Thyroid disease is a common illness that affects more than 20 million Americans. For most, the health risks associated with the disease can be mitigated with medication and ongoing treatment. For diabetics, however, thyroid disease can lead to complications that make managing blood sugar levels especially challenging.
“If nothing has changed in your diet, medications, or exercise routine, but you are experiencing abnormal fluctuations in your blood sugar levels, your thyroid may be to blame,” explains Dr. Ahmet Ergin.
A board-certified endocrinologist, Dr. Ergin specializes in helping patients to manage and control their diabetes. “Both hypothyroidism and hyperthyroidism can have an effect on blood sugars. I recommend that all diabetics be tested to determine if they have thyroid issues.”
Dr. Ergin provides educational resources on diabetes control to hundreds of thousands of people through his Youtube channel, SugarMD. His videos range from explaining the science behind diabetes to the types of foods that diabetics should avoid. More than 374,000 people subscribe to his channel.
The basics of thyroid disease
The thyroid is a hormone producing gland that influences virtually all of the body’s metabolic processes. Thyroid disease typically involves a change in the amount of hormone that the gland produces. When hormone levels are abnormally high, it results in a condition known as hyperthyroidism. When hormones are abnormally low, it is known as hypothyroidism.
Thyroid disease can be caused by a number of things. Excessive exposure to substances such as iodide or lithium are believed to increase the risk of developing hypothyroidism. Hashimoto’s thyroiditis — an autoimmune disorder — can also lead to hypothyroidism. Subacute thyroiditis and Graves’ Disease are two known causes of hyperthyroidism.
Iatrogenic hyperthyroidism occurs in patients who take too much thyroid hormone medication. Sometimes referred to as factitious hyperthyroidism, it can result from doctors prescribing too high of a dosage to patients who are undergoing treatment for thyroid disease.
How thyroid disease affects diabetes
There are several ways in which thyroid disease can interact with diabetes and make treatment more challenging. One that results from hyperthyroidism involves making the body more insulin resistance. When this occurs, it makes it more difficult for the body’s cells to absorb blood sugar. Hyperthyroidism also increases the body’s metabolism, which can result in insulin being eliminated from the body at a faster than normal rate.
Diabetes treatment primarily involves managing the blood sugar levels due to a lack of insulin production. When hyperthyroidism further affects the body’s engagement with insulin, the result can render medications or other treatments ineffective.
“When my patients suddenly discover that their diabetes treatment is not working as usual, I always check their thyroid,” says Dr. Ergin. “There are side effects that can reveal a problem with hyperthyroidism — things like excessive sweating, weight loss, irritability, anxiety, or hot flashes — but they often occur so slowly that patients do not notice them. When diabetes control goes out of control, hyperthyroidism is definitely a possibility that should be explored as soon as possible.”
With hypothyroidism, the body’s metabolism slows down as a result of the low levels of thyroid hormones. This results in medications taking a longer time to break down. For those who are controlling diabetes with medication, hypothyroidism may result in those medications not being as effective at managing blood sugar levels.
Another threat that hypothyroidism poses is triggering someone who is pre-diabetic to progress in the disease. Because the condition slows down metabolism, it can result in insulin resistance that leads to higher blood sugar levels. In addition, the slower metabolism that is caused by hypothyroidism can also lead to blood sugars being used at a slower rate. Once this begins, the conditions that lead to diabetes can develop.
For those who already have diabetes, the slower metabolism caused by hypothyroidism can result in insulin staying in the body for a longer period, leading to an abnormal drop in block sugar levels that can be dangerous.
“When the thyroid’s hormones get out of balance, even slightly, it can have a dramatic effect on the body,” explains Dr. Ergin. “For those who are trying to manage diabetes, the effect can be even more severe. That is why it is extremely important for diabetics to make sure that their thyroid levels are good. My recommendation is to have thyroid levels checked once a year and as soon as any symptoms of thyroid disease are detected.”