What do you think is going wrong?

I’ve been having a lot of health problems in the past year and my doctor and endo seem to continue to dismiss them. I’ve posted different questions about the symptoms, but the responses I’ve been getting give me an indication that I shouldn’t be suffering like this. Hoping maybe someone has an answer?

I was diagnosed with 1.5 officially in Jan 2009, but was on and off insulin since Jan. 2008. My A1cs had always been in the 6s, even at diagnosis. I got a pump in January because I’d been having the following problems and I thought maybe better control would help. I’ve gotten really sick over the last few months and to be honest, I’ve felt hopeless. I worked really hard, eating well exercising 5 days a week and no improvement. I gave up trying as hard and my latest A1c was 8.7. I was also diagnosed with hypothyroidism in Oct 2008 and I’m on 0.75 mg. My TSH is under one consistently since I started taking the pills.

What’s been happening:

  • Slow-healing cuts (for example, the needle poke for my lab blood tests is still red more than two weeks after I took the text). I’m sick with colds a lot up to once or twice every month (I have a four-year-old who brings home whatever’s going around preschool)
  • My arms and legs “fall asleep” very easily. And when they do I get pins and needles that are very painful. Some days both my arms all the way to my hands are tingly. I can’t associate this with any activity or time of day/month.
  • Sorry to male readers but - extremely heavy periods. Like more than a pad an hour for the first three days (and changing twice a night).
  • My wedding ring leaves an indent on my finger and my socks leave rings around my ankles. I think this is called “edema.” Is this a side effect of taking insulin?
  • Severe constipation. I’ve taken metamucil three times a day and still can’t go. I have to take 2x extra strength exlax just to go once every three days. And I have about 90 g of carbs a day and they’re high fibre carbs (no white bread).

My doc’s response - the slow-healing is in my head, the heavy periods are an adjustment after having two children, the pins and needles are due to the recent A1c, and my doc gave me a stool softener for the constipation.

I’m desperate for these things to get better. I’m in hot water at work for the amount of days I miss. I’m a working mom and it’s so hard to take care of kids and work as it is. To be dealing with all these things and still be expected to be all things to all people – I just don’t know how much longer I can keep it together.

Hi Kelly: I am SO sorry that you are going through all this. I have not experienced similar symptoms, but I would say in general it sounds like your hypothyroidism might not be under control. I hope that Gerri weighs in on this discussion, as she is very knowledgeable about hypothyroidism, and better testing and treatment for it.

I get edema in my ankles the first couple real hot days of the summer season, til my body adjusts. It shouldn’t be caused by insulin, unless your insulin intake is high enough and your calorie burning is low enough that you are in fact gaining weight, in which case it’s not really edema at all.

Can’t help with the new periods…mine were like that from the time I was 12 til I had a Mirena put in a few years ago for the sole purpose of making them lighter and shorter, and allowing me to function rather than being laid up in bed the 1st few days with vomiting, & cramps that were dulled a bit only by narcotics,

The pins & needles could be nerve damage. Caught early enough, it is sometimes reversible. It may also be poor circulation.

How much water do you drink? If you’re not drinking enough, that could cause constipation/blockages. Also, some meds can cause it. I’m on a lot of opiates for chronic pain and I have to force myself to drink water every day (I don’t like water) otherwise I could become constipated.

As for a1c’s in the 6’s…that’s not horrible. 8.7, now that’s not good at all. Wouldn’t you rather at least get back to the 6’s and stay there, even if you never make it into the 5’s? Isn’t that better than almost 9%?
Slow healing is associated with higher a1c’s and elevated bg levels. Bring it back down and you should see improvement in that area?

Not fair to have to deal with all this at once–sorry!

Slow healing is not in your head, of course. It can be a result of high BG,as Jeska said. Not easy to keep BG down when you’re sick with everything your child carries home. Helps to shore up your immune system to prevent or lessen the effects of illness. Since I started taking Vit D3, I don’t get sick. My husband’s a college professor & he catches viruses & colds from his students. As bad as daycare.

Hypothyroid symptoms include, persistent colds, tingling in the wrists, heavy periods, high cholesterol, water retention (edema) & constipation. Sound familiar? Others are dry skin, brittle nails, fatigue, thinning hair, low sex drive, loss of eyebrows & body hair, low body temp & sensitivity to cold. Not everyone has every symptom & it depends on the severity of the hypothyroidism. Not common for diabetics, especially women, to have Hashimoto’s (autoimmune thyroid disease).

TSH testing is useless, though that’s all most doctors prescribe. Insist that you need free T3 & free T4 levels tested. I had to argue with my doc for this. You must have this to get levels correct. Go to your doctor armed with the facts. A wonderful site about hypothyroidism: http://www.stopthethyroidmadness.com/. Agree with Melitta. From everything you listed, it sounds that you’re quite hypothyroid despite supplementation.

In the meantime, drink lots of water to help constipation & edema. Sounds contradictory to drink water with fluid retention, but it does help. Also watch your sodium intake. Chia seeds are great for constipation & have healthy Omega 3 oils & minerals. Better than Metamucil, which is habit forming & irritating.

Hope you’re feeling better soon!

My lowest A1c was 6.1 and I still had all of these problems. The high blood sugars are only a recent occurance.

For a long time I thought this must be caused by thyroid. But I now I don’t think it is.

You’re saying Hashimoto’s is not common for diabetics? I know that i have Hashimotos because I have several normal tests, then I got a really bad cold, the area around my eyes swelled up and my TSH was in suddenly in the 8s. And they tested me for the antibodies against my thyroid and it was off the charts high. I don’t believe that I have a problem with conversion, otherwise the swelling wouldn’t have gone away so quickly after taking synthyroid.

I do take Vitamin D, and a multivitamin. I just don’t get it. I know people who never eat fruits or vegetables. And they go every day. I can’t go at all.

I agree with Gerri about the TSH - it is useless. Mine was also under 1 and my FT4 was so low that it was not registering a number with the lab. I felt like I was dead and had a lot of the problems that you mentioned. Your thyroid constantly changes so just because you felt better back in 2008 when you started Synthroid doesn’t mean that is not the problem now. I went over 10 years doing OK on the thyroid med level I was on and then the bottom fell out.

Have you had your D levels tested? Mine are at 32 and the lab says that is normal but the Vitamin D council says it should be about 50-70. Low levels of Vitamin D do nothing for me.

As far as neuropathy the the A1cs, I know several people that had A1cs in the 6s and still endedup with complications - there is no guarantee that decent BS will ward them off.

Kelly,
Sorry, typo. I meant Hashimoto’s is common with diabetes. My thyroid antibodies were off the charts also. For years I was told I was just borderline hypothyroid because all that was tested was TSH. Wasn’t until I was diagnosed with diabetes that thyroid antibodies were tested. Then, I had to battle to have free T3 & free T4 panel done.



Thyroid should be tested every three months.



Are you taking D3 supplements? Vit D2 is useless. The test for Vit D is a 25-hydroxyvitamin D. Ideally levels should be at 50 ng/ml or above. I take 10,000 units of D3 daily & mine still isn’t where it should be. I’m due for another blood test for this.

To start, I would suggest that you find a Doctor specializing in women’s health issues, and seek that doctor’s opinion.

Sorry to hear you are having these issues. I am wondering if you have had your VItamin D or Calcium levels checked? Have you ever been diagnosed with PolyCystic Ovarian Syndrome? I have these issues along with Type 1 Diabetes and Hypothryroidism.

I know that every “group” has it’s own recommendations they put out but I saw a presentation by a researcher from a prominent University recently and she made a quite compelling argument for Vit D levels to be between 30-50 ng/ml. As you approach 50 ng/dl you start seeing diminishing benefits and much over that can actually be detrimental. I should mention she derived these levels mainly based upon research about bone.

I’ve been checked for Polycystic Ovarian Sydrome and I don’t appear to have it. I haven’t had my Vitamin D levels checked. But i do live in Canada, so there’s a good possibility that I don’t get enough sunshine!

Thanks for your responses!

Thanks for the suggestion.

It’s very difficult to do that in Canada. You can’t see a specialist without a referral from your family doctor.

In the US with most insurance you can’t see a specialist either without a referral. Some docs refuse to give referrals to specialists. Your situation does sound like a thyroid issue, not something necessarily specific to being a woman. Just as hard to find a doctor who understands thyroid treatment as it is to find someone who knows the ins & outs of proper diabetes treatment. They do a TSH & prescribe Synthroid & that’s it. Far more complex than that. Thyroid supplementation needs to monitored & adjusted. Some patients do better on different types of supplementation. Thyroid doses effect insulin doses also.

Gerri, actually the once-dominant PCP-referral model is shifting in the health-care insurance industry in the U.S. Patients have complained, and many of the insurers have responded by offering patients more flexibility in choosing PCPs and specialists. For example, when my insurance was with BC/BS a few years ago, I had to have an in-network PCP, and I had to have a referral from my PCP to see a specialist. However, CIGNA, the insurer with whom I have been with for the past few years, allows me to choose all my physicians. I don’t even have to have a PCP at all. If the doctors I choose are in-network, then I get a deeply discounted co-pay.



Quite a few insurers have moved to this model. It really makes better sense for patients and for insurers. For patients, they have the flexibility to see a specialist without having to also see a PCP first. For insurers, prospective customers are more likely to enroll with insurers who offer such flexibility.

I didn’t have any problem just calling an endo when I moved a couple of years ago.

FWIW, I’ve noticed the slow healing deal, despite decent A1Cs and pretty tight control. I’ve sort of given up on it but pay close attention to wounds. blisters, scratches, etc. One thing I notice recently is that this stuff called Aquaphor, that the tattoo place recommended, cleared up a TreadmillKnuckleWound pretty quickly? It doesn’t address the other stuff but if it might help one issue for you?

I am also a diabetic with Hashimoto’s.



I take Synthroid now and am better but have had trouble getting a doctor to really look at my continued symptoms.



At it’s worst (pre-diagnosis) I had bowel issues (constipation followed by the opposite), spells of being freezing cold regardless of the room temperature (e.g. shivering and teeth chattering on a warm summer day to the point where I sat before a heater wrapped in blankets when everyone around me was in tee-shirts and shorts), thinning hair, losing hair from my eyebrows and my lower legs, immune system issues (slow healing, recurring colds turning into reactive airway syndrome, a kind of asthma, etc.), thinning and peeling of my fingernails, some muscle wasting (e.g. in my calves despite exercise). My doctors found a bunch of cysts and nodules in my thyroid, one of which was the size of a golf ball and has been drained twice.



I am much better now, but my temp still runs low (my new “normal” is 97.6) and I am not sure that my dose is correct as my symptoms are not resolved completely.



I also get edema in my feet and ankles now and must be extra careful of salty foods, which was never a problem before.

I thought this was just part of the whole diabetes deal?

I have found that a cut or pimple now heals about six times more slowly than before – e.g. when I had a biopsy on my shoulder it took about six weeks to get to the same level of “nearly healed” that would have taken place in a week pre-diagnosis. Bruises take a lot longer heal, too. Insulin seems to help (lower blood glucose = more normal healing) so I guess it’s not diabetes per se but tied to control?

Other than an ob/gyn, I need a PCP referral to any specialist & can only go to in-network providers unless I pay myself. Glad to hear this is changing.