Hello!
My daughter is 12 and 1/2years old, and she has hashimotos hypothyroidism. She’s been taking synthroid 25mcg but she’s not very regular in taking her medicines. She had her bloodwork done on April 25, and I requested the doctor to do lipid, glucose, CBC, thyroid labs, and Vitamin D. Thyroid labs were ok, except Freet4 was slightly low at 0.78. Vitamin D was low at 15. We have started supplementing with Vit D3 drops with K2.
My main concern is her HbA1c level which was 5.8 and her fasting glucose was 86. Does this mean she is diabetic? What would her blood glucose levels be if her Hba1c is 5.8? Im so worried about this. Should I push for more tests?
If it helps, last year on one of her bloodworks, random glucose after one hour of breakfast was 112. But that was last year, Have things deteriorated by now?
I’m confused and worried. Please help!
Also, she hasn’t gained any weight in the last 6 months in spite of eating well. She is 61 inches and 105 pounds
ETA: She also has beta thalassemia trait inherited from me. Does that cause the hba1c to skew? I don’t know if this helps, but my Hba1c and fasting levels are exactly same as hers. Just got my labs done last week. And I also have Hashimotos
I think your daughter’s numbers show some sign of moderate blood sugar elevations, especially the HbA1c of 5.8%. I think non-diabetics range up to 5.7% with many of them under 5.0%. A 112 one hour after breakfast is not that far off the mark and a fasting glucose of 86 is a great number.
I would repeat these glucose tests at least once per year and see if they deteriorate. By the standards of people with diabetes, her numbers are very good. I suspect a lot of non-diabetics have numbers like your daughter but her numbers do not alarm me about diabetes, worth watching but not anything to worry about now.
Terry,
Thank you for your reply. I don’t know if these symptoms make any sense, but ever since the school let off for summer she has been sleeping anywhere between 11-12 hours. Is that oversleeping? She doesnt seem to be tired during the day, but then again there’s not a lot of physical activity going on. Also she seems to be more hungry these days. She had a growth spurt this year where she grew 3 inches but has not gained any weight in the last 6 months or so. She is 5’1" and weighs about 105 pounds. The fact she has not gained any weight in 6 months has me concerned a lot
Those random Blood Glucose numbers don’t mean anything for diagnosis. Non-diabetics can easily have 112 and 86. I have heard from CDEs that non-diabetics can have a BG of up to 180–but it doesn’t stay at that for very long. The A1C is a better diagnostic tool, but the symptoms that you would expect to see are much more easy to interpret:
Is she thirsty all the time?
At the same time, does she have to pee a lot more than normal?
Is she losing weight?
Is she really tired all the time?
Keep an eye on it, but if she had diabetes, you would not be able to ignore it.
There is a correlation between hashimoto and t1 diabetes (both autoimmune conditions). On the other hand all blood tests have bigger and smaller quality issues. These issues can cause deviations from the real numbers. Thus I would recommend a glucose tolerance test to start with.
Hi,
An A1c of 5.8 gives an average blood sugar of about 128, following Bernstein’s coversion chart.
This is high for a child, who typically have A1c which are in the low to mid 4s.
I would be monitoring this (seeing her fasting looks good, you might want to monitor about 90 minutes after a carb heavy meal).
Further, they should look into whether this result could be affected by the thalassemia gene. I do agree a glucose tolerance test / or at least a period of regular monitoring may be a good way to go.
I have a 7Yo who also has a higher than typical a1c (the last a1c we did was 5.6 and it is time for another one). We do monitor from time to time, and it seems fairly stable (which makes it less worrying). We do eat fairly low carb in our house (I eat very low carb, mostly as I’m the one with D), and we make sure she gets plenty of exercise.
Thank you all for your replies. I have decided to go buy a blood glucose monitoring machine today. I’m going to check her PP 90 minutes to 2 hrs to check how she is doing. The thing that has me worried is the failure to gain weight. She rapidly gained 15 lbs from from Jan 2015 - Jan 2016, and then it stopped. She started her first period in January 2016. So far she has only missed one period in between but got it back the next month. The doc said that’s normal.
Did any of you have your children’s blood sugar levels rise during puberty? Is there a correlation? I have heard the hormones could wreck the body.
Has anyone here has had any similar experiences with their non-diabetic teens?
As someone else noted, autoimmune diseases sometimes come in clusters; if you have one autoimmune condition, you are at increased risk for developing others. It’s very common, for example, to see diabetes and RA (rheumatoid arthritis) together. So while there’s no way to exactly measure the risk factor, it’s certainly present.
And while the fasting glucose number is just fine, the A1c is slightly elevated. One (only one) possible explanation is that spikes are occurring after meals, which drives up the average but doesn’t show when fasting.
This really could go either way, but there are enough question marks that it’s prudent to keep investigating. Getting a glucose meter and testing her BG for a few hours after a meal would be a good first step. Depending on what that reveals, you might need to look more deeply.
Thank you for the reply, David_dns. Yes, I’m aware of the fact that autoimmune diseases are linked to each other. That’s what is making me nervous. I’m going to check her BG levels after meals and see they how they stack up.
Personally, I think pricking her fingers and making them bleed in order to test her BG levels after meals seems over-the-top and unnecessary to me when there is no clear diagnosis. If you are that concerned, speak with her pediatrician about the possibility of having Type 1 antibody testing performed. It isn’t the worst pain in the world by far, but I wouldn’t be pricking my daughter’s fingers to calm my own fears; it hurts!
Not to mention it could pass the stress and fear on to her if she starts worrying about having Type 1 diabetes.
Exactly! She’s only 12, still a child. It’s our job as parents to protect our children from unnecessary worry, not make them shoulder part of the burden of our own fear. If your daughter does develop Type 1, you both can deal with it when (and if) it happens. I believe it would be wrong to teach her to worry about things that may not even come to pass. Please do not do this to your daughter; she already has the burden of dealing with one autoimmune disease and it just wouldn’t be right to make her worry about the possibility that she may develop a second.
If Type 1 does develop, it’s impossible to ignore, and you will definitely know something is wrong. If it’s developing now, there’s nothing that can be done to stop it. I think it would be better to simply know the symptoms of Type 1 (extreme thirst, frequent urination, unintended weight loss, excessive hunger) and have things checked out if those symptoms ever develop. And, if you want to monitor things, maybe get antibodies tested the next time she has blood work so that you know whether there’s even an autoimmune attack going on. If the antibodies are positive, maybe have blood sugar checked each time she gets regular blood work done just to keep an eye on things.
I would imagine that being taken into a lab for an additional blood test is way more painful and worry-inducing than a one- or two-time finger stick done in the comfort of your own home while relaxing and watching a movie or something, but that’s just me.
If I suspected my older son was diabetic, I wouldn’t hesitate to do a few spot checks to rule out before making a Dr. appt. He’s more scared of going to the doctor (which he now associates with his little brother being very very sick) than he is of something we do multiple times a day to his younger brother with little fanfare or anxiety.
Thanks for all the replies. It seems like the fact that she is not gaining weight, which I have mentioned many times in my post, are being ignored by everybody. Her thyroid hormone levels are in fact low, which makes her hypothyroid, and there’s weight gain in hypothyroidism. She did gain weight till January of this year, and abruptly stopped gaining weight after that. There has been no changes to the diet. In fact she’s eating more, but weight gain has stalled. I do not know what to make of it. And she’s hungry all the time. Are those symptoms normal teen development or something else, I dont know.
Getting blood sugar and antibodies checked wouldn’t be an additional lab test, though, if it were done at the same time as other lab tests (which presumably someone with thyroid disease is already getting).
I may be wrong as I’m not a doctor, but I believe weight loss in undiagnosed Type 1 is caused by the body burning fat as fuel because it can’t access glucose due to lack of insulin. If this were the case and the body had so little insulin that it couldn’t access glucose, weight loss would not be the only symptom and blood glucose levels would be very high.
I also don’t think not gaining weight is the same thing as losing weight…
Thyroid issues don’t always cause weight loss/gain. I have Graves’ disease, which is supposed to cause weight loss, and yet I’ve actually gained weight. I would think that sleeping a lot and being hungry are pretty typical for teenagers…
I also have Beta Thalassemia Minor (the gene comes from only one parent.) I’ve been looking for research online for years that says definitely that this will affect the A1C. Haven’t found any definite answer yet. My doctor doesn’t seem concerned about it. But Beta Thal Minor causes red blood cells to be abnormal, so it seems to me it might have some affect. I echo some of the other commenters to have the antibody tests done, and perhaps check yearly for diabetes.
Speaking of Beta Thal Minor, try googling Pete Sampras (the tennis player) and Beta Thalassemia. He is a great athlete, but he had trouble with losing energy towards the end of a match. His competitors knew this and tried to use it to their advantage.
My mother and I both have times when it seems that all our energy has fled our bodies. The only doctor I’ve had who confirmed this can happen has the disease herself (she is a surgeon). The conventional wisdom is that it doesn’t create any problems. Who you going to believe, the medical establishment or your own lying body?
Jen - Thank you for sharing your thyroid issues. I truly hope what my daughter is going through is just regular teen stuff and nothing serious. Thanks for your reassurances.
Michelle43 - I have Beta thalassemia trait and my daughter inherited it. She is borderline anemic 11.8 hgb, and may have iron deficiency anemia as well. Not checked for it. Her RBCs are abnormal - microcytic, hypochromic, polychromic, and other stuff. I too, look up if if that affects A1C, and couldnt find anything. I’m curious as to what your A1C levels are. Mine has been in between 5.4-5.8. My recent one was 5.8 and told I was pre-diabetic even though my fasting glucose was 85.
That’s right. The body starts burning fat when it can’t access glucose. So it’s very unlikely that a slightly elevated BG/A1c caused this girl to stop gaining weight.
@Lakshmi, you also said:
Now I don’t know much about female puberty, but could there be a correlation between weight changes and the start of menstruation?
My last A1C was 6.8, a little high for me, for the last few years. I haven’t had any of the tests you listed. My hematocrit runs a little on the low-normal side. Maybe I should ask my doctor to do the tests. My mother was recently hospitalized with a hgb of 5.4. She had tests in the morning and they called her into the emergency room that afternoon. They couldn’t believe she could walk in the door. She got three units of blood, and is doing better.