The Endocrinologists Are Thrilled!

I had my three-month followup with Dr. Fellow and Dr. Ovary this morning.  Since they were the ones who put me back on the low-carb diet to begin with, I knew I wasn’t going to get hassled about diet.

By their scale I have lost 11 pounds, versus the 14 that my own scale measures.  But anybody who’s ever been overweight knows that about the secret line in the Hippocratic Oath that requires all doctors’ scales to be off by 3 pounds.

After quizzing me about a lot of stuff, Dr. Fellow drew the conclusion that a lot of my PCOS symptoms have already cleared up (PMS, hirsutism, acne), and it’s beginning to appear that my menstrual cycles are getting more regular.  Although three months isn’t enough to establish a trend, she did mention that the three month mark is where carb restriction and weight loss start to show a benefit, at least in clinical trials.  So I should keep keeping records for a few more months.

She and Dr. Ovary both wanted to know exactly what I’ve been eating, so I gave them my usual spiel - no grains, starchy vegetables, caloric sweeteners, or fruit juice.  A little fruit, mostly berries.  Varying amounts vegetables, tomatoes, onions, peppers, and other high-fiber, low- to moderate-carb veggies.  No liquid milk, though I do eat cheese, plain yogurt, and cream.  I gave up caffeine two weeks ago when I started noticing symptoms of low blood sugar / high insulin after consuming it.  Very few artificial sweeteners.  Nuts.  The only cooking fats in our house are olive oil, butter, and coconut oil, plus rendered animal fats like bacon fat, and the occasional bottle of nut oil.  And of course, meat, fish, poultry, and eggs.

I’m so used to doctors thinking this diet is going to kill me, I felt a slight anxiety after sharing this list, even though these were the doctors who prescribed the diet.  “Well,” said Dr. Fellow, “I know what to tell my other patients.”  Well, then.

We briefly discussed metformin as a treatment for PCOS.  I said, “I’m not sure what your position on glucose tolerance tests is, but if I were to start a drug that increases insulin sensitivity, first I’d want some measure of my current insulin sensitivity.”  They seemed receptive this, though they both noted that if I keep on the path I’m on now, I’m unlikely to need metformin.

I have to go back in six months, at which point, if I have been able to maintain my weight, or even lose more, and my menstrual cycles are fairly regular, I’m discharged!  Woo hoo!

By the way, this seems to me to be almost unheard of in America - two doctors, one widely recognized as leading expert in her field, the other her fellow, at a prestigious teaching hospital affiliated with an even more prestigious university (let’s just call it “the local Cambridge school”) treating patients with nutrition and lifestyle changes rather than drugs.  The tide is turning, however slowly, and so far, of all the doctors I’ve seen, I think the endocrinologists are the only ones who get it.  Maybe when all of us who are fortunate enough to see endocrinologists start showing up in our primary care doctors’s offices with lowered weight, lowered blood pressure, improved blood lipids, clearer skin, better digestion, and fewer mood disorders, the medical profession as a whole will catch up with the endocrinologists.