Hypothyroid with low fasting blood sugar

[Daisydarling]

Hello,I am a 73 year old lady who has been on thyroxine(50) for thirty years.I also have high cholesterol no statins as Dr said good is higher than bad.My husband was prediabetic so I got a glucose moniter.For the past few weeks have been very depressed as have children and grandchildren who are key workers.Last night woke up sweating and this morning blood sugar very low 3.9. I am not diabetic and eat very healthy. Two hours after breakfast it was 5.9.This was a high sugar breakfast cereal fruit yoghurt.Still feeling shaky. Anyone else have this? For the past few months have been unable to excersise due to this and when I do feel dizzy.Thank you x

[greygoose]

50 mcg levo is a very low dose. It's just a starter dose, really. When did you have your last thyroid blood test? Did you get a print-out of your results? If so, post them here with the ranges, and let's have a look. I wouldn't be at all surprised if you're not under-medicated! And, high cholesterol would suggest that your FT3 is very low.

[Daisydarling in reply to greygoose]

Thank you,they don't test for T3 have asked them.They keep telling me it's ok have test every six months) I have always been on 50 for thirty years,and now they prob think at 73 too old to go higher.Thank you so much for your replyI will will ring and get the results x

[greygoose in reply to Daisydarling]

Too old? What nonsense! I'm 75 and am on 50 mcg T3 only, at the moment - that's three or four times your dose! It's far worse for your heart to be under-medicated than slightly over.

[Daisydarling in reply to greygoose]

Are you on 50mcg thyroxine do you mean or 50mcg T3.He did test T3 many years ago and said it was ok. How do I ask for it as they won't test.When all this virus has finally settled down I think I will see an edrincrinologist privately. I said to the doctor that my sympton feel like I am going into heart failure.Thank you for helping me.

.

[greygoose in reply to Daisydarling]

As I said, 50 mcg T3 only. No thyroxine.

Just because your T3 was 'ok' years ago, really doesn't mean it still is - even if it really were then, which I doubt!

I can't really tell you how to handle NHS doctors, because I live in France. And, when I see they haven't put down FT3 on the form, I just say 'I want FT3, too'. Sometimes they argue saying they don't know how to interpret FT3 - which I don't doubt - so I just say 'that's ok, I know'.

Be very careful in your choice of endo. Just because they're private, doesn't mean they know any more about thyroid than other endos. Most endos are diabetes specialists, with just vague ideas about thyroid. It would be a good idea to email Dionne at Thyroid UK to get their list of patient-recommended endos:

[e-mail]

[SlowDragon Administrator]

Stress can exacerbate thyroid conditions....but you sound under medicated

Standard starter dose of levothyroxine is 50mcg (unless over 65 years old).

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

First thing is, do you have any actual recent blood test results? if not will need to get hold of copies.

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels and antibodies if not been tested yet

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3, make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks currently has 25% special offer

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

High cholesterol linked to being under treated

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

Add any results you have...or

Come back with new post once you get results

[Daisydarling in reply to SlowDragon]

Thank you for such a helpful reply.I have been on 50 for such a long time and they keep telling me everything is normal.Also have low iron and thought that was causing the tiredness.I am worried if I go higher it may affect my heart.Will ring surgery and ask them for the numbers and let you know as I will need help understanding them x

[pennyannie in reply to Daisydarling]

Hello Lolasmummy

I think that because you know that you eat well and know that you have low iron, your ability to convert the Levothyroxine into T3 is probably compromised.

My ferritin needs to be up at around 100 for my conversion of the thyroid hormone replacement.

This tells me that you are not metabolising your food well and would hazard a guess that you probably need an increase in Levothyroxine to assist in your body's metabolization.

It might be a good idea to ask your doctor to also check out you ferritin, folate, B12 and vitamin D as these all need to be optimal and maintained at good levels for any thyroid hormone replacement to work effectively.

If you doctor will not help you there are private blood test companies as detailed on the Thyroid uk website where you can get a full thyroid panel including TSH, T3, T4, as well as the vitamins and minerals as detailed, and once with the results start a new post on here, with the results including the ranges and people better able than me will talk you through your next step back to better health.

[Daisydarling in reply to pennyannie]

Thank you pennyannie,so glad I posted on here.Getting some very helpful replies x

[SlowDragon Administrator in reply to Daisydarling]

Just ask receptionist for printed copies of your blood tests ...including ranges

Perhaps they can post or email them to you

[SlowDragon Administrator in reply to Daisydarling]

Low vitamins frequently linked to being under medicated

Low vitamins tend to lower TSH

One of the reasons Just testing TSH is completely inadequate

[Daisydarling in reply to SlowDragon]

Thank you x