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Insulin resistance, t3, GLUT4, dawn phenomenon

Discussion in 'Diabetes Discussions' started by Dandelade, Feb 21, 2022.

  1. Dandelade

    Dandelade · Well-Known Member

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    Hi all,

    So I’ve noticed after a couple of weeks being optimally medicated with levothyroxine that my dawn phenomenon seems to have just disappeared and insulin resistance massively improved. Like, overnight.

    Within 20 minutes of taking my morning pill the glucose readings stop rising to 6.5 and decrease back to in the 5s after another 20 minutes or so. I was really curious so had the same breakfast the next day but before my pills and up of 8.5 taking 3 hours to come back down.

    Is lack of thyroxine really the cause of the insulin resistance? My curiosity found these papers that suggest t3 is needed to activate the glucose transporters in cell membranes so that they can work with insulin to uptake glucose from the blood.
    https://academic.oup.com/endo/article/138/3/1204/2988169
    https://pubmed.ncbi.nlm.nih.gov/9048628/

    I also found along the way, some studies that hypothyroidism leads to longer turnover of red blood cells, falsely increasing hba1c. It would make sense for me, why when my bloods are averaging 5.5mmol/l (which should be hba1c of 37) I’m still reading hba1c of 43.
    https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5240076/
    https://www.thyroid.org/patient-thyroid-information/ct-for-patients/february-2016/vol-9-issue-2-p-6/

    Anyway, I thought it was interesting to share! Maybe it has been the mechanism for my raised hba1c, maybe not. Anyone else with marked change in hba1c/ insulin resistance with thyroid hormones?
     
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  2. clare56

    clare56 Type 2 · Member

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    This is interesting to read, although I can't shed any light on your experience I'm afraid.
    I have just started using a continuous glucose monitor (on trial) to try and understand what sends my blood sugars high. I've been astonished to see that my glucose readings rise through the night (from about 5.5 to nearly 9) and keep rising after a late, small, low carb breakfast (11ish) for an hour or so, then dropping all afternoon and through the evening, with very small rises when I eat.
    I'm keeping to a strict low carb diet and it's almost as if the blood sugar rises and falls have little to do with what I eat. I did have an overactive thyroid (diagnosed as Grave's disease, but i'm not so sure) and I wonder about the connection between that and my diabetes 2.
    I shall read the articles you have provided links to. Thank you.
     
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  3. AndBreathe

    AndBreathe I reversed my Type 2 · Master
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    Dandelade, it's excellent to hear you are optimally medicated for your thyroid. It must be a relief for you.

    The thyroid plays a key part of controlling our whole metabolic proccess, so it is not inconceivable insulin resistance could improve. I can't say I noticed anything dramatic myself, but that means nothing.

    In your post, you say, "...."so had the same breakfast the next day but before my pills and up of 8.5 taking 3 hours to come back down....."

    How long was it between taking your levothyroxine and eating breakfast or drinking anything containing milk? That can make a difference.

    Again, apologise for the snippet of your post, but it's easier than trying to pinpoint it in words:

    You say, "...." that suggest t3 is needed to activate the glucose transporters in cell membranes...." Yes, T3 is key critical.

    T4 (as is in your Levothyroxine) is a passive hormone. That alone will not do much for you. It is only when your body converts it to T3 that the magic happens. So, if your thyroid gland is just not generating enough T4, but your bdy can still convert it to T3, once adequately titrated you will likely feel better.

    If, however, your body is unable to convert T4 to T3 at all (or is very inefficient in it's conversion) then the individual will either end up taking very large doses of T4, or require T3 in tablet for, just like the T4. Some folks end up on dual therapy and other just take T3.

    That said, none of that seems to be an issue for you, if you have achieved optimal levels taking T4 only. That's excellent news!
     
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  4. pre-predb

    pre-predb · Active Member

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    I found this very interesting as my Hba!c has always hovered between 39 and 42 despite my low carb diet. I have only had it tested in the last few years and have been on levothyroxine for about 15 so I don't know what it was beforehand. I have recently bought a glucose meter (which I haven't had a chance to try out yet), as I was keen to find out what was causing Hba1c to be higher than I would have expected. It will be interesting to see which foods are causing highs throughout the day, as my fasting glucose has always been anout 4.5 to 4.7. However, I am now thinking it could well be the longevity of the red blood cells instead.
     
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  5. Dandelade

    Dandelade · Well-Known Member

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    Hi AndBreathe,

    Thanks for the reply - maybe optimally treated was my optimistic push but I am much much better!

    I think it was a couple of hours between breakfast and levo on my second test run. You’re right it could be absorption after breakfast causing a difference. Either way it suggests a mechanism connecting levo needed to reduce blood sugar right? I agree with you, from those articles it’s actually t3, and I thankfully I appear to be a good converter!

    I am just thankful for the improvements all round. I do get scientifically curious though!
     
  6. Dandelade

    Dandelade · Well-Known Member

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    Good luck with your monitoring and let us know what you find!
     
  7. Dandelade

    Dandelade · Well-Known Member

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    I had the exact same pattern in the morning up to 9 too then slowly down. I get the frustration that blood glucose levels were nothing to do with what I was eating my liver seemed to just be throwing a hissy from the low carb!

    It got better and better until now where I can see something happen very abruptly on the monitor that never used to. Mind you’ve I’ve no idea if it is the dose of levothyroxine and the sudden drop caused by change in t3, or if it has been my liver slowly emptying of stored glucose as restoration of the phase of insulin response in the pancreas.

    I suppose the only way to tell would be measuring insulin output before and after? Guess my meter will have to do leaving going hmmmm I wonder?!
     
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  8. AndBreathe

    AndBreathe I reversed my Type 2 · Master
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    If you are in range, which I'm guessing you must be if you feel much better, if you feel well again, then it's pretty much mission accomplished.

    Where in the range a person feels really well is highly personal. That you convert well is excellent.
     
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  9. clare56

    clare56 Type 2 · Member

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    A week on and my blood sugar seems much less volatile. I’m assuming I’m actually being more careful with my diet as the scanner is monitoring me! I’m due another set of tests soon and will ask for a T3 test. (They usually test my T4).
     
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