T4 / T3 causing significant glucose spike - Thyroid UK

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T4 / T3 causing significant glucose spike

Joyya profile image
37 Replies

Despite eating low carb and having normal fasting blood glucose in the morning, I been getting these wicked glucose spikes ***12 hours after my dose of T4 / 6 hours after my first dose of T3*** I can't determine which one is causing it yet, but it's been basically the same two days in a row.

I take 0.75 mcg T4 at 10:00 pm

3.75 mcg. T3 at 4 am and 10 am

5 mcg T4 at 4:00 pm

In the literature, both T3 and T4 are associated with increase in blood glucose

Does any have an idea on how I can minimize this glucose spike by adjusting the timing of when I take them?

I have current gone very low carb to try and minimize the effect. I had T2D for 8 years but was in remission the last 4. I really don't want to wind up diabetic again.

Thanks.

Joy

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Joyya
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37 Replies
Regenallotment profile image
RegenallotmentAmbassador

hi Joyya, what is in your low carb breakfast?

Peatfield talks about it in his book…. I’ll try and find the section 🌱

Regenallotment profile image
RegenallotmentAmbassador in reply toRegenallotment

found it page 174

Are you also experiencing great thirst and bladder frequency? Exhaustion and fatigue?

He cites Broda Barnes work in the US saying these symptoms can resolve with appropriate thyroid treatment. How are your FT4 and FT3 levels? 🌱

Joyya profile image
Joyya in reply toRegenallotment

Thanks. No thirst or bladder frequently. None of the typical symptoms of diabetes or hyperinsulinemia. My fbg is in normal range (I was t2d for 8 years, was in remission for 3 before I became hypothyroid last summer. These glucose spikes make no sense to me (I am a post grad in human nutrition). Nothing has changed except moving the T4 to at night (which helped symptoms), and slightly shifting the time of the 3 doses of T3.

I am having new blood test this week, but IN October by fT4 was only 46% through the range and fT3 was at 64%.

Been supplementing as appropriate and am having my zinc, iron panel etc rerun. B12, Vitamin D, selenium all good.

Thanks.

Joyya profile image
Joyya in reply toRegenallotment

What specifically does Peatfield say (and pardon my ignorance, who is he and what is his field?)

Regenallotment profile image
RegenallotmentAmbassador in reply toJoyya

Dr Barry Durrant Peatfield, author of your thyroid and how to keep it healthy. One of the most useful books I’ve read. He worked with like minded doctors in the US, collated an incredible amount of useful advice. I can see some similarities (not all mind you) in Dr Sarah Myhill’s approach. 🌱

Joyya profile image
Joyya in reply toRegenallotment

Ahhh, thanks. What did he specifically say about glucose spikes?

SeasideSusie profile image
SeasideSusieRemembering in reply toRegenallotment

Regenallotment

Unfortunately he is no longer alive

Where have you heard that?

There have been no reports of his death and I'm sure we would have heard, there are very many former patients of his here. He is in his later 80s and not in the best of health but if he had passed away I'm sure the news would have reached ThyroidUK and an announcement been made.

Regenallotment profile image
RegenallotmentAmbassador in reply toSeasideSusie

oh my goodness I do apologise I’ll edit my post. I don’t know where I got that from

Delgor profile image
Delgor in reply toRegenallotment

Reggie,

You may have got confused with Dr Gordon Skinner who also was seen by a large number of people on this forum and who sadly died in 2014. Like Dr Peatfield, he didn't follow medical mainstream thinking and prescribed T3 and NDT to thousands of patients, including myself, and gave us our lives back. Unfortunately the constant hounding he endured by way of tribunals undoubtedly caused his early demise but I'm sure will be remembered by so many including Dr Myhill.😘

Regenallotment profile image
RegenallotmentAmbassador in reply toDelgor

well spotted I think you are right Delgor 🌱

Joyya profile image
Joyya in reply toRegenallotment

Thanks. It's usually 1.25 cups natural cottage cheese (no fillers), occasionally 1 cup unsweetened Greek yogurt, or a whey protein shake with 1 cup full fat milk. The shake or cottage cheese have ~30 g protein, 12 g carbs, and the Greek yogurt only 16-20 g protein, 8 g carbs.

I usually eat it at 7:30 the latest, as I need to be finished by 8:00 am because I take one dose of T3 at 10:00 AM.

I'm at a loss for why I am getting this HUGE spike!

Regenallotment profile image
RegenallotmentAmbassador in reply toJoyya

yup that’s odd, how are your frees? FT4 FT3?

Regenallotment profile image
RegenallotmentAmbassador in reply toJoyya

also in Peatfield’s book, prolonged stress, lack of chromium, producing extra cortisol can shut down insulin production… anything there?

Joyya profile image
Joyya in reply toRegenallotment

Hmmm, no added stress now. I have been intermittently taking bovine adrenal gland which may have affected cortisol. But my blood glucose is in the normal range all night and in the morning? And all late afternoon I am not supplementing chromium, so will look at that, thanks.

I am having new blood test this week, but IN October by fT4 was only 46% through the range and fT3 was at 64%

I read your bio, so am going to try taking 1/2 T4 at bedtime, 1/2 in the morning with the small dose of T3 (3.75 mcg).

radd profile image
radd

Joyya,

I previously tackled glucose issues by having smaller low carb meals always with protein and never allowing myself to get hungry by carrying Pulsin’ protein bars (still do).

I took a supplement called Glucofit but there’s loads of known sugar balancing sups such as inositol that studies have found works as well as Metformin. Berberine is good, ALA and have some extra magnesium. Use cinnamon In your cooking.

It took me about 6 months as it’s about regaining insulin sensitivity as much as anything.

ps- studies show too much or too little T3 encourages blood glucose issues so check levels. It might help to multi dose T3 if you aren’t coz it’s about avoiding those peaks that risk ramping up hepatic function too much.

Joyya profile image
Joyya in reply toradd

Thanks. I take inositol daily. Also Mg. I was in remission of T2D for 2 years before becoming hypo. I was no longer insulin resistant. But I was very ill when I was finally diagnosed, so who knows.

I am already dosing T3 tid (4 am, 10 am, and largest dose at 4 pm). T4 is at 10 PM.

radd profile image
radd in reply toJoyya

Joyya

Well that's great. Once thyroid hormones get working well, cortisol function will and insulin and leptin too. It can take a while as there is a lot to reverse such as increasing glucose uptake into cells and reversing a slowed insulin response, and clearance issues. Leptin can also be playing apart as like insulin too high levels eventually create down regulation of receptors.

Previous blood glucose issues mean you risk a predisposition to it happening again so must be extra vigilant in diet. I can eat chocolate, etc fine now but I keep sugar as a treat and my foods are always balanced towards balancing blood sugars. I still eat protein at every meal (sometimes just secondary) and never allow myself to get really hungry.

Chemically, hormones may be classified as either proteins or steroids. TiggerMe has just directed me towards a full spectrum amino acid range amazon.co.uk/dp/B07GV3XMWT?... .. As well as slowing digestion of sugars, protein has the added advantage of making our T3 meds work better, eg if we don't have enough protein, we end up burning muscle. These issues are common but can be carefully nurtured.

Joyya profile image
Joyya in reply toradd

I prioritize protein at each meal, aiming for 30g of high leucine animal based protein and this week, I lowered my carbs and am now in mild ketosis (1.1 mmol/L BHB.Since my youngest son got married and left home, I am eating less veggies high in chromium (because they go bad before I can eat then). I may supplement that and see if it helps.

But still, why is my blood glucose normal later afternoon, evening, overnight and early morning and then goes nuts late morning? That's what has me really puzzled.

radd profile image
radd in reply toJoyya

Joyya

Oh, sorry. I didn’t read your question properly and have been spouting on and on .. 🥱 🥱 🥱 .. 🤣.

Intersting problem …. maybe your circadian pattern is out 🤷‍♀️. We release certain hormones to keep sugar levels adequate during our fast (sleep). Otherwise, you are eating a good breakfast so I don’t know. 

Joyya profile image
Joyya in reply toradd

Thanks. I am super dilegent with sleep timing, exposure to blue light and timing of eating to support circadian rhythms, and morning daylight.

SlowDragon profile image
SlowDragonAdministrator in reply toJoyya

Suggest you try changing timing of T3 a bit more equal through the day

Taking levothyroxine waking in morning, early afternoon and last dose at bedtime with levothyroxine

Joyya profile image
Joyya in reply toSlowDragon

Thanks. Taking my last dose of lio at bedtime won't affect sleep?

SlowDragon profile image
SlowDragonAdministrator in reply toJoyya

Many, many people find T3 at bedtime improves sleep

But some find it keeps them awake

Experiment, see what suits you

Imaaan profile image
Imaaan in reply toJoyya

Curious to know why you take your highest t3 dose at 4pm? I would be more inclined in trying an earlier time like 10am

Joyya profile image
Joyya in reply toImaaan

I tried moving it to then because I was super tired from 4 pm on.

arTistapple profile image
arTistapple

What symptoms are attracting you to the spikes which I would like to know? Or is this just the result of testing?

I have been reading about how T3 especially, releases mucin from muscle (and other tissue). Mucopolysaccarides? essentially a combination of sugars and fats which are virtually unique to hypothyroidism. This can create spikes in blood sugar but essentially it’s not diabetes, it’s just being released from where it has been trapped when suitable medication is taken. Some of this is explained by Broda Barnes. To ‘recover’ health 1.) it’s got to be released from muscle tissue, connective tissue, and organs as well as skin. 2.) it’s a proper/normal issue of metabolism. Obviously hypothyroids have a glut of this to get rid of before ‘normal’ operation can resume!

I had a very brief commune with T3 which coincided with my annual testing for diabetes. My blood sugar which has been on the cusp for years, suddenly shot up putting me in the diabetic club. So now eyes, feet, etc being monitored. However, with no change to diet and since stopping the T3, it has dropped back down again below diagnosis of diabetes. So I am back to being unable to utilise the contents of my mucin. It’s the hypothyroidism that brings about this inability to utilise the substance - I think likely contributing hugely to our physical exhaustion. Off course you could have diabetes from something entirely unrelated but what are the chances?

Joyya profile image
Joyya in reply toarTistapple

Omg! Please, where did you read about T3 breaking up mucin? This may be the missing piece!

No symptoms of high blood glucose. I started testing agsin this week after I had a wisdom tooth out and was fasting. I felt as though I was hypoglycemic, which is why I tested the first time and was shocked to see it was so high! Same thing happened yesterday.

I have been remarking as recently as last week that I now look "lumpy" because the mucin is coming out!! I had TONS of mucin in August. My legs were rock hard with it, my butt, even my abdomen. It is finally starting to come out.

It's definitely not diabetes. I work in this area. My blood glucose remains in remission most of the day. Well below cutoffs. But I get these crazy spikes.

Can you please send me the link or who wrote this, so I can read more.

I think this.may be the answer.

arTistapple profile image
arTistapple

Joyya I got this info from a number of different sources. If you google Mucopolysaccarides you can find a broad-ish amount of info about them and their content and their affinity with hypothyroidism. Another reference is the Canadian site for hypothyroidism where I am certain the reference to T3 came from. I will have a look for it and let you know. Sounds like you might be getting rid of yours big time. I have had one fat leg and one thin leg for years. Fat leg has varicose veins so I just blamed them and lived with it. I was on T3 for about a week in January and it slimmed right down. I was hoping it was gone, I was enjoying that leg being slim again. Another two months later I can feel and see it coming back. Ages ago when I first started looking at ‘mucin’, there was not that much I could find but under mucopolysaccarides (I hope I have the correct spelling) there is more. And I wish I kept better notes! Thinking of my experience with palpitations during the night, whilst on T3, reminds me of your expression of ‘spikes’ which I assumed, for me, were either when T3 dropped or was raised. It’s hard for me to tell which direction when I feel I have something to worry about. It’s not easy to ‘read’ this disease when we are doing it on our own.

Joyya profile image
Joyya in reply toarTistapple

Thank you.

I actually found this group looking for info on mucin back when my legs were so hard they looked like sausages about to explode.

I've not come across anything on the Canadian site that pointed to blood glucose spikes related T3 liberating mucin / mucopolysaccarides.

The spikes are not like palpitations caused by too much T3, but like the spikes of diabetes, while having normal blood glucose most of the time.

If you can find where you read this, I would be most appreciative.

arTistapple profile image
arTistapple

As I say my notes are not brilliant. However I am pretty certain the Canadian info was about taking T3 and a consequent rise in sugar levels noted in the blood. No reason was given there I don’t think. It was just observed.

The reference to releasing mucin into the blood/urine escapes me but I will keep looking. I do wonder though how else it could be discharged, other than through the normal channels!

The fact that the content of mucin is mucopolysaccharides, a group of chemicals (sugar, fats and salts) present in normal metabolic processes in the body but not dealt with properly by those with hypothyroidism, comes from this book - Dr. Broda Barnes, Hypothyroidism:The Unsuspected Illness, where he refers to an autopsy undertaken by another doctor who seems to have discovered mucin. His explanation of what it is and how it is stored in the body (relatively safely ha!) is all due to the inefficiency of the metabolism of the hypothyroid. If I am adding two and two and making five, I apologise. However I think it’s brilliant that you are shedding yours.

I am still confused about ‘spikes’. No symptoms? By testing? I am interested in any reaction to T3 especially because I seem to have had so much trouble trying it. In the natural way of things, some ‘spikes’ will be overt (my palpitations) and some ‘covert’ and found only through testing. Just interested in how you got the knowledge about your spikes. Are they symptomatic or is the word spikes in common usage when referring to diabetes, whether symptomatic or not? No worries if we are still not understanding each other properly. I am not nearly as articulate as I would like to be.

Joyya profile image
Joyya in reply toarTistapple

Thanks for the added information.I remember reading about that autopsy.

If you could find any credible information about T3 mobilizing mucin, I would be very thankful. BUT at the end of the day, mucin IS breaking down and it has to go somewhere. I imagine the lipid part is metabolize the same as fat stores are when they are mobilized, and the sugar component would go through the same pathway as glycogen breaking down — hence the rise in glucose. It makes sense the one or both of the thyroid hormones is responsible.

As you how I got to the knowledge about my spikes, I am a healthcare professional, as well as someone with hypothyroidism.

Thanks again!

arTistapple profile image
arTistapple in reply toJoyya

I will keep looking but as you say the important things are that the mucin is going and the spikes are not indicating diabetes. Unfortunately my testing, what I think you might be referring to as ‘sugar spikes’, have indeed been seen by medics as taking me into diabetes. No symptoms but that’s not altogether uncommon with diabetes. These spikes promptly disappeared when T3 was stopped. Previously there was no disruption to diabetes testing/levels for years (whilst always remaining on the cusp) before thyroid meds or indeed during the 18 months when only on levo. It’s my own fault for complaining. There is a sense that when one complains the medics charge into action. They feel they must do something. Whereas sometimes it’s just safer to quietly go about your business.

Sleepman profile image
Sleepman

Hi,,

edit. Just saw all the mucin discussion and this post may not be relevant.

Interesting thread. When did you start T3?

I am currently prediabetic and recently hypo/hashi.

I have similar peaks after food to 9 or 10.

Your levels at other times look better than mine, but I am not on such a low carb diet.

I wanted to go on keto diet but was a bit scared off after researching once thyroid issue understood.

I am hoping as my thyroid throttle kicks in overtime, I will improve as body "functions" improve.

My cholesterol has dropped 2 pts to 5.5 and target is below 5.

I am slowly coming down to on HbA1C. 46 a year ago, then 45 and now 44. Target is below 42.

What is your HbA1c level? I suspect better than me as I test in the morning on spot tests say 5.6 to 6.8

Started T4 in October, so recent like youself.

I was doing a spot blood test in the morning but it was not reliable as our bodies natural cycle lifts levels ready to start the day. I am certainly no expert but wonder if delaying breakfast may help.

Good luck

Joyya profile image
Joyya in reply toSleepman

Thanks. I started in NDT (non-prescription) and was doing very well. My MD wanted me to stay on it because I was doing so well, but I wanted a legal script so I could travel, and heaven forbid, needed to go to a hospital. I started on a mix of T4 and T3 in October. Was fine at first.

I had no concerns about going from low carb to a ketogenic diet (not an online "keto diet) as I am following classic 2:1 protocols and did it for 2 years 2017-2019. I am a healthcare provider and well versed in the protocol.

How does your HbA1C range from 5.6. 6-8 when tested the same day? The range should be much closer than that.

I eat breakfast before 8:00 am because of taking one of my T3 doses at 10:00. Moving my breakfast to 10:30 to see if that helps would be difficult on work days as I am in clinic from 9:00 am on. We are the most insulin sensitive in the morning, so I am at loss why I get the spike just before my 10:00 am dose.

Sleepman profile image
Sleepman in reply toJoyya

virtahealth.com/blog/dawn-p... 5.4 is 97 and 7.7 is 139 to get the chart on the same units.

Hi Joyya, I am no expert but I want to make sure I get better.

If your long term average is good, do you have to worry about these spikes ?

I find your post fascinating, my Mum is low thyroid and is struggling with swollen legs and she does not have T3 just levo.

My tests 5.6 to 6.8 (actually 7.1 looking at records) were over several months.(fasting - morning) Panic .... 7.1 was a recent one, As I said my recent HbA1C had dropped slighlty, I could not underdstand,

I read up and found the "dawn phenomenon" - your body making "sugar" from reserves of non sugars

When I charted versus time of day results all my higher results were later in the morning (9 - 10AM). Data now made sense.

As I say I am prediabetic. I stabbed/tested myself all day when I found this information and range was 5.3 to 8.1 . My 4:30 reading was 6.7 which concerned/confused me. I have stopped taking fasting bloods.

I have been dabbling with T3 over recent weeks though, as I was feeling fatigued. 1 off 25 mg tablet over a week when I have busy days. One chunk of say 5 mg first thing with my T4.

Thank you for sharing your experience/comments on keto. I will read up on Keto more. I did it for 3 months and 2 months in 2019 and felt wonderful on it. Lockdown stopped me repeating it as meals had to be more for the whole family. I am gluten intolerant (2021) and found this out a year before discovering autoimmune low thyroid.(Oct/22)

I found this interesting about response to a meal and how long and how high the blood sugar spike is. I could not get the chart displayed.

snaq.io/blog/normal-glucose...

Dawn spike - not food related
Joyya profile image
Joyya in reply toSleepman

Yes, I am very familiar with Dawn Phenomenon (and teach it). Virta is a credible site and their articles and the people that write them are credible.

Batty1 profile image
Batty1

I had a very similar experience when I would eat and go walking a couple of hours later during the walk I would start to feel drunk and start stumbling and my speech would go weird sounding and everything I looked at would bounce… never could figure out the problem after medical issues were ruled out and I couldn’t say my thyroid medicine was to blame I was on the same pills … I believe I was allergic to a filler in my thyroid meds or something I ate … switched my thyroid meds that didn’t contain “Acacia” in the ingredients and started waiting longer then 2 hours to take a walk after eating… haven’t had issue again but who knows if these things were even my issue. …. Mysteries of thyroid.

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