Put on Saxenda for weight gain and pre diabetes but not doing well, need advice!

[AnnaS69]

I am new here. I have been diagnosed with pre diabetes based on recent labs and put on prescription drug Saxenda, slowly titrating it up to 3.0 daily (maximum maintenance dose).
The good news is that, since going on Saxenda, all my sugar cravings are gone. But there are so many problems:
Not only are my sugar cravings gone, but I have no appetite at all. I also feel nauseated most of the time and am constantly tired. I simply have not felt like myself since going on Saxenda in late August.
I no longer feel like eating. I can no longer eat raw vegetables which I used to love. I don't want to eat meat or fish anymore after going on S so I've basically ended up a vegetarian. I can no longer eat a normal sized portion without feeling nauseated. I also feel more sluggish and depressed since going on S.
Some background info: diagnosed with an under active thyroid (Hashimoto's disease) 20 years ago. On thyroid hormone replacement since and labs look optimal. However, I've been struggling with weight gain ever since my hypo diagnosis.
I was diagnosed with insulin resistance (fasting insulin 13.4 uU/mL; ref 2.6-24.9; optimal <6, fasting blood glucose 90 mg/dL ref 70-105, optimal <75) three years ago). Was offered Metformin by doctor but decided to try berberine instead. I took 500 mg with each meal (1500 mg daily) and the weight just melted off. I lost 30 kilograms in six months without changing my diet or exercise routine. I kept my new, lower weight (70 kgs, 173 cm) for three years, until I was put on high doses of prednisolone for another autoimmune condition in late 2018. During the six weeks I spent on prednisolone, I started putting on weight. After four months, I had put 30 kgs back on and this time I could not lose the extra weight. Berberine no longer helps. My latest labs (late Aug) showed out of range fasting BG for the first time: 110 (ref 70-105), and insulin had risen from 13.4 to 18.1 (ref 2.6-24.9).
My doctor suggested Saxenda and it sounded like a good idea. However, the side effects are pretty horrible and don't seem to get better even though I've been on the maintenance dose (3.0 daily) for a few weeks. If anything, it feels like I'm getting worse. Also, I believe that a middle-aged woman with thyroid disease should not go on a starvation diet; however, given how little I am able to currently eat, I fear I am on a starvation diet and it's only going to backfire.
Any advice? I'd hate to have to go on insulin at some point. Would Metformin be a better choice (my doctor is pretty flexible)? Or any other anti-diabetic drug?
Any advice or input would be greatly appreciated as I'm currently at a loss...!

 

[JoKalsbeek]

I am new here. I have been diagnosed with pre diabetes based on recent labs and put on prescription drug Saxenda, slowly titrating it up to 3.0 daily (maximum maintenance dose).
The good news is that, since going on Saxenda, all my sugar cravings are gone. But there are so many problems:
Not only are my sugar cravings gone, but I have no appetite at all. I also feel nauseated most of the time and am constantly tired. I simply have not felt like myself since going on Saxenda in late August.
I no longer feel like eating. I can no longer eat raw vegetables which I used to love. I don't want to eat meat or fish anymore after going on S so I've basically ended up a vegetarian. I can no longer eat a normal sized portion without feeling nauseated. I also feel more sluggish and depressed since going on S.
Some background info: diagnosed with an under active thyroid (Hashimoto's disease) 20 years ago. On thyroid hormone replacement since and labs look optimal. However, I've been struggling with weight gain ever since my hypo diagnosis.
I was diagnosed with insulin resistance (fasting insulin 13.4 uU/mL; ref 2.6-24.9; optimal <6, fasting blood glucose 90 mg/dL ref 70-105, optimal <75) three years ago). Was offered Metformin by doctor but decided to try berberine instead. I took 500 mg with each meal (1500 mg daily) and the weight just melted off. I lost 30 kilograms in six months without changing my diet or exercise routine. I kept my new, lower weight (70 kgs, 173 cm) for three years, until I was put on high doses of prednisolone for another autoimmune condition in late 2018. During the six weeks I spent on prednisolone, I started putting on weight. After four months, I had put 30 kgs back on and this time I could not lose the extra weight. Berberine no longer helps. My latest labs (late Aug) showed out of range fasting BG for the first time: 110 (ref 70-105), and insulin had risen from 13.4 to 18.1 (ref 2.6-24.9).
My doctor suggested Saxenda and it sounded like a good idea. However, the side effects are pretty horrible and don't seem to get better even though I've been on the maintenance dose (3.0 daily) for a few weeks. If anything, it feels like I'm getting worse. Also, I believe that a middle-aged woman with thyroid disease should not go on a starvation diet; however, given how little I am able to currently eat, I fear I am on a starvation diet and it's only going to backfire.
Any advice? I'd hate to have to go on insulin at some point. Would Metformin be a better choice (my doctor is pretty flexible)? Or any other anti-diabetic drug?
Any advice or input would be greatly appreciated as I'm currently at a loss...!

Hello @AnnaS69 ,

I don't know the drug you're on (I think most people here'd know it as victoza, but I never used it). I do know that if you're succeptable to side effects, metformin might not be the best choice for you either. And you're right, a starvation diet is not going to help you at this point. So, a couple of things: Do you have a blood glucose meter? Because if you don't, do get one, you're going to need it. Secondly, discuss with your doc whether you can try diet-only. I'm going to give you a link to a quick-start guide, and if you think that what you read there resonates with you, by all means, read on over at dietdoctor.com, and dr. Jason Fung's book, The Diabetes Code. Becoming a Type 2 is not a foregone conclusion, and you do not have to feel ill and depressed due to medication. You have options, GP's often just don't know them all. Not their fault by the way, they've got a lot of balls in the air.

Anyway, the link: https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/

I have hashimoto's as well, which can affect sugar levels, so it's a good thing you're keeping an eye on your levels there too. Aand I know steroid use (prednisolone) can wreck bloodsugars for a while. So you have to figure out what works for you, because what you're doing now, obviously isn't. Like I said, you have options, and the link I gave you is just one of many.

You be good to yourself, and don't give up just yet eh!
Jo

 

[xfieldok]

You really hava lot going on. Welcome to the forum, we aren't allowed to diagnose etc but the people here are incredibly helpful.

Something to consider is your diet. You say you are prediabetic, do you know what your hba1c number was?

Many of us eat low carb high fat, keto (in my case) even carnivore.

As a T2, like all others, I have an intolerance to carbohydrates and limit my food choices to try and stay under 20 carbs per day. The result of this is that your body switches to using the fat stored in your body. Once you get through the carb addiction, you no longer crave carbs, the weight starts to melt away. I am currently on prednilolone and have been since May. I feel your pain as regards weight gain. I hate to think where I would have been now if I hadn't lost a load of weight with the keto diet first. I am currently tapering off so fingers crossed.

Are you using a glucose meter to keep an eye on what your blood sugars are doing.

 

[LittleGreyCat]

@AnnaS69 I was a bit confused when I looked up Saxenda.
Allegedly it is the same drug as Victoza (liraglutide) but is not licenced to treat T2 diabetes.
It is only licenced as a weight loss drug.
Which is confusing if it is the same basic drug as Victoza.

Anyway I would go back to your medical team and discuss the effects that you are getting, and if they are expected.

I'm not sure why you aren't keen on Metformin.
Could you give a little more detail on that, please?

 

[AnnaS69]

Yes, Saxenda is the same as Victoza, only Victoza has been approved for the treatment of D2 for some time at a maximum dose of 1.8 daily (subcutaneous injection), whereas Saxenda is approved for weight loss at a higher dose (3.0 daily). So the active substance is the same, only the dose differs. S is said to result in greater weight loss than V.
My doctor suggested Saxenda as I am pre diabetic (fasting insulin not yet over range) and overweight. It seems Saxenda is more fast acting since you take a higher dose but, apart from that, it's the same drug as Victoza.
I have read a lot about the side effects of Metformin/Glucophage which is an older drug than V/S, but I am not sure the latter have less side effects to be honest...!
I have never had my HbA1c tested, my doctor only orders fasting blood glucose and insulin. I could ask doctor to include HbA1c next time if you think that would be useful..?
Thanks for all your input and suggestions, there is a lot to digest...1

 

[Daibell]

Hi Saxenda is Liraglutide in the UK and commonly prescribed to help with weight loss. It does have some side effects so if you can gradually come of it as the weight reduces that would be good (discuss with the Doc). Before Saxenda were you having a Low-carb diet? This is the first stop to try to reduce weight and BS. Can you let us know more about your diet before Saxenda? Metformin is fine and has few side effects other than bowel problems for some when you have the plain version. The extended release version Metformin SR can avoid that. Note, however, that Metformin is not a miracle drug and only ever has small but useful effect