My Struggle with Hypothalamic Amenorrhea (HA). How I got my period back.

If you follow me on Instagram you may have noticed my post last week where I welcomed back my monthly visitor (this is what my grandmother would say) after a 10-year absence. I’ve kept pretty quiet about my struggle with HA. To be truthful, admitting my illness made me feel like an imposter and a fraud. How could someone whose job and life revolved around helping women find and nourish their own fertility be infertile and unhealthy herself?

I’ve helped countless women in my nutrition practice regain their cycles and balance their hormones. I’ve also supported hundreds more in my job as a midwife though their pregnancies and in the early months postpartum. Yet here I was, no period, no cycles, in fact, I had hormones in general (aside from cortisol). Sick, tired and at my wits end something had to give.

 

How did I lose my cycle?

 I lost my cycle 10 years ago directly following the sudden death of my fiancé. I was in a busy midwifery residency, which on it’s own was stressful, but when I lost my partner I had to find ways to cope that would allow me to feel like I had some sort of control over my life and simply keep going.

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I’ve always loved mountain activities like rock climbing, backcountry skiing and trail running. So, while in the final years of my residency, I took it upon myself to stay as “fit as possible” ,  to enable myself to enjoy the sports I loved and be fast and strong enough to keep up to all my mountain guide and professional athlete friends. The thing was, I wasn’t a professional athlete, I was staying awake for 30+ hr stretches regularly catching babies and instead of sleeping and resting to recover I would run 15- 30km. While this genuinely did feel GOOD, it resulted in over exercise, under fuelling and a general lack of relaxation in my life.

Some people call what happened to me a “female athlete triad”, but essentially what it means is you are sending your body the signal that all is not well. You force it to go into a state of self-preservation. With a lack of fuel and an abundance of stress hormones (like cortisol, which is produced during excessive exercise and a hard job where you often don’t sleep), your body prioritizes survival and shuts down reproduction because it fears that a pregnancy would not be able to be sustained.

 Sometimes tragedy can be a blessing in disguise 

Sometimes tragedy can be a blessing in disguise 

            In October 2016 I had another terrible climbing accident that left me in a cast for 8 weeks and kept me away from midwifery for almost 8 months. Although I tried to exercise during this time, being in a cast and in terrible pain forced REST on my body. I also experienced regular predictable sleep, for the first time in 12 years. I ate the same but overall, my calorie deficit was reduced and my body’s hormonal systems WOKE UP! I started to have all the symptoms of PMS (sore breasts, cramps, bloating). My body was starting to grow ovarian follicles, which produced precious ESTROGEN. This surge of estrogen stimulated my body to start holding onto body fat again.

 Get psycked to buy new clothes...and belts:) For the record, I'm now ANOTHER jean size larger than I was here and I give zero fucks about it. 

Get psycked to buy new clothes...and belts:) For the record, I'm now ANOTHER jean size larger than I was here and I give zero fucks about it. 

Over the course of 8 months I gained about 15lbs and went from a body fat of 16% to 24%. My body did this despite any modifications in my diet and despite my resumption of a high level of activity. My body wanted to survive and heal. For most women to regain their cycles they need to overshoot their previous weights and body fat percentages by an average of 5 lbs and 3-5% hitting a new “set point “ of sorts. It’s worth noting that a fertile BMI ranges anywhere from 21-24 and fertile body fat % ranges from 22-26%. If you’re below this, I’m sorry to say, but 90% of you will have to gain weight to regain your cycle.

Recognizing that my body was taking charge of it’s own health and fertility, I finally decided to pay attention and support my body’s valiant efforts to recover a cycle, hormonal health and my own precious fertility.

How did I do it?

There are lots of ways to get your period back. Some things will work better for others but these are the things that worked for me.

Get properly diagnosed

Hypothalamic amenorrhea isn’t something you should “self diagnose”. It could me a symptom of a much bigger issue. Approach your primary care provider and find a good functional medicine specialist to work with you to diagnose the cause of your lack of period. Here are the tests you should be asking for:

1.     Blood Hormone Levels: Estradiol, progesterone, LH, FSH, testosterone, cortisol, prolactin and b-HcG. Most women who have HA have: Low estrogen, low to absent progesterone, low LH, low FSH, low testosterone, high cortisol.

2.     Thyroid hormones: TSH, T3/T4, TPO antibodies, Reverse T3

3.     Blood nutrient levels: B12, Vit D, Iron and ferritin

4.     DUTCH urinary hormone panel. This is a GREAT test that I did and I now offer to patients. It helps diagnose problems with hormone pathways and tests for not just hormones but also hormonal metabolites

5.     Ultrasound: To check for excess cysts (when combine with high testosterone this may indicate PCOS) and test for uterine thickness.

 

Diet:

1.     Move less and eat more: Reduce and aim to eliminate your caloric deficit. If you need help calculating your calorie and nutrient needs you can use an online calculator.

 Never restrict when recovering. This organic vegan chocolate ice cream (with magic shell) was a key part of my recovery :) 

Never restrict when recovering. This organic vegan chocolate ice cream (with magic shell) was a key part of my recovery :) 

2.     Don’t restrict any macronutrient: You need carbs, fats and proteins to be healthy and produce hormones. Trust me I tried everything (low carb, high carb, keto, high protein)  but in the 3 months preceding my period returning I found that I was intuitively eating a balanced diet of about 33% fat 33% protein 33% carbs

3.     Eat clean, well-sourced, organic and nutrient dense foods: These are better absorbed and will cause less stress in your body. An anti-inflammatory diet is best. If you need help finding the best diet for you, send me a message. 

4.     Let go of foods and drinks that may cause stress to your body: While I’ve never been a big caffeinated coffee drinker thanks to a CYP1A2 enzyme gene) one of the biggest things I did was give up coffee (opting for organic Swiss water process). If you suspect food intolerances or if your digestion isn’t top notch, I’d encourage you to work with a practitioner to tease out what could be triggering your symptoms. All forms of stress should be eliminated in the body. I recently started working with a woman who lost her cycle and regained it by dietary modifications alone! It’s an important piece to the puzzle.

Exercise:

Move less: You’re going to have to mellow out a little bit or a lot. While some women have to give up exercise 100%, honestly, I didn’t completely. Much of the research I’ve come across suggests that giving up exercise completely (aside from short gentle walks and yoga) may help your period return faster but what really makes a difference is having a higher percentage of body fat sustained and maintained over multiple months. This sends signals to your hypothalamus that there are enough resources available to sustain a pregnancy.

How you choose to get there is up to you. But seriously, have a solid look at your workout routines and ask yourself if they support your body and goals or are causing more harm than good.

 Sometimes the best activity is  rest  and spending time with the people you love

Sometimes the best activity is rest and spending time with the people you love

Supplements:

I’m a firm believer in “smart supplementation”. I don’t like to over supplement and I think that there is no real one size fits all approach to adaptogenic or hormone balancing herbs. If you’d like help finding what may work for you please send me a note. I was continually testing my hormone and nutrient levels using DUTCH testing and blood analysis to ensure smart supplementation. Here’s what I tried and here’s what you can try too.

1.     Vitamin C: Supports your body’s response to stress

2.      Magnesium: Supports progesterone levels and reduces stress

3.     Acetyl L-Carnitine: Supplementing with acetyl-l-carnitine (ALC) restarted menstrual cycles in 40% to 60% of women with HA in two studies. This compound has been shown to affect serotonin, dopamine, and beta-endorphins, reducing the impact of those molecules on the hypothalamus resulting in higher luteinizing hormone (the hormone you need to ovulate). This did seem to help me.

4.     Maca root: This seemed to boost my estrogen levels and accelerate fat gain. For me, I think it caused a state of estrogen dominance and increased my bad estrogen (yes there is good and bad kinds). I’d use this adaptogen with caution. See how it goes for 3 months and re-evaluate.

5.     DIM: I treated my estrogen dominance with DIM. This compound found in gassy veggies like broccoli and cauliflower helps promote healthy levels of good estrogen and clears unhealthy bad estrogen (as long as your liver is strong). This may only work if you’ve already increased your estrogen levels by increasing your body fat levels AND you have maintained a higher body fat for at least 3 months.  Please don’t try this unless you’ve put on a healthy amount of weight.

6.     Calcium diglutamate: This supports your livers processing and clearance of hormones. 500mg is best for most. 

7.     Vitex- If you lose your cycles it may be due to an increase in a hormone called Prolactin. If it’s high, Vitex may work for you. This wasn’t the case for me but I tried it anyway ;) 1000mg is best for most. 

8.     Probiotics: A healthy gut is a cornerstone of a healthy hormonal system. Alternate strains regularly for a robust microbiome.

9.     Sustained Release T3: After years of HA and a high stress job, my Reverse T3 levels were sky-high. Taking a sustained release T3 (prescribed to me by my naturopathic physician) helped me clear my high RT3 and was the final missing piece to getting my period back. Please ladies, have ALL your thyroid levels checked (TSH, TPO antibodies, T3/T4 and FT3). It can be a game changer.

Lifestyle:

1.     Learn to say no:  Over the past year, my blog hasn’t gotten as much attention. I’ve been taking more time to myself to really focus on getting well. Sometimes you just have to simplify. Have a good look at what you can say “no” to in your life and just say “no”.

2.     Sleep your ass off:  Your body is stressed and in a negative energy balance. Sleep is the MOST effective way to recover and rebuild. If you have struggled with insomnia and poor sleep while you’ve had HA, many women find that once you put on some body fat you’ll sleep like a baby again. I certainly did.

3.    Stress less: I’ve taken up a solid meditation practice. It only takes 10 min each day and has changed the way I think, feel and even breathe.

4.    Care for yourself. Get a massage, spend time in nature, Netflix and chill …..if it feels good do it and make sure you do it every damn day.

5.    Acupuncture:  Give it a try, there are several studies that support its use for both stress reduction, hormone balance and fertility. I found it uber helpful.

Coping with your changing body:

1.     Buy new clothes: seriously, tight clothes are such a huge trigger and for me totally ruined my day and made me feel so bad about myself. Sell your tiny sized clothes and use the money to buy some well fitting duds. Most women, myself included, go up 2 sizes when recovering.

2.     Change the way you think about your body.: This one is hard but essential. Your body is trying to survive. It’s trying to get back into balance and be healthy. Resist the urge to pinch your fat or have negative thoughts when you see your body change…..instead, just witness it. Your body is the vessel for your soul. It’s beautiful and dynamic. This is temporary and is the birth of a new normal. If you can’t think of anything positive to say, simply try to witness your body changes without judgment. Be like Switzerland and stay neutral.

3.     Say, “Fuck it” to what people think (including yourself): This needs no explanation. You’re getting healthy; I think you’d be surprised to find that most people, if they understood what you were doing would look at you with admiration not criticism. Often times we are our own worst critics. So perhaps we really need to say “fuck you” to our own self judgment.

4.     Join a support group.:There are countless online forums and FB groups for women coping with the same things as you. Reach out, you’ll be surprised to find that you’re not alone. Ask for help from your loved ones. Reach out. You're not alone! 

This is just my journey. I'm always happy to share. Everyone's journey is their own. If you need support or help, feel free to send me a message

 

Take a chill pill....The importance of stress reduction for fertility

Squeaky clean paleo diet- check

Engage in daily gentle movement- check

Take all your supplements- check

Are a healthy weight- check

Why on earth are you still struggling to get pregnant? Well, the answer may be the one thing that is the hardest to truly change.....stress and how we manage it.  

Stress can be a good thing in moderation. A little burst of cortisol (stress hormone) helps to fire up our engines so we can run away from a lion or wildebeest (my personal fav). But, when this sort of stress and resulting cortisol release becomes chronic, unrelenting, day in and day out stress, our bodies don't cope quite so well. When this happens we start producing a hormone called alpha- amylase. Alpha-amylase has recently be discovered as a bio-marker for chronic sympathetic nervous system activation. AKA a signal that you're mind and/or body are chronically stressed out. AA has been formerly used as a way to diagnose pancreatitis or pancreatic inflammation. The geek in me finds this fascinating because when we are stressed and living in a chronic sympathetic dominant state our pancreas has to work overtime producing insulin in response to elevated blood glucose levels. When we are stressed and exerting a high level of cortisol our bodies naturally increase our blood sugars in order to mobilize energy in our skeletal muscles so we can make that mad dash away from the wildebeest. 

Recent studies have confirmed the link between stress and infertility. A few different studies measured these two hormones, cortisol and alpha-amylase. They demonstrated that while cortisol has no effect on infertility, women with high alpha-amylase had nearly double the risk of infertility. This makes perfect sense if you think about it from an ancestral perspective. Fertile women need to be able to run away from possible dangers every once in a while. A healthy cortisol response signals a fit and thriving individual. What we DON'T want is a woman who is chronically stressed. Chronic stress sends signals to our body that our world is a really dangerous place out there and isn't a safe space to raise a new little baby. The body is smart and wants to survive....so, it shuts down your ability to conceive. 

What can you do if you're feeling chronically stressed out? Here are a few tips:

 Erin Urton...practicing what she preaches...and looking simply beautiful in the process   

Erin Urton...practicing what she preaches...and looking simply beautiful in the process

 

  1. Try to sleep or rest more. Sleep is how we tell our bodies it's safe to recover. Try to get more.
  2. Practice yoga or meditation. Even 5 mins a day will make a difference in terms of your response to stress. Need a launching pad? These short guided meditations will help you on your way and feature the beautiful Erin Urton who is an expert in fertility, pregnancy and postpartum meditation and yoga practice. 
  3. Lighten up on the caffeine. Did you know that just 200 mg of caffeine (one 12 oz mug of coffee) increases blood cortisol levels by 30% in one hour! Switch to herbal tea or decaf while your body resets and recharges.
  4. Move gently everyday. I don't mean hard stress inducing crossfit WODS. I mean walking outdoors, cross country skiing, hiking and gentle weight lifting. These things are all proven to lower your body's stress response and help you chill out. 
  5. LAUGH. Surround yourself with people who love and support you and lighten up. Have a good time
  6. Give. The process of giving back helps to elevate your mood and support the body's natural ability to heal. The holiday season is a perfect time to get started on this one! 
 Gently moving in nature has remarkably restorative properties. 

Gently moving in nature has remarkably restorative properties. 



How to Balance Your Hormones- Paleo Styles

My friend Erin Urton from Tuja Wellness, finding her balance in Zion a few years ago. 

Balance.  We all desire it and yet so many of us struggle to find it! It can be complicated, like a good relationship, as well as mystical, like the snuffleupagus. When it comes to optimal female health, fertility and wellbeing finding a healthy hormone balance is critical.

How do you know your hormones may be out of balance? Well if you suffer from sleep disturbance, fatigue, unexplained weight gain or loss, acne, irregular menstruation, infertility, PMS or have been told you have PCOS, then you suffer from a hormone imbalance. 

Meg the Paleo Midwife's suggestions for helping to improve your hormone balance

1. Limit Caffeine: Remember my Bulletproof post last week? Caffeine can be great for a healthy individual, however, if your body is under stress it can wreak havoc on your delicate adrenal system. The adrenal glands produce the stress hormone cortisol in addition to sending messages to your pituitary gland. It's your pituitary gland where the hormones LH (leutinizing) and FSH (folliclie stimulating hormone) are made. These two hormones are critical for egg maturation and ovulation, which are key parts of getting pregnant. If adrenals are depleated, hormonal imbalance can occur. Choose herbal tea or decaf or half-caf coffee instead.

You cand find these awesome chips here! They do online ordering too. How did I figure out how to include chips in a post about hormones? Can you see the irony? Ha ha

2. Avoid high Omega-6 Polyunsaturated fats: These are mostly found in vegtable oils like canola, safflower, sunflower or soybean oil. Avoiding these fats is a key part of the Paleo diet as they cause inflammation and easily oxidize in the body. Inflammation contribues to endocrine/hormone balance and can cause disruptions in the bodies natural cycles. The easiest way to avoid them is to read labels and ask what kind of oil is used in restaurants!  They linger in chips (even sweet potato chips) and packaged foods. Choose fats from animals like butter, ghee or lard in addition to non-animal fats found in olive and coconut oils. Need to satisfy your chip craving? These will do it and keep you healthy! 

3. SLEEP: Sleep really does fix everything. If your body isn't getting the rest it needs then it isn't getting a chance to repair and produce its own natural hormones. Not getting sleep affects your hormones viat two main pathways. The first is via the pituitary axis. Not only does the pituitary glad produce LH and FSH (see above) it also produces GH or growth hormone. This hormone is responsible for repair and rejuvination in the body. The second main way sleep contributes to hormone balance is with the simulation of your parasympathetic nervous system. This is the system that tells your body to chill out! Most endocrine (aka hormone) organs in your body need good parasympathetic 'tone'. There are several well documented examples of sleep deprivation effecting pancreatic insulin secreation and the release of leptin from fat cells. Leptin is an appetite-suppressing hormone. Sleep deprivation also effects your thyroid gland and it's overall function. All key things to help you look and feel your best.  If you have trouble sleeping developing a few rituals around bedtime can help. Here's a link to a great article about sleep hygiene. 

4. Exercise intellegently:  Running marathons and doing 5 hard WODs a week does not improve hormone function! Exercise just hard enough to challenge your body but not so hard that it can't recover. When you work too hard you stimulate an overwhelming release of cortisol, which tells your pituitary that you're stressed! Most bodies can do this for a little while but in the long term your body gets the signal that maybe this isn't a great time to be fertile and bring new little cavebabies into the world!

Gentle cardiovascular activity done early in the day and feel enjoyable are key (late day workouts can harm sleep) . Many people enjoy hiking, walking, swimming or biking. A bonus, exercise done outside also helps improve your mood, vitamin D levels and overall sense of wellbeing!  Lifting heavy weights 2-3 times a week can also help trigger a cascade of benifical hormone responses that can be ideal for hormone balance. 

This list changes anually so be sure to keep up to date. 

5. End your relationship with toxins: Choose your organic produce wisely. Using a guide like the dirty dozen and clean 15 can help you make budget friendly choices. Try to buy local, organic or pasture raised meats and eggs when possible.

It's not just what we eat that can effect our hormones. It's also what's in our homes, cars and offices. Limit exposure to things like plastics (BPA), non-stick/teflon cookwear and read labels on your skin care products and cleaning supplies. You'd be surprised where toxins can linger. Choose natural skin care products that don't contain hormone disruptors like parabens. Consider using homemade cleaners like baking soda, vinager and soap. You'd be surprised how effective these can be! .

Eat your Boogers, Spanish Sunshine and Reflections on Motherhood

Hold the phone! It's May and I've totally fallen off the wagon with blog posts. It's been a busy spring here in Midwife land....I've caught a lot of babies recently and even squeaked in a week- long climbing trip to Spain (I wish I could have stayed a month!). While I work on a more intelligent post, here's a few things of things that have caught my attention lately. 

Mark Sisson's Post on "How to Establish a Healthy Gut in your Primal Baby ".  I've talked about this before but gut bacteria is a passion of mine! This is a good overall summary. I especially like the research about letting kids eat their boogers :) I knew there was a reason EVERY kid does this...hilarious

Megan Over at Detoxinista shares a great guide to help you get started with cloth diapers. I don't usually recommend them in the first few weeks when mom's are deprived, babies are clearing out all that sticky black meconium and it's just best to keep things easy. But, after the first few weeks, cloth is a great option and good investment especially if your planning on having a few more little paleo babies in the years to follow. 

This post on Mind Body Green is a beautiful reflection on what Pregnancy can teach you and how your changing body be a vessel for finding inner peace and acceptance. In celebration of Mothers Day today, check this article out. 

Finally, I connected with a lovely friend who is one inspirational woman! She flew from France to Spain to meet us for a few days of climbing. She flew by herself,  with a 4-month old baby and only carry on luggage (my packing hero!). Her baby was also insanely adorable!



Food and Feelings: The Effects of Gut Microflora on our brains and babies

Thank you for all your kind emails. I get so amped up and totally inspired by all your questions. I try my very best to answer each one, but these days it's been tough. I'm a bit run off my feet getting my midwifery practice re-established, buying my first house and trying to find some time for a social life..maybe even a love life too (?) 

 Still trying to find time for a little bit of ski time play....my paleo friendly sandwich during this ski day had fermented pickles in in :) 

Still trying to find time for a little bit of ski time play....my paleo friendly sandwich during this ski day had fermented pickles in in :) 

With this insane schedule, I've had to work hard to keep myself healthy. Recently I've added fermented foods into my daily routine. I'm happy to report that I've noticed big changes in my immune function, gut health and even my mental wellbeing.  I've been consuming daily doses of Kombucha, kimchi and raw kraut and find that my body just can't get enough of this good stuff!   I firmly believe in the amazing power of probiotics and am fascinated by all the kick-ass research coming out about the effects of gut micobotics on both our physical and emotional selves.  

 In a spontaneous moment of nerdy pleasure this week, I came across a recent journal article that looks at a phenomenon called "developmental programming". This fascinating theory explores how environmental influences early in an organisms development affect an organism's later structure, and function. More specifically, this theory examines the effects of gut microflora and early colonization on human development. Most of the early data indicates that gut microbiota may have systemic effects on liver function. This raising the possibility that gut microbiota can and most likely does, have developmental effects in other organs elsewhere in the body.....like the human brain.

How does bacteria get into our guts in the first place?

Good question! I'm glad I asked :) 

Before we are born, our guts are sterile, a.k.a free of all bacteria. It is the process of birth that starts the colonization process.  A recent article in the Canadian Medical Association Journal  found that the mode of delivery significantly impacts the types of bacteria found in our guts. For example, babies born vaginally have significantly more of the health promoting Escherichia-Shigella and Bacteroides species while babies born by c-section have significantly more c.difficile bacteria. C. difficile is associated with increased risk of asthma, obesity and type 1 diabetes.

So how does this affect our brains if the bacteria is in our bums?

The human brain is suceptible to cues from both internal and external sources especially during the period of  infancy when it undergoes most of it's growth and development. Some studies have indicated that there is a possible link between common neurodevelopmental disorders, such as autism and schizophrenia, and microbial pathogen infections during the perinatal period. Animal studies have show that exposure to microbial pathogens during early developmental periods result in behavioral abnormalities, including anxiety-like behavior and impaired cognitive function. Interesting stuff! 

 I'm no microbiologist...but this is pretty cool

I'm no microbiologist...but this is pretty cool

Our bellies are filled with neurotransmitter receptors for tryptophan, serotonin and GABA (AKA all the feel good chemicals) ...just like our brains. This is the reason that the gut is often called our "second brain".  So if these neurotransmitter receptors exist in our bellies....how does the health of our bellies and bacteria that colonize our guts effect our happiness?? 

Well....cliffhanger...I don't have all the answers..but it would stand to reason that if our guts help produce many of the chemical compounds that affect mood patterns in the brain, it could significantly contribute to our overall happiness and wellbeing. Perhaps overly simplified...but hey...simple is good. I'm so pumped to learn more about the science behind this all. 

" Oh man...I had to have a c-section. Does this mean my baby is at risk? "

Paleo Mama's, if you required a c-section for medical reasons don't play the blame game! Mama guilt is the worst....fear not....these things can be fixed and here are a few good places to start: 

 

BioGaia-ProTectis-droppar.jpeg

Bio Gaia - From a swedish company, this baby friendly probiotic will help support the development of beneficial bacteria in your babies little belly. 

Therbiotic Infant- Another great probiotic formula that can help optimize an infants gut colonization.

Breastfeed- Breastfed babies are have greater colonies of good bacteria. Breastmilk contains natural probiotics in addition to  large amounts of prebiotic oligosaccharides. Preboitics help support the healthy growth of beneficial bacteria in the belly. 

Further Reading:

Human Microbiome Project 

Daily Beast Article 

Chris Kresser Podcast Episode

 

To Crossfit or not to Crossfit: Part 2

“Meg the Midwife's” suggestions for working out ‘Paleo-styles’ during pregnancy

 

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1- Listen. Listen to your body’s wisdom…really listen…if you are unable to listen then stop doing crossfit. This sounds harsh but it’s important. There are so many of us  “A” types (I totally include myself in this group) running around doing burpees and pull-ups when pregnant. The name of the game during pregnancy is to grow a new life, not to expose a six-pack or set a new PR. Your healthy baby and chilled out body is your new PR. So please, if it hurts, don’t do it. If you’re really tired that day, take a break. Do some light yoga or meditate; you’re doing lots of hard work just growing a new life. This is especially important in the first trimester when your placenta is embedding itself into your uterine wall. As the placenta becomes established, it anchors itself with spiral arteries that connect it directly into your circulation. These arteries supply your baby with oxygen and nutrients. If your body is constantly moving blood away from the uterus to fuel your muscles for a 'Fran' workout , these vessels may not develop in the most optimal way. The take away message: A healthy placenta equals a healthy baby. 

2- Nourish your mind, not just your body: Ask yourself this question every day...."Is my workout nourishing my body AND mind ?" Are you stressed?  If so, take a break. Prolonged fetal exposure to high levels of maternal cortisol (the stress hormone) have been shown to affect a child’s IQ and cognitive performance. High levels of stress may also contribute to low progesterone levels. Low progesterone in the first trimester puts you at risk for miscarriage. Stefani Ruper from the Paleo for Women has a great post about stress induced low progesterone that's worth checking out! 

3-Scale: Be sure to properly scale your workouts. Check out crossfit mom for proper scaling suggestions. Join a crossfit mom’s group. No class at your gym, ask if you can start one! It’s a great way to connect with other pregnant and postpartum mom’s in a supportive environment. Balance your crossfit workouts with lots of long walks or hikes in nature. Being in nature has been shown to improve mood and overall wellbeing. Check out Mark's post here for more reasons why we should spend more time in nature. 

4- Chill out: Try to incorporate some sort of relaxation, meditation and muscle relaxing component to your workouts. Gentle restorative prenatal yoga and hypnobirthing meditations are great choices. Practice releasing, rather than engaging your pelvic floor muscles. The Spinning Babies site is one I recommend to many of my clients. The side-lying exercise found here, can be especially helpful if you're a crossfit athlete, runner or cyclist and may have some muscular imbalances in your pelvic floor.

5- Refuel:  If you're working out be sure to refuel your body with lots of filtered water (I like this filtration system) and healthy nutrient dense paleo or primal meals. 

 Recipe for a healthy Paleo Pregnancy Fitness Plan

2x Crossfit mom's/week

Lots of walks or hikes outside in nature

A healthy pinch of yoga

A sprinkle of daily meditation 

Remember, these are all just suggestions based on what I’ve learned from hundreds of women. You are your own best coach, so tap into your body’s inner wisdom and connect with what it needs. Happy trails!