It’s easy for us to chalk up fatigue to regular day-to-day tiredness. But, if you have polycystic ovary syndrome (PCOS) and are constantly experiencing fatigue, it might be surprising for you to learn that there's a connection between PCOS and fatigue.
Numerous factors contribute to chronic fatigue, and given our busy lifestyles, it's often an underestimated symptom of PCOS. The good news is you can fight fatigue with a couple of dietary changes, supplements, and lifestyle tweaks.
If you find yourself constantly exhausted, it's worth exploring the root behind your PCOS fatigue and finding ways to manage it.
Does PCOS Cause Fatigue?
While the exact cause of PCOS and fatigue is complex and not fully understood, several factors are known to contribute to it. Let’s chat about ‘em.
Insulin resistance is common in PCOS, and it happens when the body's cells become less responsive to the effects of insulin.
Insulin resistance contributes to fatigue. When cells can’t access glucose, their function is compromised, and the body’s metabolic processes slow down. With insulin resistance, your body may over-produce insulin after eating a high-carb meal, which is then quickly followed by a blood sugar crash and extreme fatigue.
Hypothyroidism is a condition that affects some folks with PCOS.
Hypothyroidism symptoms include weight gain, fatigue, slower cognition, and irregular periods. The overlap in symptoms between hypothyroidism and PCOS is striking.
Hypothyroidism has been suspected to be more common in those with PCOS. In fact, a 2013 study found that 27% of women suffering from PCOS had thyroid-damaging antibodies in their systems.
If you suspect that you have problems with your thyroid, ask your doctor for lab tests (T3 and TSH) and a physical exam of your neck.
Your adrenal glands sit on top of your kidneys and produce stress hormones that are essential to life like cortisol, adrenaline, DHEA-S, and testosterone.
In adrenal PCOS, these hormones, especially DHEA-S, are found in elevated levels in the body. High cortisol and DHEA-S cause PCOS symptoms like fatigue, irregular periods, acne, and unwanted hair growth or hair loss.
If stress, mood swings, fatigue and sleep problems are recurring for you, this could be a sign of adrenal fatigue PCOS.
The focus for managing this is to balance cortisol and reduce DHEA-S levels to within normal limits through a reduction in caffeine intake, stress management, and anti-inflammatory foods.
Building a PCOS-Friendly Diet for Energy
As a Halifax nutritionist specialized in women’s health, many of my clients ask me what to eat for PCOS fatigue. Building a PCOS-friendly diet that addresses fatigue involves making mindful dietary choices that keep energy levels stable, manage insulin resistance, promote adrenal health, and support your mental health.
If you want individualized PCOS fatigue treatment, consult a registered Canada dietitian with experience in PCOS.
However, here are some general tips:
Emphasize Complex Carbohydrates
Choose complex carbohydrates, which release glucose into the bloodstream slowly. This helps prevent rapid spikes and crashes in blood sugar levels. If you have PCOS and you get tired after eating, a blood sugar spike and crash is the likely culprit.
Complex carbs - choose often
Simple carbs - choose less often
Whole grains, legumes, vegetables, fruits
Refined sugars, sweets, desserts, soda, processed foods
Choose Lean Proteins
Including protein in meals can help slow down the digestion and absorption of carbohydrates, leading to more stable blood glucose levels after eating. Again, this prevents blood sugar crashes that lead to energy crashes.
Protein-rich foods can also increase feelings of fullness and satiety, which may help control appetite.
Protein intake should be spread evenly throughout the day – don’t wait until dinner to hit all your protein needs! You should include a source of high-quality protein with each meal. Otherwise, your energy levels will suffer.
High-quality sources of protein include:
1. Lean Meats: Chicken, turkey, lean beef, pork, and game meats.
2. Fish and Seafood: Salmon, tuna, cod, shrimp, and other types of fish and shellfish.
4. Dairy Products: Greek yogurt, cottage cheese, milk, and cheese.
5. Plant-Based Proteins: Legumes (beans, lentils, chickpeas), tofu, tempeh, edamame, quinoa, nuts, and seeds.
Healthy Fats are Essential
Fats can slow down the digestion and absorption of carbohydrates, leading to more stable blood glucose levels after meals. Like protein, fats also provide a feeling of fullness and satiety, which can help control fatigue.
Healthy fats are also anti-inflammatory and support the absorption of important vitamins for PCOS fatigue.
Some of our tips for making better fat choices are:
Limit intake of saturated fats by cutting back on processed and fast foods, red meat, and full-fat dairy foods. Try replacing red meat with beans, nuts, skinless poultry, and fish whenever possible, and switching from whole milk and other full-fat dairy foods to lower fat versions. Plant-based milks (like soy milk) are also great options.
Eat one or more good sources of omega-3 fats every day—fatty fish, walnuts, soybean oil, ground flax seeds or flaxseed oil
Opt for cooking methods that require less added fat, such as baking, roasting, grilling, and steaming.
Key Nutrients for Battling PCOS Fatigue
Maintaining adequate levels of B12 is integral to sustaining energy levels. PCOS medications like metformin and select birth control pills can interfere with the absorption of Vitamin B12.
If you experience strong mood swings, tiredness, and sensations of numbness or tingling in the extremities like arms, legs, fingers, and feet, get checked for a B12 deficiency.
You can obtain B12 from supplements, meats, fish, shellfish, egg yolks, milk, and fortified plant milks.
Iron deficiency anemia causes sluggishness and profound fatigue. Women with PCOS often have iron deficiency due to heavy and irregular menstrual periods. Consult your doctor to have your iron levels monitored.
You can obtain iron from meat, fish, legumes, fortified foods, and supplements.
Antioxidants protect our cells from oxidative damage by free radicals. Oxidative stress can contribute to inflammation and cellular dysfunction, which are factors that might worsen the symptoms of PCOS, including fatigue.
Good sources of antioxidants include:
Colorful fruits and vegetables (berries, citrus fruits, spinach, kale, bell peppers)
Nuts and seeds
Meal Planning and Lifestyle Tips
To help reduce the effects of PCOS and fatigue try the following tips:
Balanced Meal Structure
Aim for a balanced distribution of macronutrients (carbohydrates, protein, and healthy fats) in all your meals and snacks. As alluded to above, this can help stabilize blood sugar levels and provide sustained energy.
Also, aim for regular meals and snacks spaced throughout the day to maintain steady energy levels, prevent extreme hunger, and keep blood sugars stable. You should eat something every 3-4 hours and avoid going longer than 6 hours without eating.
Have you downloaded my PCOS-friendly snack freebie with 15+ healthy snack ideas yet?
While it might seem straightforward, ensuring you get enough sleep plays a significant role in managing your fatigue levels.
When you consistently sleep for less than 5 hours, your body produces cortisol from the adrenal glands, leading to a temporary increase in blood sugar levels. This surge in blood sugar provides an energy boost for coping with stressful situations – it's your body's defense mechanism. But in the long run, it contributes to insulin resistance, weight gain, and adrenal fatigue.
To minimize cortisol release and prevent spikes in blood sugar, aim for 7 to 9 hours of sleep each night.
Keep in mind, though, that quality of sleep is just as crucial as quantity. Restful and uninterrupted sleep allows your body to go through essential sleep cycles, including deep sleep and rapid eye movement (REM) sleep, both of which contribute to overall health and well-being.
Improving your daytime habits can have a positive impact on your sleep quality at night. Here are some things you can do during the day to promote better sleep:
Get exposure to natural sunlight during the day, as it helps regulate your body's internal clock and improves sleep-wake patterns.
Avoid consuming caffeine and nicotine in the hours leading up to bedtime.
Avoid heavy meals and spicy or acidic foods close to bedtime, as they can cause discomfort and disrupt sleep.
Practice regular relaxation techniques such as meditation, deep breathing exercises, or yoga to reduce stress and promote a more peaceful mindset before bedtime.
While short power naps can be refreshing, avoid long naps during the day, as they can interfere with nighttime sleep.
Limit your intake of fluids in the hours leading up to bedtime to reduce the need to wake up for bathroom trips during the night.
Hydration is an important component of PCOS fatigue treatment.
Dehydration can negatively affect cognitive function, including concentration, memory, and decision-making. This cognitive impairment can lead to mental fatigue and difficulty staying focused.
Drink water regularly throughout the day (8 cups per day) and adjust your fluid intake based on factors like activity level, sweat rate, weather conditions, and individual needs.
If you consume caffeine, do so in moderation.
Excessive caffeine intake, especially after noon, can disrupt sleep and contribute to fatigue. Caffeine also stimulates your adrenals to produce more cortisol.
Incorporating daily physical activity is not only good for mental health and heart health but it also helps lower blood glucose levels and boosts your body’s insulin sensitivity.
Choose an activity you enjoy performing, such as walking, running, cycling, or even dancing, and start with 30 minutes of physical activity each day to help you de-stress and sleep well.
Read my blog post on the best exercise for PCOS to learn more.
PCOS Fatigue Supplements
Consider discussing with a registered Halifax dietitian if PCOS fatigue supplements like inositol and vitamin D are appropriate for your needs. Check for deficiencies in Vitamin B12 and if these are the root cause of your fatigue, take supplements to restore your levels.
Looking for more PCOS fatigue treatment tips?
I’ve got your back! As a Registered Dietitian Nutritionist in Halifax, I’ve got all the knowledge and experience to help you improve your PCOS and fatigue.
What are you waiting for? Get a registered dietitian on your side. Book with me today.