Hba1c good but other bloods abnormal

[SJS5]

Hi

I have been eating a low carb diet for around 3 years.
Over this time my Hba1c has continually improved and my recent test was 44mmols.
I'm happy with this but disappointed that one of my liver enzymes the ALT has tipped slightly above normal.
It's normally in the low 20s but has gone up to 34.
Also my kidney function has dropped with egfr now of 60,.last year it was 76.

I have had type 1 for 31 years and I am aware of the long term effects , but I'm wondering what is causing the deterioration in the other bloods when over the last 3 years by Hba1c has continued to improve . I've worked so hard to get it down, yet feel I'm.now rewarded with other poor results.

My cholesterol has also increased to 6.6 from 5.6 mmols
Trigs 1.3mmole HDL 2.5 LDL 3.5

I might also add that my TSH is 6.2mmols which Is above normal. Usually around 2.
Any thoughts of what might be going on other than the dreaded complications now starting to appear.

 

[Antje77]

I might also add that my TSH is 6.2mmols which Is above normal. Usually around 2.

Hi @SJS5 , I don't have any anwers for you (I'm a newbie at T1 compared to you, at only 7 years in), but I'll tag @AndBreathe for you. She's not a T1, but she knows a lot about thyroid issues and other blood tests.

 

[AndBreathe]

Hi

I have been eating a low carb diet for around 3 years.
Over this time my Hba1c has continually improved and my recent test was 44mmols.
I'm happy with this but disappointed that one of my liver enzymes the ALT has tipped slightly above normal.
It's normally in the low 20s but has gone up to 34.
Also my kidney function has dropped with egfr now of 60,.last year it was 76.

I have had type 1 for 31 years and I am aware of the long term effects , but I'm wondering what is causing the deterioration in the other bloods when over the last 3 years by Hba1c has continued to improve . I've worked so hard to get it down, yet feel I'm.now rewarded with other poor results.

My cholesterol has also increased to 6.6 from 5.6 mmols
Trigs 1.3mmole HDL 2.5 LDL 3.5

I might also add that my TSH is 6.2mmols which Is above normal. Usually around 2.
Any thoughts of what might be going on other than the dreaded complications now starting to appear.

I will say that not all blood results relate to diabetes, so a reduction in A1c would not necessarily impact all other tests positively. That said, well done reducing your HbA1c as that should help you in the long run.

Have you changed anything else in the recent past (thinking 6 months, or less)?

Your TSH is too high, but the UK does not begin treatment for underactive thyroid for TSH of less than 10. In other countries it is treated from 5 or thereabouts. I am talking starting treatment, not ongoing treatments. The exception in UK is for repeatedly raised TSH of 5+ where hypothyroid symptoms are in play.
- Are you receiving treatment for hypothyroidism?
- Do you have hypothyroid symptoms disrupting your day to day living?

If you have the latter, it is possible to have a trial of Levothyroxine if you have more than one raised TSH. TSH is quite a dynamic score and even varies during the day. Because of that, I always have my thyroid bloods drawn first thing, before I take my thyroid meds.

What is your GP/Endo saying about your most recent bloods? Are there plans to retest any time soonish?

 

[himtoo]

well done on your HbA1c result...........as for cholesterol it is possible that the low carb diet could be contributing to the rise in cholesterol ( although this is just from individual experience )

 

[AndBreathe]

well done on your HbA1c result...........as for cholesterol it is possible that the low carb diet could be contributing to the rise in cholesterol ( although this is just from individual experience )

Untreated hypothyroidism can also be a cause of elevated cholesterol.

 

[SJS5]

I will say that not all blood results relate to diabetes, so a reduction in A1c would not necessarily impact all other tests positively. That said, well done reducing your HbA1c as that should help you in the long run.

Have you changed anything else in the recent past (thinking 6 months, or less)?

Your TSH is too high, but the UK does not begin treatment for underactive thyroid for TSH of less than 10. In other countries it is treated from 5 or thereabouts. I am talking starting treatment, not ongoing treatments. The exception in UK is for repeatedly raised TSH of 5+ where hypothyroid symptoms are in play.
- Are you receiving treatment for hypothyroidism?
- Do you have hypothyroid symptoms disrupting your day to day living?

If you have the latter, it is possible to have a trial of Levothyroxine if you have more than one raised TSH. TSH is quite a dynamic score and even varies during the day. Because of that, I always have my thyroid bloods drawn first thing, before I take my thyroid meds.

What is your GP/Endo saying about your most recent bloods? Are there plans to retest any time soonish?

Hi

I am not known to have hypothyroidism but have a strong family history of it..Mum , Grandmother and daughter!

I have not noticed any symptoms so will ask for a repeat test and thyroid antibody tests

 

[SJS5]

well done on your HbA1c result...........as for cholesterol it is possible that the low carb diet could be contributing to the rise in cholesterol ( although this is just from individual experience )

well done on your HbA1c result...........as for cholesterol it is possible that the low carb diet could be contributing to the rise in cholesterol ( although this is just from individual experience )

Yes I suspect as much but it is concerning that is gradually increasing.
I thought it would improve seeing as the HBa1c is so much better .
I may look at cutting down on my cheese consumption!

 

[AndBreathe]

Hi

I am not known to have hypothyroidism but have a strong family history of it..Mum , Grandmother and daughter!

I have not noticed any symptoms so will ask for a repeat test and thyroid antibody tests

It’s worth going through this list, although some symptoms are associated with lots of conditions: https://thyroiduk.org/signs-and-symptoms/hypothyroid-signs-and-symptoms/

 

[CheeseSeaker]

I may look at cutting down on my cheese consumption!

Madness.....madness I tell you ;-)

As I keep telling my wife - its a 'health food' - great source of calcium and errrmmmm.... other stuff...probably essential...