HBA1C testing and health anxiety

jingyd36

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Hello.

My HBA1C was tested in September due to fatigue and dry mouth. My result was 38 and I was told I was fine. I continued to feel fatigued and in December after a very stressful few months with my ill son my HBA1C was 40. I have a thyroid issue which has been causing the fatigue, we have since found this out. My GP told me my HBA1C was fine and not to worry at all.I got a second opinion and that GP was of the same attitude. They said they'd probably test annually along with my cholesterol as that was high at 6.9 (runs in my family). This all triggered awful health anxiety. I am 36, 116lb female. I follow a vegetarian diet, always wanted to go vegan but am afraid to try this now as I read a LCHF diet is best for pre diabetics. Having no health issues to suddenly having hypothyroidism looming, high cholesterol and my HBA1C being 40 triggered horrible health anxiety. I hadn't suffered since I was very young with anxiety. I had been highly stressed with my ill son which my GP said could well have been playing havoc with my test results.

So my GP suggested a HBA1C re test in the autumn along with my cholesterol, he said they're just routine nothing to worry about and couldn't understand why I was concerned of a HBA1C of 40. 4 months on I worry often about it. I suffer from fatigue due to my thyroid but recently it had lifted alot. Strange but nice to have energy. Alot of days recently I again have a dry mouth, I dont have a thirst as such just more my tongue feels dry. I don't wee more than every 2 hours. Then on my bad fatigue days I worry. Today is a bad fatigue day, I feel exhausted, my mouth has been dry since I woke up and I am going to the toilet every hour today. Of course this triggers the fear that I am now diabetic. My husband says I am worrying over nothing and probably going to the toilet more due to worry. My carbs were at 180g yesterday, I have been tracking them in My Fitness Pal keeping an eye on my diet. I had a dry mouth all weekend but no fatigue really.

I am concerned 4 months on could my HBA1C have jumped into the diabetic range and maybe these are symptoms to be concerned about.

My GP doesn't see the need to retest me until the end of the summer. I use a company called Blue Horizon to have full thyroid panel of blood work done every 3 months as the NHS can't test the full thyroid panel. They also do a HBA1C test, it's a finger prick test that you send into them. Has anyone done this? or can anyone recommend a place to be tested? Blue HOrizon give a doctors report and you forward it onto your GP, the private hospitals in the UK use their labs often too.

I hope noone minds me posting here. I am just so worried today since I have woken up feeling so exhausted. It's really hard when my GP tells me there is nothing to worry about yet I am concerned.
 

tim2000s

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@jingyd36, your Hba1C test has historically shown up as fine. My consultant laughed that when I returned a 40, "I was cured".

You say that you have hypothyroidism, and many of the symptoms you have described (including fatigue and dry mouth) are classic symptoms of hypothyroid. Are you being treated for this yet? If you are, it's very possible that your drug levels are not quite right at the moment, leading to further symptoms.

If you are really concerned about your glucose levels, don't wait for an Hba1C. Get yourself a finger prick monitor and test at home. Based on what you've said, I'm sure you will find that your glucose levels are absolutely fine.
 
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Oldvatr

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Hi. You are not at the stage where you should worry, but there is something you could probably start doing now to make sure you do not raise your HbA1c any further.
Blood glucose comes from two primary inputs in our diet. The main culprit is carbohydrates, and the other is proteins. There is a direct link between high carb consumption and high bgl levels for diabetics, so I and others use low carb diet to reduce them. You mention lchf, and this is a diet I am following myself, but it is a ketogenic diet(fat burning) that may not be necessary for you to follow.

There are many other low carb diets that you could consider that are not as severe as a keto diet. Any of these diets can be adapted for vegetarian, but vegans may have some difficulties with some of them. You already have B12 checks, so you are aware of some of these.

Lowering your carb intake will certainly help to lower your bgl levels. A keto diet is really aimed at tackling weight loss and reduction of adipose fat (fat around the inner organs) that builds up through Metabolic Syndrome with diabetes. You say you are aiming at 180 g. My DSN and the dietician advised me to aim for 120g. i am currently running at around 80 to 100g a day, and I am not triggering the keto mode in lchf. But my bgl's have certainly reduced to near normal, This is for me a halfway house, and I do not have to be severe with myself I have lost 2" off my waistline, so I see the benefit (and my toes).
 
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jingyd36

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@jingyd36, your Hba1C test has historically shown up as fine. My consultant laughed that when I returned a 40, "I was cured".

You say that you have hypothyroidism, and many of the symptoms you have described (including fatigue and dry mouth) are classic symptoms of hypothyroid. Are you being treated for this yet? If you are, it's very possible that your drug levels are not quite right at the moment, leading to further symptoms.

If you are really concerned about your glucose levels, don't wait for an Hba1C. Get yourself a finger prick monitor and test at home. Based on what you've said, I'm sure you will find that your glucose levels are absolutely fine.
Thank you, very reassuring.

No I am not being treated, my GP said 1 more test and he will treat my thyroid. Ridiclious as my TSH is already 7.51. It's been a nightmare trying to get anywhere with the NHS yet he has said I have hypothyroidism but they don't usually treat until a TSH hits 10.

That is why I won't self test because I know it would send my anxiety racing obsessing about numbers and what is normal. Plus I hate needles haha. but no honestly I would worry. Last September I had eaten cake in the morning one day, normal lunch.. it was my birthday. I had my first HBA1C booked for later that week due to fatigue and dry mouth. My step father tested my blood sugar with his monitor he uses as he has type 2. My sugar was 9.7. I panicked, went red hot in the face and was terrified. He asked when I last ate and I said 30 minutes or so before he arrived, I had cereal with milk. This was about 4pm. He said that's fine don't worry. I told my GP and he said he wasn't worried, did the HBA1C and that was 38 so I was told I was fine and to stop worrying and don't self test. I still worry about that 9.7 result to this day.
 

jingyd36

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Hi. You are not at the stage where you should worry, but there is something you could probably start doing now to make sure you do not raise your HbA1c any further.
Blood glucose comes from two primary inputs in our diet. The main culprit is carbohydrates, and the other is proteins. There is a direct link between high carb consumption and high bgl levels for diabetics, so I and others use low carb diet to reduce them. You mention lchf, and this is a diet I am following myself, but it is a ketogenic diet(fat burning) that may not be necessary for you to follow.

There are many other low carb diets that you could consider that are not as severe as a keto diet. Any of these diets can be adapted for vegetarian, but vegans may have some difficulties with some of them. You already have B12 checks, so you are aware of some of these.

Lowering your carb intake will certainly help to lower your bgl levels. A keto diet is really aimed at tackling weight loss and reduction of adipose fat (fat around the inner organs) that builds up through Metabolic Syndrome with diabetes. You say you are aiming at 180 g. My DSN and the dietician advised me to aim for 120g. i am currently running at around 80 to 100g a day, and I am not triggering the keto mode in lchf. But my bgl's have certainly reduced to near normal, This is for me a halfway house, and I do not have to be severe with myself I have lost 2" off my waistline, so I see the benefit (and my toes).
Thank you.

Yes I wouldn't want to go lower than 150g of carbs as I dropped to 100 for a week and felt so ill and with my hypothyroidism already making me fatigued I could do without any other problems. I gave up after a week LCHF it made me feel that bad plus i hated all the full fat dairy in my diet. If I was to reduce to just 150g ish how high should my fats be? that is what confuses me as I know carbs and fats together cause problems such as weight gain.

I don't eat any biscuits or white carbs. All my carbs come from oats, kidney beans, lentils, if i ever have bread it's gluten free seeded bread, sweet potatoes, rarely a white potato, brown rice pasta a couple of times a week..... So I don't eat any white rubbish.

Thank you for your help.

Julie
 
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tim2000s

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I still worry about that 9.7 result to this day.
Have you ever sought help for the anxiety? My sister suffered with anxiety about sickness and vomiting (A common occurrence with two young children) and getting help with that helped her a lot.
 

DavidGrahamJones

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I was concerned of a HBA1C of 40.

HbA1c_zps4pouuj1v.jpg

Based on this lovely little table produced by this very website, diabetes.co.uk, you shouldn't be concerned at all, there is absolutely no reason..

I am concerned 4 months on could my HBA1C have jumped into the diabetic range and maybe these are symptoms to be concerned about.

Wouldn't have thought so, but if you were concerned, you could always get a BG meter and measure your BG before and after meals in the prescribed manner. You could very well be wasting your time of course.
 
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jingyd36

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Have you ever sought help for the anxiety? My sister suffered with anxiety about sickness and vomiting (A common occurrence with two young children) and getting help with that helped her a lot.
Yes I had CBT for health anxiety many years ago, it did help but this has been triggered by actual health problems frightening me. I haven't been offered any CBT this time round. Back then I used to worry I'd die and leave my children, if I had cancer or something but I don't think like that now. This was all triggered by my high cholesterol and hypothyroidism. Then I noticed my GP was testing for diabetes so i got the figures and saw they were in the high end of normal range and it concerned me.
 

jingyd36

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HbA1c_zps4pouuj1v.jpg

Based on this lovely little table produced by this very website, diabetes.co.uk, you shouldn't be concerned at all, there is absolutely no reason..



Wouldn't have thought so, but if you were concerned, you could always get a BG meter and measure your BG before and after meals in the prescribed manner. You could very well be wasting your time of course.
Very reassuring, thank you. I think my concern was my HBA1C was 38, then 3 months on 40. Only 2 away from pre diabetes.

My husband has diabetes rife in his family, his HBA1C was 36 recently when tested, I was jealous lol!
 

Juicyj

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Hey @jingyd36

I too suffer from hypothyroidism, your symptoms describe exactly how I felt, now my levels are in range again the anxiousness, depression has gone, my symptoms ranged from dry skin, loss of hair, felt low, lethargic, gained weight, I went from being an outgoing happy person to a sloth.

I suggest you book another appointment with your GP, describe your symptoms and ask for medication to treat this, once you can get your levels right you will feel alot better, good luck ;)
 
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Juicyj

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To help you feel better mentally, lots of exercise and try some meditation, it will help alot, you can find some mindfulness ones on youtube ;)
 

jingyd36

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Hey @jingyd36

I too suffer from hypothyroidism, your symptoms describe exactly how I felt, now my levels are in range again the anxiousness, depression has gone, my symptoms ranged from dry skin, loss of hair, felt low, lethargic, gained weight, I went from being an outgoing happy person to a sloth.

I suggest you book another appointment with your GP, describe your symptoms and ask for medication to treat this, once you can get your levels right you will feel alot better, good luck ;)
Thank you.

My TSH has been rising for a while but my GP kept telling me it was normal. It was 5.35 in the range os 0.35-5.5 back in the summer when I saw him with awful fatigue. In January it rose to 6,54 and last month 7,51. He then rang me and agreed there was a trend and said I was subclinical hypothyroid. He said they don't treat hypothyroidism until the TSH reaches 10 with a low FT4. My FT4 is normal in range. 15.81 in the 12-22 range. So he is dragging his heals but has said he wants to test me again 4-6 weeks after my last test and then if the TSH has risen again even slightly he has a case to treat me. So there is little else I can do at present. I only spoke to him 2 weeks ago.

Due to the fatigue it causes me I had to stop working out but recently I am getting back into my yoga and light walking. Today is a bad fatigue day so no exercise, but I can usually exercise every other day but I do feel ill the day after, it kind of makes me crash which I have read is normal with hypothyroidism. My GP says I also have CFS but I think if he treated the thyroid I'd be fine.

Thank you :)
 

1andylock

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you do not need to be talking about diets and foods you need to be talking about managing your anxiety. Can I suggest you find a local Mindfulness class. It really works at controlling life's anxieties. Your figures are fine. Your worrying is not.
 
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uart

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Thank you.

My TSH has been rising for a while but my GP kept telling me it was normal. It was 5.35 in the range os 0.35-5.5 back in the summer when I saw him with awful fatigue. In January it rose to 6,54 and last month 7,51. He then rang me and agreed there was a trend and said I was subclinical hypothyroid. He said they don't treat hypothyroidism until the TSH reaches 10 with a low FT4. My FT4 is normal in range. 15.81 in the 12-22 range. So he is dragging his heals but has said he wants to test me again 4-6 weeks after my last test and then if the TSH has risen again even slightly he has a case to treat me. So there is little else I can do at present. I only spoke to him 2 weeks ago.

Due to the fatigue it causes me I had to stop working out but recently I am getting back into my yoga and light walking. Today is a bad fatigue day so no exercise, but I can usually exercise every other day but I do feel ill the day after, it kind of makes me crash which I have read is normal with hypothyroidism. My GP says I also have CFS but I think if he treated the thyroid I'd be fine.

Thank you :)
Hi Jingyd36. I've also had borderline hypothyroidism (untreated) and very high TSH levels, around 9 to 10, for several years. I know exactly how what yo mean about fatigue, and it's very easy for that fatigue and feelings of poor health to feed into anxiety.

Amazingly when I started a LCHF diet (that's low carb and high fat) to control my diabetes it also appeared to help massively with my thyroid issues. I know that it sounds counter intuitive but more fat (and correspondingly less carbs) in my diet have had made a big improvement to my energy levels and for the first time in years my TSH has been normal. :)

It might be something worth looking at. If you are interested then I'd recommend starting here: http://www.dietdoctor.com/low-carb/60-seconds
 

davej1950

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I used to work in a hospital pathology lab for more than 30 years. There is a lot of misunderstanding about normal values, the figures that most sources give are the ranges for 95% of the population (2 tailed statistical analysis). That means that the individual normal value for 1 in 20 of the population is outside of the stated normal values. Sometimes GP's need to respond to clinical symptoms rather than pathology results. Ask your GP for a months supply of Levothyroxine, and see what happens to your symptoms.
Also, what helped my wife enormously was trying to eliminate gluten from her diet.
 

AndBreathe

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Thank you.

My TSH has been rising for a while but my GP kept telling me it was normal. It was 5.35 in the range os 0.35-5.5 back in the summer when I saw him with awful fatigue. In January it rose to 6,54 and last month 7,51. He then rang me and agreed there was a trend and said I was subclinical hypothyroid. He said they don't treat hypothyroidism until the TSH reaches 10 with a low FT4. My FT4 is normal in range. 15.81 in the 12-22 range. So he is dragging his heals but has said he wants to test me again 4-6 weeks after my last test and then if the TSH has risen again even slightly he has a case to treat me. So there is little else I can do at present. I only spoke to him 2 weeks ago.

Due to the fatigue it causes me I had to stop working out but recently I am getting back into my yoga and light walking. Today is a bad fatigue day so no exercise, but I can usually exercise every other day but I do feel ill the day after, it kind of makes me crash which I have read is normal with hypothyroidism. My GP says I also have CFS but I think if he treated the thyroid I'd be fine.

Thank you :)

As the others have suggested, try to put this out of your head for the time being. Worrying about it is unlikely to improve it at all.

If, as your posts would suggest, you are having your TSH monitored monthly, you must be spending a small fortune on blood work (depending on which panel you have Blue Horizon do for you). It could well be you could receive better overall benefit from redirecting that cash to something targeting your anxiety.

I know you have had CBT in the past, but have you considered hypnotherapy? I used a psychologist trained in hypnotherapy some years ago to help me build strategies for dealing with high stress work scenarios, which I have been able to carry forward to use in other areas of my life.

A reputable hypnotherapist is likely to listen to all your concerns then try a session and take your feedback, based on how it went for you, your feelings afterwards, versus before, and your overall wellness.

The lady I used then delivered a further session, which was modified, based on my feedback. This session was recorded and I still have that recording, which I can use as and when I want to to re-reinforce the messages we agreed upon, and she delivered to me in that relaxed state.

Hypnotherpay isn't about putting into a zombie state where you lose control. At any time you can break the hypnosis if you are uncomfortable, but I never felt the need for that. I enjoyed the deep relaxation that seemed to go to my core. The session, if I run it in its entirity is only about 20 minutes, and I found I could fit that into a busy day without issue, when needed.

Worth considering?
 

grampadenny

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Type of diabetes
Prediabetes
Thank you.

My TSH has been rising for a while but my GP kept telling me it was normal. It was 5.35 in the range os 0.35-5.5 back in the summer when I saw him with awful fatigue. In January it rose to 6,54 and last month 7,51. He then rang me and agreed there was a trend and said I was subclinical hypothyroid. He said they don't treat hypothyroidism until the TSH reaches 10 with a low FT4. My FT4 is normal in range. 15.81 in the 12-22 range. So he is dragging his heals but has said he wants to test me again 4-6 weeks after my last test and then if the TSH has risen again even slightly he has a case to treat me. So there is little else I can do at present. I only spoke to him 2 weeks ago.

Due to the fatigue it causes me I had to stop working out but recently I am getting back into my yoga and light walking. Today is a bad fatigue day so no exercise, but I can usually exercise every other day but I do feel ill the day after, it kind of makes me crash which I have read is normal with hypothyroidism. My GP says I also have CFS but I think if he treated the thyroid I'd be fine.

Thank you :)
Unfortunately for you your GP is misguided in not treating you for Hypothyroid disease. My wife was diagnosed with this disease over 20 years ago and has had many ups and downs along the way. In order for you to feel well you most likely should have a TSH range between 1.5-2.5 (most people feel well in this range) . Your Free T3 should be in the upper quadrant of the range (sometimes this result will be low and that shows conversion issues that need to be addressed). It's total nonsense for your GP to wait until you are at or above 10 to start treating you! You should also have other tests done to see where your vitamins/minerals are at. Vitamin B12, Vitamin D, ferritin are just some of them. They all need to be in the upper end of the range to help) Cholesterol levels will go up with Hypthyroid disease. Most thyroid patients in hypo status also have what they call Hashimitos hypothyroid disease. So when testing you should have both antibodies tested as well. Gluten and lactose are two things that wreak havoc with a lot of people that have the disease also. Research as much as possible as it will give you a better background and more ammunition when speaking to your GP. There is another community out there called Healthunlocked (UK forum) that my wife belongs to and has helped her immensely in her search for answers. The people that blog on this site are very helpful individuals. Good luck.
 

jingyd36

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Unfortunately for you your GP is misguided in not treating you for Hypothyroid disease. My wife was diagnosed with this disease over 20 years ago and has had many ups and downs along the way. In order for you to feel well you most likely should have a TSH range between 1.5-2.5 (most people feel well in this range) . Your Free T3 should be in the upper quadrant of the range (sometimes this result will be low and that shows conversion issues that need to be addressed). It's total nonsense for your GP to wait until you are at or above 10 to start treating you! You should also have other tests done to see where your vitamins/minerals are at. Vitamin B12, Vitamin D, ferritin are just some of them. They all need to be in the upper end of the range to help) Cholesterol levels will go up with Hypthyroid disease. Most thyroid patients in hypo status also have what they call Hashimitos hypothyroid disease. So when testing you should have both antibodies tested as well. Gluten and lactose are two things that wreak havoc with a lot of people that have the disease also. Research as much as possible as it will give you a better background and more ammunition when speaking to your GP. There is another community out there called Healthunlocked (UK forum) that my wife belongs to and has helped her immensely in her search for answers. The people that blog on this site are very helpful individuals. Good luck.
Thank you

I had to go private for testing as the NHS only do TSH and T4.

My T3 is suprisingly in the upper range 5.8
T4 is 15.81 in range 12-22.
TSH 7.51 (0.24-4.2)

GP says I am subclinical and can't treat until that TSH hits nearer 10 and he says as T4 is fine it's not urgent to treat me.

I have had B12, Folate and ferritin checked. They were all low but now B12 is 500. Folate is 42 so a little high lol! Ferritin been low 10 years, but now at 34. Getting there slowly. I supplement them all and D3.

I have had antibodies tested, all negative.

I am gluten free, have been 4 months now.

I use HealthUnlocked Thyroid forum, it's great.

Thanks for your help.

Julie