I have a lot of symptoms which match with hypothyroidism, but every time I have been tested over the last few years I have only had my TSH checked and it was within normal ranges (I didn't know anything else could be checked until recently, also now some of my previous results could be considered higher than average for someone of my age depending on which reference you use)
However, my most recent discovery, from wearing a continuous glucose monitor (CGM), is that I get low blood sugar/have unstable blood sugar (overnight and reactive) which seems to be exacerbated when I am unwell. When I was unwell recently the blood sugar looked like quite a dramatic rollercoaster but only ever on the low end of normal to hypo levels and even now I am better unless I eat a substantial amount of carbs and/or sugar I can't seem to get particularly high/stable blood sugar (but do have a more gentle rollercoaster effect when I eat healthily).
Honestly, I got the CGM because I thought I may be diabetic having high episodes, but with research and the results I now know what I was feeling were hypo episodes (and been happening in line with my other symptoms since puberty).
I want to push my GP to refer me so I can get the other thyroid tests, as in my area those tests are not offered by GPs only consultants, but does anyone have any experience with hypothyroidism causing or being linked with hypoglycemia?
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ggp2
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Thank you, ran the tests (to be fair between 9-10am as struggled to get the finger pricking to work) and they've come back normal, so back to the drawing board!
I used Monitor my Health as it was the best value I could find (and is an NHS lab) whose FAQs say that because any one with TG antibodies and hypothyroidism would also have TPO antibodies they don't test for it?
I struggle to keep my folate up (had deficiency in 2021-2) despite regularly eating foods with it but when it was tested (couple of weeks ago) was scraping through at 10.2 (range 8.8-60.8 nmol/L), B12 at the same time was 300 (range 145-569 pmol/L), ferritin not done that time but serum iron = 13 (range 5.8=34.5 umol/L) and transferrin = 2.4 (range 2-3.6 g/L)
I have been tested for coeliac a couple of years ago and was negative, I am not vegetarian or vegan and whilst I don't eat loads of red meat I do eat some and do eat lots of other sources of iron (also, I usually take OTC supplements but stopped these a couple of months ago as still had symptoms and wanted any investigations to not be impacted by them), I did a private vit. D test last year which was normal, only other random thing is I always have just under the range of MCHC at 311-2 (range 315-345 g/L) which has persisted over all bar one blood test in the last few years (only once did it scrape in at 315) but the GP is never concerned with this...
I may save and get a private scan as I have had a swollen lymph node in my neck since childhood (always larger than most peoples i.e. >1cm but does get even bigger when I am ill), but the GP has never been worried about that either. Also, it may be in my head but since I have considered thyroid may be involved I have felt my neck and would swear the same side as the swollen lymph node is slightly harder than the other so a scan probably may be useful but surely the bloods would match if there is actual swelling?
The GP said they can try and refer me to endocrinology but think it will be rejected because none of my bloods indicate I require more investigation (they really don't see my CGM results as an issue which I find odd), so I am feeling a bit deflated that I won't get answers and don't have endless £ to keep private testing everything.
I struggle to keep my folate up (had deficiency in 2021-2) despite regularly eating foods with it but when it was tested (couple of weeks ago) was scraping through at 10.2 (range 8.8-60.8 nmol/L), B12 at the same time was 300 (range 145-569 pmol/L),
So these are both far too low
Likely to need to supplement continuously
Initially
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and a week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 until B12 over 500
Post discussing how biotin can affect test results
That's so interesting re. the link with folate and Hashimoto's, as when they told me I had folate deficiency and told me what to eat I kept thinking but I eat those every day so how can I be deficient, should I start supplementing again even before I see an endocrinologist (assuming I get to), it won't affect whatever they want to check?
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes:
Males 16-60: 30-400 ug/L
Female's: 16-60: 30-150
Both >60: 30-650
The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘
So I found an old ferritin result from two years ago, that was 18 so likely I am too low, will try and up that too then, thank you for all these helpful links
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
(Also, should the FT3 and FT4 be about the same into their ranges, i.e. is it odd my FT4 is always in the first half and FT3 always the second since they should work in tandem?)
Vitamin D in March/April 22 was 65/61 nmol/l, haven't retested recently, I don't have funds to do all the tests immediately but will prioritise a scan next and will start taking my vitamin/minerals again since it doesn't look like I'll be getting tested by the NHS any time soon, thank you
I have been tested for coeliac a couple of years ago and was negative,
Just because you test negative for coeliac doesn’t mean you might not be gluten intolerant
Have you tried gluten free diet
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
I have eaten low, albeit not completely free, gluten diets before and to be honest I think it unsettled my stomach more, but maybe I will try a more strict test on myself to rule this out
Hi ggp2. Hypoglycaemia is one of my main symptoms and it happens no matter what I eat, although is worse when I don’t eat a balanced meal. I have recently been diagnosed with Hashimotos and when you look at symptoms for this, hypoglycaemia is on the list. I’m currently seeing a functional doctor who suggested that it may be due to malabsorption of nutrients due to vitamin/mineral deficiencies (lots on this forum about this), or because of a gut issue. I’m currently waiting for results of a gut test to check this. There’s quite a bit on YouTube about thyroid function and hypoglycaemia, which explains why it happens.
I have found (and there is plenty of evidence for this, you don’t have to look far) that counteracting low blood sugar with high carbs, especially sugar is the worst thing you can do to deal with it. This path literally keeps the cycle going. Prepare/organise for these incidents (hah,) with slower release carbs, so you are not tempted to grab the first high carb thing you can to deal with the immediate situation. Low sugar incidents can happen if you don’t eat enough calories the day before OR you eat too many high carbs the day before.
I did eat properly first (which has always left me feeling drained and up/down unwell), eating low GI foods etc. for a week of my two week CGM and that's when the 'rollercoaster' of my bloods kept dropping low, when I ate more carbs on some days in the second week my rollercoaster sat higher so less lows but was still a rollercoaster and didn't go as high as one would expect, but did make me feel physically better which I do not think is normal (I would expect higher peaks and troughs eating more sugar like you've said) but I am stumped, my thyroid levels came back normal so not sure what to check now...
I too get hypoglycaemia and I recall reading something about Hypothyroid people struggling to bring their sugars back up naturally whereas a healthy person can. I definitely think this applies to me.
Have you had any tests of your blood sugar and insulin. It would be useful to know if you’re insulin resistant which leads to the body pumping out excess insulin which can lead to sugar crashes. Highly recommend you do the tests in the morning, fasting. I see you’ve done a CGM, did the model you have give you an estimate of your HbA1C?
I have had my HbA1C tested a lot over the years (as some of my symptoms suggest diabetes) which is always fine but my CGM estimate was 4.8, I’ve also had fasting glucose test recently with the GP which came back fine (according to my CGM they were too late as my drop had been about an hour and half before), I tend to drop low then come straight back up but I really struggled to keep my graph above 4 for a full day without eating a lot of carbs (I tried different things to try and keep it up this was all that seemed to do it and that was a lot of sugar/carbs I ate so not healthy), I’ll attach my worst and best CGM graphs (I wasn’t consistent with logging food on the app but kept a good journal), my GP isn’t concerned about my blood sugar though because of the results their tests have done and they don’t seem to care about my CGM readings, hence I haven’t had an insulin or other test
Best CGM (lots of sugar/carbs day before and this day)
also, may be worth adding that the CGM graph didn’t always catch some of the shorter dips, if I dipped low very quickly I would still feel it so I’d do a sensor check and it would say low but the graph didn’t always then log a red section, think it’s based on time/average over a short period, so my body can recover from lows, I’m just not sure why it’s so unstable and dipping so low when I’m eating healthily
Worst CGM
Hi ggp2
I believe hypoglycemia is associated with hypothyroidism. Plenty of info posted by others on here, too.
As an interim measure to level out your blood sugars: have you tried eating porridge in the morning?
Did that years ago and found I didn't have the drops in energy during the day.
I didn't find a lot of detail on google about it but everything posted here has been really helpful, I sadly cannot stand porridge, makes me feel sick, but I had been eating a banana every morning and even with that on some of those CGMs the spike is an hour or so after eating a banana, I am campaigning my doctor to refer me to endo so I can get more answers and if I get the hypo symptoms I am treating them with quick sugar, just wish I had more answers and a longer term plan as I would like to avoid becoming diabetic if I can
Good thing you're trying different things to manage the situation, ggp2 .
Bananas, however, are full of sugar and starting your day off with them (or other sugary food, cereal, toast, fruit) will just start the quick high with quick dumping troughs throughout the day.
Do believe your suspicion of thyroid as a fundamental cause is right but if unable to be treated with levo/NDT, you need to get off the sugar-bingeing cycle. -Just like any addiction.
Have you tried eating a main meal of meat/protein+vegies for breakfast?
Then a slightly smaller but still full and balanced meal for lunch, and finally, a light meal in the evening.
(Only having a very light meal early evening also alleviates gut problems caused by lying down to sleep with a full stomach).
-I still eat this way for even energy during the day and no night time gut problems.
It also stops me looking for a sugar-fix in the evening. The two days (over decades) where I've not eaten a main-meal breakfast, I've had the evening constantly-eating-sugary-things-but-nothing-satisfies thing going on.
Know how hard it is to fix things while you're unwell, ggp2, and wishing you the best.
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