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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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I Am 30 And Have Insulin Resistance, Hypothyroid & Acanthosis Nigricans

I am 30 and have Insulin Resistance , hypothyroid & acanthosis nigricans - Help? Hello Doctor, I am 30 year old unmarried female. Right now my weight is 82 kgs. Last year I missed my 3 periods so got my blood tested. My TSH level was found to be 6.5. I was diagnosed with hypothyroid by doctor and he prescribed me thyronorm - 50 mcg which I am taking regularly since year. He also suggested me to go to gynac for missed period, gynac performed sonography & my reports were normal except of my ovaries bit small than normal. She prescribed Norglen and after 1 week I got periods and till one year I was having periods regularly. Now once again I missed 3 periods almost since last 3 months. I went for full body profile and my thyroid levels were normal but following of my reports were not normal - wbc (white blood cells ) - 11300, fbs (fasting blood sugar) - 108.2, sgpt - 49 u/l and serum Triglyceride is 205.3 mg/dl and S HDL cholesterol is 30.4 mg/dl which all is not normal. I went to my endocriminologist. After examining me he said I am having insulin resistance and checking my skin he said I also have acanthosis nigricans which is due to elevated insulin levels. He also said my BP is high - 142/92 mm of Hg (& pr - 86 mm of hg). Now he suggested me to continue thyronorm - 50 mcg though thyroid levels were normal & prescribed me tab GLYCOMET 500 MG which I will have to take after meals 2 times a day. He said the above tablet is for diabetes but since you have pre-diabetes condition and obesity you will have to take this. He didn t prescribed anything for elevated BP level and wbc. sgpt & serum Triglyceride and low S HDL. He said sgpt (49) can be due to fatty lever and cholesterol is due to obesity. He said right now no medicine is required for everything all you need to do is reduce weight because if you won t lose weight you will have more and more problem in future. He prescribed Valbet cream for acanthosis and said it will automatically disappear if you keep insulin levels under control through exercising and proper diet and reduce weight but if you want you can go to skin specialist. I asked him whether I will have to take GLYCOMET permanently, so at first he said you will have to continue but later when he saw I am worried he said if you reduce weight and keep blood sugar under control you can stop this medicine, at-least you have to continue till you reduce 10 kgs of weight. I do trust my doctor and he is one of popular one of our city but I would just like to get second opinion for a matter. Following are my questions and doubts:- 1) Is the medicine - GLYCOMET 500 MG prescribed by him is right? I am having only insulin resistance and not diabetes so why he prescribed diabetes medicine. 2) Will I have to continue taking this medicine throughout my life or I can stop taking it if I reduce weight. Please tell me because I don t want to take it throughout my life. 3) Is he doing the right thing by not prescribing any medicine for high BP and elevated sgpt and serum Triglyceride (cholesterol) and just advicing to reduce weight. 4) Is it worth going to skin specialist and spend money for acanthosis nigricans or I do what my doctor said. 5) How do I get back my periods? My doctor advised me to go to radiologist for PCOS and go to gynac. I would appreciate your advice and be grateful to you. Thank you very much.
Sun, 17 Jul 2011
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Dermatologist 's  Response
hi
u r on right path.
1-metformin is very useful in insulin resistant .
it is not only use in diabetes .
it is also use in acne

2-u need to take it for long time .
3-u need not to take any medicine for bp or lipid,
4-better to consult skin doctor as he will treat ur skin problem ,acanthosis.
many procedure are there to improve ur skin
5-better to consult gynecologist .
I find this answer helpful
  User's Response
Hi
Welcome to HealthcareMagic.
1)Glycome 500 mg is Metformin and appropriate in your case. metformin acts in reducing insulin resistance also.
2) if There are signs of relief from insulin resistance you can stop taking this drug
3)Yes. Reducing weight will definitely help been reducing liver enzymes also.
4)you can just take the appropriate treatment given by your endocrinologist and wait for a few months . if you still have acanthosis you can go to skin specialist.
5) it is very important that you should get evaluated for PCOS.please visit your gynecologist and get evaluated for PCOS. taking hormonal pills can bring your periods back.

Hope my answer helps you.
Take care
I find this answer helpful
Pediatrician Dr. Aseem's  Response
Hi
Welcome to HCM
Read your prob, insulin resistant diabeteas, hypothyroidism is common causes of missed period , these are also cause of PCOD N PCOD is further cause of missed period. tab metformin 500mg which you take helps you in both diabetes n PCOD.the treatment which you taken is choice of treatment for that probs which you have. so do not worry ,these medicine take some days to work.
Dr aseem 9982583020
aseemadhuri@gmail.com
I find this answer helpful
  User's Response
Pri's  Response
Thank you Dr. Gaurav, Dr. Phalguna and Dr. Aseem. Thank you so much for your reply. I will get evaluated for PCOS and PCOD. Please also tell me that
1) is my doctor right for not prescribing any medicine for high BP, sgpt, lipid and wbc. 2) How do I keep BP under control?
3) and how do I improve my cholesterol levels. My Doctor suggested exercising and diet plan for cholesterol and said no medicine needed at this stage. Is he right? I am using fortune soyabean oil is it good? Which oil is good for cholesterol?

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I Am 30 And Have Insulin Resistance, Hypothyroid & Acanthosis Nigricans

hi u r on right path. 1-metformin is very useful in insulin resistant . it is not only use in diabetes . it is also use in acne 2-u need to take it for long time . 3-u need not to take any medicine for bp or lipid, 4-better to consult skin doctor as he will treat ur skin problem ,acanthosis. many procedure are there to improve ur skin 5-better to consult gynecologist .