Feeling tired is no fun. Fatigue seeps into all aspects of life: fun, cooking, making decisions, work, school, hobbies, pain tolerance, mood, aaand the list goes on.
And when it comes to PCOS (polycystic ovarian syndrome), the fatigue is typically multifaceted. What this means is that we’ve got to dot our "i"s and cross our "t"s.
Here are some of the things that can contribute to fatigue, lethargy, and feeling tired:
Iron deficiency (or low-normal iron levels). This one can get a bit confusing in PCOS, so I'm going to go into the most detail here. Ferritin is a measure of iron stores that is tested in blood. Ferritin can also act as a marker of inflammation in inflammatory conditions like PCOS. This means that maybe your ferritin was normal on bloodwork because there's inflammation and we don't really have a good idea of your actual iron levels. So, if you have PCOS, ask your doctor about your hemoglobin when discussing iron AND ask them to run serum iron and CRP (an inflammatory marker) as well. This way we get a better idea of whether or not you actually have low iron.
Vitamin D deficiency is common in those with PCOS. It also contributes to hair loss, blood sugar dysregulation, and subfertility/infertility. It's best to test and supplement accordingly.
B12 insufficiency and deficiency = quite common in the general population and associated with other things like anxiety and low mood.
Thyroid issues. Hashimoto's disease, an autoimmune condition is associated with PCOS. Full thyroid testing including antibodies can be done to assess this.
Anovulatory and irregular menstrual cycles with hormone dysregulation.
Generalized inflammation.
Body dissatisfaction and body dysmorphia related to body size, hirsutism, pattern hair loss, and skin issues like acne.
Overexercising.
Disordered/restrictive eating patterns and/or eating disorders.
Mental health and mood disorders like anxiety and depression.
Feeling lost, confused, unsupported, unvalidated and/or overwhelmed.
Sleep apnoea.
This is, by no means, an exhaustive list, but it's a good place to start and contains information you can discuss with your healthcare team. If you're looking for an ND and are in Ontario, feel free to book in with me here.
If you're looking for other resources on PCOS, check out my first and second PCOS FAQ blog posts. You can also use the search function to look for more PCOS content (there's lots more!).
