A1C, Vitamin D, Thyroid, Cholesterol

[Katsmeow]

FWIW on the thyroid part I am taking medication (25mg daily) for 4 weeks only and then re-testing. Perhaps I should suggest doing T3 and T4 tests at that time.

 

[6miths]

Katsmeow, if you lived where I do, you would not be taking thyroxine.

http://www.bcguidelines.ca/pdf/thyroid.pdf

You might want to scan this paper too, if you haven't already.

https://www.aace.com/files/final-file-hypo-guidelines.pdf

Now that's what I am talking about!

 

[6miths]

Have to run off to a meeting but looking at the paper and the Guidelines, I'm not sure that Katsmeow would have been started on thyroid medicine. I'll have a deeper look later. Thanks for the post Meadbh.

 

[Meadbh]

Have to run off to a meeting but looking at the paper and the Guidelines, I'm not sure that Katsmeow would have been started on thyroid medicine. I'll have a deeper look later. Thanks for the post Meadbh.

You're welcome, and thanks for challenging me to find peer reviewed sources. I posted the original article just to point out that there was a controversy. But it seems that it might just be an academic controversy, with no documented benefit to patients who are prescribed thyroxine with normal TSH levels......which Katsmeow's appear to be.

Thyroxine is cheap, so I don't think there is too much money to be made in that market.

Disclaimer: I am not an endocrinologist.

 

[Katsmeow]

You're welcome, and thanks for challenging me to find peer reviewed sources. I posted the original article just to point out that there was a controversy. But it seems that it might just be an academic controversy, with no documented benefit to patients who are prescribed thyroxine with normal TSH levels......which Katsmeow's appear to be.

Thyroxine is cheap, so I don't think there is too much money to be made in that market.

Disclaimer: I am not an endocrinologist.

FWIW, before I decided to try the medication I did a fairly extensive search and read a number of articles (I don't just mean popular article. I went and read legitimate peer reviewed research). I also dug out the Endocrinologists paper where they reversed their position in 2003 (under which I would be considered to not have a normal TSH level) and then went back to a higher level. I read that paper. I read a lot about the controversy. It is by no means settled what is a normal TSH level and at what point to treat. Anyway, I'm trying it for 4 weeks and I plan to ask for a ful thyroid panel to be done at that time and then will revisit the issue.

 

[Meadbh]

FWIW, before I decided to try the medication I did a fairly extensive search and read a number of articles (I don't just mean popular article. I went and read legitimate peer reviewed research). I also dug out the Endocrinologists paper where they reversed their position in 2003 (under which I would be considered to not have a normal TSH level) and then went back to a higher level. I read that paper. I read a lot about the controversy. It is by no means settled what is a normal TSH level and at what point to treat. Anyway, I'm trying it for 4 weeks and I plan to ask for a ful thyroid panel to be done at that time and then will revisit the issue.

Katsmeow, I applaud you for taking the time to do the research and addressing your health in a very rational way. As you are discovering, often the right answer is "it depends".

 

[audreyh1]

FWIW, before I decided to try the medication I did a fairly extensive search and read a number of articles (I don't just mean popular article. I went and read legitimate peer reviewed research). I also dug out the Endocrinologists paper where they reversed their position in 2003 (under which I would be considered to not have a normal TSH level) and then went back to a higher level. I read that paper. I read a lot about the controversy. It is by no means settled what is a normal TSH level and at what point to treat. Anyway, I'm trying it for 4 weeks and I plan to ask for a ful thyroid panel to be done at that time and then will revisit the issue.

Hi Katsmeow

I have high thyroid antibodies indicating thyroid autoimmune disease and a TSH that has crept above 3.0. My doctor says he likes to see TSH at 2.5 or lower.

Right now we're trying dietary changes and iodine supplementation (which I haven't quite started) to see if the thyroid antibodies come down.

I'm interested in the references you find useful. This is all rather confusing.

 

[eytonxav]

I was concerned from the posts above whether a K2 supplement would be helpful if I take the D3. Not sure whether to take one without talking again to the doc.

I have heard that vitamin K will help one absurd D. Also, if you are taking tums or other antacids, they may affect your ability to asorb D and well as other vitamins/minerals and nutrients.

 

[rgarling]

...
I was concerned from the posts above whether a K2 supplement would be helpful if I take the D3. Not sure whether to take one without talking again to the doc.

Your doc will most likely not be up to speed on k2. Here is an introduction: Vitamin K2: The Missing Nutrient

 

[bmcgonig]

Katsmeow, I applaud you for taking the time to do the research and addressing your health in a very rational way. As you are discovering, often the right answer is "it depends".

I've had cold intolerance issues for years now so I've been looking at thyroid as well. There seem to be two types of doctors out there (a simplification I know), those that only test for TSH and if that's abnormal then test the T3 and T4. Then the other ones who will take everything into account. Also, lots of debate over whether Armour Thyroid is better or worse than LevoT. Some doctors won't even prescribe Armour, the others will indeed.

Also some debate over whether the TSH test should be in the morning and fasting versus not. I had mine tested fasting and it was 4.2 (considered normal for my lab) and then 3 mos later at a different lab in the afternoon and it was 2.7. Just anecdotal for me since I haven't yet gone back to retest.

I guess the question for me Katsmeow is do you have any symptoms of hypothyroidism? Seems like you are losing the weight fine, any other issues? E.g., are you cold when everyone else around you is fine (like me?


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[eytonxav]

One of the things I find frustrating with Drs is that if something is in range, they generally don't worry about it, although not all in range values are desirable. Also, I think most Drs are poor at understanding the interrelationships between comprehensive blood test results. My DD, visited a PhD nutritionist that demonstrated far more knowledge in reading blood test results and connecting the dots than any medical Dr I have ever experienced.

 

[John Galt III]

I have achieved the best results by always taking my medication on an empty stomach and using brand name. I have tried generic inadvertently and suffered.


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I tried generic once and I felt tired. Switched back to Synthroid brand and felt better. Why on earth there sould be any difference is beyond me. Fillers? Dyes? I noticed the generic stuff is now almost as expensive as brand Synthroid now.

 

[happy2bretired]

I tried generic once and I felt tired. Switched back to Synthroid brand and felt better. Why on earth there sould be any difference is beyond me. Fillers? Dyes? I noticed the generic stuff is now almost as expensive as brand Synthroid now.

I had my thyroid removed in 2011. I take generic Levothyroxine, 88MCG. If I buy thru my insurance mail order plan , I would pay my $15.00 copayment, but I don't buy it that way. I get it at Walgreens for about $2.50 or so for a 90 day supply. I've been on generic from the beginning, so I don't know if I would feel better or worse on the brand name.


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[Katsmeow]

I guess the question for me Katsmeow is do you have any symptoms of hypothyroidism? Seems like you are losing the weight fine, any other issues? E.g., are you cold when everyone else around you is fine (like me?

Yes, I am always cold when others are fine. It is a big issue for me.

I am losing weight, but I am putting considerable effort into losing weight. Not sure how it would be if I wasn't doing that. I am often tired (but I'm wondering if that is tied to the Vitamin D deficiency. For many years I had oily hair but the last few years it has been dry (but then that sometimes happens as people get older). I have thick hair though so no hair loss.

 

[WFL]

fatigue, etc

In certain situations, including anemia, the A1c can be inaccurate.
http://www.clinicalcorrelations.org/?p=5190


You may want to research MTHFR issues for the cholesterol situation and gluten intolerance issues if the post prandial BG tests are insufficient to sort this out.

 

[sheehs1]

FWIW, before I decided to try the medication I did a fairly extensive search and read a number of articles (I don't just mean popular article. I went and read legitimate peer reviewed research). I also dug out the Endocrinologists paper where they reversed their position in 2003 (under which I would be considered to not have a normal TSH level) and then went back to a higher level. I read that paper. I read a lot about the controversy. It is by no means settled what is a normal TSH level and at what point to treat. Anyway, I'm trying it for 4 weeks and I plan to ask for a ful thyroid panel to be done at that time and then will revisit the issue.

The important question is "how do you feel". My next question is were you feeling "hypo" enough to justify the meds or did your doctor just go by the labs?
Do you feel better on the current meds or is it to early to tell?

My twin sister had Graves and had her thyroid killed many years ago (which is now controversial as well). During treatment with Synthroid, her labs were normal but she didn't feel well. Her doctor upped her Synthroid and she felt better. Sometimes it is not just about the numbers and reference ranges. In her case there was no question about needing medication.

My older sister had hypo that then reversed to hyper. I had subclinical Graves which means I had normal TSH but elevated antibodies for Graves. I felt "hypo" - the reverse of Graves/hyper. It is not uncommon to feel the reverse of what you are/what your labs say you are! My doctor opted to not put me on anything (no beta blocker, etc.) as there was evidence in the literature that "subclinical" can often revert back to normal. Took 3 years but darn if it didn't reverse. I can pinpoint almost to the day that it reversed as I felt "better".

If you aren't feeling well, with a normal TSH you might consider having the antibody tests as well.
Thyroids and the loop back mechanism with the adrenal glands can be tricky little things!

 

[Katsmeow]

A year later I went to a new primary care doctor and redid the blood work that I did last year. The original numbers:

The Good
HDL Cholesterol - 53
Triglycerides - 104
VLDL - 21
Triglycerides/HDL Ratio (calculated by me) - 1.96.
Cholesterol/HDL Ratio (calculated by me) - 4.5
Fasting Blood Glucose - 84


The Bad

TSH (Thyroid-Stimulating Hormone) - 3.41
Total Cholesterol - 225
LDL Cholesterol - 151

The Ugly
Vitamin D - 8.7 ng/ml
A1C - 5.9%

I just got back my results and was overall very pleased. Over the past year, I lost about 14 pounds to get to a normal BMI (I lost 62 pounds overall over a few years). I continued to exercise (walking, elliptical, exercise bike and weight training mostly).

Blood Glucose

Fasting Blood Glucoese - 79 (was 84)
A1C - 5.44% (was 5.9%)

I was super pleased with this. As I discussed in another thread after getting these results I bought a meter and started testing my blood sugar to see how certain foods affected me. You might think from the new numbers that I am no longer insulin resistant. That is not true. I ate something the other days that spiked my blood sugar into the 170s. So, despite my weight loss and my exercise, some foods can spike my blood sugar. I have, however, either quit eating those foods (I haven't had a Cinnamon Crunch bagel in almost a year) or I have found a way to eat them so they don't spike my blood sugar (such as by eating a small portion).

So, I still eat a small piece of dark chocolate a few days a week (has very little affect on my blood sugar). I find that I can eat a moderate amount (1/2 a cup or so) of brown rice without problem. A whole wheat tortilla is fine. But, even a small portion of whole grain pasta tends to create a spike. Legumes seem to be fine for me.

I am really glad I got the monitor and started testing as it enables me to know that I am still insulin resistant and that I need to watch what I eat to avoid those foods that are problematical for me.

Cholesterol

Total - 202 (was 225)
Triglycerides - 69 (was 104)
HDL - 52 (was 53)
LDL 136 (was 151)

I have had some higher total and LDL numbers over the year (which seems to be hereditary). I took Lipitor some years ago, but quit taking it several years ago. When I went to my new primary care doctor right before the new labs were done I was prepared to argue with him if he wanted me back on a statin due to my LDL. Thankfully, he said he didn't think it was necessary. He said that 151 was higher than the recommended 140, but my risk of some sort of heart attack in the next 10 years was only 2% so
I didn't need to be on a statin.

Anyway, the new numbers are better than the old one. I'm pleased by the changes. I am a little surprised that my HDL hasn't gone up as I do exercise several days a week, but it is high enough to be OK. I think you can see the influence of diet in how my already decent triglycerides number has dropped so much.

Thyroid

TSH - 2.41 (was 3.4)

After my test results last year I took Synthroid for about 2 months. There is some controversy about whether 3.4 is normal or not. I really didn't feel that comfortable with taking the Synthroid and wasn't sure that 3.4 was really abnormal so discontinued it. The 2.41 is a better number than the 3.4 and I don't feel I have any thyroid related symptoms. The new doctor (based upon the 3.4 before the new testing) said he didn't see a reason to treat this if I wasn't having any symptoms.

Vitamin D

14.5 (was 8.7)

The goal here is to be at 30. I took 50,000 units a week for 6 weeks. I was then supposed to continue to take a lower amount daily. To be honest, I slacked off on continuing the lower amount.

The new doctor is going to have me take the 50,000 for 8 weeks, then go to 2,000 daily and will re-test in 3 months.

Overall, I was really pleased with my results and think it shows the power of diet. I don't eat a total low carb diet. I average about 100g of carbs a day (about 70g net carbs). For me, it isn't so much about total carbs but the specifics of each meal make a big difference in blood sugar. Two meals with the same amount of carbs in them can make really big differences in my blood sugar depending upon what the specific carbs are in the meal.

And, of course, I'm sure the additional 14 pounds lost and the exercise have helped as well.

 

[haha]

Overall, I was really pleased with my results and think it shows the power of diet. I don't eat a total low carb diet. I average about 100g of carbs a day (about 70g net carbs). For me, it isn't so much about total carbs but the specifics of each meal make a big difference in blood sugar. Two meals with the same amount of carbs in them can make really big differences in my blood sugar depending upon what the specific carbs are in the meal.

And, of course, I'm sure the additional 14 pounds lost and the exercise have helped as well.

Congrats Kat. This really shows what a powerful combination is made by having good information, good feedback, and the willingness and skill to learn and implement as you go.

Ha

 

[bjorn2bwild]

For me, it isn't so much about total carbs but the specifics of each meal make a big difference in blood sugar. Two meals with the same amount of carbs in them can make really big differences in my blood sugar depending upon what the specific carbs are in the meal.

Good job,
This is consistent with the findings in a recent study published in Cell -

Observations of 800 study participants.

Elinav and Segal reported instead on their observations of a cohort of 800 healthy and pre-diabetic individuals, a sample population representative of the larger Western non-diabetic population.

Each member of the sample population was connected to a continuous glucose monitor that measured their interstitial glucose levels every 5 min for a full week (using subcutaneous sensors). They collected more than 2,000 measurements per participant, for a total of more than 1.6 million measurements for the entire population.
​

Personalized Nutrition: Healthy foods are unique to individuals

Full text -

http://www.cell.com/cell/fulltext/S0092-8674(15)01481-6

 

[Katsmeow]

bjorn2bwild - I had read about that study. I found it fascinating.

 

[WFL]

The study had the advantage of CGM (continuous glucose meters) so if the spike is delayed by fiber (such as legumes), it is still caught. Some foods appear not to spike because the spike is 3, 4 or 5 hours post-meal.

 

[rdy2go]

That is a fascinating study, thanks!