Hello, everyone!

I had my sleeve on August 31, 2011, so I am about 2 months shy of 2 years. There have been lots of events in my life the last few months, that have added to my stress, and disrupted my eating routine, and I'd like to write a little about it. Primarily to get feedback if anyone has had a similar situation, and secondarily to put my thoughts out there into a world where people can relate.

Since I had surgery, I have had lots of time to fall into a very well planned eating and drinking routine. As a student, I have had loads of time to find what works for me, and what doesn't.

However, there were many events that took place in the month of May and June that sort of disrupted that routine. In May, I gave one of the biggest exams of my life. My appetite wasn't very good, and my calorie/protein intake dropped a bit. Following this, I was in classes from 8 to 7 for a week (also a wonky eating and drinking routine), and then I was off to India - this is where things really went downhill. I was barely hitting 50-60% of my nutritional goals, and was running around all day long.

By the end of these 2 months, I had dropped 2.5 pounds below my healthy weight range. Here's the thing, many of us might even be a little happy about going below the range, but no one wants to look sick or undernourished. Losing weight with a healthy lifestyle still leaves you glowing and energetic. I, however, looked anorexic, pale, and dull. It was seriously ridiculous, and people were commenting on how unhealthy I looked every single day.

This was new for me, because I didn't realize how easily I could become malnourished if I wasn't adequately planning out my meals. (I'm vegetarian, by the way). After coming back, there was a huge function at our house, and I was eating the bare minimum for another 2 days. This put me at 3 pounds below weight. In the meantime, the low nutrition caused a bit of muscle loss around the hips, and I started having symptoms related to a pinched nerve.

So, I started pilates and yoga classes to help strengthen my core and ease the pain. At the same time, I decided I would add some more calories, fats, and carbs into my diet, to help bring back that glow and the lost pounds. On a daily basis, I added in half an avocado, 2 pieces of whole wheat toast, and an ounce of nuts. All healthy fats and calories, no?

Well, here's the kicker. By the end of 3 weeks, I had gained back those 3 pounds, plus 1 more. 4 pounds in 3 weeks.

Yes, I'm back in my healthy range, I look well nourished, I have more energy, and no one is telling me that I look sick. I can even see the difference from the yoga. However, I am terrified at learning how easy it is for me to gain weight, even when eating healthy foods. Yes, I can convince myself that it was also easy to lose the weight, and that my body reacted quickly by replacing the lost nutrition... blah blah blah. In the end, I still gained 4 pounds with very little effort, in less than a month.

I always knew that my nutritional planning would be a lifelong process, and I have learned to enjoy it. Still, I didn't realize how quickly my weight and health could fluctuate if I did not make my intake a priority!

As a man who is married to a perimenopausal woman, I agree....it's ALL about the hormones. Oh Gawd the hormones. I have seen my wife do everything under the sun from a sensible diet, Atkins, extreme fasting, running marathons....the scale simply won't move for her.

Awe, whatever do you mean. Our hormones make us glowing rays of sunshine, don't they??

I would like to ask a question on this thread that relates to balance of hormones and shifting the body into fat metabolism. It is related to this thread topic and response above, I promise.

A lot of health stores sell a product pair called Dim and DHEA for shifting the balance of sex or anabolic hormones in men towards more optimal Protein synthesis. Dim is short for diindolylmethane and DHEA is short for dehydropiandrosterone. Long names, I know. Both hormone precursors are naturally produced by our bodies or can be extracted by the body from cruciferous vegetables such as broccoli and cabbage. Dim and DHEA supplementation works by freeing up the available "free" testosterone and reducing bad estrogen in the body in order to develop more "manly" characteristics and improved protein synthesis. Many elite athletes uses these supplements to get their body into optimal conditioned form.

I have read that DHEA can be a precursor to either testosterone or estrogen metabolites and has a certain probability of metabolizing into either. There are good forms of estrogen and bad forms of estrogen. The good form of estrogen is needed by both men and women to support the shift of body composition to more muscle rather then more fat. Bad estrogen does the opposite which causes the body to store more fat and, in men, leads to other undesirable "womanly" Characteristics. It seems like a gamble as to which metabolite is going to form after the treatment of sex hormones with DHEA. Dim is used to reduce the bad estrogen levels in the body. A lot of weight gain can come from too much bad estrogen in the body.

For men, 400-500 mg dim is recommended for increasing fat metabolism and promoting weight loss / lean muscle. Maintenance dose of dim is 100-200 mg. Recommended dose of DHEA is 100 mg.

Given my short description on natural hormone therapy above using Dim and DHEA, why would DHEA be recommended at all in combination with dim if there is a chance of the outcome being good estrogen versus bad estrogen metabolites? Why not just use a recommended Dim dose alone to increase the availability of "free" testosterone in the body. Is there a clear advantage of using both Dim and DHEA together?

From my initial understanding, the answer is no to the above questions. I would love to hear an opinion from someone else.

There is only one kind of estrogen but it is produced in multiple places in the body. The pituitary (everyone), the ovaries (premenopausal women, and a lot of it) and abdominal fat ( everyone). Estrogen can be turned into progesterone or testosterone by the body as needed. Women with PCOS / metabolic syndrome are not just Iinsulin resistant, but also estrogen resistant. Our bodies are pumping out so much of it that it causes serious health problems. But everyone needs some estrogen, just like everyone needs some testosterone.

I'm post-hysterectomy and take daily estrogen even though I'm only 35. Since VSG, I've cut my estrogen in half. If I stopped taking it altogether, my bones would become brittle, hair would go grey and brittle, and skin would quickly age. I will be on HRT until I'm in my 60s most likely. I would never depend upon "natural" sources of it though, with their unpredictable potency and absorption rates.

Edited to fix typo

Misty- thanks for the additional anatomical information with regards to estrogen (never took biology or anatomy in my formal education). Did not know the specifics about where estrogen is generated in the male, but that is practical information to know it comes from specific locations. I love that there are all sorts of people with different knowledge bases on VST in order to fill in my own knowledge base about the human body. My mind is a curious magnet for information, no matter what the subject is. Cheers!

Butterthebean and Supersweetums - thank you. *blush* I've just been lazy about the pictures... and you're right, I should definitely get some up!! I'll work on that in this next week.

Fiddleman, I would like to clarify a few points about the DHEA (I haven't learned about dim much, so don't feel confident in what I would say about it). It doesn't "free up" our body's source of testosterone, it gives the precursor to help us produce and utilize more testosterone! More testosterone = more muscle, which is why athletes use it. It does not in any way reduce the estrogen production (there is also no such thing as good or bad estrogen). Whatever metabolites are not used up in the formation of testosterone will eventually be diverted towards estrogen.

The problem with hormones is that our bodies' normal ranges are so so so small. A teeny bit below or above the normal range can wreak havoc, which is why we see so many side effects in people taking supplemental testosterone. It's hard to maintain a safe range, since everyone metabolizes the drug at a different level, and then reacts to the final product differently.

Hormones are scary in another way, as well. With certain hormones (especially testosterone), the more we put into our bodies from an external source, the less our own body produces, because we trick it into thinking there is already a huge surplus. Take a look at athletes that have been taking testosterone in high doses for a long time. They may be muscular, BUT - they will have super small testes, breast enlargement, and other undesired characteristics. If you are thinking of taking these supplements, I would discourage it.

Misty takes estrogen because her body produces less of it due to the hysterectomy, and it is essential to her long term health. For someone who has balanced endocrine levels, I would not rock the boat!

Puja- dim reduces the balance of estrogen in the body in favor of testosterone. Thanks for the information about DHEA. It being a precursor, it does not seem like consumption of this supplementation is synonymous with "taking extra testosterone." That is where I have a disconnect with your explanation (which is wonderful information).

Ok, I read up on "DIM" really quickly, and feel I should clarify something. Yes, my reading was superficial, but it was enough to understand why you may be under the impression that it reduces the balance of estrogen in favor of testosterone. Everywhere in our body, we have estrogen receptors. They react differently to estrogen, which is why giving estrogen supplements can promote certain cancers while preventing other cancers. DIM works similarly. At some points in time it may be estrogenic, while at others it may be anti-estrogenic. Of course, when something is in trial, it's hard to tell if that is based on dosage range or some other factor.

It does seem to have anti-inflammatory properties, which is good... however, I'd still be wary of supplements that alter our hormonal levels.

Coming to DHEA, I'd like to provide an analogy (I hope it makes sense!). If you are driving on the street and come to a fork in the road, there are only 2 ways to go - the left or the right. There is no other option. DHEA is the same. It either goes toward testosterone or towards estrogen. It is not stored in its precursor form. Of course, if your body produces SO MUCH estrogen and testosterone that it no longer has the ability to use the DHEA, you may urinate it out. But, by then, your hormones are already out of whack.

Here's the thing, the stuff sold at GNC or whatever may not be super strong, so I can't comment on what is or is not safe. The supplements are, however, very intelligently marketed to show the pros and not the cons. I can only comment based on my understanding of biochemistry, physiology, or endocrinology.

Please let me know if what I'm saying still does not make sense!

It makes perfect sense. Appreciate the details. I've been trying dim out for a few days, but am going to dive into some more personal research before continuing on it. No loss for me to put it aside for now. I thought it might help with reducing the fat percentage in the body so wanted to try it. If it is dangerous, no need for me to take it. I guess I get a little impatient with results that are visible in the mirror sometimes despite a lot of nutritional and strength training effort day in and day out, month after month. The prize will be worth it though. And I am not just talking about aesthetics; rather, looking forward to having big time strength and agility to be a serious compete in athletic events. This is coming from someone who has never been an athlete ever. That challenge motivates me.

Fiddleman, I think it's a great idea to do a little more research before deciding if DIM is right for you or not.

You look great, and your hard work is definitely showing!! I'm so glad to hear that your new lifestyle is giving you the drive to venture into other activities that you would have never dreamed were possible.

Has anyone here been looking into the intestional "flora" at all? Its facinating. I read something recently, and then yesterday heard a story on NPR. Here is a link. It talks about how Intestinal flora (AKA Poop) is another major organ in the body, and when it gets sick, the human body gets sick too... one of the areas they are testing is obesity. They are doing fecal transplants, from naturally thin healthy people to obese people. and getting some promising results. There are some really interesting stories here...makes a lot of sense. Probiotics and pre biotic fibers are the key.

http://www.freakonomics.com/2011/03/03/the-power-of-poop-full-transcript/

http://www.motherjones.com/environment/2013/04/gut-microbiome-bacteria-weight-loss?page=1

Fecal transplants? Now there is something you do not hear about every day. As for repairing a "sick" digestion system, there are many flora supplements out there. One that I used many years ago with success is called Dr. Floras. It is a fairly expensive product, but probably one of the better ones out there on the market.

Researchers are doing new work, looking at specific strains that are associated with different diseases. Many probiotics are good, but incomplete and the numbers claimed are often not accurate. The also said the quality of what you feed them (the microbes) is a big part of the equation... pre biotic fibers is what they call that. Some things we eat kill or injure the microbes... not to mention massive doses of antibiotics.

Fecal transplants? Now there is something you do not hear about every day.

lol! I know! The Drs that are doing the research were kind of laughing about it too... they said in this culture of almost poop-phobia, its funny looking for the words to describe what they are working with and not get a "yuck". Poop (is not just what comes out of the other end...it is also a complicated symbiotic relationship without we would die or be very sick) is mostly just the shedding of this organ. The researchers are saying that sometimes we just don't see something obvious, like washing your hands after working on a cadaver before helping a woman give birth... which was overlooked till the mid 1800's.

So they are hypothesizing that obesity may be a sickness of this organ....perhaps brought on by antibiotic use and over processed foods, and the inflammation it causes.

That is so fascinating to hear about the correlation between obesity and the inflammation of this organ. I have always known obesity and inflammation is highly correlated, but this study takes that understanding to new levels. Keep us updated!

My NUT told me that people who take probiotics lose weight better on average. I never did because i was maxed out on pills just taking vitamins but I think there is something to this.