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Q. Based on my reports, kindly suggest if I need Thyronorm dose alteration and diabetes treatment.

Answered by
Dr. Zulfiqar Ahmed
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 25, 2021

Hi doctor,

I have been taking thyroid medicine for the last three years. The recent test was done three days before shows HbA1c 6.60%, cholesterol 204 mg/dL, fasting blood glucose 116 mg/dL, total T3 - 0.75 nmol/L, total T4 -12.10 mcg/dL, and TSH 12.71 mIU/L. The medicines I am taking now are Thyronorm (Thyroxine Sodium) tablets 75 mcg (since one year). Please suggest if I need to stop, change or carry on with the same medicine. Please also indicate if I need to take any medication for my sugar or diabetes.

Thank you.

#

Hi,

Welcome to icliniq.com.

Thank you for the query. Suppose your TSH (thyroid-stimulating hormone) is 12.71 mIU/L; you need to increase your Thyronorm to 100 mcg once daily before breakfast. Recheck your TSH after six to eight weeks. Your TSH should be within 0.5 mIU/L to 5 mIU/L. If it is higher than 5 mIU/L, you need to increase the dose, and if it is less than 1 mIU/L, you need to decrease the dose. If HbA1c is more than 6.5%, you have borderline diabetes, and the best treatment is lifestyle modifications. Diabetes has many complications, so it is not to bring down the numbers but to monitor and treat complications associated with diabetes. Check your feet, eyes for retinopathy, and kidney (urine albumin creatinine ratio).

1. Follow a low carbohydrate diet and avoid sugar. No sugary juices. No bread, rice, pasta, and potatoes. If you cannot stop, at least take as little as possible.

2. Include more vegetables, salads, and fibers.

3. Limit the intake of fruits. Do not take mango, grapes, and banana. Apple not more than one piece. Strawberries and other berries are fine, along with peach, apricot, and a small amount of plum.

3. Intermittent fasting will also help you control your diabetes. You can fast for 16 hours. Take your dinner at 7 PM and do not eat anything after that. The next day you can take breakfast at 11 AM. While fasting, drink only water and green tea without sugar. You can extend fast to 24 hours then 36 hours as your body adapts. You can fast two times a week or however, you feel comfortable. It will control your sugar. Drink more water and sleep well.

4. Exercise or at least walk 30 to 40 minutes daily.

The more you practice these things, the better will be your control. Check your sugar levels frequently. Your target is fasting glucose levels should be less than 100 mg/dL, and two hours post-meal should be less than 140 mg/dL. HbA1c level should be less than 6%.

Regards.


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