Hypothyroid and t2d.

Kentoldlady1

Well-Known Member
Messages
733
Type of diabetes
Type 2
Hello all.
I know that several people on here have both conditions and I need a bit of advice.

I take levothyroxine and metformin. It is well known that metformin will lower the level of tsh and warnings about the interactions of both drugs are in both packets.

My last blood tests showed a tsh in normal levels, but I am feeling hypothyroid. All the usual symptoms. Gp said "your levels are fine". I asked how they compensate for the interference of metformin and she didn't know what I was talking about. When I explained she said "well, we will never know, then, will we". And that was that. I had mentioned this to the pharmacist, who told me that the gp would be able to adjust for the interaction. Saw another gp who just said she agreed with the first gp.

How do you on both meds deal with this?

Many thanks for help.
 

Totto

Well-Known Member
Messages
2,831
Type of diabetes
Type 2
Treatment type
Diet only
You need to get the actual thyroid hormones tested, FT3 and FT4. Levothyroxine contains the storage hormone T4 and it needs to be converted to the active hormone T3.
 

carol43

Well-Known Member
Messages
1,192
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
Blood tests showed that I don't convert T4 to T3. GP blood test says 'below reference limit' but they will not prescribe T3 because they have to pay far too much for it. It is cheap in other countries but again the NHS pays through the nose. My supplier abroad has stopped selling it so now I am stuck with without it.
 

Kentoldlady1

Well-Known Member
Messages
733
Type of diabetes
Type 2
You need to get the actual thyroid hormones tested, FT3 and FT4. Levothyroxine contains the storage hormone T4 and it needs to be converted to the active hormone T3.

Thanks for taking the time to answer. I have asked for the tests, but was told "no". Both gps have said that they are not allowed to give t3 so there is no point in testing for it. Also the same response when I asked about antibodies.

The nice guidelines say that the aim of treatment is to make a hypothyroid patient euthyroid, but this is wrong. The aim of treatment is to get the numbers into a range they find acceptable. How we feel doesn't seem to matter!

Have you any experience with levo and metformin?
 

Kentoldlady1

Well-Known Member
Messages
733
Type of diabetes
Type 2
Blood tests showed that I don't convert T4 to T3. GP blood test says 'below reference limit' but they will not prescribe T3 because they have to pay far too much for it. It is cheap in other countries but again the NHS pays through the nose. My supplier abroad has stopped selling it so now I am stuck with without it.

Hi carol. How long have you been without t3? Do you have much the same symptoms as when first diagnosed?
Its the pits, isn't it, to know whats wrong and be utterly unable to do anything about it.
 

Totto

Well-Known Member
Messages
2,831
Type of diabetes
Type 2
Treatment type
Diet only
I never felt Levo did much for me so I take NDT instead. I buy it online and self medicate.
No experience of metformin at all.
If you feel hypothyroid they should do the tests and or refer you to an endo.
 
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carol43

Well-Known Member
Messages
1,192
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
When the doctor phoned me to tell me that I had an underactive thyroid I asked what the symptoms were. He said tiredness, my reply was I have been at work all day and now I'm digging in the garden, he didn't have an answer. I have taken up to 150mcginn the past but it's now down to 75mcg. I can honestly say I have never felt any different from when I was diagnosed. The only symptoms I get now is hair falling out and finger nails breaking. I wish I could find out whether losing all my weight has had some effect on my pituitary gland.
 
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Kentoldlady1

Well-Known Member
Messages
733
Type of diabetes
Type 2
Thank all for the replies. I am finding it difficult to try and explain to the hcps that metformin and levo interact. The only one who knew about it was the pharmacist and nobody else seems to care. I have asked for a referral to an endo, but I am not hopeful.
 

Kentoldlady1

Well-Known Member
Messages
733
Type of diabetes
Type 2
I never felt Levo did much for me so I take NDT instead. I buy it online and self medicate.
No experience of metformin at all.
If you feel hypothyroid they should do the tests and or refer you to an endo.

Hi toto, may I pm you?
 

librarising

Well-Known Member
Messages
1,116
Type of diabetes
LADA
Treatment type
Insulin
Hello all.
I know that several people on here have both conditions and I need a bit of advice.

I take levothyroxine and metformin. It is well known that metformin will lower the level of tsh and warnings about the interactions of both drugs are in both packets.

My last blood tests showed a tsh in normal levels, but I am feeling hypothyroid. All the usual symptoms. Gp said "your levels are fine". I asked how they compensate for the interference of metformin and she didn't know what I was talking about. When I explained she said "well, we will never know, then, will we". And that was that. I had mentioned this to the pharmacist, who told me that the gp would be able to adjust for the interaction. Saw another gp who just said she agreed with the first gp.

How do you on both meds deal with this?

Many thanks for help.
This is worth a read by all suffering thyroid symptoms :
https://drmalcolmkendrick.org/2015/05/01/treating-thyroid-patients-like-children/
First, on conventional NHS treatment :
"this is where the medical profession now stands. Hypothyroidism means high TSH and low T4. You are getting adequate thyroid replacement hormone if TSH in the ‘normal’ range. End of."
Dr Kendrick's findings :
"The conversion of T4 into T3 can be significantly reduced in some people. So these individuals can have normal T4 and TSH, but they are still effectively hypothyroid."
"I certainly find the evidence that a large number of people are effectively hypothyroid, with ‘normal’ thyroid blood tests, to be virtually overwhelming. Both from a scientific/physiology basis, and also from a patient testimonial basis.
I now firmly believe that the medical profession is currently doing these people a great disservice, and that the guidelines on the treatment of ‘hypothyroidism’ are rigid, autocratic, and just plain wrong (for a significant minority)."

If you're part of that 'significant minority', you'll meet a wall of resistance about further treatment (going beyond 'normalising' TSH with levothyroxine.)
I chose to self-fund NDT but I'm a robust kind of person and can stand my ground. This summer I've been found to have aortic stenosis, and my GP wanted to blame the NDT and suppressed TSH. Next year I'm due for surgery at Harefield Hospital and they wrote to my GP about my suppressed TSH needing attention. Haven't needed to see GP since. To keep people happy I've temporarily switched back to a lower dose of levothyroxine. I will revert to NDT after surgery.
As others have said, testing fot FT3 and FT4 is needed but not easy to get from a GP.
Geoff