Need more friends for motivation blood work came back
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My last BG was 91, my A1C was 5.4%, which was up from 5.2%...but the kicker was my fasting insulin level... 11.3. If your doctor is sincerely concerned about your risk for diabetes, I'd request a follow up testing for fasting insulin levels. My endocrinologist discovered that I was insulin resistant (due to outlying health factors, and comorbidities with my hypothyroidism, including odd outlying health questions) through questioning and testing. This predates the actual shift into diabetes. I personally would push hard for that test, as it can really give you the best chance to underline and discover treatment options.0
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cstehansen wrote: »I would concur with @RalfLott regarding taking action now. Although 5.6 is considered good by the medical community, it is more like "not totally sucky" rather than optimal. There is a margin of error of up to 0.5 on these tests, so that could be anywhere from 5.1 to 6.1. By having another test in 3-6 months, you can get a better idea of where you are.
Also, given your FBG was only 89, but your A1c was 5.6, I would wonder if your PP (post prandial - after eating) readings are more elevated than is optimal which would indicate IR (insulin resistance) which is the first step toward T2 diabetes. This is where using the blood monitoring suggested by Chris Kresser in the earlier links would help you understand where you really are now in terms of BG health.
@cstehansen - That's really interesting. My PP1 and PP2 readings were never elevated, yet I am definitely insulin resistant. I wonder if I'm the exception...or the rule.1 -
KnitOrMiss wrote: »cstehansen wrote: »I would concur with @RalfLott regarding taking action now. Although 5.6 is considered good by the medical community, it is more like "not totally sucky" rather than optimal. There is a margin of error of up to 0.5 on these tests, so that could be anywhere from 5.1 to 6.1. By having another test in 3-6 months, you can get a better idea of where you are.
Also, given your FBG was only 89, but your A1c was 5.6, I would wonder if your PP (post prandial - after eating) readings are more elevated than is optimal which would indicate IR (insulin resistance) which is the first step toward T2 diabetes. This is where using the blood monitoring suggested by Chris Kresser in the earlier links would help you understand where you really are now in terms of BG health.
@cstehansen - That's really interesting. My PP1 and PP2 readings were never elevated, yet I am definitely insulin resistant. I wonder if I'm the exception...or the rule.
Given an A1c indicates an average BG reading of 114 over the previous 3 months or so, if the fasting is 89, then there has to be a significant rise PP, a significant rise at some other time (stress induced perhaps?) or very slow reduction in from spikes. Clearly, there is some point in time where the BG is elevated and/or it never really gets down as low as it should for as long as it should during fasting periods.3 -
Thanks for that, @cstehansen. I hadn't researched into how to calculate back from the A1C...I knew it could be done, but I hadn't researched it as I was still considered "not yet a risk" nonsense. I am back on the Glucophage, and so far - only 2 days in - no real side effects...other than seemingly improved sleep. Could be psychosomatic. But, I have to acknowledge that right now, I can't do this by diet alone, even if I ever would.
Do you have any specific links for PP readings? I remember my numbers being around 110-120, but at the time, and the limited research I could find for non-diabetics, those seemed reasonable, given the fasting numbers, but I realize that may need to be revisited... I haven't tested in some time, just through laziness and cost, as my meter was free, test strips were not, and I hadn't been prescribed anything - was just doing one offs... I tested the PP during my "crashes" and the readings were not indicative of anything specific, but that was pre-keto and maybe 6 months in, so at least a year ago...0 -
KnitOrMiss wrote: »Thanks for that, @cstehansen. I hadn't researched into how to calculate back from the A1C...I knew it could be done, but I hadn't researched it as I was still considered "not yet a risk" nonsense. I am back on the Glucophage, and so far - only 2 days in - no real side effects...other than seemingly improved sleep. Could be psychosomatic. But, I have to acknowledge that right now, I can't do this by diet alone, even if I ever would.
Do you have any specific links for PP readings? I remember my numbers being around 110-120, but at the time, and the limited research I could find for non-diabetics, those seemed reasonable, given the fasting numbers, but I realize that may need to be revisited... I haven't tested in some time, just through laziness and cost, as my meter was free, test strips were not, and I hadn't been prescribed anything - was just doing one offs... I tested the PP during my "crashes" and the readings were not indicative of anything specific, but that was pre-keto and maybe 6 months in, so at least a year ago...
https://chriskresser.com/how-to-prevent-diabetes-and-heart-disease-for-16/
This is the site I use in terms of what readings should be. However, I am shooting for lower PP readings because this stupid dawn phenomenon messes with my FBG reading so much. Now that I have gotten a handle on controlling my post workout readings by use of extended cool down, my FBG is typically the highest reading of the day - about 10 higher than my average PP reading.
I know there are a ton of meters out there and I was wary of the one he mentions because it is so cheap. However, I had used both the Ultra and the FreeStyle and the readings I got from them just didn't make sense with my A1c results. When I switched to the ReliOn, I was irritated with how much higher it read, but then when I looked at it, the results were pretty much dead on with predicting my A1c. Therefore, I figured I was better off using it. It doesn't hurt that the meter was $9 at Walmart and 100 strips is under $20.1 -
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KnitOrMiss wrote: »I forget, but do you need an RX for the strips?
Not in the U.S. I can't answer for other countries. You can buy them at a pharmacy OTC. Sometimes they keep them behind the counter, but I think that is because they are not cheap and may get stolen as a result? Whatever the reason, BG test strips don't require a prescription.
However, your insurance probably isn't going to cover them without a prescription. I have to test because of T1D, so I have a prescription, it is processed through a mail-order pharmacy, and insurance pays most of it. Then again, I'm testing several times per day. Testing frequency is obviously going to affect cost and help determine whether it makes sense to ask your dr. for a prescription. Any responsible physician treating a diabetic... even if not taking insulin... should not hesitate to provide at least some amount of testing supplies.1 -
KnitOrMiss wrote: »
That ReliOn is in the pharmacy section of Walmart just on the shelf. No prescription needed.
https://www.walmart.com/ip/ReliOn-Prime-Blood-Glucose-Monitoring-System-Red/20752267
https://www.walmart.com/ip/ReliOn-Prime-Blood-Glucose-Test-Strips-100-count/38423728
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Also keep your eyes peeled for Bayer Contour Next EZ - sometimes on promo for $9-10. (Also very well rated, and there are soon-expiring strips deals on eBay for cheap now and then.)0
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cstehansen wrote: »I would concur with @RalfLott regarding taking action now. Although 5.6 is considered good by the medical community, it is more like "not totally sucky" rather than optimal. There is a margin of error of up to 0.5 on these tests, so that could be anywhere from 5.1 to 6.1. By having another test in 3-6 months, you can get a better idea of where you are.
Also, given your FBG was only 89, but your A1c was 5.6, I would wonder if your PP (post prandial - after eating) readings are more elevated than is optimal which would indicate IR (insulin resistance) which is the first step toward T2 diabetes. This is where using the blood monitoring suggested by Chris Kresser in the earlier links would help you understand where you really are now in terms of BG health.
Yep, the Kresser links are really good to have at your side when you're first starting to track your BG.
BTW, Congratulations, @microwoman999, for jumping on this early! You are doing yourself a lifetime's worth of favors.
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KnitOrMiss wrote: »So, that's odd...they ran a Total T4, but not a free T4. They ran a Free T3, but not a Reverse T3 - but a total T3, which is an outdated test, to my understand. Did you get a TSH with those numbers, @microwoman999 ? Those numbers are hard to interpret, but my T3 is close to yours, and my Endo changed my meds because I was still symptomatic...but without the other numbers for context, it could be okay, though Free T3 should be in the upper 75% of the range for optimal, to my understanding.
I'm not sure what TSH is but I will look at my paperwork when I get home. I never thought I would have issues with thyroid or T2D. Here I am over 30 and it's starting. I am due to retest Feb 1st since I've been on the thyroid meds. I don't know if he is retesting everything though1 -
cstehansen wrote: »
Given an A1c indicates an average BG reading of 114 over the previous 3 months or so, if the fasting is 89, then there has to be a significant rise PP, a significant rise at some other time (stress induced perhaps?) or very slow reduction in from spikes. Clearly, there is some point in time where the BG is elevated and/or it never really gets down as low as it should for as long as it should during fasting periods.
I don't find the calculated average for an A1c very close. I don't have a CGM, but during the period when I was testing 5-10 times a day, at times when I expected high readings, the A1c was about 7% higher than my measured average. My measured average should have been higher, based on when I was taking the readings (at 1 hour and 2 hours after eating, as well as fasting).
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I don't see anything for TSH. I do know being on the thyroid medicine I feel a little better but in the afternoons I get sleepy. I even got up at 8:30 this morning and felt tired after sleeping for 9 hrs. I took a 30 minute nap before work and I had to be there at 11. It is just strange. I'm hoping my energy level will increase.1
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You are headed down the right path. Lower the carbs and your A1c should get better, you fasting BS level is good.
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microwoman999 wrote: »I don't see anything for TSH. I do know being on the thyroid medicine I feel a little better but in the afternoons I get sleepy. I even got up at 8:30 this morning and felt tired after sleeping for 9 hrs. I took a 30 minute nap before work and I had to be there at 11. It is just strange. I'm hoping my energy level will increase.
@microwoman999 - In my experience, I had to space out my T3 medication (I take T4 medication, aka Levothyroxine, first thing in the am...it's a long acting one. I take T3 medication first thing, ~2 hours after breakfast, and about 2 hours after lunch... It's a fast acting one, and can trigger crashes if not aware...because it doesn't have to be converted.)...to get more level.
However, getting the afternoon sleepies can be as much about circadian rhythm. It is recommended to get 15-30 minutes of natural or brightest light upon waking, and then again around the midpoint of your day. For me, this is 5-6 am, and 1-2 pm, with goal bedtime of 10 pm. So, to get level here, I had to get bright light first thing, at the peak of the day, and also take D3/K2 at those times, to allow my cortisol levels (wakeful stuff) to taper naturally, and allow the melatonin levels to rise naturally as cortisol falls - which is why we need a boost of the mid-day light, too. But since we have access to light 24/7 nowadays, it's why so many folks get these rhythms distorted... I have blue light filters on my phone, settle down TV's, lights, and electronics at night, etc., set up a routine, use a sleep tracker that wakes me gently during lightest sleep, etc.
I had to combine these things, and if I have too much carbs or WAY TOO MANY calories at once, I still get sleepy...
TSH is thyroid stimulating hormone, which is actually released by the pituitary, and is generally what most doctors use to determine thyroid needs. The fact that you didn't have that test but had some of the other better tests indicates your doctor may be somewhat ahead of the curve...
And they actually say that with thyroid medications, it can take 90 days or so to really level out good. I could tell the same day or day two on the medications! Guess mine was really deficient.
There are also a number of nutrient deficiencies that worsen these conditions - or are needed for proper functioning. A big one I discovered was that with low thyroid function, your body doesn't trigger the proper production and release of bile to digest and absorb nutrients properly, which just worsened everything and became a self-fulfilling and self-fueling spiral out of control. So I would definitely make sure to notice if D3 is low, B12 (other B vitamins, too), iron, etc. These are very likely indicators of needing co-factors and/or additional help digesting and absorbing the nutrients...1 -
Knitormiss thank you for your response. I am only on 1 pill right now. He said it could take a couple of months to get it right. So right now I am trying to be aware of anyway I feel. I have more energy taking this pill for sure. I will be sure to tell him in the afternoons I get sleepy. I will look into my b12 is low I also know that runs in my family along with vitamin D deficiency. I am usually in an office that gets light and I run around outside often at work. I usually don't sit at work and am on the go most of the day.1
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This may be TMI, @microwoman999, but if you ever have flatulence or burping with meals, a light color or weird texture to your solid waste, solid waste that floats, pieces of not fully digested food (aside from corn, sadly) in your solid waste, heartburn/indigestion/sour stomach, nausea, the urge to go immediately after eating, constipation/diarrhea, or any other level of digestive drama, I would seriously look into the stomach acid factor.
It can take 10 years or more for stomach acid issues to develop enough to where we identify them easily. Since I had my gallbladder out in 2000, I should have been told to include bile salts and other digestive aids to my dietary intake. Because I wasn't told to do that, and until I went keto and identified underlying previously undiagnosed issues, I reached a level of ridiculously dramatic nutrient deficiencies. D3 deficiency, particularly for anyone with glucose management/insulin management issues, can have far reaching consequences. Low B12 can actually cause permanent nerve damage. I have one spot of neuropathy in my left thumb that hasn't eased up, despite resolving that deficiency, and it was triggered or amplified by a massive B12 deficiency that resulted from the addition of Metformin to my daily intake without knowing I needed to add additional B12 due to absorption interference.
I'd also look into the iron numbers, if you haven't yet, being Iron Level, Iron Saturation, Iron Binding Capacity, and Ferritin, with ferritin being the easiest number to track. If you are less than half into the range, you likely have digestion issues, as iron is one of the nutrients that is hardest to break down and process for proper absorption...
Try getting out on your lunch break to get some direct sunlight on as much skin as you can bear (weather and all)... Fluorescent lights are common in office buildings, and can actually cause more problems than help. I actually got a daylight lamp to use IN MY OFFICE since I often come to work in the dark, and leave in the dwindling light.
Oh, and look at when your energy drops. If it is 30 minutes, 60 minutes, 90 minutes, or 120 minutes after your meal, you might want to adjust that meal. We often have impacts to our energy based on food choices, and those changes can happen so slowly that we don't even realize them until someone else points it out. I have to constantly evaluate and change up my meals. Too much of any one macronutrient or calories, and I'm taking a food coma nap, whether I want to or not...
Still, no matter what, try not to let all of this overwhelm you, and hopefully be less of a worry and more of a curiosity. I'm wishing you improvements. To me, not much more stinks that being perpetually exhausted!0 -
I was listening to one of the presentations from the autoimmune summit last night and heard something that I thought may be helpful here. Dr. Osborne was talking about the 5 triggers for autoimmune - food being one of them, and gluten being the most studied. He said that there are actually many different glutens but that when foods talk about gluten, they are only talking about the one that is in wheat, barley and rye. However, he said many people have a reaction to other glutens or even all of them. Gluten is essentially a protein from grass (grain).
Anyway, thyroid issues are one of the main manifestations of gluten intolerance - and, again, not just the ones in wheat, barley and rye. They are in ALL grains.
Here is the part that I think @microwoman999 and @KnitOrMiss need to know: most of the thyroid medication uses corn starch (which contains a type of gluten) as a filler. So in essence, you could be taking a pill to correct an issue which contains a filler that is exacerbating that same issue.1 -
cstehansen wrote: »I was listening to one of the presentations from the autoimmune summit last night and heard something that I thought may be helpful here. Dr. Osborne was talking about the 5 triggers for autoimmune - food being one of them, and gluten being the most studied. He said that there are actually many different glutens but that when foods talk about gluten, they are only talking about the one that is in wheat, barley and rye. However, he said many people have a reaction to other glutens or even all of them. Gluten is essentially a protein from grass (grain).
Anyway, thyroid issues are one of the main manifestations of gluten intolerance - and, again, not just the ones in wheat, barley and rye. They are in ALL grains.
Here is the part that I think @microwoman999 and @KnitOrMiss need to know: most of the thyroid medication uses corn starch (which contains a type of gluten) as a filler. So in essence, you could be taking a pill to correct an issue which contains a filler that is exacerbating that same issue.
That doesn't make any sense. The auto-immune trigger is what starts the immune response. Once it is started, then, it is somewhat of a moot point as to what caused it to start. Hashimoto's is similar to type 1 diabetes in this regard (I have both), as are other auto-immune responses. Once a trigger occurs and your immune system "learns" that a particular cell is foreign and must be attacked (despite that it isn't), your immune system doesn't "un-learn" that just because you get rid of the trigger. The damage is done at that point.1 -
cstehansen wrote: »I was listening to one of the presentations from the autoimmune summit last night and heard something that I thought may be helpful here. Dr. Osborne was talking about the 5 triggers for autoimmune - food being one of them, and gluten being the most studied. He said that there are actually many different glutens but that when foods talk about gluten, they are only talking about the one that is in wheat, barley and rye. However, he said many people have a reaction to other glutens or even all of them. Gluten is essentially a protein from grass (grain).
Anyway, thyroid issues are one of the main manifestations of gluten intolerance - and, again, not just the ones in wheat, barley and rye. They are in ALL grains.
Here is the part that I think @microwoman999 and @KnitOrMiss need to know: most of the thyroid medication uses corn starch (which contains a type of gluten) as a filler. So in essence, you could be taking a pill to correct an issue which contains a filler that is exacerbating that same issue.
@cstehansen - the reason gluten and autoimmune thyroiditis are linked is because apparently the gluten molecule and the thyroid look very similarly to white blood cells...so once the body is overwhelmed by gluten and begins to attack the gluten itself, it also starts attacking the thyroid in the confusion.
Luckily, I have been tested to show that I am not auto-immune, that I don't have Hashi's, and that for the most part I don't react abnormally to gluten (I tested negative for Celiac but lowest side of mild for inflammation). I'll have to go check specific ingredients on my formularies, but I've not noticed an issue, to date...0
