best I can. In the future, I’ll go back to using the Shen Men points in my ears if I get PMS. They seem like a milder way to interfere with my body’s processes, and have a shorter effect.

Heading forward, I’m still taking DIM (diindolylmethane) to help balance the different forms of estrogen in my body. It should have a similar effect to Metformin, but is much milder. It has no known side effects (I hope I’m not the one to discover them). Hopefully the dose I’m taking (150mg daily) will be enough to keep my menstrual cycle from incapacitating me every month.

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