Why am I always tired with ulcerative colitis at 36?

Question

Hello doctor,

I am a 36-year-old female who was diagnosed with ulcerative colitis about a year ago. Lately, I often feel extremely tired, have frequent bowel movements, and sometimes have joint pain as well. Even though I try to manage my diet and medications, my energy levels are very low most days.

Why does ulcerative colitis make me feel 60 at age 36?
Could the condition itself cause fatigue and body aches like this?
Should I get blood tests to check for anemia or vitamin deficiencies that might be making the symptoms worse?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

What you are describing is something many people with ulcerative colitis go through. That feeling of being older than your age is not in your head; it often reflects what is happening inside the body.

Ulcerative colitis is not just limited to the bowel. It is a systemic inflammatory condition, which means its effects can extend beyond digestion and impact your overall energy and wellbeing.

This is mainly happening due to:

When the colon is inflamed, the immune system releases chemicals into the bloodstream. These can make you feel drained, achy, and fatigued, similar to how your body feels during a prolonged illness.
Frequent stools or bleeding can gradually lower iron levels, leading to iron deficiency anemia. This is a very common cause of persistent fatigue, low stamina, and even breathlessness.
Chronic inflammation or restricted eating can lead to low levels of nutrients like vitamin B12, vitamin D, or folate, all of which play a role in maintaining energy levels.
Some people develop inflammation outside the gut, especially in joints. This can cause stiffness or aching in areas like the knees, ankles, or wrists, and often improves when the bowel condition is better controlled.
Nighttime symptoms can interrupt sleep, and ongoing diarrhea can lead to mild dehydration, both of which can leave you feeling constantly exhausted.

Please get these tests done:

Hemoglobin and iron levels.
Vitamin B12 and folate.
Vitamin D.
Inflammatory markers.
Stool tests, such as fecal calprotectin, to assess ongoing inflammation.

This level of fatigue does not mean you are weak or aging faster. It is a well-recognized part of inflammatory bowel disease.

With better control of inflammation and by correcting anemia or deficiencies, many people notice a significant improvement in their energy and overall quality of life.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.