so i’m 2 months into HRT and still trying to figure out the glucose spikes after meals. my endocrinologist says labs look fine, but the CGM is telling a different story. anyone else experience this? i’m talking 160+ spikes after lunch, crashing hard by 4pm.
dose splitting my levothyroxine helped with the afternoon crash, but the spikes are still there. i’m starting to think it’s not just the meds, but how my body’s responding to them. has anyone else noticed a difference in glucose control after starting HRT? or is this just a thyroid thing?
fwiw, my TSH is stable, free T3 is fine, but the glucose spikes are still a mystery. trying to track it all, but would love to hear from others who’ve been through this. what are you using to track glucose, and have you found anything that helps?
that 160+ spike after lunch and the 4pm crash sounds exactly like my 2pm switch flip, just glucose instead of deep fatigue. my rheum’s labs always looked fine too, which is why i pushed for monthly bloodwork to see the actual patterns. the appointment snapshot really doesn’t show you the between-days stuff, which is why logging everything in careclinic helps me track those cross-correlations.
it’s always the cgm telling the real story, isn’t it? that “labs look fine” but your body feels off is exactly why i pushed for monthly bloodwork myself, because my rheumatologist only did yearly. my c3 and c4 drop about two weeks before a flare, long before my esr or crp look
fwiw. it’s not always just a thyroid thing or an HRT thing, sometimes it’s how your body processes everything.
my endo will say my TSH is stable and free T3 is fine but still my afternoon crash is brutal. the ‘mystery’ of the 160+ spikes feels less like a mystery and more like the doc isn’t looking at the right metabolic markers.
have they checked your fasting insulin or a C-peptide with those CGM readings?
that disconnect between the cgm data and your endo saying ‘fine’ is so frustrating, i really get it. even when my a1c looked okay, i pushed for more specific insulin resistance markers because the crashes and spikes felt like something more was happening. have you looked at your fasting insulin or tried tracking how the timing of your HRT dose might influence those post-meal numbers?