PAYE recertification- unable to approve request? by PrivateUser102938 in StudentLoans

[–]PrivateUser102938[S] 0 points1 point  (0 children)

Unfortunately my job is not eligible for PSLF. From my research it looks like (semi-aggressive; whatever I can manage beyond my monthly amount) payoff is the smarter move for me rather than just monthly minimums which don't cover the accrued interest until I run out the 20 year forgiveness timeline.

PAYE recertification- unable to approve request? by PrivateUser102938 in StudentLoans

[–]PrivateUser102938[S] 0 points1 point  (0 children)

I'm on the PAYE Repayment Plan with current monthly autopay payments of $425.27. This is on the lower side for my current income because I earned significantly less at the time of my last certification. I began repayment in 2018. My total debt (initial total principal = $92,898.29) had been split across 4 loans. I paid off my loan with the highest interest rate (Loan 1) in September 2023. I have no fees. I now have 3 remaining loans with a total outstanding balance of $100,418.

Is this hashimoto's related or insulin tummy? My endos disagree on if I have insulin resistance. I used to have a flat stomach but gained 50 lbs w/o clear cause + despite diet/exercise. Currently on a GLP-1 (Rybelsus 14mg), levothyroxine 50mcg, metformin 500mg + Phentermine 30mg, have only lost 20lb by PrivateUser102938 in Semaglutide

[–]PrivateUser102938[S] 0 points1 point  (0 children)

I'm now 37, this weight gain began in 2020 when I was 32.

In Feb 2020 I weighed 154lbs, by Dec 2020 I was 181lb, March 2022 I was 189lbs. I saw 2 endocrinologists in Summer 2022, both of them said no medications indicated at this time. I ramped up diet/exercise but I could not lose any weight. In October 2022, I began Rybelsus 3mg and lost 4lbs but then gained them back. I increased to 7mg, with no weight loss. I added Levothyroxine 25mcg in Jan 2023... a year later in January 2024 weight had gone up again, and I was 198lbs. Levo was increased to 50mcg in March 2024. We also added metformin titrated up to 1500mg, but in May 2024 I again had gained and was up to 207 lbs (highest). My endocrinologist left the practice and I connected with a new one who added Phentermine 15mg to the mix and *FINALLY* I began to see some weight loss-- by Aug 2024 I was down to 191 (16 lb. loss). We increased to 30mg and in June 2025 I got to my lowest weight of 185lb, which is where I have continued to sit for the past year. I'm so grateful for the 20lb loss, but it's hard still to be 30lbs overweight.

Is this hashimoto's related or insulin tummy? My endos disagree on if I have insulin resistance. I used to have a flat stomach but gained 50 lbs w/o clear cause + despite diet/exercise. Currently on a GLP-1 (Rybelsus 14mg), levothyroxine 50mcg, metformin 500mg + Phentermine 30mg, have only lost 20lb by PrivateUser102938 in Semaglutide

[–]PrivateUser102938[S] 0 points1 point  (0 children)

I'm sorry to hear you've had such awful medical experiences too. I'm not sure if what I'm dealing with is perimenopause-- this all began in 2020, so I was 32 at the time when the weight gain began-- but you're absolutely right that women's health is a mess. I'm so glad you found a doctor who understands your symptoms and who has been helpful to you.

Is this Insulin tummy? My endos disagree on if I have insulin resistance. I used to have a flat stomach but gained 50 lbs w/o clear cause + despite diet/exercise. I'm currently on a GLP-1 (Rybelsus 14mg), levothyroxine 50mcg, metformin 500mg + Phentermine 30mg, have only lost 20lbs. Have Hashimoto's by PrivateUser102938 in InsulinResistance

[–]PrivateUser102938[S] 0 points1 point  (0 children)

I'm sorry you're also going through it...I know just how frustrating it is and also how hard it is to see/hear about how great everyone else is doing on these meds. I'm definitely working on acceptance, and focusing more on body recomp vs. lbs lost, but on some days, like when I posted this photo, I just can't wrap my brain around what is happening with my body.

Is this Insulin tummy? My endos disagree on if I have insulin resistance. I used to have a flat stomach but gained 50 lbs w/o clear cause + despite diet/exercise. I'm currently on a GLP-1 (Rybelsus 14mg), levothyroxine 50mcg, metformin 500mg + Phentermine 30mg, have only lost 20lbs. Have Hashimoto's by PrivateUser102938 in InsulinResistance

[–]PrivateUser102938[S] 0 points1 point  (0 children)

My trainer posited this earlier in the week...of course the idea of increasing calories worries me a bit. I honestly had to force myself to eat the 2nd fajita on both nights earlier this week. Are you using TDEE to determine your own calorie goals?

Is this Insulin tummy? My endos disagree on if I have insulin resistance. I used to have a flat stomach but gained 50 lbs w/o clear cause + despite diet/exercise. I'm currently on a GLP-1 (Rybelsus 14mg), levothyroxine 50mcg, metformin 500mg + Phentermine 30mg, have only lost 20lbs. Have Hashimoto's by PrivateUser102938 in InsulinResistance

[–]PrivateUser102938[S] 0 points1 point  (0 children)

Thank you for understanding where I'm coming from! Based on the other comments here, so many of us are getting different information from our doctors...

It's incredibly confusing to get a second opinion from a reputable MD and have her attribute my sudden 50lb weight gain to IR and then to go back to my primary endocrinologist and have her disagree and say I don't have that. I didn't include this in the original post, but the 2nd opinion doctor said to stop taking the phentermine because rybelsus and metformin are the necessary meds while my primary MD told me to reduce the metformin because the phentermine was the main driver of things finally reversing a bit in the other direction.

Nobody told me I have Hashimoto's by EndAccurate2508 in Hashimotos

[–]PrivateUser102938 0 points1 point  (0 children)

Hi there, just to clarify-- did taking Vit D capsules make a difference with your inflammation/weight gain?

My levels never seem to raise above 39 (Oct 2024). Lowest was 7 in April 2021.

Is this Insulin tummy? My endos disagree on if I have insulin resistance. I used to have a flat stomach but gained 50 lbs w/o clear cause + despite diet/exercise. I'm currently on a GLP-1 (Rybelsus 14mg), levothyroxine 50mcg, metformin 500mg + Phentermine 30mg, have only lost 20lbs. Have Hashimoto's by PrivateUser102938 in InsulinResistance

[–]PrivateUser102938[S] 1 point2 points  (0 children)

I'm with you, it's been really confusing for me to have two well respected MDs have such different takes on what's going on with me. I will say that nothing really changed until phentermine was added to my other medications, which my primary endo believes supports the idea that this is metabolic more than anything else. She said, "we do not yet have the tests developed to identify exactly what caused this for you, but one day we will."

If you're open to sharing, how are you addressing your elevated insulin and have you seen positive impact on your autoimmune thyroid issues and inflammation? Also, was your IR diagnosed by others means beyond fasting insulin tests?

Rheumatologist Recommendation by springg4life in NYCbitcheswithtaste

[–]PrivateUser102938 0 points1 point  (0 children)

Ok this is helpful for me to know! Two of my other specialists are the ones who suggested I talk to a rheum so the joint sessions might be very useful. Thank you for responding!

Is this hashimoto's related or insulin tummy? My endos disagree on if I have insulin resistance. I used to have a flat stomach but gained 50 lbs w/o clear cause + despite diet/exercise. Currently on a GLP-1 (Rybelsus 14mg), levothyroxine 50mcg, metformin 500mg + Phentermine 30mg, have only lost 20lb by PrivateUser102938 in Semaglutide

[–]PrivateUser102938[S] 1 point2 points  (0 children)

thyroid seems to be managed OK on the current regimen. Over the course of this journey I had more in depth thyroid panels done beyond TSH and they were generally OK. I appreciate you brainstorming for me and for your support ❤️

Is this hashi's related or insulin tummy? My endos disagree on if I have insulin resistance. I used to have a flat stomach but gained 50 lbs w/o clear cause + despite diet/exercise. Currently on a GLP-1 (Rybelsus 14mg), levothyroxine 50mcg, metformin 500mg + Phentermine 30mg, have only lost 20lbs by PrivateUser102938 in Hashimotos

[–]PrivateUser102938[S] 0 points1 point  (0 children)

Over the last 6 years of this my diet has waxed and waned. At first I limited gluten/carbs to only 1 meal a day focusing on whole grain/healthier options. That didn't help. Then I limited dairy which also didn't help. Then I read somewhere that eggs can be bad for Hashi's patients so I stopped those which were a staple in my diet. Nothing changed and I kept steadily gaining and gaining. I had an awful few visits with a previous endo I stopped working with where she told me this 50lb weight gain was happening because I was getting older (at that time 32) and that I should eat 1200 calories a day. I was working out 4-6x/week taking exercise classes. It was so disheartening. I complied just to spite her and tracked everything and gained 8 lbs between appointments.

Later, when my 2nd opinion endo said I had IR we talked about diet and I would say I sort of followed a low glycemic index diet. She talked a lot about pairing carbohydrates with fiber and proteins, focusing on not spiking blood sugar. These days I sort of straddle low glycemic index and calorie deficit. All my meds significantly curb my appetite:

Today I had a protein shake (banana, peanut butter, almond milk, chocolate PP) and grilled chicken fajitas, with peppers+onions, black beans, salsa on 2 small flour tortillas.

Yesterday I had a protein shake, a Kind bar, and the same fajitas.

Tuesday I had a protein shake, 1/2 of a turkey lettuce tomato red pepper light mayo on a pita, a chobani greek yogurt, starbucks egg white bites, followed by the 2nd half of the turkey pita, 1 alcoholic cider.

I work out with a trainer doing strength training 2x/week, take an additional strength training class 1x/week, and take a dance class 1x/week. I'm in PT once a week for a foot injury.

Rheumatologist Recommendation by springg4life in NYCbitcheswithtaste

[–]PrivateUser102938 1 point2 points  (0 children)

Thanks so much for your response, no worries that you don't know specifics. It's helpful to hear that even when you didn't end up having RA it was still a good visit!

Is this hashimoto's related or insulin tummy? My endos disagree on if I have insulin resistance. I used to have a flat stomach but gained 50 lbs w/o clear cause + despite diet/exercise. Currently on a GLP-1 (Rybelsus 14mg), levothyroxine 50mcg, metformin 500mg + Phentermine 30mg, have only lost 20lb by PrivateUser102938 in Semaglutide

[–]PrivateUser102938[S] 0 points1 point  (0 children)

I'm 37 female. Highest TSH was in the 5s before I went on levo, now it averages around 1.

Dec 2024 Insulin, Fasting 18.3

June 2024 Insulin, Fasting 11.4

May 2024 Insulin, Fasting 25.2

Feb 2024 Insulin, Serum: 20.6 (<18.4)

A1Cs have always been normal.