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Diabetes and Thyroid disorder

Discussion in 'Type 1 Diabetes' started by AndyS, Aug 1, 2009.

  1. AndyS

    AndyS Type 1 · Well-Known Member

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    Hi folks,

    This is possibly a long shot but worth a try am trying to get some confirmation that I am not imagining things as both GP and Endo's seem to be implying.

    I was diagnosed Type 1 at the end of april but through a lot of studying and working at it managed to get things pretty well controlled quite quickly. The only thing that I do find that screws me up more than a naughty snack is forgetting to take my thyroxine in the morning.

    I used to have an over active thyroid till they nuked it a few years ago and now am on a pretty heavy dose of Levothroxine (225mcg and rising still). Before I was diagnosed I did occasionally forget to take my thyroxine in the morning but didnt worry too much as I would just take it later in day when I got home or to work if I had some stashed there.

    Now what I have noticed is that if I forget to take it now it completely screws my Insulin dosage calculations. If I forget I seem to have to wind up my insulin by a couple units... now I asked GP, Endo and DSN about this and they all said that Thyroxine has no effect on BG but this to me seems like a major case of short sightedness since thyroxine controls your metabolism and hence how fast your body is using glucose... I remember having major hypos when I was massivle over active in the thyroid department.

    So the question; is there anyone else out there thats Type 1 that also has an under (or over) active thyroid and have you seen your forgetting thyroid meddication screwing up your BG and hence insulin dose calculations?

    Cheers

    Andy
     
  2. lilibet

    lilibet · Well-Known Member

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    The endocrine system is a weird and wonderful machine and so complex that they cant bl**dy cure diabetes! So, if you have noticed there is a link, then there IS a link.

    I did find this on t'interweb though

    Thyroid Disease and Diabetes
    Diabetes and thyroid disease are both endocrine, or hormone, problems. When thyroid disease occurs in someone with diabetes, it can make blood glucose control more difficult.


    The thyroid is a butterfly-shaped gland in your lower neck just beneath your skin. It regulates your body’s metabolism, the processes of using and storing energy, by releasing a substance called thyroid hormone. If it produces too much thyroid hormone, your metabolism quickens (hyperthyroidism), too little and your body functions slow down (hypothyroidism).

    Hyperthyroidism. When your metabolism quickens, your medicines go through your body quicker. Your blood glucose level may rise because your usual dosage does not stay in your body long enough to control it.

    Hyperthyroidism and low blood glucose can be hard to tell apart. If you are sweating and having tremors from hyperthyroidism, you may think you have low blood glucose and eat extra food, causing your blood glucose to rise. Using your glucose meter to verify low blood glucose levels can help you avoid this problem.

    Hypothyroidism. When your metabolism slows, your blood glucose level may drop because your diabetes medicine doesn’t pass through your body as quickly as usual and so stays active longer. In hypothyroidism, it is often necessary to reduce your dose of diabetes medicines



    This was from the Amercian Diabetes Association journals 'Diabetes Spectrum'
     
  3. AndyS

    AndyS Type 1 · Well-Known Member

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    Hi lilibet,

    Thanks for that. That pretty much agrees with all I know about thyroid issues, which is a fair bit since I read up on it like a maniac 13 years ago when first ran into problems.

    I was just quite annoyed with the throw away comments by pretty much my entire treatment team that there was no link between the management of my now under active thyroid and the management of my diabetes. I find it annoying that the first reastion of a lot in the medical profession is to deny any kind of link instead of just thinking about it and trying to find out why WE think there is a link.

    Thanks for the article you found though..

    Andy
     
  4. totsy

    totsy Type 1 · Well-Known Member

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    hya, i started of with post partum thyroiditis 16 yrs ago, it then went ok and after my youngest child 13yrs ago i ended up in coronary care and my thyroid was so overactive, after meds to lower it it stopped working so i too am on thyroxine, i also find my bloods are higher if i do not take them, i asked my pharmacy who said they are known to lower blood sugar :D
     
  5. Senga

    Senga · Well-Known Member

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    Hi Andy,
    Just joined today and already you have informed me of something I did not even think about. I have underactive thyroid and am on thyroxine I am also on Novorapid and Levemir having few problems with highs and lows at present but will ensure I take thyroxine first thing in morning and see if it makes a difference as there has been occasions when I have taken it at different times

    Senga
     
  6. AndyS

    AndyS Type 1 · Well-Known Member

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    Hi Senga,

    The main thing I spotted was that if I did forget to take my thyroxine it did mess with my insulin needs a bit. Given that it's something I dont always do I have not worked out how exactly it would affect my ratios and to be honest I would rather not.

    I was interested to see what others were experiencing.

    Andy
     
  7. kewgirl

    kewgirl Type 1 · Well-Known Member

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    Hi Andy

    I think the Thyroxine debate and what effect it has on blood glucose (BG) levels is one for great debate!

    The complexities of the endocrine & metabolic body systems are I think so complex and intertwined & I still believe they are not fully understood - just because the textbook states a certain thing should happen I believe our bodies have other ideas. :lol:

    "Hypothyroidism. When your metabolism slows, your blood glucose level may drop because your diabetes medicine doesn’t pass through your body as quickly as usual and so stays active longer. In hypothyroidism, it is often necessary to reduce your dose of diabetes medicines." States one piece of literature!

    This is my theory based on taking Thyroxine & Insulin!

    However..... in some people with diabetes the hypothyroidism slows the actual action of the insulin thus raising blood glucose levels. In addition the 100mg tablets have the delight of lactose (milk sugar) as a main ingredient - yep just what we need some more unwanted sugar!!
    Also on Page 386 of the current Drugs Bible AKA The British National Formulary under Levothyroxine it clearly states, " antidiabetic medication including insulin may need to be increased".

    I was "warned" by my diabetic consultant that my BG might rise whilst taking Thyroxine due to the metabolism side of things & he also explained that some people with Hypothyroidism do not feel well until they are on much higher doses of Thyroxine even though blood levels show thyroxine to be in the normal range. :roll: :roll:

    I think this is a much more complex issue than textbooks would make us believe.

    I definitely notice a rise in BG levels after taking Thyroxine - which I usually take in the morning. However as part of a research experiment I might start taking it at lunchtime to see if I notice any other effect! Not sure if I would get going in the morning without it but for research purposes its worth a go! :lol:

    I will feedback after said experiment!

    Best wishes

    Tracey xx
     
  8. AndyS

    AndyS Type 1 · Well-Known Member

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    Hi Tracey,

    Yes so it seems the text books say it can do both.

    In my case I notuiced that if I forget to take my thyroxine then I need more thyroxine. The way a normal day works for me is I am on 1UI = 10g CHO at breakfast then +0.5UI at lunch, depending on BG (I trick that by working the food to the nearest 5g) then +1UI at dinner.

    So for me it seems the further I get from the thyroxine the more insulin I need. As I said I am on a fairly heavy dose of thyroxine 225 (I think the recommended maximum in the book is 250) though last 3 thyroid function tests have had border line high levels of TSH and lowish T4, but the Dr has been a little reticent to increase my dose.

    So I pretty much agree with your observations that the reduced thyroxine levels seem to slow / reduce the effectiveness of the insulin. This fits with me needing less insulin in the morning when I take my thyroxine.

    One thing I have considered trying is splitting my thyroxine between breakast and dinner, though at the moment I am still getting into the swing of things and the extra complication would probably confuse me further. I'm only 3 months down the road from initial diagnosis for diabetes and working hard at it... as I have seen in a few signature "I intend to die with my feet on"

    I suppose its a tricky one since your metabolism going up or down could affect the rate at which your body tries to use the sugar, hence dropping your BG or making your body release more. In my case my observations go against the drugs bible really.

    I hope they eventually do get a handle on the endocrine systems... though I suppose really we want them to figure out the immune system since thats what was the root cause of both these issues.

    Cheers
    Andy
     
  9. kewgirl

    kewgirl Type 1 · Well-Known Member

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    Hi Andy

    What a challenge as if the diabetes wasn’t enough to get a handle on we are also taking a medication that may increase BG levels and/or lower BG levels and thus there could be variations in the way it affects BG levels on a daily basis!

    Just out of interest I was reading some literature from IDDT & Thyroid UK when I cam across an article regarding synthetic thyroxine – I am not a huge fan of synthetic anything particularly analogue insulin hence my ears pricked up when reading the article.

    “there seem to be a lot of people who just cannot tolerate the synthetic form of thyroxine and fare much better on the natural form which contains all four thyroid hormones”
    http://www.thyroiduk.org.uk/tuk/pages/faq.html

    The article went on to say “ For a significant number of people this synthetic product (Levothyroxine) does not relieve their symptoms because they need the other hormones contained in natural thyroxine.
    More and more people are changing to the natural product.
    UK and European Law recognises that the synthetic thyroxine may not be suitable for some individuals.
    Although natural thyroxine is now unlicensed in the UK (but not the US) the MHRA has confirmed that doctors can prescribe them safety and they can be imported.”
    (IDDT Newsletter July 2009 page 6).

    Now I want to get me some of this natural stuff to try!

    best wishes

    Txx
     
  10. AndyS

    AndyS Type 1 · Well-Known Member

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    Hiya,

    I have never had a particular problem with levothyroxine. My T3 / T4 levels are generally within the "Acceptable" region though my feeling is that this acceptable region is a little on the broad side. I know that when I am at the bottom end of things I generally feel lethargic and such and my body tends to agree with my TSH often being high at that point.

    My most recent test a few months back had a TSH that was borderline high (actually outside the range) and T3 / T4 that was just inside. Personally I want to increase my thyroxine but that is another argument wity Dr altogether.

    I do have a few friends in the US who have been on the combination thyroxine (which I think is the natural stuff with a bit of levo, or vice versa) and they seem to manage much better on it really as far as I can tell.

    I have read a few interesting articles recently that suggest that 1000mg of Vitamin C taken with Levo can aide with absorption though from what I can tell the first test sample size wasn't really big enough to make sweeping claims but the results looked intruiging. I do pretty much everything I can to help absorbtion including taking first thing in morning on empty stomache and giving it 20-30 minutes to absorb before breakfast. I find if I dont do that I tend to drag quite a bit and I suspect am not getting the best.

    I know the Dr's would say that you will have a fairly constant thyroxine level through the day but my Insulin requirements through the day would tend to argue otherwise really. I know if I dose as I do for evening at breakfast I can be absolutely certain of a nasty hypo.

    Still I seem to have things undrestood now which is always good.

    Andy
     
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