I am 35. Are my UC, low HbA1c, and period issues interrelated?

Question

Hello doctor,

I am a 35-year-old woman who was diagnosed with ulcerative colitis five years ago. I am currently on Mesalamine and occasionally take steroids during flare-ups. Lately, I have been feeling exhausted, weak, and lightheaded, especially between meals, even though my bowel symptoms are relatively mild at the moment.

My recent blood work showed an HbA1c of 4.2 percent, which seemed unusually low, considering I do not have diabetes and do not take any blood sugar medications. At the same time, I have been experiencing menstrual irregularities. Sometimes I skip periods, and other times they are cumbersome and painful.

My gynecologist mentioned the possibility of a hormonal imbalance or an underlying reproductive issue. I also have frequent mood swings and occasional pelvic discomfort. I am beginning to wonder whether my UC, low HbA1c, and these menstrual changes could be interrelated in some way.

Could my autoimmune condition or the medications I take be affecting my hormone levels or glucose metabolism?

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Ulcerative colitis (UC) is not just a condition that affects the colon; it is an autoimmune disease, which means your immune system mistakenly attacks parts of your body. Autoimmune diseases often have effects beyond the main area they target. Over time, UC can influence how your body absorbs nutrients and how your hormones and metabolism function, especially during flare-ups or when you are taking medications like steroids.

Your low HbA1c (glycated hemoglobin) of 4.2 percent means that your average blood sugar levels are lower than usual. While this is not necessarily dangerous, it could explain your symptoms of tiredness, weakness, and lightheadedness, particularly if they happen between meals. This could mean your blood sugar is dropping too low at times.

Steroids, which you take during flare-ups, can initially increase blood sugar, but long-term or repeated use can also interfere with how your body regulates glucose, which may contribute to these ups and downs.

As for your irregular and painful periods, mood swings, and pelvic discomfort, these are the signs of hormonal imbalance, which is common in people with autoimmune diseases.

Inflammation in your body, the behavior of your immune system, or even side effects from medication can affect your ovaries, thyroid, or adrenal glands, which all help regulate your menstrual cycle and energy levels.

So overall, your UC, low HbA1c, and menstrual issues are all tied together through the broader effects of autoimmune disease and the impact of medications.

It would be helpful to have your hormone levels (like thyroid, adrenal, and reproductive hormones) checked, and then we can discuss the next step properly.

I hope this has helped you.

Please feel free to reach out to me again if you have further queries.

Thank you.