If you’ve been a long-time reader you might remember that in December of 2016 I announced that I had been diagnosed with PCOS (and then edited the post to report I had been undiagnosed or misdiagnosed with it).
I never thought about it again and thought I had dodged a health bullet.
Why I Should’ve Looked Further Into My PCOS Diagnosis
Mike and I had been trying to conceive over the course of a year and a half. If you haven’t read the last post we announced we’re pregnant! So back in July of 2019, my family doctor started some standard fertility tests (blood work and ultrasounds). Over the course of several months, I had been poked and prodded more times than I could count. I had lots of blood work drawn, ultrasounds and a ton of appointments.
And all of a sudden they thought I might have PCOS again. And then like last time, I didn’t. However, it’s not that easy. And this time I dug further into researching this condition.
My medical team seemed to be a bit stumped about what’s going on with my body. My family doctor and a gynecologist have told me that I don’t have PCOS according to the Rotterdam criteria.
The Rotterdam criteria requires the presence of two of the following: oligo/anovulation, hyperandrogenism or polycystic ovaries on ultrasound.
I only present with polycystic ovaries, which is why I was undiagnosed with PCOS back in 2016. My hormones show that I may be ovulating (as progesterone in the back half of my cycle was ok and an indication I had ovulated) and there is no elevated testosterone so I don’t present with hyperandrogenism. However, one of the fertility Naturopath’s that I saw last year, after taking a look at my blood work and ultrasounds requisitioned further blood work. She believed I have a whisper of PCOS. Or what is known as Phenotype D in the literature.
So why did I title this blog post… “that time I should’ve looked further into my PCOS diagnosis”. Because in addition to polycystic ovaries, I also have a high LH to FSH ratio at the beginning of my cycle. Which isn’t anywhere in the Rotterdam criteria. So if you’re working with a practitioner that only looks at that criteria, you too will be undiagnosed with PCOS. My naturopath monitored my LH for several months. And sure enough, it was always high at the beginning of my cycle. Which in simply science means my body wasn’t sure when to exactly ovulate. LH usually spikes at ovulation signaling to your body to release an egg.
If I have known how to read my bloodwork back in 2016 I would’ve known or learned that a higher LH to FSH ratio at the beginning of my cycle is problematic. And that’s what I wish I had looked further into back in 2016 when my body started to warn me that something wasn’t ok. I have definitely had moments of frustration wishing I had known all of this before spending a year and a half trying to conceive. But hindsight always does that.
Side note, I’ve never become so knowledgeable about the female body, my cycles and the hormones that support the cycle. I love learning all the things but it also boggles my mind that we may not learn these things about our body until we’re ready to start trying for a family. I wish this was taught in school!
If I look back on my blog post from 2016, I just didn’t have the medical team around me that was informed enough or forthcoming enough about women’s health to indicate what hormone levels were imbalanced and how to be proactive about balancing them. I probably also didn’t want to have to deal with another diagnosis so when an endocrinologist told me I didn’t have PCOS. I got really excited not to have another health “problem”.
The Good News
After reviewing countless blood tests since last summer I was really thankful that I did not have imbalances with my estrogen, progesterone or testosterone. So at the end of the day, I only had to address a higher LH to FSH ratio at the beginning of my cycle. I took that as a huge positive and something to be grateful for.
The Other Stuff About a PCOS Diagnosis
We did discover a few other things in many rounds of bloodwork and ultrasounds.
High Ferritin: Ferritin is a blood cell protein that contains iron. Since mine is quite high I have reduced my red meat intake considerably. Throughout the summer I was tested for many things associated with high ferritin and all those tests came back negative (I won’t get into it but it was definitely a high-stress time period). My naturopath hypothesizes that it could simply be a marker of inflammation and/or a slow or sluggish liver.
High ALT: ALT stands for alanine aminotransferase and is a liver marker… so this points back to my liver struggling…
High Thyroid Microsomal Antibodies: An indication that my thyroid needs a little support.
Highly Sensitive CRP (hs-CRP) = 1.0: So this is a blood marker that is used to discover a risk for cardiovascular disease. However, my CRP marker has come back in the normal range for inflammation in my body. But when we looked at my hs-CRP it falls within the average risk range. To any doctor, this would mean they weren’t concerned but to my naturopath, this indicates the potential low-grade inflammation my body has been dealing with for many years.
Elevated Hb and Hct: Another cue that may be associated with the high ferritin.
Hydrosalpinx: So the last fun thing that was discovered this summer was a blocked fallopian tube. This was found during an ultrasound done in July. It was explained to me as simply water or fluid blocking one of my fallopian tubes. So definitely a contributing factor to why we struggled with fertility in 2019. We have no idea how long it was there so we have no idea if it blocked eggs releasing naturally.
My Fertility Supplement Protocol
New Supplement for the First Half of My Cycle
Liver SAP by NFH: to address the inflammation in my body and support my slow, sluggish liver. I stopped taking this when we conceived.
New Monthly Supplements or New Dosage
Prenatal SAP by NFH: I took 3 capsules a day, 2 with breakfast and 1 with lunch to prepare my body to conceive. I am still taking this supplement.
Inositol Caps by AOR: I took 1 capsule a day with lunch to support hormone balancing. I stopped taking this once we found out we were pregnant.
PMS SAP by NFH: I took 1 capsule a day at lunch for cycle support. I stopped taking this once we found out we were pregnant.
NAC SAP by NFH: I’ve been taking this since my MS diagnosis so we just increased the dosage from 1 capsule to 2 which I take with breakfast. This is to combat the inflammation in my body. I’m still taking 2 capsules a day in pregnancy.
In October, I also did Castor Oil Packs on my abdomen every evening before bed for around 30 mins in the first half of my cycle.
Weekly Acupuncture: I was able to go see my naturopath once a week first thing in the morning before work for acupuncture treatments which was a great way to start the day once a week.
Mindfulness & Meditation: I’ve dived into reading Full Catastrophe Living, practicing different mindfulness and meditation techniques and truly try to keep my morning routine to a slow and relaxed morning. No more early gym dates but taking the time to meditate or read. And even less side hustle activity.
Good News Results
I had a hysterosonogram in October to discover the “state” of my fallopian tubes. As I lay on the table, with a catheter inside me shooting water and air bubbles into my uterus the doctor and nurse exclaimed you’re good. Both tubes are clear. I few happy tears slipped out of my eyes. Sure it could’ve gone away on its own but if my changed routines, supplements, and castor oil packs also worked to support my body then I’m really freaking grateful for that 🙂
In my next post, I’ll share why we opted for IUI to circumvent my hormone imbalance.