My wife and I are prepping to get her A1c down enough to start trying to conceive--it went up in the past 3 months from 7.5 to 9.1. She was was very upset today when she started her 3-day insulin support group. When they weighed her it showed that she gained 15 lbs in only two weeks and is now Class 2 Obese. And I am with her all the time--she does NOT eat that much. Maybe 2000 calories a day, maybe even less, and she always counts her carbs. We both have a few glasses of wine a week, and might've overindulged a couple nights, but have been very good besides that. She also doesn't exercise enough, but her exercise habits haven't changed in the past 2 weeks.
Has anyone experienced or heard of this? Can it just be stress (she has a LOT at work) and her recently increased basal? Or maybe water weight?
Has she had her thyroid checked? Thyroid problems are very common in Type 1 diabetics and if she is hypothyroid that could account for weight gain. That’s a lot to gain in two weeks. 2,000 calories is a fair amount for a woman, but it shouldn’t make for that kind of weight gain!
Zoe’s right about the thyroid - I’d suggest getting it checked out.
It’s important to remember that insulin is a growth hormone. The more we take, the more weight we gain. This leads to greater insulin resistance, which leads to more weight gain, which leads to more insulin resistance (and the need for more insulin). It’s a vicious cycle. According to my endo, type 1s have to work twice as hard to lose weight.
Thanks all. She had her thyroid checked less than a year ago and it was normal. Can it change suddenly though? It’s definitely a vicious cycle. She already has enough on her plate at work, with her family, etc. It’s been really tough for her lately
Does anyone see a therapist for depression related to T1?
I agree that that is a lot of weight to gain in just two weeks, even if her ideal caloric intake is <2,000. One lb is around 3600 calories, so she would need to have eaten 54,000 calories in excess of her ideal amount. A lot for 2 weeks. Is she experiencing any bloating or constipation? Drinking an inordinate amount of fluids? You’d be surprised how much fluid/solid retention can alter weight, but 15 is a lot even for that. Zoe could be right about there being a thyroid issue or some other hormonal imbalance somewhere in the system.
She definitely tries to drink a LOT of water every day–probably well over 8 glasses. I suspected fluid retention to be part of the problem, in combination with higher basal levels, stress, and lack of exercise. I suppose it couldn’t hurt to get her thyroid checked again. Can it really go from being normal to hypothyroidism in the space of a few months though??
Or I suppose that if her bg was elevated for an extended period of time and she was shedding a lot of fluids, then just getting back into the normal bg range and a normal hydration status could account for some of it. Maybe a combination of things.
Aha, I’ll tell her that. Her bg’s the past few weeks were routinely in the 200 and 300’s, thanks to being sick part of the time, plus a Plan B pill that ran them consistently really high (we wanted to be safe and avoid pregnancy with a 9.1 a1c).
Also, she went off birth control 4 months ago - could that have anything to do with it? Though I thought going off BC actually helped you lose a little weight.
When your bg’s are out of control, it definitely affects your mood, and the frustrations related to “why can I not figure out how to take care of myself” is super frustrating. Sometimes there is no real reason for poor bg control. The first thing I would want to check is my thyroid.
Another check I would ask for, because of my background, is a bmp (basic metabolic panel) which checks bg, and electrolytes like potassium, calcium, sodium, magnesium, etc. Electrolyte imbalances can cause water retention. If she is drinking mroe water than usual, and her higer bg’s might be dehydrating her a little extra, it might be enough to throw things off. Electrolyte imbalance can also make it harder to control your bg’s, too.
Yes, her thyroid can be out of whack since a year ago. If her thyroid is causing problems, that can also mess up her BS. I had been on thyroid meds for years, but when mine finally decided to totally die last year, I practically tripled the amount of insulin I was using until I got my thyroid levels back to where they should be. She needs to have Free T4 & Free T3 checked, most doctors only look at TSH and that won’t tell her anything. The Free T3 is her metabolism & energy & should be in the upper 2 3/rds of the lab range. The Free T4 should be about mid-way of the lab range. Thyroid problems can also cause depression.
Definitely get the thyroid checked, but 2000 kcals is a LOT for the average woman… I eat around 1200 a day, any more and I gain weight… if I were to try more actively to lose weight I would need to consume much less - I am already plenty active so that is not a part of the puzzle that is missing for me.
When my thyroid first went hypo my TSH was 16, it had been normal (in the 2.something range) just a few months before. I’ve flip-flopped around a LOT over the past few years… from TSH levels so low they could not be measured by the lab (with my other thyroid labs way out of whack too) to being hypo on levels of replacement hormone that had sent me hyper only several months prior. It’s a frustrating rollercoaster.
We have a tendency to look for complex solutions rather than simple ones. You should start with the simple truth - we need to burn more than we intake in order to lose weight. And people grossly underestimate how much exercise it takes to burn a few calories. The problem may extend beyond the two week window you’re focusing on.
When you hear the sound of hooves, think horses, not zebras.
Can you say more about checking Free T4 and Free T3? I thought I had heard this too, but when I brought it up with my former endo, he said just checking TSH was fine. I have lots of confidence in him (he was the best I ever had), but just want to know if I should have T3 and T 4 checked. If they were off, but TSH was not, how would that be treated? More synthyroid?
Thanks
If she is T! and has been running too high, and is now bringing her BS down to normal and could cause some weight gain. Ditto with the extra insulin. I have to work really hard to keep the weight off since starting insulin.
I totally agree, but here’s the thing. She went to the doctor 2 weeks ago and weighed in, then weighed back in yesterday on the same exact scale, 15 lbs heavier. Also 15 lbs heavier on the home scale.
Her endo is very concerned. Her whole team says it’s impossible to gain that much weight without eating an excess of 3,600 extra calories a day, which my wife is definitely not doing (she can’t–she’s T1!). The endo says she doubts it’s hypothyroidism but she ran the tests anyway. Also checking for pregnancy (even though my wife took 2 pregnancy tests yesterday and today, both negative). And finally she says it might be a rapidly growing tumor (WTF!!!). I’m also doing my usual hypochondriac Googling and found some pituitary-related disorders that I will try and have them test for.
Anyone have any other ideas? Either way, we will hopefully know more when the tests come back tomorrow.
Right??!! She is renowned in her field, she’s at UCSF (#3 diabetes center in the country after Hopkins and Mayo, at least that’s what we’ve heard) but I think she has some sort of Asperger-spectrum disorder because she doesn’t seem to have a very relateable bedside (or otherwise) manner.
Rapidly growing tumor! That’s a helluva thing to tell your wife because they don’t know what’s going on.
An endo who only does TSH to check for thyroid problems doesn’t know much, not that that’s any surprise. The tests needed are free T3 & free T4. TSH doesn’t reveal anything. I went untreated for hypothyroidism for years because only TSH was checked. I have Hashimoto’s Diease, an autoimmune disease of the thyroid.
Hope, unfortunately, a lot of endos are very good with diabetes but not with thyroid. It is possible to have a normal TSH but your other levels are not normal. I had been on thyroid meds for about 10 years and last year, my thyroid really took a nose dive. My doctor at the time tried to tell me nothing was wrong with my thyroid because my TSH was fine. I had copies of my labs sitting on my lap when she told me that and my Free T4 was so low that it was not even registering a number anymore. TSH is actually a pituitary hormone that stimulates the thyroid but doesn’t tell you how much thyroid hormone you are spitting out. The Free T4 and Free T3 will tell you how much you have available for your body to use.
Synthroid is a T4 drug so an increase can help get your Free T4 to where it should be. Although there are people that do OK on Synthroid alone, a lot of people also need a T3 drug. Cytomel is a T3 drug and is now available in a generic. Sometimes when your T4 drug is increased, that will enable your body to produce more T3 but some people still need a T3.
I take Erfa Thyroid, which is a desiccated thyroid medicine and the Canadian version of Armour Thyroid. That is a combination of T4 and T3.
Gerri posted the link to the Stop the Thyroid Madness site in this thread but here is the link explaining more why TSH is useless.
