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Dear Aunt Vadge,
I have the adrenal type of PCOS, and I’ve long thought my high cortisol, extreme stress and insulin resistance make it worse — probably why I’m so plagued by BV and yeast infections. I have high DHEAS and DHEA with normal testosterone, high 5-alpha-reductase, and I’m untreated hypothyroid with high reverse T3. My 4-point cortisol stayed elevated all day. I’m extremely depressed about the hirsutism and lack of breast development, and cry constantly. I had H. pylori as a child, years of antacids, antibiotics since age two, and was vegan for two years with several vitamin deficiencies. I have insomnia, fatigue, and I’m overweight. I know I need to manage stress. I have endless ideas for supplements but never know if they’re a good idea. I need help desperately.
Yours,
Stressed
Dear Stressed,
First, I want to acknowledge how much you’re carrying — PCOS, recurrent infections, gut trouble, and the exhaustion of researching it all while feeling so low about your body. That’s a heavy load, and reaching out for help is completely understandable. You’ve done a lot of clever thinking here, and none of this is your fault.
Before any supplement, one thing matters more than the rest: you’re untreated hypothyroid. An underactive thyroid affects everything — mood, energy, weight, your cycle, even how you heal — so please make getting that properly assessed and treated by a doctor your first priority. That’s not something to manage with herbs alone.
Your read on adrenal PCOS is spot on. In this type, stress is the main driver: it pushes your adrenal glands to overproduce the androgens DHEA and DHEAS, and high cortisol keeps the whole system revved up. So calming cortisol isn’t a “nice to have” for you — it’s the central lever, and easing it should soften the androgen-driven symptoms over time.
That’s why the daily meditation habit you’ve set yourself is exactly right. A few minutes every day, built into a real routine, lowers cortisol meaningfully. And given how much you’re crying over your body, I’d gently add that talking to a counsellor or psychologist would help enormously — both for the stress and for the very real distress underneath it. You deserve support with that part, not just the physical side.
The thyroid piece ties in here too: under chronic stress, the body converts active T3 into inactive reverse T3 to slow the metabolism down, which is part of why your rT3 is high. As cortisol settles, that conversion often improves — but untreated hypothyroidism still needs a doctor’s input directly, so loop them in rather than waiting on stress alone.
The high 5-alpha-reductase explains the hirsutism: it converts testosterone into the more potent DHT, which drives hair growth, and your DHEAS adds to that. Bringing the stress and androgen side down helps, though hirsutism rarely reverses completely — so if it weighs on you, laser hair removal is worth considering, and it’s more affordable than it used to be.
You’ve clearly worked out the gut piece too, and you’re right. Years of repeated antibiotics, antacids and infections will have knocked your good bacteria about, and an inflamed gut feeds both the recurrent BV and yeast and the insulin resistance. Healing it is a slow project — months, not weeks — built on whole foods, lots of vegetables, cutting back refined carbs and sugar, and (given your ear and sinus history) likely easing off dairy.
That dairy clue is worth trusting: if yoghurt makes your BV feel worse, that’s your body telling you something, so it’s reasonable to step it back and watch. The supplements you’ve listed can each have a place, but until your gut absorbs well they won’t do their best work — so gut first, and ideally with a naturopath or functional-medicine practitioner who can sequence things rather than you guessing alone.
For the recurrent BV and yeast that have plagued you, our free Killing BV guides walk through the whole approach step by step — start at the treatment section here — and you can book an appointment if you’d like it tailored to your complicated picture.
Above all, please be kind to yourself through this. Treat the thyroid, get support for how you’re feeling, calm the stress, heal the gut — one step at a time, with professionals alongside you, and giving each change a few months to show. You don’t have to fix it all at once, or on your own.
Warmest regards,
Aunt Vadge
This is general information based on current research and our clinical experience, not a substitute for personalised medical advice. Please see a doctor about your thyroid.
