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What Causes Elevated TSH Levels While On Liothyronine?
Question: I am 61 year old female, type 2 diabetic, no problem with thyroid till 46- had stroke caused by vascullitis
caused by over the counter diet pills, High dosage of prednisone for over 6 months, gained 40 lbs in two weeks , found I had super low thyroid after off prednisone. Height 5ft 5- weight 145 at time of stroke
2015 present time weight 215- height 5ft 5,fasting glucose is 245-268 last tsh was very high 12.8,
I have never achieved blood sugar lower than 140 in 2 years. Last a-1c was high
take thyroid medication Liothyronine (2 tab per day 5mcg) & levothyroxine ( 1 pill per day 200mcg ),
for type 2 diabetes I take metforim (1-2 x day 1000mg) and glyburide (2x2 5mg),
Had thyroid sonogram done last week, hasve not heard from dr
caused by over the counter diet pills, High dosage of prednisone for over 6 months, gained 40 lbs in two weeks , found I had super low thyroid after off prednisone. Height 5ft 5- weight 145 at time of stroke
2015 present time weight 215- height 5ft 5,fasting glucose is 245-268 last tsh was very high 12.8,
I have never achieved blood sugar lower than 140 in 2 years. Last a-1c was high
take thyroid medication Liothyronine (2 tab per day 5mcg) & levothyroxine ( 1 pill per day 200mcg ),
for type 2 diabetes I take metforim (1-2 x day 1000mg) and glyburide (2x2 5mg),
Had thyroid sonogram done last week, hasve not heard from dr
Brief Answer:
Thyroid
Detailed Answer:
Your TSH needs to be brought closer to target range i.e. around 1 to 2
You will likely need to increase your thyroid medication dose.
Most endocrinologists worldwide do not prescribe liothyronine as it can have side effects. Authoritative guidelines have repeatedly emphasised that levo thyroxine alone in the right doses is sufficient to treat an under-active thyroid.
Regarding the diabetes, it must be better controlled to avoid complications.
When I see someone like you in my practice, I order the following tests in addition to a thorough physical examination :
CBC
CMP
HbA1c
Urine Albumin to Creatinine ratio
Lipids
I suggest you see an endocrinologist in person and discuss modifying your diabetes treatment program
Thyroid
Detailed Answer:
Your TSH needs to be brought closer to target range i.e. around 1 to 2
You will likely need to increase your thyroid medication dose.
Most endocrinologists worldwide do not prescribe liothyronine as it can have side effects. Authoritative guidelines have repeatedly emphasised that levo thyroxine alone in the right doses is sufficient to treat an under-active thyroid.
Regarding the diabetes, it must be better controlled to avoid complications.
When I see someone like you in my practice, I order the following tests in addition to a thorough physical examination :
CBC
CMP
HbA1c
Urine Albumin to Creatinine ratio
Lipids
I suggest you see an endocrinologist in person and discuss modifying your diabetes treatment program
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have a XXXXXXX hump and have had for years, should I check that I might have cushings disease?
will thyroid affect my high glucose?
will thyroid affect my high glucose?
Brief Answer:
Follow up
Detailed Answer:
A XXXXXXX hump is one of the signs of Cushings disease. However there are many other signs too. So we as endocrinologists look for greater evidence on examination before proceeding to ordering a test for it.
The fact that you were on high dose prednisone for quite some time can itself cause this.
It would be a good idea to meet with the endocrinologist and jointly discuss the need for testing for Cushings syndrome.
Regarding thyroid affecting glucoses, yes that is possible. Taking higher than necessary doses can result in worsening of diabetes
Follow up
Detailed Answer:
A XXXXXXX hump is one of the signs of Cushings disease. However there are many other signs too. So we as endocrinologists look for greater evidence on examination before proceeding to ordering a test for it.
The fact that you were on high dose prednisone for quite some time can itself cause this.
It would be a good idea to meet with the endocrinologist and jointly discuss the need for testing for Cushings syndrome.
Regarding thyroid affecting glucoses, yes that is possible. Taking higher than necessary doses can result in worsening of diabetes
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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