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Dr. Andrew Rynne

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What do these following lab reports indicate?

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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1416 Questions

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Posted on Mon, 19 Oct 2015 in General Health
Question: MY TSH IS 13 AND a recent sonogram found a nodule on my thyroid, type 2 diabetic fasting blood sugar is 220-260, have been on thyroid medicatios ( synthroid and cytomel )for years, take metforim and glyburide ( 4 per day)for diabletes, XXXXXXX hump on neck,

My guestion is , I continue to gain weight, could high tsh be affecting my blood sugar
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Answered by Dr. Binu Parameswaran Pillai 32 minutes later
Brief Answer:
Inerconnected hormonal issues and diabetes

Detailed Answer:
Good day,
Noted your question and the history provided. I gather that you have diabetes, hypothyroidism and weght gain. The weight gain was after using steroids and if got right, you are not using steroids (prednisone) after the age of 45 .

TSH is 13 which means that the hypothyroidism is not well controlled. This can contribute to weight gain and uncontrolled diabetes. However, there is an other side of story too. Weight gain increase the requirement of thyroxine (synthroid) and that way TSH can increase too.

You mentioned about XXXXXXX hump which is usually seen in obesity. However, we need to consider another hormonal disorder called as Cushing's syndrome which can cause weght gain and uncontrolled diabetes. You had used prednisone in the past which also could have caused the XXXXXXX hump.

A thorugh history and physical examination is needed before doing investigations in your case.
I would strongky recommend to meet an endocrinologist in person rather than a Internist or Physician due to the complexity of the problem..
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai 1 hour later
Now 61 and weight is 215
Have had XXXXXXX hump before I was overweight, sometimes in painful
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Answered by Dr. Binu Parameswaran Pillai 8 hours later
Brief Answer:
Tests for cushing's syndrome

Detailed Answer:
Thank you for the reply. Okay, in that case, we may have to run few tests to rule out cushing's syndrome. You may need to meet an endocrinologist for this. Diabates control should be optimised before doing these tests. recommended tests are, 24 hour urine free cortisol and midnight salivary cortisol.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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