The Real Reason You’re So Tired All the Time - PCOS Diva

The Real Reason You’re So Tired All the Time

adrenal fatigueBy Amy Medling, founder of PCOS Diva

Stress attacks from all angles. We have job stress, family stress, relationship stress, local community to global issues stress – the list goes on. Unless you are superhuman, all these stressors can make you feel really, really tired or even burned out. Sadly, a majority of people all over the world can relate to this type of busy and tiring lifestyle.

Feeling tired isn’t exactly out of the ordinary, but if you feel tired all the time, then you may want to examine the cause. Chronic fatigue isn’t “normal” by any means, and it becomes more of a problematic symptom if you have PCOS.

Studies show that women with PCOS are more susceptible to stress and further, indicate that stress has an impact on our hormones and overall mental health. A 2019 study concluded that “women reporting PCOS have increased depression, anxiety, and perceived stress. Stress may play a role in the association between PCOS, depression and anxiety.”

If you’re wondering “I have PCOS; how is being tired all the time related to my condition?” There are several underlying reasons this may occur, but one common reason is you may have adrenal fatigue.

What is adrenal fatigue?

Our adrenal glands are critical when it comes to everyday health. They are responsible for producing hormones that work to burn fat and protein, manage blood sugar levels, regulate blood pressure, and respond to stressors. If you’re always under stress (whether it is constant low-grade or regular bursts of high stress), your body tends to produce too much cortisol – the stress hormone.

If you’re producing too much cortisol all the time, your adrenals wouldn’t be able to keep up, they get “fatigued,” and become unable to produce the hormones we need to feel healthy. This condition is often referred to as adrenal fatigue.

Adrenal fatigue is a condition linked to a collection of symptoms such as body aches, anxiety, sleep disturbance, digestive issues, and chronic fatigue. Some experience unexplained weight gain or loss.

Adrenal fatigue and PCOS

The tricky nature of adrenal fatigue means the symptoms don’t always stand out. As mentioned, feeling tired is just so common nowadays that we’ve associated it as an “everyday” thing. However, people with PCOS who feel tired all the time should definitely investigate it more.

One of the really troubling effects of PCOS is it causes a hormonal imbalance, often because the body is overproducing one or two hormones. Having PCOS can make someone have too much cortisol which can then lead to adrenal fatigue.

PCOS and hypoglycemia

One of the major problems with adrenal fatigue is that it can increase the risk of hypoglycemia or low blood sugar levels. Our adrenaline hormones and cortisol can trigger an immediate need for blood sugar which is extremely useful if we’re provoked or in a fight-or-flight situation. The problem lies in always being “on,” or always being stressed, which can cause the body to always demand blood sugar even though you really don’t need it to escape. If the blood sugar demand is not met every time, then that’s when you experience hypoglycemia.

Symptoms of hypoglycemia include fatigue, irregular or fast heartbeat, shakiness, anxiety, sweating, and irritability. You may recognize these symptoms when you do not eat regularly, or, if you have adrenal fatigue, more frequently.

Can exercise be the cause?

Exercise is one of the best ways to keep hormones in check, but too much or the wrong type of exercise can translate to worsening hormone imbalances. Specifically, you might end up overproducing cortisol to the point where you have problems sleeping or you feel tired, but your body refuses to fall asleep. Some have trouble recovering from exercise or healing from injuries, have problems losing abdominal fat, and crave sugar or carbs.

Coincidentally, adrenal fatigue can also cause “cortisol swings” or periods of high and low cortisol levels. If high levels cause trouble sleeping, carb craving, and slow recovery from training, then low levels make them feel lethargic, lightheaded, forgetful, and just easily tired with minimal physical activity.

For more about how to exercise with PCOS and for hormonal (cortisol) balance, read, “How to Modify Your Exercise to Work with Your PCOS Hormones.”

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Treatments for Adrenal Fatigue

There are many ways to treat adrenal fatigue. Consult your doctor to eliminate other causes, then work through these steps.

Adjust your diet

One of the best ways to treat adrenal fatigue is through dietary changes. Pack your diet with nutrient-dense foods like vegetables, fruits, seeds, whole grains, and clean protein. Be careful to avoid common inflammatory foods like gluten and dairy. The PCOS Diva programs and Seasonal Meal Plans each contain menus and recipes that fit the bill. You also must reduce or outright cut simple carbs like sugar, processed foods, fried foods, and caffeine.

A typical adrenal fatigue diet will incorporate all of that, but also fine-tune it for proper timing to prevent blood sugar spikes and crashes – preventing hypo and hyperglycemia.

Mental relaxation

Adrenal fatigue has been observed to be caused not by intense stress, but continuous, small stressors. Once you have chronic stress, even the smallest amounts, you’re more likely to experience adrenal fatigue. You can help reduce stress by practicing meditation, doing breathing exercises, keeping your phone and other electronics away, and by doing some exercise including yoga.

Supplementation for Adrenal Fatigue

Taking supplements is not exactly new for those who have PCOS. You are probably already taking herbs or vitamins to help counteract insulin resistance and maintain hormone balance. For adrenal fatigue, there are specific supplements you can take to help reduce its symptoms.

I suggest supplementing B vitamins, vitamin C, and magnesium. These three are common in multivitamins. There are also herbal extracts to consider such as licorice root, holy basil, Rhodiola Rosea, ginseng, curcumin, and ashwagandha.

  1. Licorice root: Licorice root has been cited for its energy benefits and can help regulate cortisol production.
  2. Holy Basil: This ancient herb contains vitamins A & C, calcium, zinc, iron, and chlorophyll. It has been used to reduce stress and anxiety, and can help protect against infection, lower your blood sugar and cholesterol, ease joint pain, and protect your stomach.
  3. Eleuthero: Traditionally used for boosting the immune system and as a general stimulant, eleuthero may also reduce fatigue, improve cognitive function, strengthen bones, enhance exercise endurance, reduce insulin levels, and more.
  4. Rhodiola rosea: One of the most powerful adaptogens in the world, rhodiola can reduce stress and cortisol levels while also simultaneously boost mental performance and energy levels.
  5. Ginseng: This herb can provide adrenal support and increase stamina. It can also boost memory, improve immunity, and even control blood sugar levels.
  6. Curcumin: Perhaps one of the most decorated supplements today, this potent anti-inflammatory and antioxidant packs quite a punch when it comes to health benefits. For adrenal fatigue, it’s been shown to enhance mood and reduce blood sugar levels. It can also help lower inflammatory markers triggered by chronic stress.
  7. Ashwagandha: Another adaptogen, this herb has been cited to fight stress, reduce cortisol levels, decrease symptoms of depression and anxiety, and even make you feel relaxed and happy.

All these herbs (except holy basil) are contained in PCOS Diva DeStress in optimal amounts. As always, consult your physician before taking supplements.


Being tired and stressed out can be just an ordinary feeling for most people, but sometimes it can signal an underlying issue, especially if you have PCOS. These symptoms can be a sign that you’re experiencing adrenal fatigue. Once you do confirm that you have adrenal fatigue, you can treat it by adjusting to a healthier diet, exercising, meditating, and taking a few, key supplements known to reduce cortisol and wash stress out of your system. There is hope. You don’t need to feel exhausted all the time.

Amy Medling, best-selling author of Healing PCOS and certified health coach, specializes in working with women with Polycystic Ovary Syndrome (PCOS), who are frustrated and have lost all hope when the only solution their doctors offer is to lose weight, take a pill, and live with their symptoms. In response, Amy founded PCOS Diva and developed a proven protocol of supplements, diet, and lifestyle programs that offer women tools to help gain control of their PCOS and regain their fertility, femininity, health, and happiness. 


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  5. Sabbadin C, Bordin L, Donà G, Manso J, Avruscio G, Armanini D. Licorice: From Pseudohyperaldosteronism to Therapeutic Uses. Front Endocrinol (Lausanne). 2019;10:484. Published 2019 Jul 18. doi:10.3389/fendo.2019.00484
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