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Old 07-17-2014, 12:57 PM   #1
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Recent Labs/Update/Question

Hello,

It's been awhile. I think last time I was here I was talking to someone from Iowa about doctors.

My doctor not only listened about 6 months ago, but she responded. I've been taking T4 and T3 during that time. Lab results show progress, but leave me wondering how hard to push.
  • TSH .01 Range .27-4.68
  • Free T4 1.18 Range .85-1.76
  • Free T3 3.8 Range 2.3 - 4.2
  • Vitamin D 46 Range 30-100
  • Cholesterol 171
  • Triglyceride 240
  • HDL 48
  • A1C 6.8

The good news: I feel great. I have more energy. I'm doing things I have not been able to do for many years. I still get tired after about 30 minutes, but recovery time is now about an hour. My good cholesterol has come up 4 points. I've lost 5 pounds. Blood pressure 108/64.
The not so great news: My A1C has gone up slightly. That also is a reflection of the higher triglyceride reading. Overall she did agree that good things are happening and is less concerned about the A1C right now because other things have improved. I know what I need to do, and I am working on that.
Change
I made it very clear that I was surprised about the low TSH reading, but I do not want things to change too much in that regard because I have not felt so well in years. She gave the standard two reasons (osteoporosis and I forget the other) about caution, but she was so pleased with everything else that she did not want to change things too much either.

I know there are things to work on, but overall I thought this was a good report. She reduced the T4 from 112 to 100 and left the T3 dose alone. Aside from what I need to do about the diabetes, do you think things are on the right track?

Thanks!
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Old 07-17-2014, 04:22 PM   #2
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I'm a little confused. Are you a diagnosed diabetic taking Rx to help control your BG? I'm asking because I recall your last post, and you seemed to suggest that your doctor wasn't too concerned about your A1c. I was surprised at the time, but if you're being treated, perhaps that 6.8 didn't disturb her. Certainly, if you're not being treated for diabetes, you should be. Anything over 6.0 is definitely worrisome.

I also don't understand why you feel you need to 'push' this doctor about your thyroid. I don't know of any physician who would increase Rx with a TSH that low and your adequate levels of T4 and T3. What's the problem? Are you still having symptoms of some kind? If so, you should discuss that with the doctor. Thyroid 'symptoms' are rather general and vague (which is what makes getting diagnosed often difficult), BUT many of them--e.g., extreme fatigue, could be due to other things. That's why with your current thyroid levels, any issues you're experiencing should be mentioned to the doctor so that perhaps she can do further testing.


Personally, I'd be concerned about those high triglycerides because combined with your A1C that's not good news. BOTH can be lowered with lifestyle changes, particularly eating low carb.

In my reading of your numbers, I see more of a challenge to you than the doctor.
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Old 07-17-2014, 04:41 PM   #3
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I hesitated to post because I knew if I tried to keep things brief, my post would be misconstrued. I see that I was right. I think I regret posting at this point because now I sound like a stupid airhead, and you think I'm a danger to myself. I was excited that my doctor was willing to give me this opportunity, and I don't want to push her, but I do want to know from people who have more knowledge than I that I am doing the right thing.

I am diabetic. It is entirely behavioral. I am medicated, and my doctor is less concerned about those readings because she is fully aware of what I've been dealing with and knows I can get things back on track. I had the worst emotional year that I've had in 20 years in the last year. I lost my best friend and had to attend her funeral where I knew I would encounter a stalker who had done much more than stalk me, but I kept it hidden for years because I was ashamed that I had not done something when it all first started. I lost two other loved ones including the man I'd planned to spend my retirement with. Only one of the deaths was expected, and all were significant losses. I turned back to old habits which included working long hours so that I would not have time to think.

I have already shared more than I intended, and I think I'm going back to reading instead of asking questions.
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Old 07-17-2014, 05:28 PM   #4
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Point of clarification:
Thanks for your feedback, and I apologize for reacting emotionally. When I work long hours, often I don't eat dinner until 8:30 or 9 at night, and that throws off my fasting glucose reading. It drives my A1C. The other things that seems to drive my glucose levels are stress and the constipation which often accompanies my hypothyroidism. I do eat low carb, and I am making those lifestyle changes. I know what to do, and I will get it back under control.

I don't feel I need to "push" this doctor about my thyroid any more. I have asked questions over and over again because even with medication, I still had many hypothyroid symptoms that were not alleviated. We explored every other option. The only thing I think was not followed through on thoroughly was adrenals because I have a high stress job that I am not always able to leave at work, and as I mentioned in the previous post there are times my stress levels outside of work are also very high.

I was not wanting to ask her to increase my medication with TSH that is so low and with adequate levels of T4 and T3. I came here hoping to be reinforced that I was on the right track. I was also concerned about the low TSH reading, but thought that this would improve with the med adjustment. I have not posted for a long time on either the thyroid or diabetes threads because I seem to tense up about posting and anticipate responses that are going to make me feel inadequate even though it might only be perceived rather than actual.

I believe I have adrenal issues. She knows that, but after a one time test of 24 hour urine samples, it was ruled out. As I understand it this test is not so reliable. I do have fatigue which could also be attributed to diabetes, vitamin d deficiency (I was taking 5000 UI D3 daily but recently was told I could cut back to 2000 UI daily), and about 10-12 things on the list of thyroid symptoms that could also be related to other conditions including an autoimmune condition that I do not want to discuss here or allergies.

Again, thanks for your feedback.
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Old 07-17-2014, 07:46 PM   #5
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Your thyroid labs look a lot like mine. My doctor is never concerned about a low TSH because the meds I take replace what my body would be producing. She calls it being suppressed and it is what she wants to see.

I had a similar feeling too. I felt a lot better in most ways- I am always warm, my hair isn't falling out anymore, my skin no longer looks like crocodile skin, but I had some symptoms creeping back up. I was getting tired more easily again, hungry not long after eating, fuzzy brain, trouble losing with what had worked before. I had an upcoming appointment, but I started googling symptoms. I kept coming up with thyroid. I did the same search with "-thyroid" and got hits for insulin resistance. It was a little like when I first started investigating my thyroid, I found symptoms I didn't even put together. I had my fasting insulin tested and it's about double what is considered optimal. My BS is fine for now, but my doctor prescribed Metformin to try to ward off future problems and see if I can start losing again.

Anyway, my point is keep looking, there could be something else. I read quite a bit about Metformin and it can lower B12. If you are taking Met for your diabetes it could be affecting you B12 levels, which affects energy. Diabetes is somehow mixed up with magnesium too, which can affect energy. I'm sure there's more once you start digging.

Good Luck.
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Old 07-18-2014, 01:39 AM   #6
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Ah, and the magnesium will help w/the constipation because of low carb eating and thyroid. Just take it at night time or before bedtime.
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Old 07-21-2014, 11:20 AM   #7
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Thanks, Gina. I'll keep looking and will start with getting more information about B12 levels.

Overall I feel better than I have in years. I have energy. It lasts 30 minutes to an hour, and then I have to rest. I don't notice that during the work day, but there are so many distractions there that I overlook it until I get home.

The crocodile skin is pretty much gone. Still have some dry skin and itching (itching is a mostly a phantom itch related to my other autoimmune skin condition, so I have built up some tolerance to it.).
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Old 07-21-2014, 11:25 AM   #8
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Did not think about the magnesium comments before I hit the post button.

Yes, those are good ideas, Terry & Gina. I am using epsom salt soaks for my other condition and get some extra magnesium that way. But I doubt that it is enough to do much good. I have been mixing some Benefiber (flavorless) with my coffee once a day, and that helps some. I do try to eat 2-3 servings of something green daily (broccoli, brussels sprouts, spinach, etc). I need to move more and drink more water too probably.
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Old 07-22-2014, 10:21 AM   #9
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Hi.....haven't read here for a bit, but your thyroid levels look very close to mine and I feel good. Your low TSH is nothing to consider a problem...the Rx will lower it, and I just ignore it and the good thyroid docs will ignore it as well. So, hopefully you can do that too.

From my experience your Vit. D levels are quite low and that will also be a fatigue issue. My good doc said 60 is the level I want. I have been taking 5,000/6,000 day for about 5 years now and my levels are stable at 60-80 which is ideal. We are all different, but lowering to 2,000 when you are still low makes no sense to me.

As others have said, I would be concerned with the HA1C and the triglycerides as well. But you know what to do about that. Just make sure you do what is required.

B12 is something I take daily...make sure it's the methyl and not the coco form.

Magnesium should be your beloved friend! I take mine with lunch and right before bed. It not only keeps you healthy, but helps tremendously with constipation (when you start getting the runs, you know you've had enough...I take 600-800 mg a day/split dose.... and it also helps with heart issues from what I've heard many say. Start slow with the amount and build up. It will help you sleep! there is also a pure magnesium spray you can spray on your body..helps with body aches and also gets into your blood stream nicely for those who cannot take the horse pills! :-)

I think you are doing quite well. and your latest thyroid results are darned good! Sorry the doc lowered your T4 dose, but your next testing (6-8 weeks) will show if that was a wise move or not.

Go low carb...and choose veggies NOT from the "nightshade" group....broccoli, brussel sprouts, spinach, cabbage, etc. are all from that form of veggie and unless cooked, are not the best choice for hypothyroid people. Avoid the high glycemic veggies, and really limit fruits for AM only and only 1 if you have any at all...and toss out all the grains. Yup....all of them! :-) Then see how you feel. Try it for a month. You can do anyhting for a month. Get some quest bars for when you have the urge for a dessert or sweet. They are absolutely fabulous! Dozens of flavors...you can't go wrong. When I want a treat, that's what I reach for....about 1/4 to 1/2 of a bar for dessert...always have one in the car and one in my purse for when out and about...keeps me from eating "off plan" when caught shopping or hungry out and about!

Good luck. And my deepest sympathy for all you are going through with your losses. I think many of us have "been there" with a sudden loss of someone near and dear, and know how very very difficult that is.....I send you cyberhugs and know that time heals the heart! Take care and feel free to write whenever. We are here for you!
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Old 07-23-2014, 05:07 PM   #10
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Thanks, Shelley. One was a high school friend who suffered from complications of type 1 diabetes. One of the others was a man I loved dearly. It's a good reminder never to take things for granted and to make the most of each day.

I have felt all along that I need the D a little higher for both the thyroid and the other autoimmune thing I have going on. I will add the B12 and the magnesium to the routine also. I'll look for the quest bars. They sound ok.

All of those veggies I've been using are cooked with the exception of cole slaw on rare occasions. I limit fruits, but it is very hard in the summer. I love strawberries, peaches, and Muscatine melons. But I do try to go for those things in the morning because that is when I am best able to eat them and manage the glucose. Grains are not a non-issue here, but I do eat them sparingly and earlier in the day. I need to go back to what I was doing to keep things in line before (no junk food, no regular soda, no processed foods, and consistent times for meals and sleep). Just changing those behaviors brought all my readings back to non diabetic without Metformin with the exception of the morning reading. Things have to get back to normal. It feels too good to have the energy & good feelings back, and I don't want to backslide again.
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