radd I'd like to pick your brains if I may? I'd also be grateful to hear from anyone who might be able to help me understand things!
When I did the Zoe test in January my average blood glucose level (estimated hba1c) was 5.5. but have attached the daily readings - (according to diabetes.co.uk prediabetes is 6 -6.4) so average reading was fine but daily I had some days at 5.9. So I resolved just to keep an eye and try to eat better.
I've been thirstier than usual lately; I've been awake an hour and already drunk a litre of water. (Posted recently thinking it might be Sjogrens!) Subsequently I've been weeing a lot too.
Since dry mouth, dry lips, itchy eyes, tingly lip, increased thirst, and thrush (which I currently have for maybe the 2nd time in my life 😫) are all symptoms of diabetes I bought a glucose meter.
I don't have an increase in appetite or weight change though. I also don't know if my increased fatigue is thyroid related because it could well be as my TSH had risen from 0.03 to 1.1. (Endo wouldn't change my dose so could well still be rising.)
2 hours after a brie bagel my glucose was 10.5 which is 'prediabetic' (7.8-11) but I know I respond poorly to white bread. So tested again 2 hours after a bean and stilton soup, no bread or refined carbs, just the soup and it was 8.3.
Fasting glucose this morning was 5.8 (prediabetes 5.5-6.9).
Obviously I'll keep checking my glucose... Want to be sure before I go to the GP.
But really, my question is asking for help to understand how diabetes works.
I'd have expected bean soup to be fine! (Certainly scores well in Zoe!) So I'm not sure why I struggled with it.
Can all diabetes be controlled with diet? And I've just picked 2 bad meals to test? Or is this insulin resistance? My understanding is Type 1 diabetes comes on quickly and I don't think I tick that box. So logic would suggest type 2 diabetes or insulin resistance?
I'm so far out of my wheelhouse with this and I know technically I'm on the wrong board but the diabetes board is SO quiet. All the best people are here. 😁
In fact I'm not even sure what my question is. Just rambling hoping for a bit of support and advice!
you have so many questions, and there are so many gaps in your story it’d be hard for anyone to effectively fill in any gaps.
Two things I would suggest would be asking your GP for an HbA1c tests which reflects an average of your blood glucose for several weeks, 8-12ish.
Many, many things impact blood glucose readings in addition to what you eat and drink. Things like, quality and quantity of sleep, stress, illness/viral activity, weather, hormones, hydration, exercise to name just a handful.
Some forms of diabetes can be managed by diet and lifestyle, but not all, and whilst we tend to categorise diabetes as Types 1, 2 and 3c, there are multitudinous nuances across those types.
Secondly, if you are looking to learn about diabetes, then a focused diabetes forum/site is really the place to go. There you will be on the receiving end of centuries of collective lived experiences.
My suggestions would either be diabetes.co.uk , or diabetes.org.uk.
Sounds like blood sugar testing is much like BP testing the more you do it the more anxious it is likely to make you... I can't decide whether to try the blood sugar testing route as it will just give me biscuit anxiety 🙃
Perhaps; I find each dodgy glucose result vindicating rather than anxiety-inducing though. That something is still not-quite-right, and hopeful that I can change it!
It's natural that by instinct you think of diabetes with these symptoms. The thirst and weeing a lot I had in early hypothyroid days particularly, it was all investigated for diabetes and turned out to be nothing. I'm still not diabetic.
Your TSH has risen so there's a clue.
Strange question but bare with me. Do you have hypermobile joints/double jointed?
I was never sure if it related to the connective tissue issues I have tbh or just plain under medicated! I went through a phase of waking in the night and having to down glasses of water I was that thirsty.
Dr Peatfield I think it was used to call hypothyroidism the great mimicker, which if you think about it with thyroid hormone being needed by every cell in the body, it makes sense. You might want to think about pushing for an increase and see if that makes a difference.
I have seen on some groups people saying they are in 'remission' from various hypermobility related issues due to adding T3, vitamins optimal etc. I'm only really a few months into beginning to get things right and have a long way physically to recover so fingers crossed!
If it’s insulin resistance low carb diet is likely to help. Foods you previously thought were healthy (and they are if you can process them) contain more carbs than you think, for example beans.
I’ve found the people over at diabetes.co.uk to be really helpful and friendly. There is another.org forum that are different and have a different philosophy and not so much with the low carb.
There is a link between diabetes and thyroid mind. I think if you’re not optimised with thyroid medication you’ll show high blood sugar because you can’t metabolise it and it looks like insulin resistance, which I suppose by definition it is, but not caused by diet rather not optimised thyroid meds. Just my opinion and not particularly reflected in accepted science.
So the low carb might help but not if thyroid isn’t optimised.
would you be able to add which is the .org site you refer to with the different approach? Keen to see what this might be given right now low carb is in fashion!
There is diabetes.co.uk whose members mostly (not all) low carb. If you go to newly diagnosed you’ll see posts from others asking for advice along a similar vein to what I think you’re after.
There is diabetes.org.uk who will give a more broad strokes approach on advise on a range of healthy eating, switching simple to complex carbs, include fruit, and advocate support in the form of medication.
I’m definitely not disparaging either group, we’re all trying to muddle along finding something that helps us. For me, my diet is healthy, it made no sense to continue the same so tried low carb with some success.
I have blood sugar numbers very similar to you (food dependent) and managed to my hba1c from 48 to 41, with no more than 100g carbs a day, max 30g carbs a meal, 2 meals a day. The rest I think needs more t3. It really is worth going to your gp to get hba1c checked because you might be lower overnight so average out to under 42 for your hba1c.
My delightful gp wouldn’t test for thyroid saying; “you’ve just let yourself go. It’s your age (I’m 43). It’s the menopause (regular periods).” If I’d continued with their advise I’d be under medicated for thyroid, on statins for cholesterol, metformin for blood sugar, gaining weight, and thinking it was all my fault. But there is always the hope that there are great gps with a holistic view out there.
I suggest you make an appointment to speak to your GP. They will arrange for testing as appropriate. It may be diet will sort out your issues if not then medication will be offered as appropriate. I have been T2 for some years now and I don’t test unless I am feeling hypo. In that case I need to sort out very quickly.
When I was prescribed a particular drug I was given a meter and testing instructions. I followed this until stable on the drug. I soon realised how life never mind food/ excercise affected levels.
Certainly I now wouldn’t be testing with the regularity you are as I know it would probably give odd results unless life followed exactly the same pattern every day. In reality it doesn’t and I know even thinking about having to test so much would make me a little stressed. My heart goes out to T1 people who need to test constantly.
Diabetes UK offers a lot of useful advice but it makes it clear we are all individuals. There is no one size fits all. The downside of Diabetes UK is the forum side of things. Unlike here there are no admins with clear sensible advice. I find it populated by a number of overly obsessed individuals. Maybe they are right and I am wrong but I am doing well and have regular reviews where bloods are monitored by diabetes nurses.
Yes - Most people would be at the GP by now but having had such an horrendous experience with medical gaslighting etc with my thyroid I'm reluctant to go back unless I absolutely have to.
At this stage I'm just putting out feelers to see if I can support my health myself without needing medical intervention.
Hello there, I know that you start seeing a pattern with your glucose, but like others have mentioned, if your thyroid is not working properly or your replacement is not optimal, things can start to 'creep up'. Your metabolism is strongly connected to the amount of thyroid medication you are receiving, if the TSH is going up, it may be that you will need more thyroid medication to keep you going. If you have less hormones available, consequently glucose and cholesterol levels may go up, as your metabolism is less efficient in clearing these from your circulation.
In general, if you do a random blood glucose test (not fasted), anything above 200mg/dl or 11.1 mmol/l is considered diabetes, your tests may imply impaired glucose tolerance, but it would be interesting to see if your cholesterol has gone up as well, as this would be in line with the metabolism slowing down due to the lack of thyroid hormones.
Yes, pre-diabetes can be managed by diet and lifestyle, but if it is the thyroid medication that is the culprit, you should optimise this first, because if that is the reason, the blood glucose levels will return to normal without any dietary intervention. Many moons ago, GPs diagnosed thyroid dysfunction on elevated glucose and cholesterol levels and prescribed replacement until the levels were normal again, these days, they are obsessed with the TSH and fitting everyone into the 'normal range'. How many cases of pre-diabetes or even diabetes could be prevented if GPs would treat their thyroid patients accordingly....
After all the comments on here and the reading I've been doing I'm inclined to think this is impaired glucose tolerance. My (private) consultant has refused to change my dose so while I also think I need an increase, I'm not going to get one until I can afford an initial appointment with a different endo so this dose is as best as I'm going to get without going 'off-piste'. Which I am prepared to do but as a last resort, and I'm not there yet!
So - I do what I can with what I have! At the moment I think I'm going to need to try managing my glucose levels with diet and see what that brings.
Oh, I feel for you. Everything drives everything else.
If you can get blood sugar levels properly balanced, it will help improve the state of your mental health. When my sugars used to suddenly plummet when out, I used to feel really shaky, see double, didn’t know what was going on around me, anxiety levels went through the roof. I felt out of control and all compounded by that extra cortisol/ adrenaline release trying to get sugar balance under control.
And its not only about refraining from excess carbs/glucose foods, as involves thyroid hormones, the adrenals and pancreas. Eating the perfect fats, proteins and carbs ratios will encourage better glucose metabolism but if there are underlying problems such as low thyroid hormone or insulin resistance it will be difficult to regain wellbeing.
It important to understand sugar levels can elevate without us eating, when cortisol released in response to hypoglycemia, signals to the liver to break down proteins/fats for energy by stimulating stored sugar (glycogen). This is a safety mechanism to ensure the brain gets enough fuel but used continually will induce inflammation, and changes signalling on many levels to lower metabolism (more RT3, etc), and if insulin resistance is present that glucose might hang around for ages in the blood.
Low or impaired thyroid hormone function will impair further thyroid hormone function, eventually reducing the rate our cells uptake glucose, the response of insulin secretion and clearance, and encourage excess cortisol release until finally signalling reduces output and we don’t have enough (aka adrenal fatigue). The cortisol hasn’t worn out, its just conditions aren’t right to make enough.
Low somatostatin (pancreas) may also impair glucose gut absorption, and leptin resistance which is a major regulator of body weight and metabolism will suppress good use of T3 when the body sensing starvation will increase or retain fat stores (same as calorie deficit or continued hypoglycaemia!). Like the impaired DIO2 in hypo peeps, there is also research showing hypos tendencies towards various genetic mutations identified with gluconeogenesis, glycogen metabolism, and insulin signaling.
Have you done a saliva cortsiol test? Regulating cortisol is paramount and can be encouraged to normalise through use of adaptogens. I reversed my blood sugar issues over 6 months by eating several smaller healthy meals a day that all included protein, healthy fats and low GI carbs. Protein is important as is filling and takes longer to digest so keeping you feeling full for longer and sugar levels balanced. You can also a protein powder/bars (I still use pulsin’ when I'm out and about). Protein also makes tyrosine which helps make thyroid hormones (if you have any gland left).
I have used plenty of Ashwaganda as my adrenal support over the years and berberine, Alpha Lipoic Acid for sugar issues, later switching to a Glucose Support combo. Recently I’ve switched to sprinkling a little myo-inositol on my breakfast. Oh, and I’ve just bought some full spectrum amino acids recommended by the lovely Eeyore.
The glucose monitor is great but we can get too hooked up on the numbers. Blood sugars do wax and wane (its normal), and it's the state of our metabolic flexibility that determines if we are able to reduce these wide variations or withstand them.
I like this old paper as easier to understand. ... Reduced glucose absorption from gastrointestinal tract accompanied by prolonged peripheral glucose accumulation, gluconeogenesis, diminished hepatic glucose output and reduced disposal of glucose are hallmarks of hypothyroidism.’
Sorry for the delayed response, radd. I wanted to reply properly from an actual keyboard and not my phone!
I've been testing upon waking, before meals, and 2 hours after meals.
Waking have all been low 'pre-diabetes' range,
Before meals are all 'low-normal'
2 hours after eating are all mid to high 'pre-diabetes'.
We went for a day out yesterday. Arrived at 11 walked for an hour, stopped for lunch then walked until we went home at 2:30. A hefty walk at about 7km. BG dropped to 3.2!
My hbA1c result in Jan 2022 was 35 and in Feb this year was 33. (Had it done at the GP within the year but they retracted all my access 🙄 so I can't see the results but I remember it was in the low-mid 30's. ) So hba1c looks pretty stable. So if hbA1c is stable, and looks to be a reliable test (outside of T1 diabetes), then it's pretty safe to rule out T2 diabetes.
So I'm either looking at T1, which isn't outside the realm of possibility give its autoimmune, but unlikely. I also think my symptoms and results are too mild for that. So, all that is logically left is glucose intolerance. So I think the task here is to work out if it's being driven by my thyroid or not.
In truth, I've read your post about 5 times and I'm still trying to process it!
For a long time I was flapping about trying to fix all the things at once, this was a mix of feeling so unwell but also the obsessive/compulsive bit of my brain. Now I've got to a reasonable level with my thyroid the storm is calming. I've never tested cortisol - never seem to have the spare cash for it and I took the stance that if I can get my thyroid under control that might settle any cortisol issues. If not, I'll cross that bridge when I get there.
I have recently (3 days ago!) started a GF trial so we'll see what that brings. Without bread and pasta readily available I'm forced to avoid the carbs that I know I don't tolerate well so that might make a difference to my BG levels.
I have also noted that the OCD/anxiety is connected to my menstrual cycle, getting much worse in the 2nd half.
SO with all that in mind I am inclined to think there is something not quite where it should be but it's almost certainly hormonal. Having put all that down on paper along with a few other symptoms it could also be suggestive of peri-menopause ... except I'm only 36... but further confirms it's hormones.
As I mentioned to Tina_Maria, I'm not going to get a change in dose from the endo. He is happy with my results and was adamant there would be no increase. I've been changing my dose every 12 weeks since June 2020 and in all honestly, I'm exhausted by it. So while I still think there is room to improve my thyroid, I'm grateful for the 'permission' to stop changing dose. I will give this dose another 3 months and test again and see where I stand.
In the meantime, I need to support my health another way. It is, perhaps, a kickstart to re-commit to the zoe app....
I wrote that reply to make you see there is no one answer or a quick fix as blood sugar issues are a complex combination of many systems not functioning optimally.
Going g/f is an excellent move forward. It made such a difference to me and many have said the same. Not just on the reduced farting and a flatter gut 🤣, but reducing low grade inflammation and allowing hormones to work better. Even my brain fog cleared.
And the Zoe app is all about balancing blood sugars, and eating more mindfully. I can't wait to start mine. I'm pretty good eating anyway but I want it confirmed I'm heading in the right direction. Good luck.
I think you mentioned in another post that you were urinating a lot since the intro of T3. If I am wrong I apologise. However the same thing happened to me when I introduced T3. It had nothing to do with what I had been drinking. I think I was getting rid of mucin. I had a ‘swollen’ leg for about thirty years and although my T3 was cut short, so far, the leg is virtually the same as the other now. I have no idea whether this will remain. What I want to highlight here (as others have referred to as well) there is a close relationship between under medicated hypothyroidism and type 2 diabetes. Apparently mucin contains some form of sugar too. It could just be simply the effect of the T3 and likely temporary until the body balances out. Usual question “How do you feel?” How are you measuring the sugar?
That wasn't me! My weight hasn't changed since I was 18 (apart from during my pregnancies) so in theory it was 'great' but I'm sure it's part of why it took so long to get a diagnosis. I didn't fit the mould.
I'm using a blood glucose meter to test levels. Fasting, before meals, and after meals.
I just feel a bit under par.. lethargic and headachy... better than I did 3 years ago but still not back to 'health'.
You're right, it's stressful and hard work to look after ourselves without any guidance or support from GP's!
According to medics there are an awful lot of people not fitting the mould for hypothyroidism - even overweight ones! It’s the medics ignorance which brings about ‘late diagnosis’ and it’s their ignorance which means even when there is a diagnosis, they treat it improperly. They just see Type 2 diabetes as a Co-morbidity and surprise surprise they want to treat that. It may be that it comes to that. It’s what Co-morbidity is about. However (like cholesterol levels) this might settle when you get your thyroid optimally treated.
hi. I’ve just started Zoe too and have been amazed by the glucose monitor and what it is teaching me. I have huge spikes which means high insulin. I am also in early pre-diabetes. I have been reading the glucose goddess, see her book on Amazon and her Instagram account. She proposes that the key to almost everything is to flatten the spikes, which reduces the insulin and many other benefits, reduced inflammation, reduced oxidation. I seem to have reactive hypoglycaemia so crash well below baseline when asleep Anyway, I have been trying her ‘hacks’ and in one day, yes one day, my spikes are gone. It will take a while to properly reduce the insulin but this clearly works. I’m on my phone now so not explaining it fully but intend to do a full post when I’m further in. Feels like the most important health step I’ve taken. Highly recommend checking her out. It is things like greens before protein before carbs. Vinegar before eating. Walking after eating. I’ve done these things and had no spike.
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