Jagged little pill--warning controversial topic ahead!!

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About a year ago, I was not feeling quite right and was looking for answers. Sound familiar? I was already supplementing with iron to boost my iron stores which I knew were low. I was taking vitamin D since I know that tends to be chronically low for me too. I suspected that I was also suffering from low estrogen levels. I wasn't showing signs of this in terms of my female cycle, but I had really low body fat and just assumed that my estrogen levels would be low. My doc and I discussed this and she okayed me to go on low dose BCPs. I actually started feeling better fairly quickly after that and pronounced myself cured by BCP. About 3 months later I started getting ocular migraines every other day. I normally get these 1-2 times per year. This was a huge red flag. I never once attributed the migraines to the hormonal supplements, but I was urged to stop taking the BCPs because of the fact that they, and all other estrogen-based hormone supplements, greatly increase your chance of having a stroke if you're a woman over 40 who also gets migraines with aura.

Now, I am pretty convinced that it was the BCPs that were causing my increased migraine frequency. I am eternally grateful to the doctors, including my sister-in-law, who urged me to stop taking the pills. Who knows how close I came to having a stroke. I will say that I am still fuming that my gynecologist told me it was totally safe to take these when my record clearly indicated that I had migraines with aura. This isn't the first time she missed something in my record and made a mistake. I finally switched doctors, but the new one isn't much better. Ah, the joys of having Kaiser as your HMO.

The reason I am so convinced that the BCPs caused my headaches is that I finally went in to get my estrogen levels tested. My ex-Kaiser doc refused to order tests for me, so I did it myself at HealthTestingCenters.com. I didn't know anything about this cool service until a month or so ago when I was looking for a place to get my serum ferritin tested. You simply order your test and they call it in to a lab close to your house. You go in, do the deed and *voila*, test results in 24-48 hours! It was almost as cheap as what I would co-pay at Kaiser. $39 for a ferritin test. The estrogen test was $99, but I didn't have a choice there.

The result? My estrogen levels were off the charts high and during a time of the month when they shouldn't have been maxed out. Who knows what they are when they're at the peak. The chart put me in a level commensurate with women undergoing IVF treatment to get pregnant. I did some research into high estrogen levels and found that this condition is actually more common than I thought in women. It can manifest itself with symptoms similar to low estrogen, but it just doesn't get as much attention. The problem is, there aren't a lot of simple things to be done for high estrogen. So, think about me having these high estrogen levels and then adding a continuous supplement of estrogen pills to that mix. Recipe for migraines? Uh, yes.

Can I rant for a minute? Wait, maybe I have been already. The reason I think that there is so little info out there about high estrogen levels is that doctors aren't testing for it. When I asked for these tests, my doctor refused on grounds that hormone levels change daily so why bother? That is a load of crap. While it is true that hormone levels do fluctuate a lot, that is not a legit reason to not test. Why not take readings at certain points in the cycle to establish a baseline for the patient in order to try to correlate these levels to better manage her symptoms? Wait, that would cost money and makes a lot of sense. Sorry, my bad.

What I found through my research is that having high estrogen alone isn't really the issue. It's typically an imbalance of the three big guys, estrogen, progesterone, and testosterone, that cause symptoms. There are clinics and whole centers designed around "women's health" that do good work along these lines. I just don't know the secret handshake to get in the door. I could, of course, pay out of pocket for these services, but I've decided not to pursue it.

This is where this post is going to be CONTROVERSIAL. When I probed more into managing hormone-related issues, I found a world that made me very nervous as a competitive athlete. I started hearing rumors of men and women taking testosterone boosting supplements to relieve legitimate symptoms associated with aging, however completely inappropriate for competitive athletes since the substances are banned. The rationale, as it is rumored, is that if it is a legitimate medical condition, then it's okay to take the banned substance. I even heard, second or third hand of course, this couched as something that would never show up on a drug test if the athlete's levels were low enough to start with. Still cheating.

So, when I thought about getting my testosterone and progesterone levels tested, I also had to think about what I would do if I found out they were low. The progesterone is easy, because it is not a banned substance. Add a dab of cream here and there, and I'm golden. Anything I took to raise my testosterone levels would almost certainly be a banned substance, and while it might make me feel better, I am not a cheater.

The issue of supplementation with substances that aren't banned, such as thyroid stimulating hormone (TSH), was recently a huge topic of controversy, and I found the discussion fascinating. There are those that say that if you can't handle the training load because your body breaks down (e.g. thyroid doesn't function), then that's just separating the men from the boys, so to speak, and you shouldn't be allowed to compete if you have to supplement. Take this a step further and you find those who say, if you can't get all your nutrition from food alone and have to supplement to train and compete, then you shouldn't be competing. That, I believe, is going too far. Should I not be allowed to take iron supplements because I happen to have a body that gets iron depleted easily with hard training?              

Where do you draw the line? Well, that's actually pretty easy. The line is drawn for us by WADA. If the substance is banned, and you are taking it. That is cheating.

Just. Say. No.

Where does this leave me? Well, my hormones are probably whacked out beyond belief, but, for once, I'm not sure I want to know the numbers right now. My body is aging but I can still train hard and compete well. I may end up going through periods where I feel super low energy, like I did the last 2-3 months, but this comes along with the role of playing the part of a woman in her 40s. The good news is, I don't have to worry about low body fat levels causing low hormone levels, which is actually quite a relief. Bring on the strength training and washboard abs!