Wednesday, December 29, 2010

WOW (edited)

For those of you who are following the vitamin D3- AMH story, here is the latest.

3 weeks ago, I was in the deficiency/low range for both Vitamin D3 and AMH.
Vitamin D3= 16 ng/ml, AMH= 1.1 ng/ml.

The low AMH sparked off an avalanche of fears about diminished ovarian reserve. Then I took gigantic doses of Vitamin D (60000 IU weekly) for 2 weeks

Then I gave blood again,  and tested both Vitamin D3 and AMH.
Vitamin D3 = 70 ng/ml (perfect) and most amazingly AMH= 5.18 ng/ml  (high and now in PCOS range)

Overall, a four fold increase in AMH levels (going from 'low fertility' to 'optimum fertility' in the lab classifications), which I found just incredible. Its always possible the first lab really messed up the test, but I think that there is really a fair chance (based on the study I posted about) that AMH went up because Vitamin D did. Anyway, I've let the group at Stanford studying this know and maybe one day a formal study might be launched. 

Right now, the primary emotion is  massive relief that I'm not dealing with a case of low ovarian reserve here.

Interestingly, my testosterone levels also changed dramatically, they went from being fairly high in the Vitamin D deficient state to being low after my deficiency was corrected.

Currently, my theory (derived from combining very few facts with a lot of speculation and intuition) is that my problem could be two-fold,  first low vitamin D3 (found in about 40 % of cases with PCOS ) and a possible undetectable issue with insulin resistance, which could be addressed with metformin.

Other than the now corrected Vitamin D deficiency, my only PCOS parameters are lots of antral follicles and now high AMH and slightly high DHEAS- The million dollar questions are:
1)  is this messing up egg quality and thus responsible for my two losses?
2) Is it tied to sugar metabolism and be fixed by metformin?

I have a very strong family history of type 2 diabetes (practically everybody in my father's side develops this), though I could find no indication whatsoever of insulin resistance in me. But still, metformin has been shown to help even when there is no overt insulin resistance. Nothing is a sure-fire fix. Last time I attempted conception I was praying the thyroid hormone would be the magic fix I needed. The next time, I will be hoping its all of this.


  1. Interesting. We're all looking for the magic bullet, right? I really hope the Stanford group decides to study it!

    Have you tried using a home diabetes kit to check your blood sugar for insulin resistance?

  2. I don't understand any of this but I'm confident that it's good news.

    Fingers crossed for you!

  3. Very interesting. I hope you're right.

  4. That is fascinating. I hope that Stanford does follow up with a study. Glad to hear your AMH is back in the normal range!

  5. @ C- I've had my blood tested for insulin resistance, my fasting glucose levels are perfect and my insulin levels are low. In other words, no overt insulin resistance whatsoever- the opposite in fact, I actually have insulin sensitivity.

    But it looks like that there can be some issues with glucose metabolism even when there is no insulin resistance, and women with PCOS with no insulin resistance have been helped by metformin.

  6. Wow Jay.. you are your own advocate. I can't believe you discovered all these findings by yourself. You should get an honarary MD degree.

  7. Isn't being a scientist awesome like that? I'm also hoping this is part of the magic bullet that fixes the problems you're having. All this stuff together is the big picture stuff that I think Drs often miss... Hopefully with your thyroid issue being "resolved" and now this everything will come together.

  8. I am eager to get back to work and check my vit D levels :)

    We use pmol/L here for AMH so I had to convert your results, by my chart you have only just sneaked into the high range (if you were 29 or under your 5.18 ng/mL would be considered normal). I'm really interested in how quickly you saw a rise in AMH.

    What maintenance dose of vit D are you going to take? We routinely treat people with (or at risk of) low bone mineral density at 50000IU per month without regard to their pre-existing (or subsequent) vit D levels, this is considered a reasonably safe maintenance dose and not likely to result in hypervitaminosis (in otherwise well people). I am going to consider this for myself.

    My AMH converts to 2.38 ng/mL which at 40y puts me at the upper limit of normal for my age group (and I don't have any clinical PCOS indicators). I suspect my AMH doesn't need boosting, but I am interested in vit D's potential effects on egg quality...or implantation.

    Thanks for the research Jay and good luck with this. When is your next fertility treatment?

  9. Well, about the AMH, I think different labs have different cutoffs. According to the testing lab, I'm in the 'optimal fertility' range. They say they regard only AMH of over 6.78 in PCOS range. But I'm going by this article, which says 3-5 is 'high normal' and anything above 5 is considered in PCOS range.

    With regard to supplementation, I took 60000 IU per WEEK so I guess its not too surprising my values jumped up like that. I think its a good idea to tailor your dose to your blood level. I'll be interested to see what your levels come up as, let me know!

    I get practically no sunshine and its not going to be helped by the fact that I'm moving from sunny California to NYC in a month, so I need a larger dose for maintenance. I'm going to take 3000 IU/day and then recheck in about 2 months to see if this is maintaining the value above 50 ng/ml.

    I'm not going to be attempting anything for several months now, for many reasons :(

  10. this is so cool!!! i think we are really in a very similar situation. i haven't had my Vitamin D tested, but I recently got AMH back and it was high. and i was put in metformin a few months ago and am loving it. its helped my skin immensley! no baby yet, but hoping that it will help in my upcoming IVF cycle... so here's the deal w/ metformin for me.... prior to taking it, my fasting glucose was borderline high and my good cholesterol was a bit too low (signs of insulin resistance, right?) after 3 months, fasting glucose was back down in the normal range, and good cholesterol shot up 12 points! amazing. i think it really is helping. i hope that you find the magic combination... and ps.. you sound like me... very scientific and analytical on your research. i don't write about it a lot in my blog, but its mostly what i concentrate on. i'll be following your story!

  11. Thanks for the link. I have based my AMH status on an Australian fertility clinic's research (of 800+ women) at varying ages. It's in pmol/L, but does show an interesting range (chart is on last page of this .pdf).

    I'll let you know when I get my vit D result. I am also out-of-the-game for a while, but for different reasons :(