Diabetes & The Body

Diabetes and Thyroid Disease

The thyroid is a butterfly-shaped gland in the anterior (front) neck below the skin and muscle layers. The gland makes thyroid hormone, which has an effect on nearly all tissues of the body where it increases cellular activity. It regulates our body’s metabolism, the processes of using and storing energy, by releasing a substance called thyroid hormone.

Diabetes and thyroid disease are both problems of the endocrine system. Besides, when thyroid disease occurs in someone with diabetes, it can make control of blood glucose a difficult task to achieve.

Hypothyroidism

When less than adequate levels of thyroid are produced, it results in hypothyroidism in which the body functions are slowed down. The common symptoms are:

• Fatigue
• Sluggishness
• Depression
• Feeling of being cold even when others feel warm
• Constipation
• Weight gain unrelated to increase in eating
• Low blood pressure
• Slow pulse

Studies have shown that the incidence of hypothyroidism seems to be increased in both people with type1 and type2 diabetes, especially women over the age of 40. Persons with type1 or type2 diabetes are therefore advised to get their TSH levels checked every 5 years so that any signs of hypothyroidism can be detected and treated accordingly.

Further, people with diabetes who develop hypothyroidism may find it hard to manage their diabetes. As the body metabolism slows, the blood glucose level may drop as diabetes medicine doesn’t pass through your body as quickly as usual and so stays active longer. In hypothyroidism, it is often necessary to reduce the dose of diabetes medicines to prevent low blood glucose.

Besides, fatigue may set in and persons suffering from it don’t feel like undertaking any physical activity. This may lead to weight gain from the decreased physical activity and a slower metabolism.

However, once a person with hypothyroidism receives thyroid replacement medication, their thyroid levels usually return to normal, as does their diabetes medication requirements.

Hyperthyroidism

An excess of thyroid levels result in hyperthyroidism. Some of the common symptoms are:

• Pounding heart
• Quick pulse
• Increased sweating
• Weight loss despite normal or increased appetite
• Shortness of breath when exercising
• Diarrhea
• Muscle weakness or tremors
• Trouble concentrating
• Change in menstrual periods
• Thick skin on the knees, elbows, and shins

The start of hyperthyroidism in a person with diabetes means that their blood glucose levels may rise slightly. If the condition remains untreated and becomes more severe, diabetes management can be much harder. Weight loss may occur, too many ketones (which are the end result of fat breakdown) may begin circulating in the blood, and more insulin or medication will be required to lower blood glucose levels. However, management of diabetes can be improved by treating hyperthyroidism successfully.

When the body metabolism quickens, medicines travel faster through the body. The blood glucose level in a diabetic with hyperthyroidism may rise because the usual dosage does not stay in the body long enough to control it.

Besides, hyperthyroidism and low blood glucose can be hard to tell apart. If a person is sweating and having tremors from hyperthyroidism, he is likely to think that the blood glucose level is low. As a result of this he may take extra food causing blood glucose to rise. Therefore using a glucose meter to verify low blood glucose levels can help to resolve this problem.

Timely intervention

Any symptoms pertaining to either hypo or hyper thyroidism needs to be discussed with a health care provider. Remedial steps include:

1. A physical examination and simple blood tests to identify hyper- or hypothyroidism.
2. In case of hyperthyroidism, medicines and other treatments can help slow metabolism by controlling the release of thyroid hormone.
3. In case of hypothyroidism, a health care provider can prescribe thyroid hormone pills to speed up metabolism.
4. Follow-up blood tests every few months to adjust dosage of thyroid hormone.