Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Thyroid Cancer, Nodules & Hyperthyroidism (Expert Forum)
Thyroid issues still or insulin resistance?
Answered by
Mark Lupo, M.D. - Thyroid Nodules, Thyroid Cancer, hyperthyroidism, hypothyroidism, Thyroid Ultrasound
Thyroid & Endocrine Center of Florida
Sarasota - FL
Questions in the Thyroid forum are answered by Mark Lupo, MD. Topics covered include Goiter, Graves Disease, Hyperthyroid, Parathyroid/Calcium Problems, Thyroid Cancer, Thyroid Nodules/Cysts, Thyroiditis, Thyroid & Pregnancy, Thyroid Stimulating Hormone (TSH), Thyroid Tests, and Thyroid Surgery.
Thyroid issues still or insulin resistance?
by wonderone, Dec 17, 2008 12:50PM
Dr. Lupo:
Thanks for your answer to my earlier question. I have hypothyroidism and I have also been diagnosed with PCOS using labs and ultrasound on ovaries. I am still experiencing horrible fatigue and occasional tingling in my hands and feet. I had thought this was thyroid-related, but now I am wondering about insulin resistance. I am concerned since I have PCOS as well as relatives with type 2 diabetes. I asked my doctor about it and he said that my fasting-glucose levels have always been normal (in June it was 81), my non-fasting serum insulin was normal (level was 8), non-fasting c-peptide was normal (level was 2.9), so it isn’t an issue. I requested the 2hr GTT w/insulin check. He felt it was a waste of my time to get this test, but gave me the order to get it done anyway. I did that yesterday.
1) What would indicate insulin resistance with this test? I am considering switching doctors because I am not sure if the doc I am seeing is right for me.
2) Would a reproductive endocrinologist treat both PCOS and hypothyroidism or do they only treat people with issues in trying to get pregnant?
3) I have heard of many people with PCOS taking Glucophage. If this is a proper treatment for IR, is the extended release version better than the regular?
Thanks for your help.
Most recent labs:
November (while on .88mcg Synthroid, 10mcg Cytomel, 200mg Prometrium 18days/mo)
Free T4 1.2 (.8-1.8)
Free T3 325 (230-420)
TSH .22 (.4-4.50)
TPO AB 411
Thanks for your answer to my earlier question. I have hypothyroidism and I have also been diagnosed with PCOS using labs and ultrasound on ovaries. I am still experiencing horrible fatigue and occasional tingling in my hands and feet. I had thought this was thyroid-related, but now I am wondering about insulin resistance. I am concerned since I have PCOS as well as relatives with type 2 diabetes. I asked my doctor about it and he said that my fasting-glucose levels have always been normal (in June it was 81), my non-fasting serum insulin was normal (level was 8), non-fasting c-peptide was normal (level was 2.9), so it isn’t an issue. I requested the 2hr GTT w/insulin check. He felt it was a waste of my time to get this test, but gave me the order to get it done anyway. I did that yesterday.
1) What would indicate insulin resistance with this test? I am considering switching doctors because I am not sure if the doc I am seeing is right for me.
2) Would a reproductive endocrinologist treat both PCOS and hypothyroidism or do they only treat people with issues in trying to get pregnant?
3) I have heard of many people with PCOS taking Glucophage. If this is a proper treatment for IR, is the extended release version better than the regular?
Thanks for your help.
Most recent labs:
November (while on .88mcg Synthroid, 10mcg Cytomel, 200mg Prometrium 18days/mo)
Free T4 1.2 (.8-1.8)
Free T3 325 (230-420)
TSH .22 (.4-4.50)
TPO AB 411
Doctor's Answer
by Mark Lupo, M.D., Dec 17, 2008 07:54PM
, Dec 17, 2008 07:54PM
1 - testing so far is not diagnostic of insulin resistance, but PCOS is an insulin resistance syndrome, so the basic tests may be normal in early disease
2 - depends on the doc, some would treat both
3 - this can be done, the ER version decreases stomach side effects. I am not as up to date with the role of glucophage in PCOS, but is is a common approach. Diet/exercise is the best approach.
Thyroid levels look ok, no room to increase the doses though.
2 - depends on the doc, some would treat both
3 - this can be done, the ER version decreases stomach side effects. I am not as up to date with the role of glucophage in PCOS, but is is a common approach. Diet/exercise is the best approach.
Thyroid levels look ok, no room to increase the doses though.
