I am 27 years old person. Recently I was diagnosed with type 1 diabetes and hypothyroidism. 11 november 2018 my hba1c - 15 and tsh - 12.46 ,c peptide fasting - 0.29, but after taking medication metformin- 1000 mg ,istavel-100 mg ,pioz-7.5 mg and thyronorm -25 mg. After using this medicine for 80 days my hba1c reduced to-6.9 ,c peptide fasting -1.76 (increased) but nothing change in tsh. Please suggest what I have to do next. For diabetes I am taking metformin -500gm and istavel 100 mg after breakfast. Please guide.

Dr. Prabhakar Laxman JatharEndocrinologist48yrs exp

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Hello, Thanks for the query. You have T2 DM, (not T1). It is good to know that HbA1c% has come down to 6.9, that shows good control. You have to continue the same treatment and lifestyle. As regards TSH level if it has not come down, then there is a need for increasing the dosage of Levothyroxine from 25 mcg to 50 mcg per day. Then check TSH after 6 weeks to see what is the impact. TSH should be maintained around 3 to 4 mU/L, at which all the symptoms of hypothyroidism will be in check. If you have any questions please do come back. Thanks. 

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