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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Leads To Drowsiness While Taking Thyronorm And Insulin?

Hello Dr. i am 54 year old male from India. I am having hypothyroidism and hyperglycemia for the past 10 years. I have been taking now 75 ucg of Thyronorm early morning and 24 units of Insulin ( 12 units in the morning and 12 units before dinner). One peculiar problem is that HB1ac is remaining more than 12% since past 5 years. If I try to increase the insulin dose i am having a problem of getting drowsyness at around 11 am and this goes away only if I eat some sweet biscuits. But if i check the blood glucose at that time it will be more than 160 mg earlier i have tried oral hypoglyceamin agents like metformin, januvia etc. and all these have produced more of this symptom. I have a feeling that taking thyronorm and other drugs is creating this problem to me. if i forgot to take this tablet on a day, that day the drowsiness will not come. Dr. Can you please tell me some thing on this.
Fri, 24 Feb 2023
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General & Family Physician 's  Response
Hi,

I do not think, that Thyronorm, itself may cause a feeling of drowsiness. More over, you are already taking it for 10 years. I do not know, if you are getting your T3, T4, and TSH levels checked periodically to titrate the dose of Thyronorm.

Also, a reading of HbAIc >12%, shows that you are not having a good control of your sugar level & any level of HbA1c >7.5 may have serious consequences on the body, some with fatal outcome. You may change the timing of insulin or may spread the dose of insulin to three times instead of two to maintain the controlled sugar level for 24 hour period.

I am still of the opinion that, you may try some other anti-diabetic oral drug out of a vast range of medicines available under guidance of your doctor. Some of the drugs, you may choose from be, Glimepiride, teneligliptin, vildagliptin and so many newer preparations.

Also, you feel drowsiness even with your glucose level > 160, is due to the reason, that your body has adapted to increased level of glucose. With controlled normal glucose levels, your body will adjust itself gradually to normal values of glucose in the body.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Satnarain Bansal, General & Family Physician
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What Leads To Drowsiness While Taking Thyronorm And Insulin?

Hi, I do not think, that Thyronorm, itself may cause a feeling of drowsiness. More over, you are already taking it for 10 years. I do not know, if you are getting your T3, T4, and TSH levels checked periodically to titrate the dose of Thyronorm. Also, a reading of HbAIc 12%, shows that you are not having a good control of your sugar level & any level of HbA1c 7.5 may have serious consequences on the body, some with fatal outcome. You may change the timing of insulin or may spread the dose of insulin to three times instead of two to maintain the controlled sugar level for 24 hour period. I am still of the opinion that, you may try some other anti-diabetic oral drug out of a vast range of medicines available under guidance of your doctor. Some of the drugs, you may choose from be, Glimepiride, teneligliptin, vildagliptin and so many newer preparations. Also, you feel drowsiness even with your glucose level 160, is due to the reason, that your body has adapted to increased level of glucose. With controlled normal glucose levels, your body will adjust itself gradually to normal values of glucose in the body. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Satnarain Bansal, General & Family Physician