Monday, March 17, 2014

Return to Clomid

We had a follow up with our NaPro doc on Friday; somehow those appointment always seem overwhelming. It always feels like a giant data dump, with too much to take in at once. We didn't really do anything over the weekend, which helped me work through things a little bit. Despite it seeming like a lot of information, I'll try to keep this brief.

The biggest change is that I'll be switching back to Clomid next cycle. My post peak estrogen levels have been far too low on Femara, which is the reason for the switch. I've done 9 cycles on Clomid previously when we were working with a local RE. I will be continuing the post-peak HCG. Husbandido was not thrilled about my going back on Clomid since I had so many side effects; realistically, though, the only side effect I had on Clomid that I haven't had on Femara/HCG was the hot flashes. This will be a lower dose than I was on previously(25 mg days 3-7 vs 50 mg days 3-7), so I may not have as many side effects (we can at least hope). I'll also be taking clarithromycin and flagyl for 14 days during this cycle and the next 2, in case there is still any kind of infection (still having TEBB and quite a few 2Ws during the 2WW). To counteract the disruption of the gut flora, I'll also need to go on a probiotic. He also suggested adding 200 mg CoQ10 to help improve CM. 

We'll be re-checking my vitamin D levels at my next blood draw to see if they have increased at all. Our doc doesn't check reverse T3 since it's an expensive test that not all labs can do; it also doesn't change how he treats thyroid conditions. Since everything but my anti-thyroid antibodies is normal, he feels no need to put me on anything for my thyroid. I am of mixed emotions about that one, since I do have a lot of the symptoms of hypothyroidism. 

Lastly, our doc has changed his dietary recommendations. Instead of GF, he is now recommending Paleo. After brief consideration, I told Husbandido "If you think that's what it takes to have a child, you're going to need a new wife." Fortunately for me, he is even more adamant than I am about that not being required. Here's the thing: I can understand the rationale for going GF, given the purported structural or sequence similarities between gluten and the target of the anti-thyroid antibodies. I will be waiting to see whether being GF has lowered my antibody titer, though; if it's not having an effect, then I may go back to eating gluten containing foods. I find much of the rationale for going Paleo specious; evolution did not stop in the Paleolithic era. Please note that I am not saying no one should try or adhere to this diet; I am however saying the arguments that everyone should be Paleo have not convinced me. If an individual tries it and feels better, has more energy, etc., then yes, that would be evidence that it is a good fit for his or her genetic and biophysical makeup. Is it true that most Americans consume more carbohydrates and sugars than they should? Yes. Is it likely that being aware of the glycemic index of what you eat can make a difference? Maybe. I'm coming to a point where the questions isn't "Do you want a baby?" (As Jelly Belly's foolish acupuncturist asked) but what and how much am I willing to sacrifice for a chance at getting pregnant. I'm willing to try and cut back on carbs and sugar, but there is no way I am giving them up entirely. I do have to maintain some quality of life here. Besides, there is a high probability that the medications I will be taking will make me queasy, and the last thing I want to eat when I feel like I'm going to throw up is MEAT. 

Over the weekend I had a few doubts, wondering if maybe I should try going Paleo. Fortunately Husbandido (not literally) smacked some sense back into me. 


  1. It is so hard to decided what nurtition is best for your body and which route to take. Everyone has their opinion and there are studies that confilct each other so it is up to the patient to decide. I try to limit my grains because I know that a higher protein and veggie loaded diet is best but I am not giving up my gluten free waffles no way! I think you are making the best decision you can for you at this point.

  2. Wow - sounds like a lot going on! Good luck with everything, and I hope the side effects of clomid are more manageable this time around.

    I think your perspective is great - we're not obligated to do every last thing to try to have a baby. Personally I feel best when we take it slow (i.e. at our own pace) and when it comes to nutrition, I find all the options and diets pretty overwhelming.

  3. Oh these appointments are so overwhelming. I go back next Tuesday and I'd be lying if I said I wasn't already trying to mentally prepare for it.

    I agree with Kat, do your research, evaluate how you feel and then make the best decision moving forward. I think I've told you, I'd never have stuck with being gluten-free if I didn't feel better.

    I'm praying for you as you begin chlomid. And feeling very grumpy on your behalf that you have to make this change. (((Hugs)))

  4. Wow! We're pretty similar in our treatments -- I'm also on clomid (50 mg on CD3-5), HCG injections, and now we just added a monthly antibiotic (biaxin). I mean, it's no crazy coincidence seeing that we're both IF, but I still felt very connected to you when I read we were on the same meds.

    As for the diet, I totally get where you're coming from. I'm sure willing to give things up to have a baby, but how crazy am I willing to get in terms of my diet? And especially when we never know upon starting these restrictive diets if they'll actually do the trick! It's really difficult to discern where I draw the line, but, I mean, I'm hardly good at the anti-inflamm. diet and that's after several months of trying. I cheat all the time. A cookie here, a slice of pie there. Clearly diet is not my favorite route to conception.

    Best of luck with your switch back to Clomid!!

  5. During this crazy IF journey I discovered that not only was I allergic to gluten, but I'm also insulin resistant, which has really changed my eating habits. The Paleo diet is hard to follow, especially if one has other allergies (eggs and dairy for me), so I do let myself indulge in some gf grains -- an IF girl needs cupcakes!!!

    Good luck with the Clomid!

  6. I think you'd be surprised about Paleo ;) This from the Italian girl who, after going GF discovered a dairy sensitivity and thought, "OMG, I'll never eat Italian food, again!!" I am not 100% grain-free (I was for a while, now I do some GF grains about 10% of the time or less) - but I can honestly say I am not deprived, and in fact, get SO EXCITED about meal planning and what we're going to eat NEXT!
    I don't think you or everyone for that matter needs to adhere strictly to any specific "diet" regimen - but it's the way that we approach our food and nourishment that does need attention. Paleo, to me, doesn't mean paleolithic, eating like a caveman. It means eating WHOLE foods in their natural state, the way they were supposed to be. Grassfed and pastured meats, using all of the animal (for stocks, etc.), and all of the veggies and fruits I can get my hands on. If grains are a part of the diet, natural, whole organic grains (in their pure state) and basically, no more over-processed cra*p! I don't miss it at all. (I also have a healthy dose of desserts!)
    Whatever you decide to do, I think your rationale is extremely healthy - you want your quality of life to be good, so DO NOT deprive yourself. When I first went GF/DF, I was all about the deprivation, and that was not heathy for me.

    As for the switch back to Clomid, I've seen that work very well in my office - after Letrozole with poor post-Peak numbers.

  7. It sounds like to got lots of info from your last appointment. Glad that your hubby was there with you to hear everything. I hope that going back to Clomid at a lower does goes well. I totally understand not wanting to go Paleo. I never even went GF. I guess that's because I didn't think it was going to be worth all the trouble when we also have big male factor IF. I think you are right to listen to your hubby regarding that, and just do what you can handle.