Brief Answer:
Continue taking both medications.

Detailed Answer:
Hello!
Welcome to HealthcareMagic!
I read carefully your query and understand your concern.

You should take regularly both these medicines.
Diabetes and Hypothyroidism are chronic and long-term conditions.It is very important to take both medications and regularly.

Metformin doesn't interfere with Synthroid (Levothyroxine) or with thyroid function.
The only problem in your case is that Synthroid can affect the glucose level in the blood by increasing it.
In this way Synthroid reduce the effectiveness of Metformin or other diabetic medications in controlling blood sugar.
So you just need to monitor your blood sugar levels closely.In case that your blood sugar is high your doctor may need to increase the dose of Metformin to control it better or add another diabetic medication.

So for now you should continue taking your medications (Synthroid and Metformin) and monitor the glucose level.

Hope it helps.
Let me know if you have other questions or doubts to clarify.
I will be happy to assist you further.

Kind Regards,
Dr.Rovena Murati.

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Brief Answer:
You can take Synthroid and Metformin together.

Detailed Answer:
Hello again!

I really apologize for the delay in answering your follow-up query.

As I said in the previous answer , taking Synthroid and Metformin together can decrease the effectiveness of Metformin in controlling Diabetes.
Your value of Hemoglobin A1c of 0.063 (6.3 %) indicates that your Diabetes is well controlled with the medication that you are taking.

You can take these medicines together and keep monitoring your blood sugar level.
If your HbA1c is high (over 7%) next time that you measure it ,then your endocrinologist may increase the dose of Metformin that you are taking.

Your hypothyroidism is also well controlled with Synthroid and this indicates that you should continue with the same dose.

Right now your Diabetes and Hypothyroidism are well controlled so you don't need to worry about taking these drugs together.

Regarding your frequent infections ,you may need a complete evaluation.
An uncontrolled diabetes can cause frequent infections but in your case your diabetes is under control.
The level of IgM is normal.

If you are having frequent infections of respiratory tract ,possible allergies should be excluded.You may need to do the allergy tests .

If you are having very frequent infections I would suggest to consult an Infectious disease specialist or an Hematologist.You may need a complete evaluation of immune system including the evaluation of Lymphocytes B ,C (number and function),Immunoglobulin level ,evaluation of Neutrophil Function,evaluation of Complement etc.
An accurate medical history, family history and physical examination are critical in developing the best strategy for laboratory evaluation.So consult a specialist and get examined.

Hope it helps.
Wish you all the best.

Dr.Rovena

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Brief Answer:
Detailed below.

Detailed Answer:
Hello!

Obstructive sleep apnea can be the cause of your tiredness and fatigue.Because you can wake several times during night ,your quality of sleep is poor and you will feel tired,sleepiness during day ,headaches, irritability with the inability to think clear,concentrate.

Left untreated Obstructive sleep apnea can cause serious complications including :
-High blood pressure
-Insulin resistance (Type 2 Diabetes )
-Heart disease
-Pulmonary hypertension etc
For this reason is very important to treat this condition.If CPAP is not the right choice for you ,you should try another option like dental appliances.

Usually Obstructive sleep apnea doesn't cause frequent and persistent respiratory infections like sinusitis ,bronchitis or pneumonia.
Usually chronic upper respiratory conditions can cause sleep apnea for example nasal septum deviation ,enlarged tonsils and adenoids ,chronic sinusitis.
I assume that your doctor has examined you and has excluded these conditions .

I can't tell for sure if it is the right choice to take a course of antibiotics.For this it is necessary a detailed medical history ,a detailed list of your symptoms and most important a careful physical examination.
I don't have all the information necessary to make a judgement about this.

If you have frequent respiratory tract infections there are 2 conditions that should be taken in consideration:
-Possible allergies
-GERD (gastroesophageal reflux disease) which is a condition when the acid reflux moves up into esophagus and during night it move up to the throat and the airways.This causes inflammation of the esophagus,throat and airways.
Sometimes GERD doesn't cause the classic symptoms of heartburn and chest pain but can present with chronic dry mouth, sore throat ,chronic cough , frequent pulmonary infections etc.
I would suggest to discuss this option with your doctors in further consults.

If GERD is excluded and you have frequent infections in all your bod( not only respiratory infections) ,then it is the time to do a complete evaluation of your immune system to figure out the cause.


I sincerely hope my answer has helped.
Take care,
Dr.Rovena

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Brief Answer:
Consult an Immunologist.

Detailed Answer:
Hello again!

Well ,the immune system has 4 different parts:
-Humoral Immune System
-Cellular Immune System
-Phagocytes
-Complement System

Any patient with suspected immunodeficiency should have baseline laboratory tests such as a complete blood count with differential and complete metabolic panel. Then, depending upon the history, types of infections, and pretest probability, the four separate parts of the immune system can be evaluated.

1)Humoral Immune system : Serum immunoglobulin IgG (including subclasses IgG 1, 2, 3, 4), IgA, and IgM .
2)Cellular Immune System : Lymphocyte count , CD4, CD8, and NK cells levels.

As I said the best thing to do is to consult a specialist ( hematologist or immunologist ) and after examining you they can decide if these tests are necessary or not.
An immunologist or infectious diseases specialist are well trained to understand better if all your recurrent infections are indicative for immunodeficiency or are related to other systemic conditions.Medical history and physical examination is very important.

Wish you all the best.
Regards,
Dr.Rovena

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