Help with test results? Trying to understand

[Viajera]

Hi everyone!

I am new here. I really could use some help understanding my test results. I have researched on my own, and I am not having much luck. I am wondering if someone wants to take a stab at helping me to interpret these test results, and/or point me to resources that might help me better understand?

I had full metabolic and CBCs done last week. I am 50 years old, knocking on menopause's door. I am on a low dose 0.025 "starter" estrodial patch and 100 mg of progesterone for night sweats. I also have a thyroid issue and take 90 mg daily of dessicated thyroid. I do have one small thyroid nodule.

I have gained 30 lbs in the last 4 years. Nothing - and I do mean NOTHING takes the fat off. Calorie restriction. Low carb high fat. Moderate carb/higher protein. Weight loss medication (Phentermine). Exercise is dance class 2-3X a week, and strength training 3x. I have a job where I stand a lot. My diet when I am not attempting to lose fat is has been very high carb in the past, as sugar and sweet cravings the last few years have been off the chart. Like... I cannot even describe how bad the sugar cravings have been. The low dose estrogen seems to help with that a bit.

I am 5'7" and weigh 166. My normal weight is around 140.

An Oral Glucose Tolerance Test was done to see if I am insulin resistant. When the results came back, the endocrinologist was "intrigued" and "interested" but didn't really give me any information except that I should eat lower carb to lose weight and come back in 3 months. Well, that would be terrific - except...weight does not come off. I lose like 3 pounds then all weight loss comes to a halt.

So... please let me know what you think of these test results? Do I need to be proactive with anything?

If I have left out any other relevant info, please let me know. I really am at a loss of what I should be worried about (or not!) and where to go next.

All results fasting from food and meds (only thing I take is thyroid med)

OGTT - Blood Glucose
Fasting 84
1 hr 84
2 hr 88

OGTT Insulin
Fasting 3.5
1 hr 32.8
2 hr 18.3

A1C (done last month: 5.7  - (this was down from 5.8 in February. Last year it was 5.4)
__________________________________________

Total Cholesterol 194
Triglycerides 70
HDL 75
VLDL 14
LDL 105
LDL/HDL ratio 1.4

C-Peptide, Serum (fasting) 1.0 [range 1.1-4.4]

Anion Gap 15 [8-14]

BUN:Creatinine Ratio 23 [9-23]

Iodine 39.3 [40-92]

THYROID
TSH 0.016 (low due to my taking dessicated thyroid - no worries on this0
Free T4 0.88 [0.82-177]
Free T3 2.5 [2.0-4.4]
TPO antibodies 19 [0-34]
Thyroglobulin Antibody 1.4 [0.0-0.9] - this just means I have Hashimoto's form of hypothyrodism

[prediabetes]

i dont know what Phentermine is but one thing i read and everybody agree on this one that diabetes progress very slow. so jump from 5.1 to 5.8 is unlikely diabetes related probably your med is responsible. still if you get 160 blood glucose sometime its not healthy. i just repeat what other say but 140 and higher is when you do damage. athough nobody actual went with microscope and look to confirm what happen at 140 glucose. this number is all based on tracking diabetes patients and what happen to them down road.

[Viajera]

Sally, lol, I am not grazing on sweets now...I was when the cravings were INSANE. A low dose estrogen patch really helped with the cravings, allowing me to not eat sugary junk 24/7.

About the Phentermine that I just commented on ... both of my last A1Cs which were 5.8 and 5.7 were during a period where I was taking Phentermine. My A1C in March 2014 when I was not taking it was 5.1.

I am wondering if that is my "spike."

I think I will get a meter. It should be interesting to see what I find!

[Viajera]

Also, I was taking Phentermine, which raises BG.

[Super_sally888]

Get a home meter and test what happens 1 1/2 - 2 hours after eating.  This may allow you to see if and when you are going high and guide you on how to change your diet to avoid the highs.  Grazing on sweets and candy all day will surely be doing nothing for your weight either. :)

[Viajera]

Yes, clearly, I am spiking somewhere, sometimes. But if 75 grams of glucose on an empty stomach with no fiber or fat to slow it down didn't cause a spike... then I am hard pressed to figure out what does!

[prediabetes]

A1C is how much sugar stick to your red blood cell is not insulin. if your fasting glucose is 84 that mean when you eat your candy for half day you need to be at 160 to get A1C 5.7. and 160 is not normal for such long time. anyway dont mean scare you but this diabetes is really complex everytime i think i find explanation i hear something new that says opposite

[Viajera]

I think my 5.7 A1C can be explained by grazing all day on sweets and candy. My insulin never has a chance to come down...

[prediabetes]

yes all extra insulin sensitivity clear blood sugar very fast. unfortunately it convert a lot of it to fat because muscle glucose absorb can not keep up. so make it hard to lose weight. still how to explain your 5.7 hba1c?

[Viajera]

Hi Super Sally,

Thanks for your ideas. I agree that I actually think this is related to the thyroid more than the pancreas. Thanks, as I didn't know the term "Flat Curve," but knowing that now, it allowed me to research this morning and find some research and journal articles, which seem to show that this is not a diabetes precursor, thank goodness! That I am extremely insulin sensitive, and not resistant. I like the idea of getting a meter and testing.

I do think I need to increase my thyroid meds and plan to talk to my endo about that!

[Super_sally888]

Hi.

you have what is known as a flat glucose tolerance curve.  It can be a precursor to overt diabetes.... it was for me....  I had flat glucose curves for a few years before things really went awry,.

However, with a hba1c of 5.7 your average blood sugar is somewhere around 120, which is a bit higher than idea.

I think you need to increase your thyroid meds further.  Your Ft3 and FT4 are both at the bottom of the range.  FT3 and FT4 should both be at least mid range, not bottom.  Increasing your thyroid meds may help with the weight (might make it marginally easier - from impossible back to just terribly difficult).  I do agree you should be eating low carb diet and avoiding sugars as much as possible.  Keep up with the exercise.

Get a personal meter and test from time to time, particularly fasting (you may see it starting to creep up - it did for me).... and then test 1 1/2 - 2 hours after a big meal and see what happens.  Just keep an eye on things.

See if your Dr may be willing to prescribe Glucophage.  It increases sensitivity to insulin and may help bring things down.

[prediabetes]

my monitor suppose to be <5% error for reading below 100 range also my lab result was 108 consistent with what monitor tell me. but same lab result also say 5.3 hba1c. it possible my glucose was up for some reason when i give blood and my monitor gives error on high side but what are chances of that?

[Viajera]

I don't think that is a mystery since glucose monitors have a fairly larhe margin of error. Check how much of a one yours has.

[prediabetes]

ok this like blind leading blind i wish someone else answer this. but only one thing i can suggest is buy glucose monitor. if you in usa relion brand is super cheap. for one day test your sugar every hour and see if you get high reading. for hba1c 5.8 you need average 120. i am also confuse about my number. its opposite to yours. my hba1c is 5.3 which equal average gluoce 105 but all my meter reading come in above 100

[Viajera]

I agree, something...odd is happening. But I don't know what. My doctor was vague, even when pressed.

[prediabetes]

people here know a lot more than me i am also new. but i can sya your numbers dont add up. if your glucose at 84-88 all time then your hba1c should be 4.7 not 5.7 something unusual happen to your bg control.