“Beautiful Banting Baby”
I really like Gabi’s story because it is simple, clear-cut PCOS. But like every other story, there’s always a twist…
I knew Gabi well, she had been my patient and friend a few years back in 2009, looking to lose a bit of weight in her early 20’s. We both lived in Mozambique at the time.
Gabi had been on the pill consistently since she was 18 years old. In early 2016 when Gabi and Hugo got engaged, Gabi decided to get off the pill as Hugo and her wanted to start a family right away. They had been dating for many years, and now they were going to get married and be a family. From the time Gabi got off the pill in January, until a few months later, when she got married in April, Gabi did not have a period. Gabi’s first period post-pill came during their honeymoon…
Once Gabi got off the pill, for the first time in her life she developed acne. Unlike most women who tend to lose weight due to nerves just before their wedding, Gabi gained 5 kg. The only possible reason for her acne and weight gain was the fact that she got of the pill. Up until then, her pill had kept her symptoms at bay.
After their wedding Gabi went to her doctor to do a check up and to express her concerns. Besides her weight gain, she had headaches, almost daily. These headaches would last days on end and she was on painkillers all the time. Her labs showed that she had increased androgen (male hormone) levels which explained the acne and missed periods. She also had abnormally high cholesterol levels. An internal ultrasound showed that she had multiple small follicles in her ovaries. She fit all 3 diagnostic criteria for PCOS: 1) abnormal periods, 2) hyperandrogenemia, and 3) PCO (Polycystic Ovaries). Gabi was diagnosed with PCOS. Her doctor talked to her about Insulin Resistance and told her that although it was not impossible for her to get pregnant, it would be more difficult. She also had a family history of Diabetes.
Like me, Gabi was a thin young woman with PCOS. Weight was not the issue. It was her insulin levels. She weighed at the time 62 kg (138 lbs) and was 1,67 m (5’6”) tall. Her BMI was 23, perfectly normal. Also like me, once she got off the pill she gained 5 kg (12 lbs) in just a few months. The pill had masked her PCOS symptoms for many years. Once the exogenous female hormones were gone, hyperinsulinemia (high insulin) took over creating an imbalanced androgen level which caused her to develop acne, fat in her belly and stop menstruating. Although she tried, she struggled to lose the weight. She felt like anything she ate caused her to retain water. She produced an abnormal insulin response to even “healthy” foods.
This is when Gabi looked for me again. During our visit she told me that she felt devastated. She felt very down and low. She expressed what I and many people feel when trying to conceive. Why did it seem so easy for others to get pregnant and so hard for her? I could totally relate to her. I assured her that this was all due to Insulin Resistance and that, through diet, we could reverse this condition. I know that she believed me. She had done her own research. She felt empowered and determined. I was happy to know that after our consult she felt much better and had a plan! I went over a LCHF (Low Carb High Fat) Keto diet with her. She was familiar with the Keto diet which in South Africa is called Banting.
After starting Keto, the next month her cycle went from 73 days to 56 days. A normal menstrual cycle comes every 25-30 days. Something else that happened after Gabi started Keto was that her headaches went away almost completely, she stopped taking painkillers and her skin cleared up. That was in the course of just a month.
After 2 months on Keto, Gabi told me she felt amazing, less bloated, much more comfortable. She finally lost some weight and she started to ovulate in between her periods. She kept on the keto diet and was cautious to stop all snacking, even on “keto friendly” foods. A this point Gabi introduced some 24h IF (Intermittent Fasting).
In January 2017, Gabi’s cycle (which was now closer to normal) was late by a couple of weeks. Out of curiosity, she did a urine pregnancy test which came out POSITIVE. Like any woman trying to get pregnant she wanted confirmation right away. She went to the lab and did a blood test. Because she lived in Mozambique, doing a lab test was as easy as driving to the lab, ordering the test, and paying for it. The test came back NEGATIVE. She was devastated. Her breasts were swollen and she had serious back and muscle cramps. Something felt different…this is not what she normally felt like before her periods. She did 2 other urine tests 2 days in a row and again, both tests were POSITIVE.
Gabi called me that day with her concerns. I too was worried. I couldn’t explain why her urine tests kept coming back positive but the lab test, which is supposed to be much more accurate, came back negative. I did not want to alarm her but I kept thinking, could she have an ectopic pregnancy? Did she have a miscarriage? What was going on? I was very cautious of what I said to her, but my gut told me that she was pregnant and I felt a sense of urgency. She had no bleeding which was good news. I tried to get her an appointment at a private clinic in Mozambique for an ultrasound to no avail. Knowing how nerve wrecking this whole process can be, I encouraged her to drive across the border to South Africa.
The very next day she was able to get an appointment in Nelspruit (South Africa) at her sister’s gynecologist. He took her in right away. They redid the blood test and did an internal ultrasound which confirmed her pregnancy. She was 5 weeks pregnant and all was well! Most likely a mistake from the lab in Mozambique. Big blunder! She was amazed! I was relieved! What a great way to start the new year, she said! She honestly thought because of the PCOS it would take much longer to get pregnant. I was 99.9% sure she would get pregnant, and quickly, and she did. Keto works! Insulin resistance is reversible. I encouraged her to keep low carb during her pregnancy, so as to prevent Gestational Diabetes and further complications. Women with PCOS are more prone to these. She did her best.
During her pregnancy she had good and bad days with the diet and stuck to it as much as possible. She had a smooth pregnancy. No nausea, no morning sickness. Check ups all normal, baby growing well and healthy.
“Beautiful Banting Baby” was born in October 2017.
Thanks for sharing your story with us Gabi and Hugo.