I m 51y old.suffering from papillary carcinoma, thyroid removed in 2002,also diabetic from 2011.using medicines 1.metformin 500+500mg 2.Glimepiride 4mg, 3.thyroxcine 150mcg. 4.Qalson D 1 tablet.
My blood test. TSH=1.5 (.27-4.2), T3=6.48 (4.26-8.1), FT4=25.7 (12-22), BSF=141(70-110), GH HBA1C=8.4(4.2-6.2) ,pl any one tell me about the above medicine formula right(compatible) or need replacement.
Welcome to our forum and I am really sorry you had your thyroid gland removed due to papillary carcinoma.
The recommendation is a TSH of 1 or lower. It is also advised that we should have blood tests for thyroid hormones at the very earliest possible, fasting (you can drink water) and allow a 24 hours gap between last dose of levothyroxine and the test and take afterwards.
Also, levothyroxine should be taken either first thing when we get up with one glass of waterand wait one hour before eating (food can interfere with the uptake) or at bedtime, as long as we've last eaten about 3 hours before. Food interferes with the uptake of hormones. If taking a bedtime dose, we should miss this if having a blood test and take after test and at bedtime the same day.
I am not sure of this result - FT=25.7 (12-22), is it Free T4 or Free T3?
You should check Vitamin B12, Vit D, iron, ferritin and folate. All have to be optimal.
Do you have clinical symptoms at present or do you feel well with no symptoms?
thyroiduk.org.uk/tuk/about_...
I am not medically qualified but others who've had similar to you will also respond. However, this is what I have just read about metformin and hypothyroidism: Excerpt:
but may not be suitable for people with hypothyroidism because it can interact with levothyroxine -- thyroid replacement hormone -- and lead to high blood sugars.
Was metformin prescribed to you before you were diagnosed as hypothyroid?
FT= 25.7 is actually FT4 pl
Thanks for your reply.
Just to complicate things, there are blood tests for T4 and T3 and for Free T4 and Free T3, so I am assuming your T3 above is Free T3 which is o.k. However, do you take all your other medications about 4 hours apart from levothyroxine? Some can interfere with the uptake of thyroid hormones
If you didn't follow the above advice re tests (none of us knew this when first diagnosed) that the blood tests have to be at the very earliest, fasting, etc. This is because the TSH is highest then and may prevent the doctor reducing our dose. I would suggest you get another test
Your FT4 is above the range so it may be that you are not converting levothyroxine to sufficient T3 and you would need a Free T3 test and follow the procedure suggested above if you have it tested. I will give you a link for your to see why both FT4 and FT3 are recommended.
Levothyroxine also known as T4 is inactive and converts to T3. T3 (also known as liothyronine) is the only active thyroid hormone and is required in our millions of T3 receptor cells.
thyroiduk.org.uk/tuk/testin...
thyroiduk.org.uk/tuk/testin...
thyroiduk.org.uk/tuk/about_...
I would ask to be referred to a doctor who is aware that metformin may interfere with levothyroxine and lead to high blood sugars.
Hi.no one want to reply me?
iqbaly I am really surprised you had no responses on your post. I can only assume that there were quite a number that day and members on that occasion haven't had thyroid cancer so couldn't respond.
As your post is now six months old, I tried to add T4 into your FT but because it is an older post now I wasn't allowed to do so.
Would you like to put up a fresh post and if you can copy/paste into a new one it shouldn't be too much trouble. I would put in the Heading "Papillary Cancer and thyroid gland removed". which will draw attention.
I try to scan most posts but this one rings no bells for me.
Afraid I know so little about the diabetic side, it is probably better if I don't answer!
We cannot answer if we don't have the knowledge. Maybe someone will be able to later.
shaws please can you give me a link for the information about Metformin reacting with Levothyroxine. This year my son's T2 steroid induced diabetes has worsened, requiring an injection to now be given.
can't actually find anything on metformin interfering with levo in fact seems to be the opposite (2013)
thyroid.org/patient-thyroid...
There is this article on American Thyroid Association about hypothyroidism affecting HbA1c levels (2016)
thyroid.org/patient-thyroid...
metformin affects B12 absorption and can lead to deficiency in 40% of patients.
iqbal - if you are concerned about drug interactions suggest that you consult with the dispensing pharmacist - they are generally more aware of drug interactions than general practitioners etc.
Thanks for this information Gambit62 . I know these two points, but it is good to have them written down to show GPs and Endos.
discussed this issue with my endo for so many time.but they ignoring,probably for psych issue,but being a patient I well known there is interaction between metformen & thyroxine.
iqbaly It would be good if doctors knew about medication interactions. I hope you find some answers that can help you.
Hi there, I was hoping someone would answer your questions, as I am Hypothyroid and both my parents have type 2 diabetes which they both got in their 60s. I am not diabetic now, but as it is very strong in my family, I think it's a possibility I will get it when I'm older.
I don't know much really about diabetes but I'm currently reading Dr Peatfield's book, 'Your Thyroid and how to keep it healthy' and I noticed there is a chapter on Thyroid & Diabetes. Here's a link to the book: amazon.co.uk/Your-Thyroid-H.... There is also another book by Dr Broda Barnes, 'Hypothyroidism, the Unsuspected Illness', that looks into the link between hypothyroidism and diabetes. Here's a link: amazon.co.uk/Hypothyroidism....
Hope you get some answers from others. Good luck.
Have to admit ShinyB I have not read all of Dr Peatfield's book, but have had it years. Must get round to finishing quite a few books. Have recently ordered the Broda Barnes book.
I've got lots of books, a lot of them unfinished. I dip in and out of them. The only one I read cover to cover was Broda Barnes' book, which was fascinating, and also written in a very simple yet compelling style. I actually splashed out on Dr Lowe's book, which is the size of one of those old Bibles in old churches. I've yet to even try picking it up, let alone reading it...! I struggle to concentrate with brain fog, and it drives me bonkers 
Good morning,
I am sorry members aren't qualified to answer about your diabetes. The following is a link which may be helpful re diabetes. There are quite a number of different diabetic forums on the following link:-
healthunlocked.com/search/p...
I will give you some points which may help with your hypothyroidism.
We take levothyroxine or other thyroid hormones usually when we get up with one full glass of water and wait an hour before eating. Food can interfere with the uptake of the hormones (i.e. levothyroxine).
When we have blood tests for thyroid hormones, they always have to be at the very earliest, fasting (we can drink water) and allow a gap of 24 hours from your last dose of levothyroxine and the test. This procedure helps to keep your TSH at its highest and it drops throughout the day and could mean you don't get the increase you may need. Always get a print-out of your results with the ranges and you can post if you have a query.
If you are taking levothyroxine and are gaining weight, weight gain can be caused by not being on a sufficient dose of levothyroxine and the addition of some T3 to T4 can help raise our metabolism and lower our TSH. Research has shown that a combination of T3/T4 is beneficial. i.e. T3/T4 is liothyronine/levothyroxine.
TSH means thyroid stimulating hormone and it rises when the thyroid gland begins to fail. Once on levothyroxine our TSH can be below 1 or suppressed whichever makes us feel better and relieving symptoms is a priority.
Blood tests should be: TSH, T4, T3, Free T4, Free T3 and thyroid antibodies (if you haven't had antibodies tested before). If you have antibodies you have an Autoimmune Thyroid Disease also called Hashimoto's. The antibodies attack the thyroid gland and they wax and wane until you are hypothyroid. Eating gluten-free food can help reduce the antibodies.
Your doctor should test B12, Vit D, iron, ferritin and folate. All of these have to be at an optimum level for thyrod hormones to work.
Always get a print-out of your results with the ranges and post if you wish to have comments upon and put them on a new post for comments,
The following is a list of clinical symptoms - we don't get all, thankfully but they should be relieved when we are on an optimum dose of levothyroxine of T3/T4.
my new blood result
T3=2.05 (1.3-3.1}
Ft4=24.24 (12-22)
TSH=0.328(0.27-4.2)
HB1AC=7.6 (4.2-6.2)
medication=thyroxine 2.5mcg
glimepiride 2mg morrning
sitagliptin+metformin=50/1000mg night
pl any suggestion
Hi Iqbaly
I have been diagnosed with type 2 diabetes over 12 years ago, and managed it with diet/excercise. However soon after problems with hypothyroidism also showed and I saw an endocrinologist- who ignored the hypothyroidism ( and blood results showing very poor T4 conversion to T3) and put me on metformin, which I still take, along with Gliclazide. However about four years ago a 'botched' bile stone removal, resulting in acute pancreatitis and septic shock, made me permanently insulin dependent too. I found out fairly recently about how metformin compromises B12 absorption, and suggest as indicated above it might be worth getting your B12, Vit D, folate and ferritin tested, and if below optimum for good thyroid health, supplement to get in upper part of ranges.
From the point of view of managing hypothyroidism and diabetes, I believe there is a link, as I personally got both diseases at the same time post menopausal, which differs from your cancer ( never mind gender). I have never been told of any link to metformin and hypothyroidism, even by my pharmacist, who unIike my doctors, seems more knowledgeable. From the point of view of managing the two diseases in many ways it is the diabetes that is more easily managed with daily(or more) tests of blood sugar levels- you might record them in relation to what you eat/ excercise (even if it's a day painting the house or gardening rather than a gym session). Your Hb1ac is on the high side at 7.6, yet you already take 3 antidiabetic drugs...have you tried lowering the amount of carbohydrates in your diet, or monitor the difference if you have most in the morning or evening etc? The hypothyroidism however is far more slow to pick up if the medication is wrong, for eg with months of tiredness, or hair falling out etc and you may rely on blood tests ( complete with the active FT3 result) to give an idea if your thyroid 'meds' are right...your thyroid bloods are not quite right; you might benefit from some extra T3, to raise your FT3 level over halfway in range ( 2.2); your FT4 is already above the range indicating more levothyroxin/T4 wouldn't be the solution to increasing your FT3. But worth getting your vitamins/minerals checked and improved, add selenium, zinc and magnesium too to aid conversion of T4.
Hi Judithdalston,read urs history,so sad,but amazing courage along with enhancing the courage of other peoples.being a universal truth,that patient become a half doctor, yours advice about the medicines is the confirmation of my observation.thanks
Hi every one.After a year I understand that metformin suppress pituitary gland & lower TSH level.Doctors almost follow TSH & reduce thyroxine dose,and thus triglyceride+Hb1ac rises.
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