Thyroid and Diabetes

[Treepie]

I take levothyroxine and metformin. My blood results for diabetes are too high. My TSH is below range ,T4 just in range at upper level .Levothyroxine may increase the diabetes result. Should I reduce the levothyroxine?

[Judithdalston]

Do you have any thyroid blood results other than TSH ie FT3/4 and antibodies (TPO and / or TgAb)? And your high diabetes levels are presumably from a HbA1c test not for eg a contnuouos blood glucose monitor showing low % ‘time in range’? From experience of having both diabetes and hypothyroidism I would expect your GP will regard the diabetes treatment as the priority, but I would suggest trying to control the TSH to under 1 might improve your diabetes plus cholesterol etc levels. What are all your blood results? Do you maintain good ferritin, folate, b12 and vit D levels? Might be worth you getting a free Libre 2 continuous blood glucose monitor ( assuming you have a compatible mobile phone), from Abbott, as that is a relatively easy way of showing over 2 weeks what foods eaten, when, cause you particular problems with your carb./ sugar levels. When I was first diagnosed as diabetic c. 24 years ago i too was hypothyroid at nearly 6 TSH but not told until 2 years later when it reached 10+, and had problems with cholesterol, gall bladder/ stones, liver etc which I think could have been avoided if treated together earlier…good luck.

[Treepie in reply to Judithdalston]

Seeing practice nurse on Tuesday.Agree diabetes will be seen as priority .Yes Hb1 Ac .Some years since I had a range of private tests . Concern on Thyroid was interrupted by stage 4 lymphoma and lockdown. TSH 0.14 ,only F4 tested in addition no doubt because of the low TSH. I have increased metformin which reduces B12 so balance is getting worse, I supplement .Metformin reduces TSH but is that grounds to reduce levo?

[Judithdalston in reply to Treepie]

Don’t remember my surgery ever testing B12 despite 24 years on high dose metformin, and only relatively recently have I seen it lowers TSH…don’t think Gp would consider that as reason for my very lower TSH! You might find it easier to get your bloods done privately to make sure you have the ones you want not what Gp decides…numerous times I though I was having x, y, z tested to find they only did x etc. At the moment with your low ( but I think acceptable) TSH and high ish FT4 there is bound to be a suggestion of lowering your levo. from your Dr., if it’s a Diabetic Nurse you are seeing she will concentrate on that and from my experience can be good at persuading dr.to allow other bloods to be tested. What was your HbA1c?

[SlowDragon Administrator]

what vitamin supplements are you taking

GP should be testing B12 as you are on Metformin

Request testing folate, ferritin and vitamin D too

Or test privately

[Treepie in reply to SlowDragon]

B12 and B complex , C with levo and D3 much of year .GP never tested B12 . Will have to consider resuming private tests but experience shows GPs not interested in them despite not doing them themselves. One GP told my wife ,who taught him maths, that I was a case study for his students. The locality where many read up on their ailments and challenge them.Of course he disagreed with me. Reckoned FT3 was an unreliable measure,as if TSH and FT 4 were!

[SlowDragon Administrator in reply to Treepie]

Testing vitamins is for yourself to help you self manage

Most medic’s disinterested in vitamin levels

Thyroid patients find optimal vitamin levels invaluable in reducing symptoms

[SlowDragon Administrator in reply to Treepie]

nhs.uk/medicines/metformin/...

Vitamin B12 deficiency

Taking metformin can cause vitamin B12 deficiency.

[Foxylady1066]

Have you tried cutting out carbohydrates and gluten from your diet.

I was diagnosed type 2 and immediately cut my carbs, I take 150 mg of thyroxine daily .

Cutting carbs and being responsible for what I eat means I’ve lost weight 21/2 stone and got my HA1C down to 39 not medication for the diabetes.

I’m feeling healthier than I have for many years.

[Treepie in reply to Foxylady1066]

Yes but afraid I like red wine too much. Gluten free did nothing for me . Also on 150 mg ,weight stable.

[serenfach]

Cutting carbs can be dangerous when taking Metformin, can cause sudden low sugar, especially if you a hormone disorder. It wont help the thyroid either. Personally I would want a full blood test with vits etc to see if that points to a problem.