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Could I ask some advice please

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emmieloulou

Member
Messages
13
Hi,
Could I please ask a bit of advice.
A bit of background I have autoimmune hypothyroidism which is optimally treated however in August I became very suddenly ill and am still off work now. Along with all the millions of recent tests I’ve had done I had a 4hour OGTT, this was done purely because my blood sugars kept dropping, my hba1c has been tested repeatedly over the last 12 months and never been above 36
My results for the OGTT are
9.30 0 mins 4.0 mmol/L (fasted sample)
10.00 30 mins 10.7
10.30. 60 mins. 14.6
11.00. 90 mins. 12.00
11.30 120 mins 14.1
12.00. 150 mins. 9.6
12.30 180 mins. 7.0
13.00. 210 mins. 5.6
13.30. 240 mins. 4.9

This has really confused me as my hba1c is ok and the fasted glucose is fine but I don’t really know how to interpret GTTS
I’m also having tests for adrenal/kidney as I have adrenal insufficiency symptoms/low cortisol and my egfr isn’t great
Thanks for your help
 
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Hi and welcome @emmieloulou

As I am sure you realise, none of us here can give medical advice, or diagnose anything, but I can say that your readings don't fit the norm. In most people, with normal glucose tolerance, blood glucose is lower than yours at 2 hours, so I wouldn't be surprised if your doc says you have some kind of glucose intolerance.
I am curious to know what your doc said about those results?

When I had my GTT tests, I recall that the criteria were something like, if you are over 11mmol/l at 2 hours, that was counted at diabetic, but I am afraid I cannot remember what level (at 2 hours) is counted as being pre-Diabetic. However, most diabetics have raised HbA1cs.

What happened after the test? Did you feel OK?
Do you know what happened to your blood glucose after the times listed?
Most glucose tolerance tests are 2 hours long. yours seems to have been 4 hours, and I have heard of some people with 5 hr and 72 hr tests.

From what I understand, only the 72 hr tests can give a full picture with some of the different glucose tolerance issues.

I am afraid that I don't know nearly enough about hypothyroidism to know how/if that may be affecting your results. Nor do I know what your doc will say about a normal HbA1c and those GTT results.

You may find it interesting to read www.bloodsugar101.com website. There is a lot of information on there on what constitutes 'normal' blood glucose, and what doesn't. also there is a section on how people's glucose tolerance deteriorates (it can deteriorate in different ways) as they move through the glucose intolerance spectrum.
 
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Thank you replying.
I totally understand that no one is medically trained and can only offer options.
The gtt was ordered by my endocrinologist and was only done on Wednesday so I’m not expecting to here from him before the new year to be honest. I’ve dropped of the results with the gp this afternoon as the hospital and gp are under different trusts so it’s easier and quicker for me to print them myself and take them to the surgery. I’m sure they won’t look at them until after Christmas though.
When I had it done I felt really weird for about the first hour or so I’ve I’d drunk the vile drink but then no worse than normal. I’ve had constant nausea for 4 months now and that was quite bad.
I looked on the webpage and tried to figure it out but was totally confused as the hba1c and fasting where absolutely fine but the other figures shout diabetes!
This is one of a few tests that I’ve had due some very strange symptoms, I’ve had 2 short synacthen test(for adrenal insufficiency) both of which have been borderline, brain mri, pelvic and abdo ultrasound, an endoscopy and bloods for a million weird and wonderful things and everything is coming back fine x
 
emmieloulou said:
Hi,
Could I please ask a bit of advice.
A bit of background I have autoimmune hypothyroidism which is optimally treated however in August I became very suddenly ill and am still off work now. Along with all the millions of recent tests I’ve had done I had a 4hour OGTT, this was done purely because my blood sugars kept dropping, my hba1c has been tested repeatedly over the last 12 months and never been above 36
My results for the OGTT are
9.30 0 mins 4.0 mmol/L (fasted sample)
10.00 30 mins 10.7
10.30. 60 mins. 14.6
11.00. 90 mins. 12.00
11.30 120 mins 14.1
12.00. 150 mins. 9.6
12.30 180 mins. 7.0
13.00. 210 mins. 5.6
13.30. 240 mins. 4.9

This has really confused me as my hba1c is ok and the fasted glucose is fine but I don’t really know how to interpret GTTS
I’m also having tests for adrenal/kidney as I have adrenal insufficiency symptoms/low cortisol and my egfr is great
Thanks for your help
Click to expand...

Hi @emmieloulou
I have read your post and your half hourly readings from your eOGTT.
My interpretation is and I could be totally wrong because of your other hormonal issues. You spike very quickly, (like me) your first insulin response is weak, hence the double figure spike. I would call this gastric dumping. Then as your glucose is used probably helped by a second insulin response, your glucose levels head back to normal levels. (3.7-6 mmols) Your fasting level is in normal glucose range.
(As mine is)
It is a pity they didn't extend the test longer because you may have gone low enough for a hypo, (low glucose levels)
How did you feel after the last reading?

Didn't they say anything?

There are a couple of conditions that have these results and how your hormones interact with this is open to debate.

There is clearly something amiss, but only tests can give you a definitive diagnosis.
An eOGTT is the first step, along with the myriad of blood tests.

If you have any of these types of conditions a glucometer is important to discover what is happening after eating.
Most of these conditions can be controlled by dietary changes.
Certain food groups exacerbate your glucose levels and if your hormones are all over the place because of your hypothyroidism, your glucose intolerance will cause an imbalance of glucose/insulin in your blood.
What symptoms do you have?
To be fair, probably all the symptoms will be from both conditions.
My daughter suffered from both hyperthyroidism and hypothyroidism at the same time. Dietary changes helped her.

If you need to ask more, I'm sure, that someone who has hypothyroidism can answer them.
If you need advice on how food can help, and what triggers the glucose surge, there is the RH forum, or the low carb forum.

My experience with this type of condition, is now nearly five years from seeing my endocrinologist, then understanding how to get control to get my health back.

Best wishes
 
emmieloulou said:
Thank you replying.
I totally understand that no one is medically trained and can only offer options.
The gtt was ordered by my endocrinologist and was only done on Wednesday so I’m not expecting to here from him before the new year to be honest. I’ve dropped of the results with the gp this afternoon as the hospital and gp are under different trusts so it’s easier and quicker for me to print them myself and take them to the surgery. I’m sure they won’t look at them until after Christmas though.
When I had it done I felt really weird for about the first hour or so I’ve I’d drunk the vile drink but then no worse than normal. I’ve had constant nausea for 4 months now and that was quite bad.
I looked on the webpage and tried to figure it out but was totally confused as the hba1c and fasting where absolutely fine but the other figures shout diabetes!
This is one of a few tests that I’ve had due some very strange symptoms, I’ve had 2 short synacthen test(for adrenal insufficiency) both of which have been borderline, brain mri, pelvic and abdo ultrasound, an endoscopy and bloods for a million weird and wonderful things and everything is coming back fine x
Click to expand...

I have also been told by my doctors that I am weird!
The reason you felt weird is because of the quick rise in glucose levels, as I said, the spike is very quick. Then as you started to return to normal glucose levels, you felt better. The glucose is worse as you refrain from sugars, it is so sweet and sickly! (Yuk!)
Your Hba1c is in normal range, your fasting like mine is normal but after meals it's all over the place, and I got misdiagnosed T2 for over ten years!

I do believe and I always advise that you start a food diary.
This will help you understand what certain foods can do to you.
You can record your meals and portion size and what your blood glucose levels are before food and after food at certain times.
This will help your doctor and specialist.
It will really help with diagnosis.

I have had loads of tests including a 72hour fasting test in hospital.

Best wishes
 
Thank you.
I have a range of strange symptoms but the major ones are constant severe nausea(I now take regular ondansatron) extreme fatigue, even having a shower exhausts me, zero appetite, I’ve lost 4 and a half stone in 4 months but having put a lot on in the at least 4 years I was undiagnosed with a thyroid problem I needed to. My bp and pulse are all over the place, either really low or sky high, I’ve started shaking especially in the morning but when I do a bm it’s fine, dreadful brain fog, headaches, really clumsy, peripheral neuropathy but I had guillaine barre syndrome 20+ years ago and I’ve always struggled with the last 2.
My thyroid levels are perfect and I’m really on the ball with them so don’t just accept normal!
This all started very suddenly 4 months ago and they still have no clue what’s going on x
 
Lamont D said:
I have also been told by my doctors that I am weird!
The reason you felt weird is because of the quick rise in glucose levels, as I said, the spike is very quick. Then as you started to return to normal glucose levels, you felt better. The glucose is worse as you refrain from sugars, it is so sweet and sickly! (Yuk!)
Your Hba1c is in normal range, your fasting like mine is normal but after meals it's all over the place, and I got misdiagnosed T2 for over ten years!

I do believe and I always advise that you start a food diary.
This will help you understand what certain foods can do to you.
You can record your meals and portion size and what your blood glucose levels are before food and after food at certain times.
This will help your doctor and specialist.
It will really help with diagnosis.

I have had loads of tests including a 72hour fasting test in hospital.

Best wishes
Click to expand...

Could type 1 diabetes present in this way? I only ask because I obviously have a predisposition for autoimmune disorders(I’ve had 3 upto now)
Would the fact that I’ve hardly eaten for months be the problem?
 
emmieloulou said:
Could type 1 diabetes present in this way? I only ask because I obviously have a predisposition for autoimmune disorders(I’ve had 3 upto now)
Would the fact that I’ve hardly eaten for months be the problem?
Click to expand...

Only tests can do this, the test for this is called a c-peptide and they would also do a GAD test.
I would be very surprised that is not one of tests that should have been done already.
It should have been the first.
Was you told that your blood vials would be sent to a lab and would take time?
I don't believe that you have T1, because an eOGTT is not a test for diagnosis.
I don't eat much at all now, I feel better not eating! (Weird or what?)

I have a lot of intolerance to certain foods, and have to be careful what I do eat.

If you are like me, I can't abide some food because my body has repeatedly told me, later proven by tests, that I can't eat certain foods or amount of yummy sugary foods because it makes me ill and I quickly put weight on.
I have discovered why!
So I don't bother.
You could say that I can't eat what most dieticians would call healthy foods. The typical British staple diet!
So I don't
They make me ill!

You would not believe the change in my health since diagnosis and taking control of my body and what goes down my throat.

I am in perfect health especially for an oap of my age and I feel great.
I was really ill, with so many problems to my health.
 
Diabetes wasn’t on the list of possibilities as I’d always had normal fasting and hba1c results. I only had the gtt because my blood sugar kept dropping and they thought it might be reactive hypoglycaemia. I’ve definitely not had any of the bloods taken you mentioned and I’ve had a looooootttttt done recently.
Food is not the problem at the minute because if eat more than 2 pieces of gluten free toast(I’m celiac), a bit of fruit and a rice cake a day I’m lucky.
Before all of this I loved food I’ll be honest x
 
Brunneria said:
Has anyone checked your B12 levels?
Click to expand...
Hi yes my b12 was good anyway, over 550 however my wonderful Gp still gave me b12 injections every other day for 4 weeks in case it helped. Sadly not
All my vitamins levels are very good, not just normal, now as they were terrible when I had the hypothyroidism diagnosed x
 
emmieloulou said:
Thank you.
I have a range of strange symptoms but the major ones are constant severe nausea(I now take regular ondansatron) extreme fatigue, even having a shower exhausts me, zero appetite, I’ve lost 4 and a half stone in 4 months but having put a lot on in the at least 4 years I was undiagnosed with a thyroid problem I needed to. My bp and pulse are all over the place, either really low or sky high, I’ve started shaking especially in the morning but when I do a bm it’s fine, dreadful brain fog, headaches, really clumsy, peripheral neuropathy but I had guillaine barre syndrome 20+ years ago and I’ve always struggled with the last 2.
My thyroid levels are perfect and I’m really on the ball with them so don’t just accept normal!
This all started very suddenly 4 months ago and they still have no clue what’s going on x
Click to expand...

Sorry, missed this post!
Those are a few of my symptoms, not the Guillen Barre syndrome, (never heard of that, will Google that!)
But the brain fog, shaking and so on.
I had quite a few mental health issues or symptoms depending on who my GP was at the time.
The trouble is discovering the symptoms that you have not recognised to help with finding how to treat that particular symptom.
I had really bad symptoms of anxiety, memory loss, brain fog, brain function loss, forgetfulness, even getting through the day and remembering things.
I have also had bouts of depression, but not severe.
Anger, rage, frustration, little things would really annoy me, I wanted to hide away, barely functioning and even work was a chore. I really struggled.
Headache, blurred vision, eye strain, itching, lethargy, and on top of all that, sleep deprivation and vivid colourful dreams, that hampered my health and didn't help to get through the day.
Always warm and sweating, and gaining weight due to eating the wrong things, a so called healthy diet from my dietician.

I know there was more symptoms.

This lead to endocrinology problems, fatty liver, liver and kidney function, heart, BP, gastric problems, exacerbated by of course eating the wrong foods for me!

Yep, weird!
 
You will get to the stage where you will ask yourself, why am I not normal?

But as you learn more, you will find that no one is normal,!

You are special but weird!
 
Not sure if this helps or not but I note you said that you have not eaten properly for months - my understanding ( non- medical just what I have read! ) is that a person should be eating normally before a OGTT so for example if a person had been eating low carb before a test it is suggested they should try and eat more carbs for a period( a week? ) before the test as that shows a more accurate position. When you see your doctor he / she will no doubt know how to interpret the results.
 
dipsydo said:
Not sure if this helps or not but I note you said that you have not eaten properly for months - my understanding ( non- medical just what I have read! ) is that a person should be eating normally before a OGTT so for example if a person had been eating low carb before a test it is suggested they should try and eat more carbs for a period( a week? ) before the test as that shows a more accurate position. When you see your doctor he / she will no doubt know how to interpret the results.
Click to expand...
Hi, thank you, I read this as well and did try but I’ve suffered for constant nausea for 4 months so really struggled. I’m hoping this is the reason for the strange results. Would it have made that much difference though?
At the minute my appointment is in April so I’ll be on the phone next week to move that
 
I like unique
dipsydo said:
Not sure if this helps or not but I note you said that you have not eaten properly for months - my understanding ( non- medical just what I have read! ) is that a person should be eating normally before a OGTT so for example if a person had been eating low carb before a test it is suggested they should try and eat more carbs for a period( a week? ) before the test as that shows a more accurate position. When you see your doctor he / she will no doubt know how to interpret the results.
Click to expand...

Not for an eOGTT!
Usually fasting blood is used to send to labs as a baseline for further bloods taken later or in future tests.
If it is to test for someone with normal fasting blood glucose levels, a non fasting test will skew the test!
A non fasting glucose tolerance test is for those with T2.

The op is being tested for another metabolic condition.
 
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