# Going to see dr are these hypo symptoms?



## tebee (Oct 18, 2012)

I'm off to visit my doctor in the morning to see if he thinks I am Hypothyroid after my lab results.

TSH 4.95 mUI/l range 0.25-4.20

I've put together a list of all the minor symptoms I've been having the last year or so. I would be grateful if you could tell me which are fairly defiantly hypothyroidism related as I think some could be caused by my DM although my poor control here could equally be down to hypothyroidism.

Muscle weakness 
Muscle and joint pain 
Lack of stamina 
Disturbed sleep
Feel cold and unable to get warm 
Constipation 
Stomach problems and gas 
Nocturia
Bradycardia
Mental fog
Lack of enthusiasm
Short term memory problems 
Constantly hungry 
Gain weight - hard to loose

Tom


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## CA-Lynn (Apr 29, 2010)

What is "DM"?

Many of the symptoms on your list could be caused by thyroid disease.......and they could also be caused by other physical and psychological issues.


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## Bethany79 (Jul 24, 2012)

CA-Lynn said:


> What is "DM"?
> 
> Many of the symptoms on your list could be caused by thyroid disease.......and they could also be caused by other physical and psychological issues.


I believe DM is diabetes, am I right?


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## tebee (Oct 18, 2012)

Yes, sorry DM is Diabetes mellitus - I have a bad habit of using Medical terms or shorthand, it's what comes of being married to a Dr - sadly she is not an endocrinologist.

Tom


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## CA-Lynn (Apr 29, 2010)

That's one option, and the use of "poor control" in the same sentence certainly would support Diabetes Mellitus...... but still, so many medical terms:

diastolic murmur 
dry matter 
Deciduous molar 
Defined Medium 
deformable mirror 
dermatomyositis 
Descemet's membrane 
dietary modification 
differentiation medium 
dipole moment 
double minute 
dry mass 
dura mater 
dystrophia myotonica 
daunomycin 
defined media 
degenerative myelopathy 
degree of methylation 
deltamethrin 
depressive mood 
dermorphin 
Descemet membrane 
desmin 
Desmoplastic Melanoma 
Detarium microcarpum 
Deutschmarks 
dexamethasone 
dexamethasone 21-mesylate 
dexmedetomidine 
Dextran magnetite 
Dextran magnetite complex 
dextromethorphan 
dextromethorphan hydrobromide 
diabetes mellitus type I 
diabetes mellitus type II 
diabetic mellitus 
diabetic microangiopathy 
diastematomyelia 
diencephalon-midbrain 
diethyl maleate 
dimethoate 
disability management 
Disease management 
dispersion-managed 
dissection method 
distal metastases 
distal myopathy 
distant metastases 
Distant metastasis 
etc.


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## tebee (Oct 18, 2012)

As far as I'm aware the only two medical conditions DM is used to refer to are

Diabetes Mellitus
Myotonic dystrophy.

Go figure the second one......


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## tebee (Oct 18, 2012)

Ah ! forgot two symptoms - see I told you I had memory problems !

Numbness and tingling in hands
Ringing in ears

Tom


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## CA-Lynn (Apr 29, 2010)

Ok, so you have Type I diabetes? Not well controlled?

Ringing in the ears could be ANYTHING.

Numbness and tingling: more likely a diabetic reaction to poor control. What meds are you taking for it? And have you been out of control for long?


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## Octavia (Aug 1, 2011)

I agree that the numbness & tingling are likely due to the uncontrolled diabetes, and that is far more concerning to me than possible hypothyroid issues.


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## tebee (Oct 18, 2012)

OK a little more of my history.

I'm type 2 diabetes, diagnosed over 12 years ago and until recently have had very good control with pills, though I've had to take ever increasing douses.

Few years ago got married to a wonderful woman and decided I'd better start taking better care of myself. Gave up the car and started cycling everywhere. I'm lucky I live in Europe an even though I live in a rural area, there is public transport available for longer journeys. I lost almost 50 lb and was able to reduce my diabetes medication for the first time.

About 18 months ago I started having problems, having to go to the toilet 4-6 times each night, sleeping badly, lack of stamina and worst of all being confused and forgetful. My blood sugar control was fine , if anything a little lower than usual. Things got worse and during one of my check-ups my dr found my pulse rate was too slow 50-55 a min and my blood pressure was a little on the low side. Now I'd been on medication for High blood pressure for over 10 years so I stopped taking these and things sort of got back to normal.

My BS level kept falling and I reduced the level of my diabetes medication even further eventually stopping completely for about 3 months with my BS level being mostly Ok without medication, though my Doctor was not entirely happy with this.

I'm have blood work regularly and one thing my wife noticed was my TSH level was often out of range, though not by much. She is Hyperthyroid and suggested I point this out to my doctor who said it was nothing to worry about.

About 6 moths ago my blood sugar level started to rise and I went back on a low dose of my diabetes medicine again. I also started to gain weight, not a huge amount, about 7lb but it seemed very hard to lose it again. I also started to feel very lethargic and seem to have gone very weak - I find it hard to lift a weight I would have had no problem with a short while ago. My normal exercise now leaves me very tired and worn out for several hours.

My diabetes control seems to be getting still worse even though I have increased the dose again, the problem is it is suffering large swings, one day being fine and the next high - even changing considerable within the day. It seems to bear no relationship to what I eat or what I do. It's not dangerously high but more than myself or my doctor would like - a maximum of 10-12 on the good days it is 5-6 but sometimes lower.

Now when I was researching about the problems my wife is currently having I came across this site and realized that many people on here where reporting symptoms similar to what I have been having but being caused by hypothyroidism.

My Dr had been attributing my problems to my DM. Given that my TSH is above norms I also appear to be hypothyroid too. I'm trying to find if there is anything that can differentiate between the two.


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## Octavia (Aug 1, 2011)

Okay. Do you any other thyroid results, other than TSH?


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## Andros (Aug 26, 2009)

tebee said:


> I'm off to visit my doctor in the morning to see if he thinks I am Hypothyroid after my lab results.
> 
> TSH 4.95 mUI/l range 0.25-4.20
> 
> ...


Hey, Tom! What is DM?

I think you have a good list of hypo symptoms there; I really do. Due to nocturia and gasteroparesis, you might want to have glucose test too! Do you have sleep apnea?

Our dog had sleep apnea. Come to find out, he was hypo. It stopped once the T4 (thyroxine med) built up in his system. LOL! That is because hypo causes myopathy all over including a relaxed palate.

Wishing you all the best in the morning!


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## CA-Lynn (Apr 29, 2010)

As a Type 2 diabetic myself, I can tell you that there's a "tipping point" - that is.....if my weight goes above a certain point, the floodgates turn into evil insulin resistance gate keepers! My A1C goes up, my endo starts harping about meds.......and all other things go haywire.

Why not take a two pronged approach:

1. Get the full complement of thyroid tests, including those for antibodies
2. Do what you have to to get any surplus weight off.

Believe me, I HATED the diabteic meds more than any other meds I took and that includes some heavy duty stuff for RA. Frankly, I didn't get much help from them [Metformin]; I got a whopping 10 point drop in glucose. Big deal.

Also, there's typically a "honeymoon" period when you get off most diabetic meds.....takes about 3 months [if I recall] before the weight starts coming back and the labs start elevating.


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## tebee (Oct 18, 2012)

DM is Diabetes mellitus - Keep using these short-cuts, it's what comes of having a doctor in the house I'm afraid, I get used to talking with them, even though I often have to ask what she means when she talks about having a US-FNAC !

Yes, I do have sleep apnea . That to is a symptom? I've had that on and off for years.

I often have problems telling whether my big old mutt is still breathing when he sleeps, but I think that's just the deep way he sleeps rather than him not actually breathing.

I've no other thyroid tests - I'm looking for evidence to persuade my dr to order them - the TSH one is done as part of my tri-monthly diabetes check up , but he says the fact that it is slightly out of range is not important. I noticed the range seems to have changed on the most recent tests, last year that figure would have been acceptable, I wonder if he has not noticed this?


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## CA-Lynn (Apr 29, 2010)

It would be helpful if you post the last set of tests....yes, even if they are mostly diabetes-related.

As far as the range changes.....that's not unusual.


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## tebee (Oct 18, 2012)

Test results in full, ranges in brackets.

Haematites 4,640,000 mm3 (4.20-5.70)
Hemoglobin 15.1 g.100ml (13.0-18.0)
Hematocrit 44.1 % (38.0-54.0)
V.C.N 95 u3 (83.0-98.0)
T.C.M.H 33 pg (27.0-32.0)
C.C.M.H 34 % (31.0-38.0)

Leukocytes 7,000 mm3 (4000-10000)
Poly.neutrophiles 64% 
Poly.eosinphiles 4%
Poly.basophiles 0%
Lymphocytes 24%
Monocytes 8%

platelets 210,000 mm3 (150,000-400,000)

HGA1C 6.9 % (4-6)

protein c reactive 2.00 mg/l (<5)

glycemie 1.89 g/l (0.7-1.1)

clearance creatinine 11,0 mg/l (7-12)
clearance cockroft 64 ml/mn (>80)
clearance MDRD 73.ml.mn (>90)

UREE .30 g/l (.16-.49)

uric acid 46 mg/l (34-70)

cholesterol total 2.50 g/l (1.5-2.4)

cholesterol HDL 0.42 g/l (>0.45)
ratio total/HDL 6 (<5)

triglycerides 1.42 g/l (0.5-1.5)

cholesterol LDL 1.80 g/l

sodium 141 mEq/l (136-145)

Potassium 4.2 mEq/l (3.4-4.5)

chlorine 103 mEq/l (98-107)

Transaminase SGOT 19 UI/l (5-40)

Transaminase SGPT 22 UI/l (5-41)

gamma GT 31 UI/l (18-61)

phosphates alkaline 46 UI/l (40-130)

Bilirubine total 9 mg/l (<12)

TSH 4.95 mUI/l (0.25-4.20)


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## CA-Lynn (Apr 29, 2010)

Thanks for the quick response.

That A1C......must bring it down. What plan do you have in place to do that?

Your TSH - lots of doctors wouldn't think twice with that result. But I and countless others with Hashimoto's will tell you that most of us feel like crap when it's above 1.0. I feel my best when my level is actually non-existent!


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## tebee (Oct 18, 2012)

The Problem I have now is I don't how to control my A1C. It's fluctuating wildly for no apparent reason. Before if I had a bad result I could almost always tie it in to eating something "naughty". Now I've not eaten one bad thing for months and am exercising regularly and I can't get my weight down or control it.

I test myself with a meter and strips first thing in the morning and a couple of hours after my meals. 70% of the time I'm in the right range (4-6 though confusingly the meter they issued me with uses the other set of scales to the lab) often though I'm in the 9-10 range, though oddly enough , rarely in the middle ground. Probably about 5% of the time though I'm a long way either too high or too low. The maximum I've had is around 12 and the lowest 2.2 - don't feel good then. Oddly the morning score is often the worst.

I'm trying to make sense of all this and finding it hard. Something seems to have changed in my metabolism but I'm not sure what. Being hypo seem's to fit the bill but I hope I'm not clutching at straws.

Tom


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## Octavia (Aug 1, 2011)

What you are saying makes some sense. You need more thyroid labs other than TSH.


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## Andros (Aug 26, 2009)

tebee said:


> DM is Diabetes mellitus - Keep using these short-cuts, it's what comes of having a doctor in the house I'm afraid, I get used to talking with them, even though I often have to ask what she means when she talks about having a US-FNAC !
> 
> Yes, I do have sleep apnea . That to is a symptom? I've had that on and off for years.
> 
> ...


Yes to the apnea re diabetes and thyroid.

Get your dog a thyroid panel done.


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## CA-Lynn (Apr 29, 2010)

Teebee,

Go to this website which is all about Type2 diabetes. You'll get really good information and the benefit of the others' experience.

http://www.diabetesforums.com/forum/type-2-diabetes/

Did you get any education on nutrition when you were diagnosed with Type2? If not, you really need this.

What worked for me was testing before meals, an hour after and two hours after meals, plus logging the foods I ate. In time I learned exactly what I could eat and what I couldn't. And now my A1C runs fairly consistently at 5.6.

It's all about staying away from white food.


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## CA-Lynn (Apr 29, 2010)

Deal with the diabetes first. Get that under control.


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## tebee (Oct 18, 2012)

Well I went to see my doctor and he aggres I'm possibly hypo though he does not think I should have any symptoms at my level. He is sending me for more tests and an ultrasound.

My problem with getting my diabetes under better control is I don't know what I am doing wrong. I'm eating half what I was doing a year ago, being fairly careful of what I do eat and exercising regularly.

One problem I'm starting to get now is a major lack of stamina. If I do exercise I'm completely worn out afterwards. I'm also much weaker than I was - I keep dropping things either because I twitch and fumble or just that I can't support the weight.

I'm also finding it harder and harder to think some days. Though other days I am much better and have more energy - these don't coincide with bad day in my blood sugar level though.

I feel like I did in the early days when my BS was not under control and running at about 20 but I'm nowhere near those levels now.

Tom


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## CA-Lynn (Apr 29, 2010)

Here is the surefine way to find the diabetes culprit.

If you're really computer savvy, make an Excel spreadsheet with the following columns [or just hand-write it on paper and xerox the pages]:

Date / Time / Glucose / Food Eaten

Now, for the following week just eat as you normally do. The difference is that you're going to test yourself [glucometer/strips] BEFORE you eat, an hour after you eat, and two hours after you eat. If you have 3 meals a day, you'll be stabbing yourself 9 times. It's important to write clearly what you've eaten [e.g., broiled chicken, boiled egg, steel cut oats, sweet potato, broccoli, steak.....]

Also make note of condiments and any cream or sugar added to coffee. Note, too, any beverages and type [diet, non-diet, milk......]

You'll figure it out. And don't hesitate to go on the diabetes forum for help. The folks are really good there and you'll get some spot-on answers.

One of the things I did when I was diagnosed was go to the Univ of CA Irvine Medical school where they have a diabetes nutritionist on staff. She gave me a real education on what to eat and what I had to stay away from. Frankly, every diabetic should have this kind of mentor.

Something worth knowing about endocrinologists, at least in my neighborhood: they either specialize in diabetes or thyroid. So if you have both diseases, you almost have to go to two endocrinologists. [Fortunately mine is "fluent" in both diseases.]


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## Octavia (Aug 1, 2011)

My husband has been diabetic since his early 20s...or at least that's when he was diagnosed. He's now 40, and a few years ago, we met with a Diabetes Educator after a couple of low blood sugar episodes in which I had to call paramedics. She really gave us a lot of great information, AND worked with an endocrinologist (my husband had never met with one of those, either) to get his insulin regimen changed to a more "modern" standard of care.

Meeting with the Diabetes Educator made a huge difference for him in the way he manages this disease. Do you have such a person where you live? The person we met with is a Registered Nurse...I'm not sure what they would be in Europe.

Just a thought.


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## CA-Lynn (Apr 29, 2010)

MIne was an RN, too, and she had a Master's in nutrition. So she really understood all the related medical issues.


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## tebee (Oct 18, 2012)

Well I finally got my lab results back and it looks like I'm not hypo.

Tsh is 2.6 range 0.25-4.20 - this was 4.95 last time

T4 free 13.10 range 12-22

T3 free 4.4 range 3.1-6.8

Anti-TPO <5 range <34

I've been managing to keep my diabetes under much better control, seem to have a little more energy this week so more exercise. I have testing before meals , 1 hour after and 2 hours after a was suggested here. Two things seem to upset it - rice which is not too surprising, I always try not to eat too much rice anyway, hard when you are married to a Chinese girl though! Other is a little less expected, smoked salmon. Will try some tinned salmon soon and see what effect that has


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## sleepylady (Mar 18, 2012)

TeeBee

Those numbers are not necessarily "not hypo".

Many people feel best with TSH at 1 or below.

Also your FT4 and FT3 are in range but look low. Many people feel best at at least 50-75% of ranges.

Have you had any other antibodies tests run?

Andros can give you the low down as to what other tests you should ask for.


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