Hi, it’s been a while since I’ve been on here, hope everyone’s doing well!
I’m just posting really to see if anyone has any advice on my recent blood test results. My HbA1C is 7.3% which I’m fine with. My TSH is 7.89, so I’m raising my Levothyroxine dosage by 25mcg.
My serum sodium is 135mmol/l (reference range 136-148) and my serum potassium is 3.3mmol/l (reference range 3.8-5.0).
Obviously, I’ll be checking with my doctor on this when I get a chance. I’m just wondering whether anyone has any experience with slightly low sodium and potassium levels. Should I start taking a low dose potassium supplement or make dietary changes? Is this of any concern at all, or should I just ignore it? Could it have anything to do with diabetes? Or hypothyroidism?
I have no idea what side effects the thyroid meds will cause.
I wouldn’t be too concerned, but I would keep my eye on it. Levels like those can cause you to be exhausted or light headed though, depending. Also, remember those are ideal levels for most people. It is possible you are not "most people."
An A1c above 7 is considered the point to where you could be getting dehydrated from low blood sugars, according to my doc. My doc says anyone with an A1c above 7 is probably malnourished (because you are not absorbing nutrients properly) and should take a multivitamin. Dehydration can cause the lower sodium and potassium levels.
You also might ask your doc to check your vitamin D levels, because there have been a few conversations here that imply that vitamin D levels tend to be lower in diabetics…also a dr on referenced a study that stated that if your A1c is above 7, you should have your vitamin D levels checked. If the level is below 50, I’d probably take a supplement, even though the docs think that 30 is okay.
How much water do you drink? Drinking too much water (or coffee or tea) can also drop your sodium and potassium levels. If that is the reason, the solution might be decreasing your fluid consumption.
I also was hypothyroid for years until thyroid cancer and removal of thyroid and RAI treatment and now am on Levothyroxine and, yes, I consistently have low sodium and potassium. I would say to start taking potassium supplements and see how it goes. As long as I take potassium I am able to keep it in the low average range but if I don’t take it it will drop. Low potassium is not good.
I’m not sure what your current levothyroxine dose is, and my docs have always been really reluctant to up the dose and do so only in the tiniest increments, but a TSH of 7.89 might take a couple of steps increasing the medication to bring into a good range.
Low serum potassium could be because of dehydration and/or DKA. Even a brief stint of mild DKA can mess up electrolyte levels. Do you ever check for ketones?
An A1C of 7.3% isn’t bad by any means but you might be occasionally spilling glucose and that leads to dehydration.
I drink water when I’m thirsty. It generally comes to about 3L per day, which is quite a lot I guess. I hate not drinking when I’m thirsty, though. I’ll ask about vitamin D at my next appointment, thanks.
My current dose is only 25mcg (yep. They’re VERY cautious).
I’m definitely not dehydrated (3L water per day, roughly), and I don’t think I could miss DKA. I get ketones easily, but I check with a blood ketone meter and keep things under control.
I have low potassium pretty regularly and am on a prescription strength potassium supplement when it goes super low. However, believe it or not, a side effect of insulin is low potassium. Now, usually taking insulin isn’t enough to cause this, but with underlying conditions or medications that can lower it, it seems to have almost a compounding effect. I have hypertension and am on medications for that along with an ACE inhibitor, so the combination of those meds and the fact that I’ve been on insulin going on 20+ years, it’s not a surprise when my potassium comes back low. I’ve had it low enough that i’ve had to have IV potassium and that sucks super bad.
Thanks. I’m not on any meds besides Levothyroxine, insulin and an antihistamine (nothing for hypertension). Mine obviously isn’t very serious at the moment, but I’m going try to eat more potassium-rich foods and get back on a multivitamin, to stop it getting any worse.
Thanks. I’m going to go back onto a multivitamin I used to take - don’t worry, I’d never take anything stronger than that without speaking to my doctor first.
