Should i be worried?

[jingyd36]

Sorry to post again. Here is my last post that gives background on me and why I'm concerned http://www.diabetes.co.uk/forum/threads/little-update.116608/ incase anyone wants to read but you don't have to.

I have an interactive thyroid. For 18 months I've had chronic fatigue most days and randomly I get energy crashes where legs feel weak and shaky, I feel woozy and so heavily fatigued in head and body. I struggle to even go to the toilet on those days and I spend the day in bed resting. They had become less frequent so I hoped the thyroxin was helping my thyroid. I've recently had an increase in dose. In the last 3 weeks I've had 3 crashes that last a day. Today is one of them, I feel so fatigued all over and weak shaky legs. High anxiety and scared to even walk to the toilet.

So my gp thought the crashes were due to my thyroid and he thinks I had chronic fatigue syndrome but of course he can't officially diagnose. I had a full MOT of bloods done in December 2015 and again November 2016. Gp said all were fine. I got a print out and saw my random glucose was 8.9 so slightly over range but my hba1c was 35. He never mentioned it in November when I saw him for the results; he said all were fine and they reassured him it was just the thyroid and possible cfs.

Then last month he rang about my latest thyroid results and I assumed just to discuss an increase in dose as my tsh was raised again. He then said he was concerned about my random glucose from November and he was worried it was why I was so exhausted daily and why I had crashes. It terrified me. I asked why he was mentioning this now when in November he dismissed it as hba1c was normal. He knew I was crashing often landing myself in bed for a day or 2 and daily fatigued but he never worried. He said he was worried as it's gone on for 16 months. So my anxiety as you can imagine is sky high right now. I have bad anxiety and agoraphobia this last year since being ill.

My hba1c results have been...
September 2015 - 38
December 2015 - 40 (I panicked about this but 2 doctors told me it was fine and to not worry including the gp that's now worried it's at 35 lol).
April 2016 - 35
November 2016 - 35

My random glucose was taken 30 minutes after a nakd bar which is a natural dried fruit bar but I'm told has a lot of sugar in. I'd also eaten 2 meals that day. So it wasn't a fasted test.

I've had no symptoms of diabetes. What promoted him to test me in September 2015 was I had a constant dry mouth, not a thirst but very dry tongue and sore tongue. But hba1c was fine. I had a dry mouth again last year, a coating on my tongue that was sore so hba1c was done and again fine in april. I've not had a dry mouth since until the last few days and it's been a dry sore tongue making mouth feel sore. Then today I've hit a crash, woken up tired, weak and fatigued. It's made me panic diabetes!!! My gp has caused me this worry wanting to repeat the hba1c and saying he wants to do it 4 x a year. And I can't understand why. I'm not obese and eat well.

So today my anxiety is up worried is the sore dry tongue diabetes. Is the crash to do with sugars even though I've had these crashes here and there the last 16 months and they usually happen after physical or emotional exertion. Yesterday I did a lot around the house physically and my son was in hospital last night unwell so I was anxious.

My hubby googled diabetes symptoms and he said it doesn't even mention dry mouth just a bad thirst. I'm seeing a little more but only because I'm drinking water to help my tongue but nothing excessive. Usually I'd accept a crash day as my cfs and thyroid but as my gp has scared me about my hba1c and glucose I'm an anxious wreck the last few days just because my tongue has been dry.

I'm having my thyroid tested next week and gp wants to 're do the hba1c not random glucose. Is this the best way to diagnose it?

Sorry to post again, I hope it's ok I have.
Julie

 

[Jamesuk9]

Hi, to be honest, a random measure of 8.9 30 mins after a bar loaded with sugar is quite normal for even non diabetic people. Ideally it should remain below 7.8 however in the real world many people get a short lived high after a sugar or carb heavy snack or meal. it is at 30-45 mins after consumption that blood sugar would peak.

The important thing is that it is clearly short lived as your hba1c results indicate adequate glucose control.

You could if you are concerned impact your hba1c positively by cutting out sugar, processed carbs and starches like bread, potato, rice and pasta.

Even reducing portions and/or consumption frequency can have a dramatic postive effect on overall control.

As hba1c indicates an average glucose reading over 2-3 months, it is clear your doctor wants to do it 4 times annually just to keep a close eye. This is positive and nothing to be worried over.

 

[jingyd36]

Hi, to be honest, a random measure of 8.9 30 mins after a bar loaded with sugar is quite normal for even non diabetic people. Ideally it should remain below 7.8 however in the real world many people get a short lived high after a sugar or carb heavy snack or meal. it is at 30-45 mins after consumption that blood sugar would peak.

The important thing is that it is clearly short lived as your hba1c results indicate adequate glucose control.

You could if you are concerned impact your hba1c positively by cutting out sugar, processed carbs and starches like bread, potato, rice and pasta.

Even reducing portions and/or consumption frequency can have a dramatic postive effect on overall control.

As hba1c indicates an average glucose reading over 2-3 months, it is clear your doctor wants to do it 4 times annually just to keep a close eye. This is positive and nothing to be worried over.

Thanks James for replying and very reassuring too.

So my dry mouth or tongue doesn't sound like anything to do with diabetes? I'm just not sure if how I'd feel so I was concerned.

Yes my friend said his dad is diabetic so he has a meter and often my friend will check his own while visiting his dad. My friend has normal hba1c twice a year but he recently tested 15 minutes after dinner at his parents and his glucose was 9.5. He said his hba1c is good so he's not worried and it's normal right after eating to spike.

I was just concerned why if my hba1c is good that my gp would want to test as frequent as every 3 months. So it's made my anxiety quite bad since he said that and the last few days having the dry mouth I worried then to wake up in one of the crashes I get from time to time frightened me.

Thank you for replying to me.
Julie

 

[Bluetit1802]

Your doctor is doing his best to look after you, but doesn't seem to have offered any other diabetes test markers. If your red blood cells are in any way different from the average, an HbA1c is not a satisfactory marker on its own. The test requires that your red blood cells live the same length of time as what is considered average. (ie around 120 days) It is documented that many people have short lived RBC and many people have long lived RBC. We do not all have the same, yet our doctors rely on what the HbA1c tells us, even if it contradicts other markers, such as post meal glucose etc.

Have a look at this
https://chriskresser.com/why-hemoglobin-a1c-is-not-a-reliable-marker/

 

[jingyd36]

Your doctor is doing his best to look after you, but doesn't seem to have offered any other diabetes test markers. If your red blood cells are in any way different from the average, an HbA1c is not a satisfactory marker on its own. The test requires that your red blood cells live the same length of time as what is considered average. (ie around 120 days) It is documented that many people have short lived RBC and many people have long lived RBC. We do not all have the same, yet our doctors rely on what the HbA1c tells us, even if it contradicts other markers, such as post meal glucose etc.

Have a look at this
https://chriskresser.com/why-hemoglobin-a1c-is-not-a-reliable-marker/

Thank you. My gp did a blood test in November and it included an fbc which was all my red and white cells. All normal?

I shall get hubby to read the link for me as no doubt I will worry more lol.

 

[Bluetit1802]

Thank you. My gp did a blood test in November and it included an fbc which was all my red and white cells. All normal?

I shall get hubby to read the link for me as no doubt I will worry more lol.

Yes, your red cells may be normal in size and contents, but these tests can't tell you how long they live. Basically, we have no idea how long our RBC live and nor does your doctor. I believe there are some tests, but not available on the NHS and involve a lot of complicated testing, mostly done on trials for research purposes.

 

[Jamesuk9]

Thanks James for replying and very reassuring too.

So my dry mouth or tongue doesn't sound like anything to do with diabetes? I'm just not sure if how I'd feel so I was concerned.

Yes my friend said his dad is diabetic so he has a meter and often my friend will check his own while visiting his dad. My friend has normal hba1c twice a year but he recently tested 15 minutes after dinner at his parents and his glucose was 9.5. He said his hba1c is good so he's not worried and it's normal right after eating to spike.

I was just concerned why if my hba1c is good that my gp would want to test as frequent as every 3 months. So it's made my anxiety quite bad since he said that and the last few days having the dry mouth I worried then to wake up in one of the crashes I get from time to time frightened me.

Thank you for replying to me.
Julie

I fully understand health anxiety having lived with it myself for years. It is highly possible that the dry mouth and tongue symptoms could be anxiety related.

The hba1c test every 3 months is absolutely nothing more than your GP doing his job correctly and giving you a level of support you are entitled too. There is nothing sinister in his approach.

 

[jingyd36]

I fully understand health anxiety having lived with it myself for years. It is highly possible that the dry mouth and tongue symptoms could be anxiety related.

The hba1c test every 3 months is absolutely nothing more than your GP doing his job correctly and giving you a level of support you are entitled too. There is nothing sinister in his approach.

Thank you James. I appreciate your kind replies.

 

[Mark14400]

New Thanks James for replying and very reassuring too.

If it's any help Julie...I got through 3 litres of water during the night days before I was diagnosed...I didn't have a dry mouth as such, just a thirst only a diabetic would understand...Hope this helps

 

[Energize]

@jingyd36

Your syptoms of a sore tongue and CFS is ringing bells -Vit B12 deficiency or Pernicious Anaemia. Perhaps you would like to check your symptoms here and see what you think?

http://www.nhs.uk/Conditions/Anaemia-vitamin-B12-and-folate-deficiency/Pages/Symptoms.aspx

Do you have anyone in your family that have Pernicious Anaemia, or relatives, Grandparents etc? Another thing is, do you take any Protien Pum Inhibitor, Anti acid medication? Also, you say you have Hypothyroidism, which is also a link.

I would suggest you ask your GP if he would include Vit B12, Folate, Ferritin and Full Blood Count along with your blood test due soon. Then, be sure to get a print-out of the results and post them here for help in interpretting them. I would suggest you may well be deficient in Vit B12 in particular, even though your result may be in the lower end of the 'normal' range. If so, there could possibly be a 'magic' treatment, assuming your GP is as good as he seems to be

In the meantime, please don't get more anxious, and maybe do some research on B12 and associated vitamins etc - it's a vast and under-diagnosed issue

Good luck and a few {{{Hugs}}}

 

[chalup]

Some medications can cause a very dry mouth as well. You might want to ask your doctor if that is a side effect of any meds you might be taking.

 

[jingyd36]

@jingyd36

Your syptoms of a sore tongue and CFS is ringing bells -Vit B12 deficiency or Pernicious Anaemia. Perhaps you would like to check your symptoms here and see what you think?

http://www.nhs.uk/Conditions/Anaemia-vitamin-B12-and-folate-deficiency/Pages/Symptoms.aspx

Do you have anyone in your family that have Pernicious Anaemia, or relatives, Grandparents etc? Another thing is, do you take any Protien Pum Inhibitor, Anti acid medication? Also, you say you have Hypothyroidism, which is also a link.

I would suggest you ask your GP if he would include Vit B12, Folate, Ferritin and Full Blood Count along with your blood test due soon. Then, be sure to get a print-out of the results and post them here for help in interpretting them. I would suggest you may well be deficient in Vit B12 in particular, even though your result may be in the lower end of the 'normal' range. If so, there could possibly be a 'magic' treatment, assuming your GP is as good as he seems to be

In the meantime, please don't get more anxious, and maybe do some research on B12 and associated vitamins etc - it's a vast and under-diagnosed issue

Good luck and a few {{{Hugs}}}

Thank you.

I have those vitamins tested regular. In August 2015 my b12 was 212 (190-900 range). My gp said it was fine, thyroid UK told me it wasn't at all so I supplemented and got my levels up to 1070. I stopped supplementing and now my levels are around 500 on the November test a few months ago. My ferritin has been low for over 10 years. I can't take iron from the gp as it hurts my stomach so I take a gentle liquid iron which never gets it more than 49 in a range of 15-150. The lowest was 8. It's now around 34. Folate is always good around 17 in a range up to 19.

I'm never actually anaemic as my gp says my actual iron level is very good at around 14.6. Yet I've always had iron stores. He referred me to a haemotologist years ago and they said not to bother seeing them as it was just low ferritin and at the time blamed my heavy periods which were super heavy and definitely lowering the ferritin worse but I went on the pill to lighten them and I still have low ferritin levels of I don't supplement it droos quickly.

 

[jingyd36]

If it's any help Julie...I got through 3 litres of water during the night days before I was diagnosed...I didn't have a dry mouth as such, just a thirst only a diabetic would understand...Hope this helps

Thanks Mark.

I wake with a very dry mouth which sometimes wakes me but wouldn't say a thirst more a dry feeling.

Thank you for reassuring me.
Julie

 

[Dark Horse]

Waking with a dry mouth can be due to breathing through the mouth during the night. This is more likely when people have a blocked nose due to cold, allergy etc..

Thanks Mark.

I wake with a very dry mouth which sometimes wakes me but wouldn't say a thirst more a dry feeling.

Thank you for reassuring me.
Julie

 

[jingyd36]

Waking with a dry mouth can be due to breathing through the mouth during the night. This is more likely when people have a blocked nose due to cold, allergy etc..

Thanks. It seems to last all day some days, that's why I was concerned but some days it's eased by lunch time.