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:

Exercise: Getting into the groove is harder than I thought

You guys know I am trying to workout. The doctor says 20 minutes of exercise a day…and I am still struggling. While I had some success following these tips to get up in the morning and exercise, I have had a difficult time maintaining the routine.

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Writing to you guys about working out motivated me to get up in the morning and do it…hopefully, this post will help inspire me and some of you to keep that fitness motivation going.

Need an instant dose of inspiration? Take this quick, healthy-habit quiz. (I’ve used diet as an example, but you can plug in any behavior that you’re trying to maintain). Answering these questions often helps to boost motivation just enough to remind you of why you started the diet in the first place…

If I stop my diet, how will I look in six months or one year from now?
If I stop my diet, how will I feel in six months or one year from now?
If I stop my diet, what will my health be like?
If I stop my diet, how will my family and friends be affected?

This mini-quiz definitely puts exercising into perspective for me. If this isn’t enough, here are a few more tips to keep that motivation going:

Drink more water.

This is something I can do throughout the whole week to help set me up for success.

For years, dieters have been drinking lots of water as a weight loss strategy. While water doesn’t have any magical effect on weight loss, substituting it for higher calorie beverages can certainly help.

Food with high water content tends to look larger, its higher volume requires more chewing, and it is absorbed more slowly by the body, which helps you feel full. Water-rich foods include fruits, vegetables, broth-based soups, oatmeal, and beans.

Cells that don’t maintain their balance of fluids and electrolytes shrivel, which can result in muscle fatigue. “When muscle cells don’t have adequate fluids, they don’t work as well and performance can suffer,” says Guest.

 Drinking enough fluids is important when exercising. Follow the American College of Sports Medicine guidelines for fluid intake before and during physical activity. These guidelines recommend that people drink about 17 ounces of fluid about two hours before exercise. During exercise, they recommend that people start drinking fluids early, and drink them at regular intervals to replace fluids lost by sweating.

If you think you need to be drinking more, here are some tips to increase your fluid intake and reap the benefits of water:

  1. Have a beverage with every snack and meal.
  2. Choose beverages you enjoy; you’re likely to drink more liquids if you like the way they taste.
  3. Eat more fruits and veggies. Their high water content will add to your hydration. About 20% of our fluid intake comes from foods.
  4. Keep a bottle of water with you in your car, at your desk, or in your bag.
  5. Choose beverages that meet your individual needs. If you’re watching calories, go for non-caloric beverages or water.

Change your perspective

Shift your thinking from couch potato mentality to thinking like an athlete. This may sound like a big challenge, but it’s not as big a leap as you think.

Try to think about exercise as a blessing rather than a sacrifice. Find inspiration in others—looking outward for extra motivation. Take inspiration from everyone you meet—even people who can’t be physically active.

Here are some great articles that helped inform this post:

Progress Check-In: Eating late and weight gain

It has been my routine to weigh myself every Thursday, first thing in the morning, to check on my progress. As I continue down my journey of fighting Insulin Resistance and PCOS, I hope to document my progress every Thursday along with tips that can hopefully help you as you journey toward a healthier, happier you.

Before I jump into the specific progress of this week, I think it is worth capturing the progress I have already made. When I was first diagnosed with Insulin Resistance and PCOS, I was overweight and my testosterone levels were at about 90 (an average woman is about 40 and below). Since being on a low carb diet and taking medications prescribed by my Endocriologist, I am down 9 pounds and my testosterone levels went from 90 to 40 in one month. To keep this momentum, I have been working on the following goals:

  • Stay under 110g of carbs per day
  • Consistently take my medication (post coming soon on medication I am taking)
  • 20 minutes of exercise per day

We all know the holidays are a time for joy, love, family, and…weight gain. I was on a great path before the holidays of being down 12 pounds, but alas. All that egg nog and holiday cider caught up with me.

I have been on a great path this past week, but I am sad to say I was up 2 pounds since my weigh in last Thursday. Here are the successes and challenges of the past week that I believe could have led to this weight gain:

  • Got back to exercising for the first time in MONTHS. I committed to begin exercising yesterday and continued momentum this morning with another workout!
  • Cut out alcohol during the week. Trust me, this is a BIG success because nothing makes me happier than a glass of wine after a good day. Or a hard day. Or any day.
  • Stayed low carb for virtually every meal. That includes saying no to some delicious and free office treats

  • Continue the momentum of this week’s workout success and work to meet my goal of 20 minutes of exercise…every day. For next week, I will aim for 4 out of the 7 days. If 7 happens, then AWESOME…but in my experience, going from 0 to 60 is not very maintainable
  • Last night was an especially late night, so I did not eat until after 9pm. I think this is a BIG reason I was not down this morning’s weigh in.

Since eating late from time to time is a reality for most of us busy people, here is some info I found on weight gain and eating late to help keep me motivated that I am moving in the right direction.

Eating late and weight gain:

The truth is…

“A calorie is a calorie,” says Mass. “If your total calorie intake for the day is greater than what you are burning, this can lead to weight gain regardless of what time it is.” But if you eat healthy, regular meals throughout the day and typically have dinner around 8 p.m., there’s no reason to stress.

Problem is, research suggests that many women take in nearly half of their daily calories at—or even after—dinner. One study found that a third of people consume 15 percent of their calories after 11pm.

What’s more, binging close to bedtime can increase your blood sugar levels for a full 24 hours, according to one study in Obesity of Research & Clinical Practice. Meanwhile, research in the Journal of Clinical Sleep Medicineshows that noshing on high-calorie, high-fat snacks at night can make for restless sleep. The result: Overeating the next day in a feeble attempt to boost your energy levels, says Mass.

There’s nothing wrong with eating a light, healthy snack after dinner as long as you plan for it as part of your daily calories. To keep from overeating, pay attention to your food while eating, avoid eating in front of the TV, and choose a portion-controlled snack.

When you’re trying to lose weight, eat regular meals and consume 90% of your calories before 8 p.m.  The benefit of eating meals every three to four hours is it helps regulate your blood sugar, and thus control hunger and cravings. That should leave you about 150 to 200 calories to play with for a late-night (and guilt-free!) snack.

What this means for me: Hopefully, late night eating will be prevented as I learn more about my new job AND find a way to balance the blog with work. I will NOT get discouraged about my weight today and will keep on keeping on.

Here are some great resources on eating late and weight gain I referred to in this article:

Morning workout: 1, Snooze button: 0 = FITNESS SUCCESS

It happened. It really happened. THE SNOOZE BUTTON GOT SCHOOLED BY A MORNING WORKOUT! I appreciate all the support and accountability you all have given me…it honestly is making me a healthier, happier person.

Since my Endocrinologist only prescribes 20 minutes of exercise a day to get started, I bought myself an awesome stepper:

Sunny Health & Fitness Twister Stepper with Handle Bar
by Sunny Health & Fitness
Link: http://amzn.com/B001IDZHF6

  • Twist stepper workout machine with handlebar and multi-function LCD computer
  • Twist action works and tones your bum and leg muscles with reduced bone/joint pressure (good for me because sore joints are a side effect I endure from Insulin Resistance and PCOS)
  • Computer functions include: time, calories, scan, and count
  • Adjustable stepping height; handle bar for balance
  • Very small footprint and lightweight making it easy to store

It was a great start and I am feeling very accomplished! Today was a great day at work…I think it has a lot to do with a great start to the morning! I will admit, now that we are into the evening I am EXHAUSTED. Even right after the workout, my pups tried to lure me back to bed as you can see from this photo…but I was strong:

Cute pups trying to lure me back to bed

Here are some of the tips I tried that worked great for me:

Laying out my clothes the night before 

By doing this, I really was mentally prepared for the harsh reality of the alarm. It also made getting ready much, much easier.

Making my bed right away

It isn’t quite as easy to go back to bed if it is made!

A burst of sunlight

The morning hours really are beautiful. By opening up the blinds, the sunshine really woke me up in a lovely way…I felt like I was getting a great head start to the day.

Coffee!

This was ready to go thanks to Keurig almost instantly after I was up. I will admit that I had to up the coffee intake today, but it was nice to start the morning with that jolt of java.

Now let’s see if I can make this work again tomorrow…

Morning workouts and the snooze button: An epic battle

It’s cold outside. Your blankets are extra soft. Your pet is extra cuddly. You stayed up extra late to catch up on your DVR. You are having an amazing dream that you can eat whatever you want and never gain weight. [Insert cheesy tropical ringtone.] All of the happiness and comfort you were experiencing just a moment ago is gone as you consider getting out of bed to exercise.

If you are like me, this scenario is all too familiar. My Endocrinologist prescribed me 20 minutes of exercise each day to truly fight Insulin Resistance and PCOS, but none of that seems to matter in the epic battle between morning workouts and my snooze button. After a few minutes of negotiating with myself, I determine that I will likely be late if I workout and that work has been extra challenging this week and I deserve the extra sleep. The snooze button is activated and I am reunited with the comforts of bed.

While lunchtime workouts are an option for some, my curly hair tells me that unless I want to look like I stepped out of a 1980s music video that was running short on hair product, lunchtime workouts are not an option for me. Every time I think I can squeeze in a lunch workout, I am reminded of the following: 1.) If even a drop of sweat comes in contact with my hair, major frizz is activated leaving me looking unprofessional and like I traveled to 2015 from 1985. Tying my 1980s quaff back only seems to make both of these statements even more true. 2.) My boss surely would not appreciate me taking a 2 hour lunch. All these things considered, lunch workouts are out for me.

Evening workouts have been something else I have considered, but since my work hours can be late and I have to brave a 45-60 minute commute in LA traffic, consideration has dwindled. Once I get home, working out is the last thing I want to do especially if PJs have been activated.

With morning and evening workouts ruled out, I am left with my battle of morning workouts vs. snoozing. I will admit that putting in writing that I cannot drag myself out of bed 20 minutes earlier to get healthier sounds ridiculous, but I assure you…THE STRUGGLE IS REAL. Research suggests the early morning hours are the best time to get your sweat on—fueling your metabolism, energy level, and mood all day long. So balancing research with doctor’s orders really seem to be great weapons to battle that snooze button.

My hope is that blogging about exercise will hold me more accountable. Tomorrow shall be the day that morning workouts triumph over the snooze button! It is documented now on the Internet, so it must be true.

Knowing the challenges I have waking up in the morning, here are some tips that I will hope help me (and maybe even some of you) wake up tomorrow morning. May the force be with us all:

1.  Prepare your gear the night before. This has two benefits – the obvious one being that you’ll free up another ten minutes of sleep the next morning. As you can tell by this article, I am all about that sleep, so I will take any extra ZZZs I can get. The less obvious benefit is that the feeling of preparedness should make you fall asleep a little better. You won’t have the, “I still have to get my stuff ready tomorrow” thought gnawing at the back of your brain as you lay in bed.

2. Stash Mints in Your Nightstand. Brett Hoebel, founder of Hoebel Fitness and trainer on NBC’s Biggest Loser season 11, suggests grabbing a mint the second your alarm goes off. The sugar in the mint will excite and your brain, and the mint itself will liven up your tongue’s taste buds and nerve endings, says Hoebel. “You can completely fool your body into thinking food is coming,” he says. The gist: You’ll get rid of morning breath and wake up your mind and body for a sweat session.

3. Get a blast of sunlight. When your eye senses light, it sets off a chain reaction in your brain that leaves you feeling alert and energized, according to the National Sleep Foundation. Soak up rays by standing near an open window, or position your bed so it faces east and natural light will wake you.

4. Hydrate. Did you know that you can lose up to a litre of water while you sleep? True story. Start every morning off with a big glass of water and return your body to hydrated-status.

5. Have a Pre-Sleep Ritual. Getting up is exponentially easier when you have had a good night’s rest. Insure a solid 7-8 hours by having a pre-sleep ritual. Caffeine has a pretty big impact on me, so I try not to drink any caffeine after 3pm to help me get a better night’s sleep.

6. Have a set of cues for when you wake up. Habit is an extremely powerful thing. Use it to your advantage by creating a set of cues that will make getting up a habit instead of having to rely on willpower. Here is an example–

Turn off alarm.

Open blinds.

Make bed.

Go to the bathroom.

Drink a full glass of water.

Make breakfast.

Watch the news for 5 minutes.

7. Coffee!!! You know that drinking coffee stimulates your brain, but one study found that just the scent of java can ease stress caused by sleep deprivation, potentially coaxing you into workout mode. If your coffee pot has a timer, set it to brew a few minutes before your alarm clock for an amazing smelling wake-up call.

8. Tell the world about your plans. Well, here’s to hoping this one works. But seriously, tell your family, friends, Facebook, Twitter, co-workers…anyone who will listen! By spreading the word you are starting a morning exercise, it holds you much more accountable. So go post on social. And maybe tag #MyCarbBreakup. Because that would be cool.

Here are some great articles I referenced on helping you wake up for a workout:

Do you have any tips on what helps you wake up in the morning? Share your advice in the comments!