A plant-based diet is incredible at lowering blood pressure, reducing your risk of heart disease, decreasing your risk of cancer and improving your mental health and well being. Eating plant-based can help improve your gut health and improve your immune system and reduce inflammation. Plant-based diets can lower cholesterol and stabilize blood sugar levels.  Not to mention that plant-based diets are good for the environment and animal welfare. 

If we all ate more plant-based, millions of human lives would be saved from chronic disease annually. And millions of animals would be saved from the cruelty of factory farming. 

However, that does not mean that plant-based diets are perfect. There is no such thing as a perfect diet. If you are an omnivore and eat like many American’s, you are putting yourself at a higher risk of heart disease, cancer and diabetes. But if you eat a strict plant-based diet you may be at risk for some nutrient deficiencies that can also cause harm.

That is why here at plant-whys we have always preached a 90/10 approach. Because there is value in all foods–even meat, dairy and processed foods! And sometimes a little bit of those foods can help not only your physical health, but also your mental health. 

One of the amazing aspects of plant-based diets is that you are generally eating less calorie dense foods. This is great if you are like many Americans and overweight. Eating plant-based can help you lose weight without counting calories or going hungry. But the problem is that for a small percentage of women who are naturally thin and are at childbearing age, if you add a plant-based diet and excessive exercise, plus stress because of young motherhood or work, then you may be at a higher risk for Hypothalamic Amenorrhea. (loss of a period) 

What to do When You Lose Your Period on Your Vegan or Plant-Based Diet?

EAT MORE CALORIES:

One of the important factors for many women with Hypothalamic Amenorrhea is eating enough calories. When you lose your period due to an energy imbalance, increasing your energy intake is very important.

If you have already lost your period, then it is important not just to eat enough calories, but you may need to overeat. You need extra calories to heal and repair the damage caused by not eating enough calories previously.  You can definitely do this on a vegan or plant-based diet simply by eating more calorie dense foods. However, as many plant-based foods are less calorie dense, this can be a struggle.

Nutritional rehabilitation is an important part of recovering your menstrual cycle. This means flooding the body with as many building blocks for repair as possible. Nutrients that can be difficult to obtain and absorb in a vegan diet include iron, zinc, B12, calcium, vitamin A (retinol) and vitamin D.

Under stress or excessive exercise, our bodies use some nutrients at a much faster rate than usual. Yes, it is possible to eat a well planned vegan plant-based diet which meets all of the recommended daily amounts. Supplementation is key. Which is why I recommend taking a plant-based vitamin (I love the brand Wholier–Use code ALISIA25 for 25% off) However, even though supplementation can help, we don’t have control of our internal processes. Often hormonal imbalance and compromised digestion go hand in hand. If your digestion is poor, you can’t be sure you are benefitting from all of these nutrients.

EAT LESS FIBER

It may be that you need to be eating LESS fiber rich foods if you are trying to nutritionally rehabilitate. Aim for around 20-30 grams of fiber a day, and try not to go over. It may be that you need to cut down on cruciferous vegetables, raw vegetables, low sugar fruits, nuts and seeds. Then once your body is healthy and your period is back you can consider adding in more fiber rich foods slowly.

ADD SALT

Plant-based diets are naturally low in salt which is great if you have high blood pressure. But if you are already a healthy individual, not getting enough salt could actually give you dizzy spills. You may not be getting enough electrolytes–especially if you also drink a lot of water. Drinking too much water can actually flush out your electrolytes. Iodine is also an important nutrient that can be lower on a plant-based diet. Try to buy and use salt with iodine and eat plenty of sea vegetables when possible. 

REDUCE YOUR STRESS AND EXERCISE LESS

Yes, I said it. You may need to exercise LESS. Exercise, especially difficult workouts, actually creates stress in your body. Which is a good thing and helps you build muscles, endurance, improves your heart rate, etc. But while you are healing and especially if you want to recover from Hypothalamic Amenorrhea you need to rest and reduce your stress. This is even more important if you are feeling chronically sore from your workouts, or are a cardio junkie. These are signs your body is feeling stressed and overloaded.

You don’t have to stop exercising, but rather choose workouts that don’t trigger your sympathetic nervous system. Instead choose to go for walks, dance, do yoga, or even a relaxing pilates class. 

EAT MORE OF THESE FOODS:

As I mentioned before, nutrients that can be difficult to obtain and absorb in a vegan diet include iron, zinc, B12, calcium, vitamin A (retinol) and vitamin D. That does not mean that omnivore diets are therefore perfect. In fact most omnivores aren’t getting enough of many nutrients. In fact 92% of Americans have a vitamin deficiency. 50% of Americans are deficient in vitamin A, vitamin C, and magnesium. More than 50% of the general population is vitamin D deficient. And 95% of Americans are not getting enough FIBER!

According to the CDC and the U.S. Department of Agriculture (USDA):

• 9 out of 10 Americans are deficient in potassium
• 7 out of 10 are deficient in calcium
• 8 out of 10 are deficient in vitamin E
• 50 percent of Americans are deficient in vitamin A, vitamin C, and magnesium
• More 50 percent of the general population is vitamin D deficient, regardless of age
• 90 percent of Americans of color are vitamin D deficient
• Approximately 70 percent of elderly Americans are vitamin D deficient

There are lots of reasons for this. Processed and fast foods are a staple food in this county and are very nutrient poor. Plus, only 1 in 10 Americans are even eating the minimum 5 fruits and vegetables a day. Furthermore, multiple studies, dating back to 1936, have found that the soil of farmland around the world is deficient in micronutrients, which therefore lower the micronutrient content in produce. 

In 2003, Canadian researchers compared the data of current vegetable nutrient content to data from 50 years ago. Their findings showed that the mineral content of cabbage, lettuce, spinach, and tomatoes had depleted from 400 milligrams to less than 50 milligrams. 

Overall, most Americans would benefit from eating MORE, not less plants. We simply aren’t eating enough, and the fruits and vegetables that we are eating now are not as nutrient rich as they were hundreds of years ago. Does that mean we shouldn’t be eating them? No, quite the opposite–we need to be eating more of them. 

However if you are struggling to get a regular period, you may have to temporarily eat more of the following foods:

ORANGE JUICE

Orange Juice fortified with vitamin D. (preferably right after a meal so it doesn’t spike your blood sugar) Dairy milk, plant milks, and some orange juice are fortified with vitamin D. But in order to absorb vitamin D, your body needs calcium. There is a debate on whether your body can absorb the fortified calcium in plant milks as well as it can absorb naturally occurring calcium in dairy milk. But the calcium in fortified orange juice has been found to be absorbed as easily as the calcium in dairy milk. 

ADD MEAT SPARINGLY

Add meat to your diet once or twice a week. Fish like tuna and salmon contain vitamin D (make sure the salmon is wild caught to avoid antibiotics). Though tuna is very nutritious, it is high in mercury compared to other sources. Sardines, oysters and beef liver are also nutrient rich and great options if you can stomach them. You could also try taking beef liver supplements if the thought of eating liver grosses you out. 

Your body needs iron. But there is a Goldilocks zone when it comes to iron, especially heme iron. Heme iron can promote oxidative stress, leading to subsequent cell apoptosis and cell death. Diets high in iron make you age faster. High doses of iron may lead to increased peroxidation of lipids (a process involved in atherosclerosis), protein modification, and DNA damage (increasing your risk of cancer). Basically heme Iron comes barging into your body, and too much of it can cause harm in the form of chronic disease. 

Non-heme iron however is more polite. It needs an invitation from vitamin C to be absorbed into your body. For most people this is a good thing. But if your iron levels are too low, this can add to your risk of losing your menstrual cycle. 

Adding in heme iron rich foods occasionally can help restore you to normal levels. These foods include oysters, clams, mussels, beef or chicken liver, organ meats, canned sardines, and beef (as well as poultry in lower amounts). You can also supplement with iron, but adding in a small amount of animal sources with your supplementation can help.

Remember vitamin C increases absorption of both heme and non-heme iron absorption. A half cup of orange juice is enough to increase iron absorption, other sources are any citrus fruit, bell peppers, strawberries, tomatoes, white potatoes, and fresh broccoli. 

Because zinc is also needed to restore menstruation, adding in foods like oysters, beef, eggs or chicken occasionally can help. Other good food sources are beans, whole grains, and nuts.

*A note on phytates or phytic acid that is found in grains, beans and nuts. Many claim that they can reduce mineral absorption (like zinc and iron).  And yes, studies show that it can reduce mineral absorption in a single meal. But studies have also shown that when grains, beans and nuts are habitually eaten as part of one’s normal diet, the effect that phytates have on reducing absorption is greatly diminished to a non-significant level. 

Phytates found in nuts, seeds, legumes and grains should not be avoided. Phytic acid binds to iron and reduces lipid peroxidation which is a good thing. Lipid peroxidation is part of the process that leads to atherosclerosis (heart disease). And phytic acid also helps pre-cancerous cells die, a process called apoptosis.  We don’t want to avoid eating beans, nuts, seeds, and whole grains just because of the phytic acid or “anti-nutrients” they contain. 

EAT DARK CHOCOLATE 

Adding in a moderate amount of minimally processed, high quality dark chocolate may help improve menstruation. It is high in fat which can be beneficial to absorb certain fat soluble vitamins and nutrients. Aim for chocolate that is at least 70% cocoa. This contains more natural fiber, iron, magnesium, zinc, and copper. Chocolate is a powerful source of antioxidants. 

ADD BLACK STRAP MOLASSES

Molasses has a great mineral profile, providing iron and calcium in particular. Drinking 1-2 tbsp of molasses in hot water with lemon can be a great strategy to help boost iron levels and recover from iron deficiency.

TAKE YOUR MULTIVITAMIN

B12 is needed to form red blood cells and DNA. B12 is produced by bacteria, not animals or plants. Animals, including humans, must obtain it directly or indirectly from bacteria. Before modern technology and sanitation, humans naturally got it by being exposed to bacteria laden soil, plants, or drinking untreated water. Many farmed animals received B12 by being exposed to bacteria laden manure or drinking untreated contaminated water. Some ruminant animals like cows and sheep absorb B12 produced by bacteria in their own digestive system. 

Currently, farmed animals receive b12 by eating supplemented feed. In our modern food supply the only “natural” source of B12 is from animals who have been supplemented with B12. So if you don’t eat meat, you need to get B12 from a supplement directly. 

DHA: Algae oil is a plant-based source of EPA and DHA, two omega-3 fatty acids that are essential for health. Fish contain these same omega 3’s but all fish, whether wild or farmed, get their omega 3 content by eating algae. Algae oil supplements are found to be nutritionally equivalent and work the same way as fish in your body.

While eating fish has nutritional benefits, it also has potential risks. Fish can take in harmful chemicals from the water and food they eat. Chemicals like mercury and PCB’s can build up in their bodies over time. If you choose to eat fish, make sure to do so sparingly. And everyone can benefit from supplementing with Algae oil.

(I love taking my Wholier plant-based vitamin. Use ALISIA25 to get 25% off!)

IN REVIEW

Remember, just starting to add a multivitamin might not bring your period back right away. You may need to restore depletion by nourishing first, and then continue your plant-based diet with a muti-vitamin after your period has returned. Here are some tips to help restore menstruation for those who have lost their period after eating a plant-based or vegan diet:

• Eat more food and calories overall and listen to true hunger cues
• Cut down on intense exercise and only walk or practice yoga or easy pilates
• Drink less water and add more iodized salt to your diet
• Include more calorie dense plant based foods like starchy root vegetables (potatoes, carrots, parsnips) as well as breads, avocados, nuts and seeds. 
• Be careful not to go overboard with fiber. Decrease your fiber intake to 25-35 grams a day. (Only 5% of Americans are getting to 25-35 grams a day, no need to go over that)
• Drink orange juice to help with vitamin D absorption
• Eat meat sparingly to help improve depleted iron and zinc levels
• Add in saturated fat and other nutrients in the form of dark chocolate
• Consume molasses and lemon to help with iron levels
• Regularly take a multivitamin

CONCLUSION

We have to be very careful not to become too reductionist when trying to sort out healthy food choices from unhealthy food choices. There is no perfect diet. All diets will be deficient in some type of nutrient. Overall a plant-based diet is best for human, animal and planetary health. However, a plant-based diet doesn’t mean vegan, and occasionally you may need to add in some animal foods to improve your nutrient levels. 

There are a myriad of ways food interacts with human physiology. It is important to look at studies that focus on actual health outcomes and not single mechanisms. End outcomes like how long people tend to live or what’s their risk of disease show you more about the effects food has on our bodies over time. The net outcome is more important than a single nutrient or mechanism. It is vital to focus on large scale multi decade cohort studies that look at plant based foods and their association with outcomes we care about (like the biomarkers that predict disease risk or change the risk of disease incidence). When you focus on these studies you find that overall the intake of more plants, not the intake or more animal foods, increase your lifespan.  

Only a very small number of Americans follow a plant-based diet or even the national dietary guidelines with any type of success. How can we blame the dietary guidelines or a plant-based diet if very few people actually adhere to them? Obesity in the United States has been steadily increasing for over 100 years. No recent dietary guidelines, or fad diet has ever changed that. The real problem is that we are swimming in a sea of nutrition confusion with constant marketing of hyper processed foods, lack of nutrition education, and very few people cooking meals from home. Carbs or low fat diets aren’t the problem. The real problem is that we are not eating enough whole plant foods. Randomly controlled trials show that when individuals switch from a standard American diet, towards the governmental dietary guidelines, their health improves and risk of early death decreases. But unfortunately only 1 in 10 Americans are even reaching the minimum guidelines of eating 5 fruits and vegetables a day. 

If you have currently lost your period after switching to a plant-based diet, it may mean that you need to make a few adjustments and add a little animal products or specific nutrients over time. It is also important to reduce your stress levels and consume more calories over all. Over time once your menstrual cycle has returned and your levels have improved, you can continue with a more strict plant-based diet with regular supplementation. Remember, it is a Goldilocks zone, and everybody is different. A strict plant-based diet for a woman in her 50’s going through menopause can significantly improve symptoms and help reduce weight gain, while that exact same diet for an exercise loving, stressed out woman with small kids in her 30’s may contribute to Hypothalamic Amenorrhea. You have to find what kind of plant-based diet works best for you, for the stage of life you are in. 

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