RED-S recovery is making me feel worse, not better — gained ~8 kg, exhausted, low HRV, amenorrhea still not resolved. What am I missing?

I'm posting because I genuinely don't know what to do anymore and I'm hoping to hear from people who have actually been through RED-S/hypothalamic amenorrhea recovery.

Background: I'm a 34-year-old woman, 169 cm, currently around 77 kg. At my fittest one year ago I weighed 63kg. I have a history of anorexia/bulimia and, afterwards, years of exercising a lot while restricting carbs. I developed amenorrhea in 2023.

Initially there was concern that I might have premature ovarian insufficiency and I was put on HRV. However, my gynecologist then diagnosed functional hypothalamic amenorrhea caused by low energy availability. She connected me to a nutritionist, whose advice was simply to increase carbs from 200g/d to 350g/d. This was my hormone lab before the intervention when I myself already started eating a bit more carbs:

FSH: 7.7

LH: 1.1

estradiol: 84.4 pmol/L

progesterone: 1.1

testosterone: 0.7 nmol/L

AMH: 1.27 µg/L

After increasing intake massively for several weeks and hitting around 2,200–2,500+ kcal and ~300–350g carbs per day my period has come back for two cycles. However, I have been feeling physically and mentally awful during this time.

My weight has gone up substantially — I'm now around 77 kg at 169 cm.

I carry considerable fat around my belly and thighs now.

No clothes fit me anymore.

I'm tired almost every day.

I don't feel like exercising.

I have no motivation to do anything.

I have various aches/pains.

I feel depressed and frustrated and have extreme PMDD.

My sleep has become poor again with an avg. Score of 70. I sleep on avg. 6-6.5h and especially dont get any REM sleep.

My HRV has been declining, it used to be 140, now its 80.

My RHR used to be 39, now its 48.

My VO2 Max. Has been on a downward spiral from 53 to now 46.

I have never felt so unfit in my lift.

My respiration rate has gone from avg. 13 to 14.

My wearable is repeatedly showing high stress.

I've had days where I take multiple rest days and still feel exhausted.

What's really messing with my head is that I seem to feel better when I go somewhat back toward my old way of eating, but then my period doesn't return. When I follow the recovery advice more strictly — more food, more carbs, more rest — my weight goes up but I don't seem to feel better.

I recently had three rest days in one week, because I was exhausted, and I still felt like things were getting worse.

Another strange thing happened recently: I had dinner, felt completely full afterwards and remained full at night. I woke at around 2 a.m. when my husband came to bed and then couldn't fall asleep for about 1.5 hours. I wasn't hungry, but I ate literally two bites of a tiny muesli bar and almost immediately fell asleep. I have no idea whether this is relevant or just coincidence.

I'm really struggling with the standard advice at this point.

I understand that the answer to RED-S is generally to increase energy availability and reduce excessive exercise. I'm not looking for permission to go back to restricting carbs or exercising excessively. But I also don't want to blindly keep increasing calories and resting indefinitely while gaining weight and feeling progressively more exhausted.

I'm at this point where I'm wondering whether something else might be going on, or if this is really RED-S whether it might be better to just go on HRT, because “eat more and rest more” seems to cause other mental and physical health problems.