Supplements And Micro-Nutrients in Hypothalamic Amenorrhea Recovery
There are a ton of different supplements recommended in Hypothalamic Amenorrhea recovery. In this post I walk you through different supplements that may be beneficial in Hypothalamic Amenorrhea Recovery. But first a big disclaimer. There is no quick fix for Hypothalamic Amenorrhea recovery. If you don't tackle your lifestyle, by that I mean eat more, exercise less, you will not recover. That being said, if you have done necessary lifestyle changes, there are a few things you can do to tip the scale. If you are not working on the other more important aspects of recovery, supplementing will bring you nothing but an empty purse.
Supplements to support the return of period
Acetyl-L-Carnitine
As I mentioned in My Story, the supplement Acetyl L-Carnitine helped me regain my period after weaning. Acetyl L-Carnitine is an amino acid found in nearly all cells of the body. It increases the activity of certain nerve cells in the central nervous system and helps your cells produce energy. The amino acid appears to lead to increases and decreases in hormones as are expected and necessary for recovery of periods missing due to Hypothalamic Amenorrhea (e.g. GnRH, LH, estradiol, cortisol…).
It is recommended to take 1 gram per day split into two 500 milligram doses. Take the first dose in the morning on an empty stomach, so that the compound is rapidly digested to help activate the brain from the get-go. Take the second dose with a glass of water between meals, at least 1 to 2 hours either side of food.
You should stop taking the supplement if you get pregnant due to lack of information about pregnancy effects. You should also not take it during breast feeding since it can be transferred to a baby through breast milk (remember a lack of period during lactation is not the same thing as HA).
Vitamin C
Vitamin C, or ascorbic acid, is a water-soluble nutrient. It is contained in citrus fruits, berries, broccoli, spinach, peppers, and tomatoes. It helps support your immune system, aids in iron absorption, and has antioxidant properties that help protect against damage from oxidative stress. And stress we want to minimize during recovery of HA. In addition, it is thought that high dosage vitamin C can elevate your estrogen levels, and low levels of estrogen are one of the common characteristics in HA.
If you wish to try this out, go for 1000 milligrams per day. The best would be to take it two times 500 milligrams per day. As with all supplements, please be careful to stay within the recommended limit.
Flax seed
Flax seed consumption has been shown to reduce an-ovulatory cycles and improve progesterone production by increasing ovulation regularity. It has a positive effect on the follicular phase (including ovulation). It also seems to slightly increase the length of the luteal phase (on average 1.2 days longer than with no flax seed consumption). It is also believed to reduced stress hormones and perception of stress. And we know by know that stress minimization is important in Hypothalamic Amenorrhea recovery.
Since it comes with no adverse consequences, I think it could benefit your recovery journey to add some flax seeds to your daily intake. The recommended daily intake is 10 grams per day (1 table spoon).
Ground flax seed might be preferable over whole flax seed in Hypothalamic Amenorrhea recovery because it is easier to digest and better absorbe (see my post on digestive issues in Hypothalamic Amenorrhea). I prefer the ground flax seed and eat it with my breakfast yogurt every day. You could also add it to your smoothie or baked goods.
Once you have regained your period, you could consider start timing your intake of seeds depending on where you are in the cycle (see my post on Seed Cycling). But if you feel this is too much effort, just stick to the tablespoon of flax seed and you'll be perfectly fine.
Omega-3 fatty acids / fish oil
Omega-3 fatty acids are essential fats that have numerous health benefits. They’re deemed essential because they’re necessary for health but cannot be made by your body (thereby you must get them from your diet). Rather than being stored and used for energy, they play important roles in many bodily processes, including inflammation, heart health, and brain function.
Supplementing with a Omega-3 fatty acids has been showed to improve egg quality, delay ovarian aging, improve pregnancy rates, and support healthy fetal and infant development. Since it´s been a while since the eggs were maturing fully in those with HA, I think supporting with a good omega-3 supplement is reasonable. I usually recommend one containing the fatty acids DHA and EPA. The recommended dose is about 300 milligrams per day.
Supplements to support bone health
As explained elongated in the post about Bone Health And Hypothalamic Amenorrhea, there is a strong correlation between Hypothalamic Amenorrhea and poor bone health in form of osteoporosis and osteopenia. It is therefore crucial for someone with Hypothalamic Amenorrhea a nourish with adequate amounts of both Calcium and Vitamin D (in addition to Protein):
Calcium
Another supplement that is worth considering in Hypothalamic Amenorrhea recovery is calcium. Calcium is needed to support the repair and health of your bones.
The recommended intake is 700 mg per day. Calcium is found in dairy-based foods like yogurt, cheese and milk. Try to have them every day if not even every meal (but be mindful of the prohibitory interaction with iron absorption). If you are not getting enough calcium in via the food a calcium supplement may be useful in supporting bone repair and health. Supplemental calcium is best absorbed in small, more frequent doses. As with all supplements, please be careful to stay within the recommended limit.
Please note. Calcium alone can't build strong bones and tissues, it needs phosphorus and vitamin D to maximize its bone-strengthening benefits. A variety of foods naturally contain phosphorus, and the richest sources are dairy, red meat, seafood, legumes, and nuts.
Vitamin D
Calcium works alongside Vitamin D and other nutrients to maintain bone health and achieve peak bone mass, providing a key structural element within bone tissues. What’s more, research indicates that vitamin D may play a regulatory role in ovulation. Among others this study showed that women with low Vitamin D status were five times more likely to experience menstrual cycle disorders than those with adequate Vitamin D levels. So come as no surprise that Vitamin D deficiency is very common among those with Hypothalamic Amenorrhea.
It is contained in oily fish, red meat, liver and egg yolks. During the summer months, the body can synthesize Vitamin D from sunlight. The recommended intake if you have no deficiency is 10 µg per day. If you are suffering from a vitamin D deficiency, higher levels, 25–100 µg or 1,000–4,000 IU per day is required. As with all supplements, please be careful to stay within the recommended limit.
Other Micro-Nutrients to support Hypothalamic Amenorrhea recovery
Magnesium
One more micro-nutrient that might be advisable to support Hypothalamic Amenorrhea recovery is magnesium. Magnesium helps you deal with stress and contributes to good sleep. Stress and high intensity exercise is often associated with magnesium loss. And magnesium deficiency is indeed frequent for those suffering from Hypothalamic Amenorrhea. In addition, magnesium is required to activate enzymes that metabolize Vitamin D.
The recommended intake is 310-420 mg per day. Magnesium can be found in spinach, cashew nuts, almonds, seeds, avocado, banana and dark chocolate.
Iron
Iron is a component of both haemoglobin and myoglobin, two oxygen-carrying proteins essential for physical performance. It is also a component of the enzymes and proteins involved in energy metabolism as thyroid hormones (in fact, low iron status may impair thyroid function). And as we know, Hypothalamic Amenorrhea is characterized and driven by low energy availability, which could be worsened by a state of reduced metabolism. It also plays an essential role for the central nervous system where it supports lipid metabolism and synthesis of myelin and neurotransmitter synthesis.
Although not having a period, the vast majority of my clients are diagnosed with low iron status (I think this could be partly due to digestive issues). Iron is therefore a good supplement to consider in Hypothalamic Amenorrhea recovery. The recommended daily intake is 18 mg. Heme iron (from animal food sources) is the most easily adsorbable form of iron. This is contained in red meat, blood sausage, shellfish and liver. Good sources of non heme iron are seeds, dried fruit and green leafy vegetables. It is good to have your iron source together with some vitamin C to help the absorption. Lastly, try to avoid calcium-rich foods or caffeine when eating iron rich food since these inhibit absorption.
Further reading:
*All content is for informational purposes only. It is not intended to be a substitute for professional medical advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition.
