High cholesterol. Hypothyroid. Type one!

[ktbubble]

I had my first consultant appointment last week and sadly Came out feeling deflated and overwhelmed, if I'm totally honest. I thought I was beginning to manage my diabetes ok. With a healthy diet and lots of exercise (3-6 times a week doing classes spin/body pump etc). I'm still in the honeymoon phase and have been managing to take 5units of background insulin at night and novo rapid with only my evening meal. My breakfast and lunch if not to high in carbs don't require insulin. My BMs generally are 5-9.5. So was surprised when he said that I need to be injecting insulin with every meal. I have attempted this over the weekend and found my Bms are dropping and I'm now having to eat more to keep them up. He explained that while my exercise is keeping my Bms lower I need the insulin to feed my cells. The plan he suggested was to drop background insulin by one unit the days I exercise and inject novo rapid with each meal (1-5units depending on carb amounts) As I should not be solely relying on my background to control my Bms. Since I've come away I'm wondering if my own ability to produce some insulin is enough to drop my novo back to only my evening meal? Not sure if this makes sense, but would love some advice on others experiences.

Also my cholesterol was high 6.4 no family history of heart disease. Freaked at the mention of statins! I take 25mcg of thyroxine and have read that hypothyroidism can raise cholesterol. I was thinking of asking go if I could increase my thyroxine to help lower my cholesterol???

Thanks in advance

Kate X

 

[Totto]

One symptom of hypothyroidism is high cholesterol, particularly high LDL. Do you have the different numbers for LDL, HDL and triglycerids?

25 mcg Levothyroxine is the starting dose usually given to old, sick people with heart conditions. To be properly medicated we usually need a lot more. I'm on NDT but before that I was on 150-200 mcg Levo, with a suppressed TSH, a FT4 slightly above range and FT3 in the upper part of the range.

 

[tim2000s]

He explained that while my exercise is keeping my Bms lower I need the insulin to feed my cells.

Hmmm. An interesting statement to make. If your BG levels are remaining in the 4-8 range, then the insulin you have on board is providing the catalyst to feed your cells, and the exercise will be increasing the efficiency of the GLUT4 receptors. The fact that your blood glucose level is remaining in the range it is means that you are using the glucose.

The other side of that is that if you are relying on your body to produce insulin, you are increasing the Auto Immune attack on your beta cells by doing so as the production of insulin increases the auto immune attack.

Given most therapies look as though they will require some levels of beta cells, it may be wise to take insulin to reduce this dependency.

 

[ktbubble]

One symptom of hypothyroidism is high cholesterol, particularly high LDL. Do you have the different numbers for LDL, HDL and triglycerids?

25 mcg Levothyroxine is the starting dose usually given to old, sick people with heart conditions. To be properly medicated we usually need a lot more. I'm on NDT but before that I was on 150-200 mcg Levo, with a suppressed TSH, a FT4 slightly above range and FT3 in the upper part of the range.

 

[ktbubble]

Thanks for responding. I Don't have the different results. I will ask at my next appointment. I've been on 25mcg for 2yrs as My results were only borderline but I was symptomatic. Since my tsh has remained top end of normal parameters. T4 also normal. Not had this weeks results back yet.

 

[ktbubble]

Thanks @tim2000. I think I will continue to inject with all meals and drop my background to 4units. I want to protect my beta cells as much as possible!!

 

[Totto]

Thanks for responding. I Don't have the different results. I will ask at my next appointment. I've been on 25mcg for 2yrs as My results were only borderline but I was symptomatic. Since my tsh has remained top end of normal parameters. T4 also normal. Not had this weeks results back yet.

Most of need TSH to be 1 or lower to feel well. The most important test is FT3.

 

[teacher123]

Hmmm. An interesting statement to make. If your BG levels are remaining in the 4-8 range, then the insulin you have on board is providing the catalyst to feed your cells, and the exercise will be increasing the efficiency of the GLUT4 receptors. The fact that your blood glucose level is remaining in the range it is means that you are using the glucose.

The other side of that is that if you are relying on your body to produce insulin, you are increasing the Auto Immune attack on your beta cells by doing so as the production of insulin increases the auto immune attack.

Given most therapies look as though they will require some levels of beta cells, it may be wise to take insulin to reduce this dependency.

So you should be taking some amount of insulin at every meal despite exercising afterwards?

 

[ktbubble]

Yes according to my consultant.

 

[tim2000s]

So you should be taking some amount of insulin at every meal despite exercising afterwards?

If I'm honest, I'd say that you have to work with your meter. If you are a late onset T1/T1.5, you are in an awkward position. You want to try and retain beta cells while avoiding hypos. I'm not in a position to provide a medical opinion or prescribe, but I would try and run a balance, taking some insulin (but not as much as I required when not exercising) and making sure I monitored the effects to understand how it all worked on me.

Patterns do develop if you keep records and I would use these to determine the best approach. http://crick-tech-munch.blogspot.co.uk/2015/11/the-3rs-record-review-react.html

 

[ktbubble]

Thank you