Supplements for Hypothalamic Amenorrhea
Supplementation for HA recovery is extremely valuable, but how do you know what to take?
In this article I will go through what I recommend to the vast majority of my clients. Remember I’m not your doctor and a professional opinion on your situation is crucial to ensure you’re getting the support you need and not over-consuming anything.
The reason these supplements come up a lot with my clients is because our modern diet is typically deficient in these and many of my clients are also wanting to prepare for conception at the same time. In general, if you want a healthy, optimized menstrual cycle I find these to be effective recommendations.
Fish Oil/Omega 3
I recommend fish oil to all of my clients almost all of the time. It’s been a while since our eggs were maturing fully and releasing, and fish oil is known to help with egg quality as well as other symptoms that I see regularly in women with HA: joint swelling and brain function along with a myriad of other symptoms.
Let’s look more closely at fish oil to help you understand why it’s a powerful tool in HA recovery:
Omega-3 fatty acids have been a part of the human diet for millennia in many cultures. They are polyunsaturated fatty acids found in the form of triglycerides in fish, algae and plants.
The most beneficial substances, DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), are mostly derived from fatty fish like salmon, mackerel, eel, and sardines and algae.
Up to 97% of the brains omega-3 fatty acids are DHAs, which makes the substance crucial for brain health and development (especially memory and reaction). EPA on the other hand is responsible for positive emotional function of the brain. In practice I find that women who do supplement with fish oil are also reporting these improvements.
Omega-3 fatty acids have proven to be extremely beneficial for:
cardiovascular health (lowering blood pressure, decreasing triglycerides and abnormal cholesterol levels, preventing blood from clothing) many of which symptoms show up in the blood levels of women with prolonged amenorrhea
general pain and swelling of joints and curbing inflammation in the body which are common symptoms especially in women who are athletes or have recently began recovery
fatty liver disease (not induced by alcohol consumption)
healthy kidney function
menstrual cramps and period pain – I often see this is women who have recovered but on a poor diet
symptoms of rheumatoid arthritis
healthy pregnancy and brain and eye development of babies (especially DHA)
Supplementing with a normal, low dose (300-600 mg DHA+EPA and 1100-1600 mg ALA) is considered safe and consistent use is associated with improved egg quality, embryo morphology, and birth outcomes (higher pregnancy and live birth rates).
Electrolytes: Sodium, Potassium, Magnesium:
Electrolytes are substances that are electrically charged when dissolved in liquids. These trace elements contribute to specific biochemical functions in the body and are found in our body water, urine, blood and sweat.
Electrolytes are responsible for water distribution in the body, regulation of the acid-base balance of the blood, and transmitting electrical stimuli between muscle and nerve cells.
Symptoms of a lack in electrolytes can be: high blood pressure, arrhythmia, nausea, constipation, chest pain, cramps, muscle fatigue, paralysis, lethargy, confusion, behavioral change, headache, and in extreme cases, loss of consciousness. (food sources: dark chocolate, avocados, almonds and brazil nuts, legumes, tofu, seeds, whole grains, …)
The best sources of electrolytes are table salt, whole grains, mineral water, electrolyte drinks, nuts, whole grains, meat and fish, eggs, and even avocados..surprise surprise, a whole-food diet.
Some of the most relevant electrolytes are:
Sodium occurs in the body as a positively charged particle – especially outside the cells. It contributes to the build-up of electrical voltage at the cell membranes and is therefore important for the transmission of nerve impulses, heart rhythm, and muscle function.
Sodium is also of great importance for the distribution of water in the body. Sodium plays a role in the regulation of the water balance due to its high water binding capacity (osmotic activity).
Furthermore, sodium is involved in the regulation of acid-base balance and blood pressure. Although it is said to contribute to high blood pressure, it is vital in bodily functions. Water consumption influences the sodium levels and even moderate fluctuations in its concentration in the body (from dehydration or drinking too much water) can lead to disturbances in the transmission of nerve impulses.
Note that if you have a highly processed diet, which is common when people use the “all in” method of recovery, you are unlikely to need to supplement with sodium. If you’re recovering on a whole food diet as many of my clients are, supplementation with all the electrolytes is necessary.
The daily intake of sodium should not exceed 2300 mg per day.
Potassium influences multiple biochemical processes in the human body, including kidney function, bone health, cardiovascular health, hormone secretion and action, vascular tone, gut motility, and glucose and insulin metabolism. It helps the walls of blood vessels to relax and loosen up and thereby prevent high blood pressure and associated heart problems. It is often used in combination with diuretics, because the kidneys are responsible for potassium excretion. (food sources: yam, dried apricots, milk, chocolate, almonds, potatoes, bananas, avocado, …)
It is recommended to aim for 3500 mg of potassium per day.
Magnesium is another crucial mineral that plays an important role in human body functions. Depending on the type of magnesium (oxide, sulfate, citrate, malate, L-threonate, …), it helps with sore muscles and cramping, constipation, trouble sleeping, bone health, stabilizing blood sugar levels, or brain function.
If you consider yourself very busy, tense or struggle with any of those symptoms, magnesium will be important for you.
The ideal dosage of magnesium is 310-420 mg per day.
Beef Liver
I have almost all of my clients on beef liver. Here’s the thing: if you have had HA and furthermore if you’ve been on the pill for a good amount of time, you’re nutrient deficient in some way. This doesn’t mean you won’t get a period, but it will put you ahead of the game with better period symptoms (i.e less cramps, acne etc) and help you to have better pregnancy outcomes because pregnancy steals many of the vitamins and minerals from your organs and bones. Taking beef liver will help to replenish and fortify your body after all it’s been through.
Liver is the most concentrated source of nutrients including essential amino acids, healthy fats, vitamins and minerals. It contains significant amounts of Omega 3 (both EPA and DHA), vitamin A and all B vitamins, minerals like iron, copper, phosphorus, zinc and selenium, and it is a good source of coenzyme Q10. The iron in liver can be much better absorbed and used by the body than iron from other sources. Compared to muscle meats, liver holds between 10 and 100 times more (depending on the animal) nutrients.
The recommended amount is 100-250g per week. It can be prepared fresh as a meal, or consumed as a supplement in the desiccated form in capsules, which, for a lot of people, is more palatable.
Adding liver or a liver supplement to the diet can be beneficial for:
hormone health
the immune system
blood quality
bone and tooth health
energy production
But there are also risks associated with the over-consumption of liver. Eating too much liver is hard to do, it’s very potent and you only need a small amount each week but if you are really in to liver (for some reason) and eat too much you might be at risk of vitamin A toxicity. The true risk however is actually in the synthetic form, so check your multivitamins for synthetic vitamin A. Eating too much vitamin A in its natural form is much harder to do and not something to worry about. I am adding this in because it’s a very common concern I hear.
Overconsumption of synthetic vitamin A can cause liver damage, vision problems, skin changes, pressure on the brain, or bone pain. This stuff is POTENT. Especially pregnant women should be cautious with synthetic vitamin A or over consumption of beef liver, because a high intake of vitamin A has been linked to birth defects. Again, if you’re eating that much liver, you should be studied. That’s wild.
Since liver is a detox organ, another common concern is that it contains and stores toxins. However, the liver processes toxins so they can be safely removed from the body.
Many brands are good, I use Grassland Nutrition and you can get 10% off at the checkout with HASOCIETY.
CoQ10
CoQ10 is a nutrient naturally produced by the body and is located in the mitochondria and in extramitochondrial structures. It is a free radical scavenger and functions as an antioxidant.
Most healthy people naturally have enough of the nutrient, yet there is evidence that adding more (with a specific diet or supplements) may be beneficial, especially since levels decrease with age.
The substance is found in organ meats, fatty fish, whole grains and nuts.
There is a wide range of benefits for CoQ10. It may:
prevent heart disease
reduce the risk of diabetes
improve symptoms in people with Parkinson's disease
decrease the frequency, severity and duration of migraines
improve egg and sperm quality and therefore pregnancy rates
enhance physical performance
Studies have shown that it stabilizes membranes and protects DNA from damage, which can prevent tumor growth cells.
Bioavailability of CoQ10 differs according to pharmaceutical formulation, so choosing the right kind of supplement is crucial. A typical daily dose is 100-200 mg, but it can be upped to 1200 mg.
Side effects of CoQ10 may be nausea, diarrhea and heartburn and it can interact with thyroid medication and blood thinners.
I don’t recommend this standard with everyone, it typically is something I bring up after prolonged years with HA and a long time spend on birth control.
Seaweed/Kelp (Iodine Natural Form)
Seaweed/kelp is an algae found on the Japanese and Korean coast. It has an ideal nutrient profile and therefore a wide range of therapeutic and nutritional benefits. Besides iodine and iron, it also contains calcium, folate, potassium, magnesium and vitamin K.
Iodine has a wide range of health benefits as it contributes to:
optimized thyroid health
controlling diabetes
increasing mental function
prevention of anemia
supporting metabolism and energy levels
protection against radiation poisoning
Studies have shown that Japanese, who have a diet high in iodine, live an average of five years longer than people in the US. Furthermore, breast cancer mortality rates were three times higher in the US than in Japan, and infant deaths were over twice as high in the US as they were in Japan. All of this is said to be related to the Japanese high intake of seaweed and iodine.
Most of the foods consumed nowadays are very low in iodine, this is why supplementing with seaweed is the best way to get dietary iodine.
The content of iodine in seaweed varies widely, depending on the species and environmental factors. The highest iodine content can be found in Kombu or sugar kelp. Kelp can be used to flavor soups, in or as salads, or as flakes to season meals.
The recommended intake for adults is 150 mcg per day (220 mcg when pregnant, 290 mcg when breastfeeding)
Overdosing on iodine can lead to thyroid disorder and should not be taken by people with hyperthyroidism. Another concern with the consumption of kelp is its heavy metal content. It contains aluminum, cadmium, arsenic and lead, especially when harvested from industrial areas. However, the amounts normally consumed with food are not enough to cause problems, as they stay below toxic levels.
Again, don’t bother with supplemented iodine without the advice of your doctor. Seaweed snacks are a good idea or you can take the desiccated beef liver capsules with kelp, which is what I do (use HASOCIETY at check out for 10% off)
Conclusion
Using supplementation along with a full, whole food diet with sufficient calories is helpful when we’re coming up out of a nutrient deficient state. I always recommend whole food natural supplements like the ones listed above as a foundation to build upon. Getting tested for extra peace of mind is recommended. Remember, this is a blog post and I’m not your health practitioner.
I could be, though!
Learn more about recovery and period coaching with us here.
References:
Omega-3 / fish oil
https://www.sciencedirect.com/science/article/abs/pii/S1568997218302179
https://www.tandfonline.com/doi/full/10.1080/10408398.2018.1425978
https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000038493.65177.94
https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/
https://www.brain-effect.com/magazin/dha-epa
Electrolytes: sodium, potassium, magnesium
https://www.nature.com/articles/1001955
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400604/
https://www.cerascreen.at/blogs/gesundheitsportal/elektrolyte
https://doi.org/10.1093/ajcn/nqab153
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181280/
https://www.webmd.com/diet/foods-rich-in-potassium#091e9c5e815af466-2-6
https://ro.co/health-guide/types-of-magnesium/
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0180067
https://academic.oup.com/ajh/article/15/8/691/143851?login=true
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000937.pub2/full
Beef Liver
https://www.doctorkiltz.com/beef-liver-supplements/
https://www.paleo-britain.co.uk/liver-our-most-nutrient-dense-superfood/
https://www.healthline.com/nutrition/why-liver-is-a-superfood#TOC_TITLE_HDR_7
https://www.webmd.com/diet/liver-good-for-you
https://www.medicalnewstoday.com/articles/beef-liver-nutrition#risks
https://www.consumerlab.com/answers/desiccated-beef-liver/beef-liver/
https://chriskresser.com/natures-most-nutritious-superfood/
CoQ10
https://doi.org/10.1017/jns.2021.39
https://link.springer.com/article/10.1007/s10787-021-00817-8
https://doi.org/10.1016/j.mad.2021.111521
https://health.clevelandclinic.org/what-is-coq10/
https://www.mayoclinic.org/drugs-supplements-coenzyme-q10/art-20362602