Advise please: Levo lowered and pre-diabetes gone to 47

[dragon51]

Hi all

in a bit of a dilemma. Had levo reduced from 100mcg to 75mcg 10 February 2020 and a recent blood test revealed my pre-diabetes of 43 done in October 2019 has risen to 47. Now I am in panic mode, one step away from type 2 diabetes despite being skinny, eating a good healthy diet. No sugar, cards and as little fat as possible and getting enough excercise for my age. Attended diabetic group but as other folk who were overweight lost some weight, I the skinny one gained a little weight.

Question: is weight gain a symptom of hypothyroidism or is it the norm?

Shocked when blood test revealed pre-diabetic reading had shot up from 43 to 47....one step away from being diagnosed as having type 2 diabetes. Shock horror!!!!

Question: Is it normal for diabetes reading to go up so quickly despite all the efforts I made to keep it down?

The blood test also revealed high levels of potassium in my blood. More shock horror!!! From previous symptoms relating to kidneys I suspect in hindsight that I had undetected kidney problems that only came to light because I sort of demanded that my GP do something about my very low motabilism. Hence the blood test.

Question: Is there a link between thyroid problems affecting the kidneys?

Levo was reduced Feb this year from 100 to 75 and I suspect my cholestorol and diabetes levels have shot up since then.

Question: Is it possible for such a sharp rise to occur so quickly?

Am contemplating asking for thyroxine to be increased because I do not think they should have been reduced in the first place. Not asking my GP though. He thinks I am a pain in the butt because I keep harping on at him about the importance of looking at T4 to T3 conversion instead of just TSH levels.

Had enough of Nhs an going to see a private endocrinoligist next week.

Question: If I self medicated and increased thyroxine to 100mcg would this help reduce cholestorol levels.

sorry for asking so many questions......

thank you all

[SeasideSusie Remembering]

dragon51

It might help to answer your questions if you could post the test results - with their reference ranges - that prompted the reduction of your Levo from 100mcg to 75mcg.

I don't understand why it was reduced when in January your endo was willing to increase it from 100mcg to 125mcg.

[dragon51 in reply to SeasideSusie]

Endo who wanted to increase to 125 from 100 suggested this as an alternative because I asked for a reduction of the 100 to 75 and a trial of low dose T3.

This endo had october thyroid blood results when she suggested the alternative 125 increase refusing my option of reduction and T3 added.

Week later saw the boss endo who gave me down the banks over T3 and he reduced the thyroxine because of cardio symptoms that am still waiting to have tests for diagnosis.

The boss endo did have thyroid blood results from blood test the week before and I did not ask for a copy of these results because I was so disheartened and decided there and then to walk away from NHS endo

[dragon51 in reply to SeasideSusie]

hi again susie will post the october blood results that may have prompted the endo who suggested increase of T4 from 100 to 125. Then again she may not have been working from these blood results but rather from how unwell and upset I was at that time. She could see how desparate I was. But still I will post them.

thank you

[dragon51 in reply to SeasideSusie]

Ohh I am loosing the plot Susie. Just re-read your message and see you requested blood results that prompted boss endo to reduce my thyroxine. I did not get a copy of these results and have just realised how important they could be. Question is: did he reduce thyroxine due to results of thyroid blood test or did he reduce T4 because of heart symptoms under investigation.

Ohh just remembered, the blood results would have been flawed because I did not stop taking Bcomplex seven days before as it was an emergency appointment out of the blue.

Wont send you october blood results because don't think they are relevant

[dragon51 in reply to SeasideSusie]

hi again susie i have found endo letter to my GP with thyroid blood results that may have prompted endo to reduce T4 from 100 to 75

in his comments he states: free T4 levels of 26.3 pmol/L with a TSH of 0.15.

I NOTICE THERE IS NO MENTION OF FREE T3...!

He (endo) also states to GP that i am over medicated and most of my symptoms are attributed to over medication.

as i said earlier these blood results are flawed because i was still taking b12 complex at time of thyroid blood test.

Susie to what extent does biotin effect these results?.

Is it safe to assume he has done the right thing by reducing T4?

[SeasideSusie Remembering in reply to dragon51]

Susie to what extent does biotin effect these results?.

Nobody knows. Even when the lab mentions Biotin, it states only "false results".

Is it safe to assume he has done the right thing by reducing T4?

Without the reference range it's not possible to say but I doubt that he has done the right thing. If it was my lab's range you'd be hugely over the top as it's 7-17, but we also see higher upper limits of 22 and 23, even 24. So it depends on the lab's range how much over you are. But he could, of course, just be looking at your TSH because that is very likely to be below range.

But the biggest mistake is not testing FT3. If your FT3 is low compared to your FT4 then you are not converting and need less Levo and the addition of T3.

We have to remember that the majority of doctors don't understand T3, nor the importance of the FT3 result. this is what keeps many of us ill.

[dragon51 in reply to SeasideSusie]

thanks Susie

Yes reduction in T4 and addition of T3 was what I hoped for after THS blood results October 2019 which shows poor conversion issues. No wonder my heart, kidneys etc are failing me .....not enough FT3 to promote good working order.

Got an appointment to see a private endocrinologist next week. Hope he is willing to take into account the importance of paying attention to my concerns about T4 to T3 conversion issue. Plan to take him a research paper concerning conversion if I can find one.

many thanks

[BadHare]

Just a quick reply...

Good fat doesn’t make us fat, carbohydrates do. Look up low GI (glycaemic index) foods. Lots of free pre diabetes/autoimmune information on Chris Kresser’s website, also Michael Mosley’s re diabetes & lowering blood sugar. Some good articles in the Guardian re type ii.

[dragon51 in reply to BadHare]

is fat from brazil nuts good fat. Guy running diabetes group said not to eat them. Was annoyed because brazil nuts were my source of selenium

[SeasideSusie Remembering in reply to dragon51]

Was annoyed because brazil nuts were my source of selenium

Don't worry about that too much. If the pack doesn't state "Grown in selenium rich soil" or the area grown in, or the actual selenium content, then chances are there's little to no selenium in them. See:

honey-guide.com/2012/11/19/...

I believe Sainsburys state the selenium content (not sure if it's tested or how accurate it can be) and that M&S Natural Brazil Nuts have information about selenium content.

Often it's best to take a supplement to be sure of how much you're getting.

[BadHare in reply to dragon51]

Yes, nuts are good, aside from peanuts as they are a pulse & the oil can be inflammatory. I eat a few Brazil’s a day but opt for almonds as they’re high in protein, & also walnuts. These have healthy oils. Chia & linseeds are also good. If you feel you’re more hypo than usual, see if you feel better without as some people find them goitrogenic. I tried exclusion, but feel much better for eating these foods.

[SlowDragon Administrator]

The easiest option is to try increase in levothyroxine....as outlined below

If that doesn’t help, then look at slight reduction in levothyroxine and addition of small dose of T3 alongside levothyroxine

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor



please email Dionne at

[e-mail]

essential to regularly retest vitamin D, folate, ferritin and B12

Yes ALWAYS stop any supplements that contain biotin a week before any blood tests

[greygoose]

No sugar, cards and as little fat as possible

That is not a healthy diet. You need carbs to convert T4 to T3. If you're not converting well, then you're making yourself more hypo.

The body needs good fat for all sorts of things. Low fat diets are dangerous, can lead to depression and suicidal thoughts. You also get your energy from fat. The fats to avoid are the highly processed seed oils, but butter, animal fat, olive oil, nut oils, etc. are necessary for a healthy diet.

[janey1234]

I absolutely agree with BadHare 's words and recommendations. Also check out Dr David Unwin, a GP who has had huge success reversing pre / diabetes with carb' education. Here's a link which will show you the sugars in everyday foods that he has produced for NICE , etc.... phcuk.org/sugar/

An eye opener 🙂

[Angel_of_the_North in reply to janey1234]

Shame about spelling errors, make me unwilling to trust it. Also numbers in fruit chart are not the same as common food chart. Does no one use copy editors and proofreaders any more? Charts contain very few foods so not terribly useful. I'm sure there are better sources.

[janey1234 in reply to Angel_of_the_North]

not sure what's wrong with this source? Dr David Unwin's work with diabetics is highly regarded & he is followed by the ITT campaign, Drs Clare & Michael Mosely and many more influential campaigners for better health information. Lots of people have benefited from his research and guidance and reversed their pre / diabetes 🙂

[Angel_of_the_North in reply to janey1234]

Uncorrected spelling error and numerical inconsistency = shoddy workmanship. Very few foods listed. OK, there is white rice, potatoes and bananas which everyone knows are high GI, but where are the other fruits and veg and non-wheat "grains" and seeds. I think there are about 4 things on all those charts that I actually eat. I found Patrick Holford's Hybrid Diet much more useful as it has lots of foods and both GI and GL charts. Doesn't matter how good his knowledge is if the published information is not up to scratch.

[Tina_Maria]

There is a strong connection of hypothyroidism with increased glucose and cholesterol levels. If you do not get enough thyroid hormones, your metabolism will slow down and your clearance of glucose and cholesterol from the blood is impaired, hence the elevated levels.

Before the introduction of the almighty thyroid function tests, a high cholesterol and glucose level was seen as indicative of hypothyroidism and warranted treatment with thyroxine. These days GPs / endos are more concerned with sticking everyone into the 'normal' reference ranges, without looking at the whole picture and what else is going on. Many don't realise either that if you are giving too little, other systems are also impacted by this lack of hormones.

And another thing, if your thyroid hormone level is not properly adjusted and tailored to your individual needs, no amount of dieting or starving yourself will get your weight, cholesterol or glucose concentrations down. You need to get your levels assessed properly (including free T3 assessment) and then you can see what the problem is. I suspect that you would need an increase not a decrease in hormone levels. Also, a suppressed TSH is no reason to decrease your thyroxine, even if your free T4 is slightly over the normal range and especially if no T3 was measured. And once you are on the right dose of thyroxine again, your cholesterol and glucose levels will improve as well, therefore it is important to get this sorted! Good luck!

[dragon51 in reply to Tina_Maria]

hey Tina Maria so sorry for late reply to your most welcome comment which is so informative and helpful that put things into perspective for me. A life saver really. Printed your comment to help me try and retain the info because i totally agree with you.....it all makes sense to.

thank you most kindly

[Tina_Maria in reply to dragon51]

No worries - lots going on at the moment!

Glad you found this helpful, try to follow it up sooner than later if you can and don't take no for an answer - the sooner you can get to the bottom of this, the sooner you can get it sorted! All the best x