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How do you know if you have “thyrobetes”? You might not have heard this term before, but it’s a combination that illustrates the dangerous relationship between an underactive thyroid and diabetes. You should never be in the dark about your health, so let’s find out today if you’re struggling with this condition. Today, we’re taking steps to put your health back into your hands.
The Origins of Thyrobetes
I have started coining the term “thyrobetes” to illustrate the relationship between these two diseases. The most important aspect I want to emphasize is that diabetes and thyroid dysfunctions do not simply exist on their own. They create an “environment of risk” for patients.
The association of hyperthyroidism and the worsening of diabetes goes all the way back to 1927 (1). This was just the beginning of how we started to understand the complex and nuanced relationship that thyroid dysfunction and diabetes share. We now have over 100 years of research attempting to understand how we can properly treat these diseases – but first, let’s start off with a very basic definition.
Without getting too in depth, let’s illustrate this relationship like so:
- If you have thyroid disease, you are at risk for developing diabetes.
- If you have diabetes, you are at risk for developing thyroid disease.
In Conclusion: Well-chronicled and well-researched, the connection between thyroid disease and diabetes runs deep. There is no way to avoid it, so it helps to know about it.
How These Diseases Overlap
When we think about diabetes and thyroid disease, we need to understand that they constitute what we might call a mutually destructive relationship. Basically, when you have one, your risk for the other grows (2). They enable one another, and that can be scary stuff for your health.
The two main types of thyroid disease that we are going to look at today are hyperthyroidism and hypothyroidism. You might not know it, but both can play a role in worsening conditions for diabetes – or increasing your risk, overall.
Graves’ disease is when your thyroid goes into a state of overproduction (3). This results in what we know as hyperthyroidism. When this happens, three functions of the liver are increased:
- How much glucose is being put out by your liver.
- How intolerant we are of glucose.
- How resistant we are to insulin.
All of this means that those who are prone to a higher “t3 state” are at a higher risk of developing Type 2 diabetes (4). That amount of glucose in our system becomes more difficult to manage, and our bodies become unable to regulate it effectively.
Key Insight: Hyperthyroidism causes problems with your liver, which have a direct effect on your glucose levels and your insulin resistance. It’s a combination that can put you at risk for developing diabetes.
Hypothyroidism is a state of underproduction in the thyroid gland (5). This can result in Hashimoto’s disease, which can have a whole host of effects on your body. There’s a bunch, so we are going to need to dive a bit deeper on this one…
- You may see a reduction in your glycemic index (GI) glucose absorption (6), as well as an increase in the accumulation of glucose in your bloodstream. You might also have a decrease in the output of liver glucose.
- An increase in gluconeogenesis, which is where your body produces more glucose because it’s not getting it in your diet. It’s a fundamental imbalance, as your body is trying to give your brain the energy that it craves.
- A lower burning rate of glucose in your muscles.
- Thyroid hormones affecting insulin resistance and high-density lipoproteins (HDL) (7).
- Thyroid hormones affect risk for becoming diabetic, and it is worse when your thyrotropin (TSH) levels are above 2.5 (8). When your TSH is higher, your insulin resistance and beta cell function actually become lower (9).
- Your gene GLUT4 is a major glucose transporter in your body. It is also controlled by your “T3” state and can elevate glucose transport both ways – passive and insulin-mediated. Phosphofructokinase, which is a control element of glycolysis (10), and glycolytic enzymes are also associated with GLUT4 activity that T2 regulates (11).
Key Insight: There is a whole host of ways that hypothyroidism can put you at risk for developing diabetes. Most of it has to do with the way that it stresses your body out, and the role that glucose plays in your body (whether it’s been produced or moved around your system).
Thyroid Risks for Diabetics
Until this point, we have been primarily focused on understanding how thyroid diseases can put you at risk for diabetes. Let’s look at it from the other perspective, and see the ways where diabetes can put you at risk for thyroid disease. This is the other aspect of “thyrobetes” that we cannot ignore.
- Unmanaged early diabetes leads to euthyroid sick syndrome. This means a low T3 state, high rT3, normal T4 and TSH (12). Research shows that diabetics, in general, simply have a higher rate of developing thyroid disease, often 2-3 times more likely than non-diabetics. Especially amongst females, these numbers tend to play themselves out every time (13). Thyroid hormones control insulin secretion by beta cells and how beta cells respond to sugar and stress hormones.
- Your heart is important to your health, and when these diseases overlap you are putting your heart at risk. Your risk of heart disease, like hypertensive heart disease, multiplies when you are dealing with thyroid dysfunction and diabetes at once.
- Studies have also shown that hypothyroidism is common in those with type 2 diabetes mellitus (T2DM) (14). The failure to notice this risk has also proven to be detrimental in the overall management of diabetes. Those with T2DM also have higher weight and triglycerides with higher TSH. These are all hypothyroid tendencies (15). When your TSH level is higher than 3, there is a higher risk for diabetic neuropathy. These nerve disorders can really damage your body, and carry a whole host of symptoms like pain, tingling and numbness throughout the body (16).
- It’s a scary thought, but those with diabetes are simply at a higher risk for developing thyroid cancer (17).
In Conclusion: When it comes to having diabetes, you already need to be very conscious of your health. When you allow thyroid problems to get in the way, you put yourself at risk for multiple other complications (like heart disease and thyroid cancer, to name just a few).
What action steps can I take for diabetes and thyroid problems?
While we do want to understand the complications that are born from thyrobetes, we do have an opportunity to manage and correct these potential health risks. There are action steps you can take, and they are easy to follow when you know where to start.
I have broken these tips into two sections. One section is for diabetics who are concerned about their thyroid health, and the other is for those afflicted with thyroid diseases that want to decrease their risk of having diabetes.
So, let’s see the steps that we should be taking…
For Diabetics: Screen Thyroid Functions
Consult with medical professionals who know what they are doing, and screen thyroid functions carefully to nip any problems right in the bud. Your thyroid-stimulating hormone TSH needs to be below 2.5 mlU/L. This will help lower the risk of diabetic complications. Make sure that you are also screening for antibodies, and that your rT3 is not elevated, and that your T3 is neither too high or too low. Screen appropriately, and keep a watchful eye on your health.
For Diabetics: Be Aware of Thyroid Cancers
As a diabetic, your thyroid cancer risks are, unfortunately, higher. That is why we need to be so aware of the risk that thyroid cancers can pose. Schedule exams and ultrasounds to understand where your health stands. Avoid thyroid cancer taking you by surprise, and get examined today.
For Thyroid Disease: Watch Your Blood Sugar
One of the best things you can do to mitigate your risk for diabetes is to watch your blood sugar. It sounds simple enough, and with the right tools it can be even easier. I have already written about some tips to stabilize your blood sugar (18), and there are always more on the way. Taking the right steps to manage your blood sugar is not just about decreasing your risk for diabetes, it’s also about keeping your overall health in mind, too.
For Thyroid Disease: Know Your A1C’s
Your A1C is widely used as an assessment for your glycemic control (19). With that in mind, we should be testing our A1C twice per year. Aim for under 5.4, or else you might find yourself at risk for health complications (20).
For Thyroid Disease: Screen, Screen, Screen
It’s important that you are also screening two important elements, which are your morning fasting glucose, and your fasting insulin. Keep both of these in mind, as they are both essential elements in understanding how your blood sugar is operating and if you pose any risk of developing diabetes.
For Thyroid Disease: Glucose Intolerance Testing
A more substantial indicator of diabetes, the glucose intolerance test is a way to find out how easily your body’s cells are able to absorb glucose (21). We should consider this as another way to learn about your body, and to learn if you are predisposed to suffering from diabetes.
For Thyroid Disease: Consider Resistant Starches
You might have heard that carbs are bad for your diet. I definitely do not agree with this rushed assumption. I think good carbs can be great for your diet – the same way that bad carbs can be harmful – and that they can be especially helpful when it comes to your blood sugar (22).
Research has shown that resistant starches can help increase insulin sensitivity in the body (23). This means that with more resistant starches in your diet, you can feel healthier, less fatigued and you can prevent the onset of Type 2 diabetes. Sounds like a pretty great combination, if you ask me.
In Conclusion: Whether it’s getting screened or changing our diet, there are action steps we can take to managing our potential risk for thyrobetes. Keep these steps in mind, and do what’s right for your body.
Need to learn more about diabetes and thyroid problems?
The world of thyrobetes might seem complex, but it can be easy when you tackle each issue with actionable change. Take a moment to watch one of my latest videos, and know that change is possible.
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, and regain energy. Learn more about the surprising story that started his quest.