Here we are, but not where we thought we would be 

Have you ever focused so much on taking a day at a time you don’t realize how many days have passed?

I started this blog over two years ago thinking that Pre-Diabetes and PCOS would be my biggest challenges – and they were not easy. Limiting what I eat, feeling jealous that others could eat whatever they want and not have concern…that was hard.

But the challenge has evolved. This evolution has kept me from writing because moving from a health struggle to an infertility struggle seems embarrassing and taboo. I have received guidance from some of my closest confidants to not share and just fight.

But I can’t. I am literally sitting in the back of a car with friends and family talking and I can’t engage. After choosing the wrong doctor with the wrong treatment for 5 months and now having to embrace more extreme fertility treatments – I feel overwhelmed. And isolated.

I know I am surrounded by love and support –  but truthfully no one knows what to say. To be honest, I can’t even articulate what I am going through as I work to balance the craziest combination of fear and hope.

So here I am again. Writing to you because you listen. You may be going through what I am or know someone who is. I am writing to you because you empathize. Because you  are a safe space.

While I worry about who knows me personally and is reading the start of a very raw and open testimony  I really think this platform is made for a place to articulate pain and get support.

So thank you. Thank you for reading and caring. Thank you for knowing every post on social media that seems perfect may be built on a foundation of struggles and pain. Thank you for being honest, open, and for withholding judgment. And thank you for allowing me to express myself.

A new normal – trying to stay positive 

It has been 16 months since I was diagnosed with PCOS and Insulin Resistance.

16 months. 36 pounds lost. 9 pills a day. 1 injection a week. 1 chemical pregnancy. 

While I know I have had a battle and I have been a successful warrior, I am feeling…exhausted. Exhausted from feeling like this condition is consuming my identity. Exhausted from frustrations of not being able to start a family. Exhausted from all of it to the point that I don’t even want to be around my own thoughts any more.

Tonight I looked back at photos of my self 36 pounds heavier and am feeling shocked at how I looked. During the heaviest weight of my life I will forever be immortalized in 3 different sets of wedding photos where I was honored to serve as bridesmaid. I look back and can see how far I have come, but wonder how far I have to go.

This blog and this community have given me strength when I have needed it most. Now as I wait (with some super fun GI problems from my medication) on the eve of an endocrinologist appointment, I am praying my levels will be ok. Praying for progress. And praying for the ability to give my husband a family.

I am so thankful I am alive. Thankful for my progress. Hopeful things will continue to get better. This journey really has no end. So I look to you – my strong inspirations- who continue to fight and succeed with PCOS and IR. Thank you for sharing your stories and voicing support. Thank you for reminding me I am not alone.

We can all do this – we won’t stop, we will keep fighting. 

 

Weigh-in Wednesday: New Year, Back on track

So December was fun. Lots of fun.

holiday-weight-loss-tips

I literally got back with carbs in a way that pretty much evolved us from exes to being married. All the carbs. I mean, I didn’t discriminate. I was an equal opportunity carb monster. Between work gifts, holiday parties, holiday dinners, and overall feeling festive I really went for it. Maybe I was trying to be like Santa and be as jolly as possible for December. Let’s just say I was committed.

One thing I seemed to forget during this food fest was that I had an upcoming Endocrinologist appointment in January and that my blood work results do not come with caveats or forgiveness. Nothing brings cold, hard honesty to your life like blood work. Nothing.

After returning from another ridiculous amount of carbs on a vaca in Orlando, I had my appointment today. Here is how it went:

Pros –  Last visit 3 months ago, my levels showed the start of Non-alcoholic fatty liver disease. It is great the non-alcoholic is at the start of this diagnosis because I was about to REALLY regret decisions made in college. And my 20s. And my 30s. And last weekend.

While it is important to limit, alcohol, that is not the cause of this condition. What I did learn on Wikipedia is that this is the most common liver disorder in developed countries (around 30% of Americans) and is directly tied to my lovely Insulin Resistance (or pre-diabetes).

I was also down a couple pounds from the last visit. Down is always good…but when I am doing all I should be, I should be down a lot more.

Cons – My testosterone levels were higher than last visit. Luckily nothing close to what they were before, but definitely not as low as they should be. This brings me closer to needing insulin every day in full diabetes mode and also makes future plans for a family nearly impossible down the road.

PrintAs I work to be more positive this year I am going to take my cons and say the POSITIVE about them is that I have control over these results. These results are directly tied to the amount of carbs I am eating. I know FOR A FACT I have not been anywhere near my goal of 110g of carbs/day for the last 6-8 weeks. I wasn’t even keeping track.

I am happy to say that I also was NOT given more meds this visit. When I am not doing what I am supposed to, my endocrinologist finds additional meds to help make up for what I am not being responsible enough to do on my own. This visit, no more meds…just a pep talk on the reminder of why I need to stick to 110g carbs/day.

So here I am. Back at my desk. Eating a burrito bowl. Ignoring the Chick-fil-A my co-workers are eating. Ready to food journal. And under 30g of carbs for 2 meals and a snack so far today.

Resolutions are important…but this is more than that. This is to be well. This is to help my husband eat a healthier diet. This is for a future ability to have a child (ren). This is bigger than how good that carb dates.

3 months from now will be my next Endocrinologist appointment. Here’s to striving to beat my personal best and to being my healthiest self. We can all do it!

We_Can_Do_It!

References:

Wikipedia

 

Truth and Thanks – The realities of PCOS and IR 

PCOS and Insulin Resistance have rocked my world. It has been almost a year since diagnosis and I can’t believe how much my life has changed.

For anyone battling a health issue, you can relate to the challenge of preventing said issue from consuming your identity. For me, I have battled mood swings, persistent nausea, vomiting, fatigue…all the things that engulf my life and are impossible to ignore.

Sometimes I feel so frustrated that I can’t get away from these feelings and symptoms. For a short term sickeness or even a diet, there is a light at the end of the tunnel. You know that you will get better and all discomforts will be done at some point. I think for me, that’s the hardest part of PCOS and IR – that all this discomfort is permanent and all these lifestyle changes must be permanent as well if I want to stay healthy (and alive).

The human component of fighting a disorder is the part we need to remember. We aren’t machines. We will falter. We will get frustrated. But we can keep fighting.

After a bad stick last night with my Tanzeum that caused a bit of bleeding, after needing to run into the bathroom at work during a meeting to be sick, after being so frustrated that I can’t eat the carbs that everyone around me are eating…I feel discouraged and exhausted. But I know this is what I have been dealt and that I am lucky to be alive. So I am going to keep putting all my energy into finding the positive and being strong. No matter what.

My Carb Breakup has given my strength during the darkest times…times like now. So thank you – thank you for reading. Thank you for commenting. Thank you for your kindness.

thankyou

Blood work DONE: How to make blood work as smooth as possible

You know how sometimes you finish a major project at work or perhaps there was a big chore at home that had been put off for months and is finally done? Completion of such tasks surely deserve a reward or celebration, right? In my world, getting blood work done  and not having a panic attack is an achievement on the same level as a year end report or reorganizing every closet in your house. Seriously.

Now that it is over, I will wait…wait for Monday and the results that could change my whole life.

In the interim, at least there are fun things to fill the time. Between now and then I will be at E3 (gaming convention) for work, go to a concert I have been looking forward to, make it to the weekend, and celebrate Father’s Day. I am also hoping to spend more time with you…sharing things I have learned to make for a healthier, low carb lifestyle (especially to battle PCOS and Diabetes)

Since I know everyone has to have blood work done at some point, I thought it would be helpful to share some tips I found to help make the draw as smooth as possible. It would have made my Glucose Tolerance Test along with all the other blood work fun I have had much better if I read something like this…so I hope it helps you.

1f3db061265a30289ef6e73a1a2cd3d3.jpgWater is Vital: Drinking water is highly encouraged before a blood draw. Being well-hydrated means your veins are full and easier for thephlebotomist (the person who draws your blood) to find. In essence, being well-hydrated could mean a quicker, less painful draw for you! This will also help your blood pressure from dropping.

anigif_enhanced-875-1423067122-14Get your blood pumping. 
I’ve noticed that my veins seem to be easier to find and the blood flows betterwhen my blood is really moving. To help with this, I always park as far away as possible when I’m going in for a blood draw, and I jog or walk briskly into the office. (Yes, I just admitted how pathetically out of shape I am that that a short jog across the parking lot really gets my blood going.)

9535-Take-A-Deep-Breath-Girl

Take deep breaths. In through the nose, our through the mouth. Seems super intuitive, but it definitely is not for me. All I want to do is hold my breath as I stare longingly at the exit sigh. Deep breaths really did help me today. The lady taking my blood told me to think about being at yoga…a bit of a stretch, but I think her intent was obviously good. I found closing my eyes and breathing really did help quite a bit.

And now…we wait for Monday’s appointment.

Day 1 of new meds: Research on nausea

Day 1 of medication and so far, been nauseated and even vomited…in my work bathroom. Luckily, I was alone…the last thing I need is co-workers thinking I am pregnant! Even though it was rough, I will say I am in much better spirits today. I know the nausea means my body is responding to the medication which means I am that much closer to being healthier.

My hope is this blog helps people going through similar circumstances. I figure whatever I am researching to get through battling PCOS and Insulin Resistance can also help many of you.

So today’s research…how to fight nausea and keep on keepin’ on.

Here are some important things to keep in mind. Reading this made me feel like I wasn’t alone and although this isn’t fun…it is a very common side effect:

  • Many medicines can cause nausea or vomiting.
  • Nausea or vomiting from a medicine is not an allergic reaction.
  • For most people, the dizziness and mild nausea caused by pain medicine often goes away in 1 to 2 weeks
  • If your provider recommends that you follow a regular routine to prevent nausea and vomiting, do not wait until you are severely nauseated or vomiting to start the routine. It is much easier to prevent nausea and vomiting from happening than to treat it after it has started.
  • If you have nausea or vomiting, your provider can prescribe medicines to lessen these side effects. If those medicines don’t reduce your nausea and vomiting, your provider might change your pain medicine so you have fewer side effects.

Call your provider or the consulting nurse right away if you have any of the following:

  • Nausea that lasts longer than 24 hours
  • Vomiting that lasts more than 4 hours
  • Blood in your vomit

Things you can do to help prevent nausea and vomiting:

1. Take it easy for the first several days after you start an opioid pain medicine for the first time, or when your dose has been increased. I am definitely not cancelling my sushi double date tonight, but will be mindful of how much I drink and eat.

2. Take your medicine with a meal or small amount of food. You can also take your medicine with 1 to 2 tablespoons of antacid to help coat your stomach. I definitely did not do this and I think this was part of the problem

3. If you have bloating that makes you feel sick to your stomach, make sure you’re having regular bowel movements (infrequent bowel movements can make you feel bloated.

If you continue to have nausea or vomiting after trying the things listed above, your provider might prescribe medicine to help treat and prevent this side effect. To make sure you get the right medicine to help with nausea or vomiting, tell your provider the following information:

  • Describe the side effect – is it nausea, bloating, dizziness, or vomiting?
  • When does the side effect happen – constantly or within an hour of taking your medicine? o When was your last bowel movement?
  • Have you taken your medicine with food or on an empty stomach?

They say knowing is half the battle…here’s to hoping!

Health update: Scared, but resilient

jour·ney
noun
an act of traveling from one place to another.

Over the last couple of weeks, I have developed false faith that I was better. I convinced myself that December’s visit to the Endocrinologist was so good, that I could get back together with carbs on a regular basis. I have been evolving my diet the way I have in the past…after months of being good, I believed I was on the right track and could afford eating the way so many people around me do indulging in carbs on a regular basis.

I was wrong. Very wrong.

This morning’s appointment was eye opening. When I started this journey back in November, my testosterone level was at 90. The healthy rating for a woman is 30. If I did not get treated, I was on a path to have heart failure. In the next decade. After starting this blog and staying very disciplined in my carb breakup, I got my testosterone level down to 53. This gave me false comfort to allow carbs to creep back into my life…first, when I was stressed. Then, on the weekends. And ultimately, whenever I felt like it. My testosterone level was at 56.

My Endocrinologist is one of the kindest, most talented people I have ever met. Today’s appointment would have been terrifying if it wasn’t for his sense of humor, open dialog, and genuine concern he has for me and all of his patients. Even with his skill and kindness, today was still a very scary wake up call.

I shared with Dr. Marcus that I have been exhausted. I was exhausted from staying on the diet and feeling so limited. Exhausted from taking so many pills every night. I admitted that I have not stuck to 110g of carbs today, had not been regularly exercising 20 minutes a day, and even have been skipping medication on days I am over taking pills. Admitting all of this to him was obviously imperative for him to help course correct, but more importantly, it caused me to be honest with myself.

In addition to staying on track with my carb breakup, Dr. Marcus made the following adjustments to treat my Insulin Resistance and PCOS. Every case is different, but here is how we are approaching my journey to health:

Increased Metformin from 500mg to 2000mg. I am not happy to take 4 times as many pills. (larger pills are available, I am just not a strong pill taker). I have read various posts from many of you about Metformin side effects which had not really been bad for me before. I will be interested to see how side effects progress with this higher dosage.

strong>Exercising 20 minutes a day is imperative. Time to look back at my tips to wakeup in the morning and exercise. The epic battle with the snooze button will continue.

Now for the newest and for me, the scariest change. Once a week, I will now need to give myself an injection. For those of you that have been following my journey, you know that I am terrified with needles which is why the Glucose Tolerance Test was so difficult for me. Each week I will be injecting myself with Tanzeum. My doctor was very open to discussing this medication and we decided it would be the best thing for expediting a cure for my PCOS and Insulin Resistance. I will admit that when he mentioned this, I hit the cap on holding in my emotions. It was hard enough to hear that if I did not get my diet and health in order, I would likely not make it to my 50th birthday in 20 years. Then learning that my results needed pushing and it was time to introduce injections…I lost it in his office. He kindly listened and coached me through how to use this prescription. I was shaking in fear to give myself my first shot…but I did it. I really did. I feel braver and stronger for being able to do this. As much as I hate needles, I will do whatever it takes to be healthy again. For those of you interested in learning more about this prescription, check out this

Carbs and I got back together this weekend…and now I am tired and wanting more!

This past weekend carbs and I definitely got back together. In a big way. One of my best friends and her husband were visiting us in LA from Nor Cal, so we were constantly eating out and overindulging. We did get a great hike by the Hollywood sign in, but the weekend was filled with all you can eat brunches, mimosas, and late night pizza deliveries. While this was all fun and good at the time, I have been VERY tired this week and craving more carbs.

Confession: last night I got home much earlier than my husband and was starving. I had a healthy low carb lunch, but by the time I was home I wanted whatever I could get my hands on. Unfortunately for my PCOS and IR, leftover pizza won the no carb battle.

As I explore the challenges of this new lifestyle, it has been helping me to really understand the impact carbs have on my body. The more I know, the harder it is for me to get back together with carbs by staying strong in my decision for  us to break up.

Here is some of the info I found to help me stay strong and just say no to carbs:

Why are carbs making me tired?

Insulin resistance is a process in which the body is inefficient at managing sugars and starches you have eaten in your diet. When you eat a carbohydrate, such as a piece of bread or something sweet like ice cream, your body releases insulin from your pancreas to process that sugar. Without insulin, you would not be able to assimilate this sugar, called glucose, from your blood stream into your liver and muscles. In insulin resistance, your body makes too much insulin for the amount of carbohydrate consumed. This extra insulin is what causes so many of the listed problems, both functional problems (those which precede pathological), as well as pathological problems (those with tissue alterations.) Initially, the extra insulin often ends up processing sugar too rapidly and blood glucose levels are driven too low. This is called hypoglycemia or low blood sugar. This adds stress to the body and causes the production of other hormones (especially adrenal gland hormones like cortisol), which increase blood sugar levels. As CI gets worse, more and more insulin is needed to process a small amount of sugar. The insulin eventually becomes ineffective at driving the sugar into the cells where the nourishment is needed. The cells have become resistant to the insulin.

As CI is developing, the extra stress on the hormonal system, particularly to the adrenal glands, overworks these organs. This results in a complex pattern of symptoms that differ from person to person.

Symptoms of CI include but are not limited to sleepiness, drowsiness, lack of concentration, or a feeling of being bloated after a meal, especially one containing sweet foods or starches. Always feeling hungry or having weak legs or knees after eating is also a symptom of CI. These are just a few of the functional symptoms.

All of this explains why I have been so incredibly tired…especially the more carbs I eat.

Why does eating carbs cause me to want more carbs?

Sugary foods and drinks, white bread and other processed carbohydrates that are known to cause abrupt spikes and falls in blood sugar appear to stimulate parts of the brain involved in hunger, craving and reward, the new research shows. The findings, published in The American Journal of Clinical Nutrition, suggest that these so-called high-glycemic foods influence the brain in a way that might drive some people to overeat.

For those who are particularly susceptible to these effects, avoiding refined carbohydrates might reduce urges and potentially help control weight, said Dr. David Ludwig, the lead author of the study and the director of the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital.

Also, research suggests that when blood sugar levels plummet, people have a tendency to seek out foods that can restore it quickly, and this may set up a cycle of overeating driven by high-glycemic foods, Dr. Ludwig said. “It makes sense that the brain would direct us to foods that would rescue blood sugar,” he said. “That’s a normal protective mechanism.”

Makes a lot of sense why I am wanting more carbs…my body thinks it is a reward and is wanting to restore low blood sugars when my levels plummet after they spike. I also have heard from a lot of other people that it is hard to change the mentality that a whole day or even week is wasted once you slip up on your diet. Have to take it a meal at a time…

Getting back on track:

Knowing all this, I am proud to say I made a healthy choice for lunch today:

IMG_0956

Greek salad with fresh feta and grilled chicken kabob. I especially love the garlic sauce many Mediterranean or Lebanese restaurants have. It is just garlic, lemon, olive oil, and ice!

Here are some great articles that helped inform this post:

PCOS: How to explain what you are going through to those you love

As I work through PCOS and Insulin Resistance, my hope is that along with sharing my journey, I can compile some of the best articles I find to make my blog a one stop shop for others looking for comprehensive info on PCOS, IR, and healthy living.

I don’t know about you, but I feel like PCOS has caused such a big lifestyle change, I am constantly trying to explain what is going on with me. Typically, I explain it in a way that my body takes carbs, turns them into fat, and then stores them for longer periods of time than other people. If we were in a zombie apocalypse and food was scare, I would be set. But as a 30-something woman living in LA, fat storage is not nearly as desireable.

Here is an amazing article from one of my favorite resources, PCOS Diet Support. This POV is for your partner, family and significant other. Here is an explanation of PCOS for our partners and significant others..something that makes PCOS easy to understand.

WHAT IS PCOS?

I have PCOS or Polycystic Ovarian Syndrome. I know that you think of it as “woman issues” but it’s important that you know what is happening with me and my body because it affects both of us and I’m really going to need your help in coming to terms with it, living with it and getting it under control.

So, I do have “woman issues”. Basically I don’t ovulate every month, which means that my cycle is very irregular. I also might have some cysts on or in my ovaries. The biggest thing, though, is that I don’t process carbohydrates properly and my body is over sensitive to insulin. This means that I produce too much insulin for the carbs that I eat. The insulin also makes my ovaries release too much testosterone (all women produce testosterone – I just have too much of it).

PCOS is pretty common. Every 1 in 10 women have it so I’m not abnormal or alone in it.

THE SYMPTOMS

The symptoms of PCOS are pretty rough for me to deal with and can make me feel unattractive. I sometimes struggle with my weight. It’s not for lack of trying, I promise! All of that insulin quickly stores my carbs as fat and makes it difficult for me to lose it.

I have hair where I really don’t want hair and I may lose some of my hair on my head. I also may have bad skin (think teenage boy acne). It’s that darn testosterone.

One of the hardest things about PCOS is that having babies might be a struggle. It’s not impossible by any means but might take longer than we’d like.

WHAT I NEED TO DO FOR ME

PCOS is not a death sentence and I’ve made a decision that although I have PCOS, it doesn’t have me. There are things that I can do to manage my PCOS and help with my symptoms.

The biggest thing I can do for me is to lead a healthy lifestyle, keep active and eat properly. This will make my symptoms easier to manage (exercise and diet are huge in dealing with the insulin which will help with the testosterone). The way I eat is not necessarily aimed at me losing weight (although it will help) but on getting healthy. So we can change the way we eat and get healthy together. There are also some supplements that I take regularly which have been really helpful in managing my symptoms.

I can get help from my doctor or endocrinologist (hormone doctor) and there are medications I can take.

If we’re not ready to think about a family, I can also take birth control, which will keep my symptoms in check for a while. As soon as I come off the pill, though, my symptoms will come back so birth control is a temporary fix and can have unpleasant side effects.

If we do decide to have a family and we’re struggling to, we can go to see a reproductive endocrinologist to look into fertility treatments. They’ll want to check you out too and treat both of us if need be.

WHAT I NEED YOU TO DO

The biggest thing I need from you is your love and support. There are times when living with PCOS is going to make me angry, depressed and feel unattractive. Please just love me through it.

I’m going to do everything I know to do to eat properly and exercise. Please help me by eating healthy too and being active with me. Let’s go for lots of long walks, take up mountain biking or ballroom dancing. If you do have treats (which you’re totally entitled to), please hide them from me so that I’m not tempted by them. Also, please share with them with me once in a blue moon because I also deserve a treat every now and then.

Bearing in mind what I said about feeling unattractive, when I’m having an “ugly” day (and they do happen), please remind me how beautiful I am. Encourage me to get my hair done, have a pedicure or a massage. Sometimes I get so caught up in the daily grind of work, keeping a home and our family, looking after my health, that I forget to take some time just for me. I need you to help me do that.

THANK YOU

It sounds a bit trite but thank you so much for taking the time to read this. It shows me that you want to understand what I am going through and want to support me and that means the world to me. Thank you for loving me in spite of my many faults (PCOS included) and thank you for choosing to walk this road with me. Having PCOS is not easy but with you by my side, it makes it a little more manageable!

You can find the full article here: http://www.pcosdietsupport.com/pcos-symptoms/pcos-explained-partner/

PCOS & Insulin Resistance: Fighting Fatigue

Lately it has been harder and harder for me to wake up. Initially, I assumed it was because I was taking on new responsibilities at work and the learning curve was taking a toll on my energy. As it as seemed that fatigue has not improved, I thought I would do a little more research on PCOS and Insulin Resistance to determine if they are contributing to this not so fun fatigue my normal energetic self has been encountering.

As I develop questions on why things are happening to my body while fighting PCOS and IR, my hope is to share my findings with you and make my blog a one stop shop for being the healthiest and happiest you can be. Since I have been feeling so tired, I started to do some research and compiled the best info I found in this post. I hope it helps those of you with PCOS/IR…and people who have just been feeling extra tired lately, too! Many of these symptoms can be due to fluctuating hormone levels and increased anxiety.

As it turns out, PCOS and fatigue are both linked to an imbalance of the endocrine system and are characterized by an excess of male hormones. Fatigue, a symptom commonly associated with PCOS, is also closely linked to the thyroid and adrenal glands. At the heart of both of these issues, however, is a disorder known as Insulin Resistance. Lucky for me…I have both IR and PCOS.

To add insult to injury, fatigue frequently causes women with PCOS to treat their low energy with carbs and caffeine, which dumps more glucose into the blood in a never-ending spiral of weight gain and increasing insulin and glucose levels. As fatigue and insulin resistance worsen, excess fat cells produce too much of another hormone, estrogen.

Here are some additional causes of fatigue and how to combat them. Here’s to hoping this will lead to a more energetic week next week!

Lack of Sleep: Obviously, the first sign that you are zapped of energy could be that you aren’t getting enough sleep. Most adults need 7 to 9 hours of sleep nightly. My Endocrinologist prescribed me with Trazodone to help me sleep…I have noticed a big difference in how rested I feel and my husband says he has noticed I am not tossing and turning as much.

Poor diet: One of the most common causes of low energy can be from eating the wrong foods. Eating a diet high in refined carbohydrates and simple sugars will cause your blood sugar and insulin levels to skyrocket and then crash, leaving you ready for a nap. Start the day with a meal that contains at least 10 grams of protein (eggs or Greek yogurt are two good ones). Swap refined carbs for whole grain ones (try quinoa, faro, or oats) that won’t send your blood sugar into orbit. Over the last week, I have not been eating well due to the nausea, so perhaps this has been a big cause of my fatigue.

DehydrationStudies show that even mild dehydration can result in significant dips in energy levels. You need 6 to 8 cups of fluid each day for proper hydration (yes, this includes caffeinated coffee and tea) so drink up! I really have not been drinking all the water I should…I used to be really good at finishing at least one large water bottle a day at work, but lately not so much.

Exercise: Even if you are tired, exercising can give you more energy thanks to the secretion of feel good chemicals called endorphins. One study found that just 20 minutes of low-intensity aerobic activity three times per week decreased subjects’ feelings of fatigue by 65 percent. This 20 minutes of exercise is right in line with the 20 minutes prescribed by my doctor…I just need to make it happen.

Iron deficiency: If you experience heavy monthly bleeding, don’t eat animal products, or are an intense exerciser, you may be deficient in iron. Since iron’s main role is to transport oxygen, not having enough will make you feel exhausted and out of breath, even with minor exertion. Discuss getting your levels checked with your doctor before supplementing your diet with extra iron. My doctor did prescribe iron for me and even Vitamin C to help improve the absorption of iron. I also do not eat red meat or pork, so I certainly have iron deficiency in diet.

Hypothyroid: When the thyroid doesn’t produce enough hormones it can affect your energy levels. Ask your doctor for a full thyroid panel (TSH alone is not enough).

Gluten sensitivity or Celiac disease: A hallmark feature of someone with celiac disease or gluten sensitivity is fatigue or “brain fog” after eating foods that contain gluten. It’s recommended to be checked for celiac disease, an autoimmune disorder, before adopting a gluten-free diet, which can mask symptoms and prevent an accurate diagnosis.

Vitamin B12 deficiency: If you take birth control pills or metformin or eat a vegan diet, you may be deficient in Vitamin B12. A defiiency in B12 not only causes chronic fatigue, but permanent nerve damage. Ask your doctor to check your B12 levels. Since I am definitely on Metformin, it looks like I should be adding B12 to my daily vitamin regimen as well.

Depression: Depression and fatigue are a vicious cycle with each fueling each other. Being depressed can be like living in a constant fog. Lack of motivation and sleep disturbances can contribute to depression. Engaging in regular exercise can help boost mood. If you feel you are depressed, we recommend seeking treatment from a mental health expert.

Sleep apnea: Several studies have shown that women with PCOS suffer from a much higher rate of obstructive sleep apnea, a disorder that causes your airway to be narrowed or blocked. Even if you do get a sufficient amount of sleep, if you’re not oxygenating well, you won’t feel rested. This can account for the tossing and turning my husband has been tolerating for the last 9 years.

Now that I have a better understanding of these causes, it will make it that much easier to get back to my energetic, positive self again. I hope these tips helped you as well!

Here are some of the helpful articles that helped inform this post: