low sugar levels

I think that's far too low from what I've read on these forums, though someone who knows more will hopefully reply soon.

Do you know what your last hbc1a was? That's the one that shows the average of your blood sugar over the last 3 months.

What dose of metformin tablet are you on? 500mg, 2000mg? It seems strange that your doctor told you to reduce the metformin, rather than stop taking the Actos. Actos can give you hypoglycemia (too low blood sugar), metformin can't.

I don't know what effect your operations might have had, but from what little I do know I would have thought stuff happening to your pituitary gland could affect blood sugar, it's to do with regulating hormones and stuff I think?

I'd expect them to try the max dose of metformin before trying Actos really, it's safer. The max dose for metformin SR is 2000mg (so 4 500mg tablets) or so it says on the leaflet, I think for normal metformin it was a bit higher though, 2500mg iirc.

That's not the minimum dose of Actos either, it comes in 15mg tablets.

From personal experience, what my doctors did was raise the dose of metformin to 2000mg, then when that didn't work prescribe Actos in 15mg, then when I still had high blood sugar raise it to 30, then again to 45mg when it was still high.

If your blood sugar is that low, I personally would stop taking the Actos now until you can get a doctors appt, because high blood sugar will take a while to hurt you, whereas low blood sugar can be very dangerous, though I'm not sure how low it has to get.

I'd definitely go back to your doctor. It might well be worth dropping both meds before you see him to get an idea what your unmedicated levels are like, or at least discuss the idea with him.

The entire endocrine system is a massive chemistry set and all interlinked, so it's very likely that the pituitary tumour and its absence will have affected things in the same way that thyroid and adrenal problems do