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Avatar universal

Thyroid issues still or insulin resistance?

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
1 Responses
Avatar universal
MEDICAL PROFESSIONAL
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.  

From NIH MEDLINE encyclopedia:

Normal blood values for a 75-gram oral glucose tolerance test used to check for type 2 diabetes:

Fasting: 60 -100 mg/dL
1 hour: less than 200 mg/dL
2 hours: less than 140 mg/dL.
Between 140-200 mg/dL is considered impaired glucose tolerance or pre-diabetes. This group is at increased risk for developing diabetes. Greater than 200 mg/dL is a sign of diabetes mellitus.

2) Would a reproductive endocrinologist treat both PCOS and hypothyroidism or do they only treat people with issues in trying to get pregnant?  

Most can treat both.

3) I have heard of many people with PCOS taking Glucophage.  If this is a proper treatment for extended release version better than the regular?

I recommend taking the non-extended release because I think it works better.
You can take 500mg three times a day or the 850mg twice a day.
But first you should check the 2 hour GTT and fasting insulin level to see if you are a candidate to take Metformin (Glucophage).
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