Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Does Low Thyroid Cause Increased Glucosylated Hemoglobin A1c?
Question: I'm 27, no high BP, cholesterol levels are good, and had a physical 3 months ago with a fasting blood sugar level of 95. I recently got my insurance back and visited a doctor to treat my hypothyroid and sleep apnea. They did an A1C that came back as 6.0, and said not only am I prediabetic, that my hypothyroid is masking that I'm probably already a diabetic. He recommended metformin and trulicity for weight loss and sent me on my way. I feel like something isn't quite right here-can hypothyroidism mask diabetes? Is it possible the low thyroid is increasing my a1c? Would you typically recommend starting on metformin right away or giving the synthroid time to kick in first? I'm just feeling like this is not the right way to go about this situation, and I'm just looking for extra opinions.
Brief Answer:
hypothyroidism may worsen glucose control
Detailed Answer:
Hello,
the facts are:
- hypothyroidism may worsen glucose control
- although the increased glucosylated hemoglobin A1c is not quite normal, it's not enough to diagnose diabetes, particularly at the level of 6%
If your hypothyroidism is more than mild (TSH>10 and symptoms of hypothyroidism) then I would definitely recommend waiting for 2-3 months and doing an oral glucose tolerance test (OGTT) later. 6% is not high enough to start treatment right away. You can try various measures first like increasing physical activity and reducing your body weight.
If you only have a mild hypothyroidism then you can do the OGTT right now. The recommended OGTT consists of two measurements of blood glucose. The first one is the fasting glucose. Then you'll have to consume 75gr of glucose and another measurement has to be taken two hours later. Three days of increased carbohydrate consumption has to precede the test in order to have accurate results.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
hypothyroidism may worsen glucose control
Detailed Answer:
Hello,
the facts are:
- hypothyroidism may worsen glucose control
- although the increased glucosylated hemoglobin A1c is not quite normal, it's not enough to diagnose diabetes, particularly at the level of 6%
If your hypothyroidism is more than mild (TSH>10 and symptoms of hypothyroidism) then I would definitely recommend waiting for 2-3 months and doing an oral glucose tolerance test (OGTT) later. 6% is not high enough to start treatment right away. You can try various measures first like increasing physical activity and reducing your body weight.
If you only have a mild hypothyroidism then you can do the OGTT right now. The recommended OGTT consists of two measurements of blood glucose. The first one is the fasting glucose. Then you'll have to consume 75gr of glucose and another measurement has to be taken two hours later. Three days of increased carbohydrate consumption has to precede the test in order to have accurate results.
I hope you find my comments helpful!
You can contact me again, if you'd like any clarification or further information.
Kind Regards!
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
