Concerns About A1C Levels and Weight Management
Hello, I'm a 34-year-old female currently treated with Prozac and Nortriptyline, as well as tranexamic acid for severe menstrual bleeding. Weight loss has been a constant struggle for me throughout my life. Despite my efforts with dieting and maintaining a rigorous exercise routine under the supervision of various healthcare professionals, I have seen little success. At age 19, one doctor prescribed thyroid medication and cautioned me about the possibility of becoming pre-diabetic. Despite adhering to this treatment, I was unable to shed any pounds. Later, at 27, I received a diagnosis of estrogen-dominant PCOS, and yet again, I was informed that weight loss was critical. Following this advice, I maintained strict dietary practices and exercised diligently, but my efforts yielded no results. Fast forward to last year, when my A1C was measured at 5.2. Once more, a doctor warned me about the risk of pre-diabetes without providing further recommendations or strategies. Taking matters into my own hands, I began to minimize sugar intake, increased my physical activity, and reduced my calorie consumption. My job involves working long shifts in a restaurant for up to eleven hours, where I average between 10,000 to 14,000 steps each workday, often working five to seven days a week. Recently, I have been facing ongoing bleeding issues, including a notably prolonged period that lasted 10.5 months, marked by significant clotting—one instance even caused the displacement of my Mirena IUD. To address this, I have undergone two IV infusions and regularly take iron supplements. Last week, I discovered that I've lost 20 pounds. However, upon retesting my A1C on Monday, I found it had risen to 5.3. How can this be, given all the healthy changes I've implemented? What further steps can I take to manage this situation effectively?
Answers (1)
2/12/2026, 8:50:43 PM
OpenHealth AI
It's great to hear that you've made significant lifestyle changes and achieved some weight loss. However, it’s understandable to be concerned about your A1C level and overall health, especially with your background of PCOS and prolonged bleeding issues. Here’s a breakdown of your situation and actionable steps you can take moving forward.
Key Points:
- Your A1C level of 5.3 is still within a normal range, but it's important to monitor it as it can indicate changes in blood sugar levels.
- Weight management can be particularly challenging, especially given your history with PCOS and hormonal treatments.
- Ongoing bleeding and experiencing issues related to your IUD further complicate your condition.
Explanation:
A1C is a measure of your average blood glucose levels over the past two to three months. While your A1C rose slightly, it still reflects normal levels. Fluctuations can occur due to various factors, including stress, diet, hormonal changes, and even recent weight loss. With your history of PCOS, managing weight can be more complex, often requiring tailored approaches that consider hormonal balance, insulin sensitivity, and your overall lifestyle.
Actionable Next Steps:
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Continue Healthy Eating: Focus on a balanced diet rich in whole foods, including vegetables, lean proteins, and whole grains. While minimizing sugar is helpful, consider engaging in a structured meal plan that combines macronutrients effectively to stabilize your blood sugar levels.
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Monitor Carbohydrate Intake: Reduce refined carbohydrates (like white bread, pastries) that can spike blood sugar levels but ensure you are getting enough fiber, which helps regulate blood sugar. Using a food diary may help identify patterns related to your responses to certain foods.
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Regular Physical Activity: It sounds like you’re quite active due to your job, which is fantastic. Consider incorporating strength training twice a week, as it can help improve insulin sensitivity and promote muscle mass, which can aid in weight management.
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Address Menstrual and Hormonal Effects: Given your experience with prolonged bleeding and the displacement of your IUD, consider focusing on managing any underlying hormonal issues with your current treatments. Continuous or prolonged bleeding can be affected by hormonal imbalances, so it may be worth discussing with your healthcare provider a reevaluation of your current medications and potential treatments.
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Monitor Your A1C and Blood Sugar: As your situation evolves, keep an eye on your blood sugar levels, perhaps with the help of a home glucose monitor if feasible. Regularly checking your fasting glucose can give you clues if any adjustments are needed.
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Seek Support: It may also be beneficial to consult a registered dietitian who specializes in PCOS and diabetes. They can provide personalized guidance tailored to your unique metabolic and hormonal needs.
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Stay Hydrated and Manage Stress: Ensure you're drinking enough water and consider stress-management techniques such as mindfulness or yoga, which can also help balance hormones.
Remember to celebrate the progress you’ve made, and be patient with yourself. Managing health can be a journey, and it’s important to focus on the small victories along the way. If you have more specific concerns or symptoms, follow up to discuss them in more detail.
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