Posts by wiredseal13

vividsailor7 said:You’ve shared quite a bit more detail than you did before. Since you've added fenofibrate—specifically Lipitor—to your regimen, I have to ask: is that a fibrate? Also, could you please list your actual triglyceride levels from your latest lipid panel?
Look, this whole approach just makes zero sense from every possible angle. First off, we have to address the elephant in the room: diet and physical activity. That is the fundamental question here. If you aren't getting those two things right, then what is even the point? All the Glucophage and statins in the world won't matter if the foundation isn't there. It's all for nothing!
Inaccurate medical history, questionable thyroid prescriptions... what on earth is going on? This is just ridiculous.
First things first: you need a thorough checkup and some serious diagnostic work from an endocrinologist.

To be honest, I'm inclined to agree—I mean, it seems like the most logical path forward. I'm not actually based in Washington, D.C., but I am planning on seeing an endocrinologist who specializes in metabolic disorders, so I suppose that makes D.C. my best bet to get things started.
Do you happen to have any recommendations? And just out of curiosity, are you an endocrinologist yourself?

vividsailor7 said:Everything seems pretty clear to me here.
Furthermore, why on earth are they insisting on a diuretic? Isn't just taking Amlodipine enough for you?

The side effects of Pioglitazone can be brutal. And which ones? Weight gain is one possibility—it happens through fluid retention, but also by increasing subcutaneous fat relative to visceral fat. This can lead to a weight increase of about 2–3 pounds after a year of treatment, though adding Metformin would likely mitigate that gain to around 1.3 pounds.

It is extremely important to highlight that Pioglitazone has incredibly positive effects; some of them include benefits for fatty liver, atherosclerosis/plaque buildup, blood pressure, and lipid profiles.

There’s that problem again: you say you're "dieting," when all you really need to do is eat healthy without those massive, restrictive limitations.

Well, I actually didn't realize that was also a diuretic, though I suppose I can see why she chose it—likely because she previously mentioned suspecting Cushing's syndrome due to my facial and hand swelling, even though the tests didn't show anything. My urine output is low, but my cortisol levels are normal, so she said it probably isn't that. 🤷, so the conclusion is that the swelling is actually from the hypothyroidism I've been dealing with for four years now.

I've been prescribed Lipitor for my lipids, and regarding the pioglitazone, she is being quite firm about it—perhaps because she thinks it might just wear me down, since I'm already dealing with swelling—so that is really why I was seeking your opinions.

And, oh, I almost forgot one thing—I've been put on PMS free, which is supposed to replenish my progesterone. My new regimen for metabolic syndrome is this:

In the morning:
- 150mg Synthroid
- 5 mg Indapamide
- PMS free

During the day, Glucophage 850 three times a day

At night:
- Lipitor
- Amlodipine

Does this all seem okay? I'm 40.😕

vividsailor7 said:Let's break this down order by order.
THE ANSWER TO ALL YOUR QUESTIONS IS DIET AND EXERCISE!!!
Honestly, using Torsemide as a first choice for treating hypertension makes zero sense to me, especially considering the unfavorable metabolic impact of diuretics. There are much better options available, like an ACE inhibitor—something like Lisinopril or Benazepril—or perhaps a combination with a thiazide diuretic, such as Lisinopril/HCTZ.
Then you have calcium channel blockers like Amoxapine or Pinox.
As for the Metformin, you could increase it to 3x1000mg if kidney function allows, or even consider introducing Pioglitazone.
Also, it is vital to determine your HbA1c, C-peptide, maybe do an OGTT, check 24-hour proteinuria, and keep a log of your blood pressure, urate levels, and lipid panel.

Thanks for the reply; you've definitely given me a lot to think about.

After reading your post—and after I really pushed for it—my primary care physician decided to switch up my regimen. Now, I'm taking Indapamide 5 mg in the morning and 5 mg of Amlodipine in the evening. She mentioned she originally chose Torsemide because it was on the essential drug list, so... what can you say to that? ............. (I'd love to hear what you all think—is this a better setup?)

My labs show an HbA1c of 5.5 (ref. 4.0 - 6.2)
cholesterol at 6.06 (target is under 5)
HDL cholesterol is 1.05 (for women, they usually recommend over 1.2)
LDL cholesterol is 4.01 (target is under 1.2)
VLDL cholesterol is 1.00 (ref. 0.12-0.50)
CRP is 5.31 (ref. 0.00-5.00)

Regarding the Metformin, my endocrinologist is suggesting Pioglitazone instead of ramping up the Metformin dose, but she warned me that the side effects could be pretty intense—one being weight gain, which is the last thing I need right now—so she told me to mull it over before my next appointment.

To answer the "ultimate question" from your opening sentence: I don't get much physical activity, and my attempts at dieting haven't been very successful (though I promise you, I really have tried).

vividsailor7 said:

I’ve been sitting here staring at my latest lab results, and quite frankly, I am absolutely livid. How is this even possible? One day you think you’re doing everything by the book—watching every single gram of sugar, sticking to the regimen like glue—and the next, your numbers look like a disaster movie. It feels like a slap in the face! I was looking over my Lipid profile earlier, and let me tell you, it is not looking pretty. My Endocrinologist had some "suggestions" for adjustments, but honestly, it feels like we're just moving the goalposts every time I get close to a target. It’s exhausting. You spend all this energy trying to stay on top of things, only to have the data tell you that you’ve failed. It’s infuriating! And don't even get me started on the medication dance. We’re talking about switching up doses or adding things like Metformin 2 x850mg just to try and stabilize the baseline. It feels like a constant battle against my own biology. I want to believe the progress is happening, but when the numbers scream otherwise, it's hard to stay positive. Does anyone else feel like they're running on a treadmill that keeps speeding up? Just venting. I needed to get that out. kaže:
I’ve been sitting here reading through this whole thread on Metabolic Syndrome, and honestly? It’s enough to make my blood boil. I couldn't just sit back and stay silent after seeing some of the discussions happening here—it actually prompted me to finally reach out and weigh in.
..............................

I’m only 37 years old, but let me tell you—I feel like I’ve aged a decade overnight. I feel 55! It is absolutely exhausting. I am done with this feeling. I want to be healthy, I want my vitality back, and I want enough energy to actually live my life!

From what I can see, everything we need is right here—assuming, of course, that it hasn't already been taken care of.
I just got my latest round of test orders back, and honestly, I am beyond frustrated with how disjointed this whole process feels. They want me to get a Doppler ultrasound of the veins and arteries in my lower extremities, an echocardiogram—because apparently, an X-ray isn't a sufficient method for assessing heart condition—and a renal ultrasound too. It’s just one thing after another!
Alright, here’s the full rundown of what I need for my bloodwork and labs: transaminases, a complete Lipid profile, urea, creatinine, and urate levels. I also need a urine analysis, a 24-hour proteinuria test, and cortisol checks at the 8-hour, 16-hour, and 24-hour marks via urine. On top of all that, they’re running TSH, fT4, ANCA, and ANA. It's a massive list.
Look, if you ask me—and obviously, you should always run this by your doctor first—it would be a smart move to ditch the diuretic. It’s just not doing your metabolic health any favors. Instead, you should look into switching over to an ACE inhibitor, or even better, a combination pill like an ACE inhibitor plus a thiazide, something like Ramipril 2.5/12.5mg. It's a much cleaner approach.
Listen, I’ve been thinking about this, and frankly, it’s high time we talk about titration. Why settle for mediocrity when you can optimize? If you’re currently on a low dose—say, just one 500mg tablet of Glucophage after a meal—why stay stuck there if it isn't doing the job? You should be looking at stepping that dosage up. It’s about monitoring the actual impact on your numbers and then making the move to increase it. Don't just sit there waiting for things to improve on their own!
It all comes down to what those lab results actually show. Depending on the numbers, you might have to step in with something like a lipid profile medication, Allopurinol, or whatever else the doctor deems necessary. It’s not one-size-fits-all.

I’ve been trying to send a private message, but it just won't go through—apparently, my inbox is too full or something, so I can't receive new ones. So, I'm turning to you all here... if you could help me answer a few things. For instance, what happens when the medication doesn't seem to be working? I've been taking Metformin 2 x850mg three times a day, and even after eight months, my postprandial Insulin level was still sitting right around 950 (though my fasting levels are normal).

It’s been about three or four years since I was diagnosed with hypothyroidism, and now, another autoimmune issue has cropped up. I'm 42.
Basically, about eight months ago, I was diagnosed with insulin resistance. It was part of a much larger diagnosis involving metabolic issues—sort of a "syndrome X" situation, where I have insulin resistance, high blood pressure, elevated lipids, and so on.

Regarding the insulin resistance, my fasting Insulin was 125 (with a reference range of 17.8–173), but my postprandial Insulin—two hours after eating—was 990.1 (where the range is supposed to be 17.8–173). Since then, I've been taking Metformin 850 three times a day with every meal, and after six months, I went back for more tests. The results were identical to the first ones; my postprandial Insulin remains stubbornly high.
My question is this: If I've been on this treatment for six months and the numbers are exactly the same as they were before I started, what am I supposed to do? Is there another medication, or maybe something else entirely I could try? And honestly, how likely is it—and how quickly might it happen—that this insulin resistance will progress into diabetes? My fasting A1C is hovering near the upper limit, somewhere between 5.5 and 6.0.

So, currently, I'm taking 150mcg of Levothyroxine in the morning for my thyroid,
5mg of Torsemide for hypertension,
Metformin 850 three times a day with meals,
and I recently started taking one pill in the evening for my cholesterol.

I really, truly hoped that once I was diagnosed and started treatment, things would start looking up, but nothing seems to be helping. My weight hasn't budged, my lipids are still high, my postprandial Insulin is still elevated, and I'm already on the maximum dose of Levothyroxine. By the end of this year, I fear my labs will look exactly the same. My Endocrinologist just tells me to stay the course with my current medications.

Does anyone have any suggestions for my next step? I feel like I've hit a wall, and I'm just feeling a bit lost about what to do next.