Why do I face difficulty in losing weight?

Question

Hi doctor,

I am a 35 year old woman. My height is 5'3" and weight is 147 lbs. I do not have a child yet, but will be trying to conceive soon. I am a vegan and eat healthy. I workout five days a week and sometimes will go for a 3 miles runs around two to three times a week as well. I went off my birth control pill about three months ago and have not had a period since. I was diagnosed with PCOS when I was 15, but after going vegan two years ago, doctor said it definitely helped with symptoms. I have been eating right and working out for the last three months, and my weight has not budged. In fact, it seems I have gained numbers on the scale. Three months ago, I was 139 lbs. Is there anything in my report that could be the reason for not being able to lose weight or abdominal fat? Is there anything in the infertility test portion that could indicate the issues in trying to conceive? I would like to get a professional advice on my blood work results. I am mainly looking to find out if anything on here can indicate infertility or difficulty in losing weight. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through the reports (attachment removed to protect patient identity).

The only evident abnormality is low vitamin D levels, which need to be improved. They do have a role in maintaining a healthy ovulation, follicular growth and also a healthy bone mass maintenance. The FSH (follicle stimulating hormone), LH (Luteinizing hormone) and progesterone levels are corresponding to the ovulation phase of the cycle and hence normal. The testosterone and DHEAS levels (Dehydroepiandrosterone) are also well within limits, being the insulin and sugar levels. So, definitely the PCOS - polycystic ovarian syndrome effect has decreased. However, considering that you have been on birth control for long it is likely that withdrawal bleed gets delayed. But, as it has already been three months you must opt for a withdrawal bleeding with progesterone to restart your menses. Considering the estradiol and insulin levels being normal, the weight can be further controlled naturally by reducing at least 100 calories further per day. You need to take 4-5 quarts of water daily for adequate hydration and for normal functioning of reproductive hormones. Presently, vitamin D supplementation with 60K IU per week for four weeks should be undertaken. You should opt for a withdrawal bleed considering suppressed progesterone levels of 0.2 at present. Consult your specialist doctor, discuss with him or her and take the tablet with consent.