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Dear Diabetes: Diabetes and the Thyroid

What to know about thyroid disease if you live with diabetes

The thyroid is a butterfly-shaped gland made of two connected lobes. The main hormones it produces are triiodothyronine (T3) and thyroxine (T4), which are primarily responsible for regulating metabolism.

If a person’s thyroid isn’t functioning properly, it may produce too much thyroid hormone, known as hyperthyroidism, causing an increase in metabolism (the process of converting nutrients into energy). A thyroid may produce too little thyroid hormone, known as hypothyroidism, which causes metabolism to slow down.

Thyroid disease and diabetes

People with type 1 diabetes may have a higher risk of thyroid disease. Thyroid disease is also more common in people with type 2 diabetes than in the general population. Almost 7% of the general U.S. population has some type of thyroid disorder; it’s more common in women than in men. By some estimates, the risk may increase to about 11% among people living with diabetes and up to 30% for women living with type 1 diabetes.

When thyroid disease occurs in a person with diabetes, it may make blood glucose management more difficult. “Every person with diabetes should be aware of the potential for thyroid conditions,” says Dr. Mariela Glandt, an endocrinologist affiliated with Bronx-Lebanon Hospital in New York.

Hyperthyroidism symptoms

Some symptoms of hyperthyroidism may include:

Causes of hyperthyroidism

The most common type of hyperthyroidism is Graves’ disease. The condition occurs when the immune system produces an antibody that causes the thyroid gland to make an excessive amount of thyroid hormone. Graves’ disease runs in families, and usually affects younger women.

Other conditions that may lead to hyperthyroidism are inflammation of the thyroid gland, or one or more lumps or nodules on the thyroid, which increase the gland’s activity.

Hypothyroidism symptoms

Some symptoms of hypothyroidism may include:

Causes of hypothyroidism

Inflammation of the thyroid gland may cause it to stop producing sufficient hormone. The most common cause of hypothyroidism is autoimmune thyroiditis (also called Hashimoto’s thyroiditis), a form of thyroid inflammation caused by the immune system.

Other causes of hypothyroidism include surgical removal of the thyroid gland, abnormal growths in the thyroid gland or certain medications used to treat a variety of conditions.

Because of the higher risk of thyroid disease among people living with type 1 diabetes, it’s important to be tested.

A blood test can detect thyroid disease. The American Diabetes Association recommends that everyone with a type 1 and type 2 diagnosis be tested at the time of their diabetes diagnosis.

Concerns for those living with thyroid disease and diabetes

Thyroid disease may complicate blood sugar management. Production of too much thyroid hormone (hyperthyroidism) leads to worsening blood glucose control and increased need for insulin.  “People with diabetes and hyperthyroidism may need higher doses of insulin or oral medications,” Dr. Glandt explains.

Dr. Glandt says that the opposite is true in the case that the thyroid does not release enough hormone (hypothyroidism). When metabolism is slowed, medications may remain in the body too long, explains Dr. Glandt. “People with diabetes [who also have hypothyroidism] could experience low blood sugar levels.”

Both hypothyroidism and hyperthyroidism are treatable. Talk to your healthcare professional if you have concerns about your thyroid.

“If you have diabetes, make sure you are being screened for thyroid disease,” says Dr. Glandt. “And it’s important to know the symptoms of thyroid disease so it can be diagnosed at its onset before it has a chance to wreak havoc with your metabolism and blood sugar levels.”

Jessica Apple is the co-founder and editor in chief of the online diabetes lifestyle magazine A Sweet Life. Her writing has appeared in many publications, including The New York Times Magazine, The Financial Times Magazine, The Southern Review, The Bellevue Literary Review and Tablet Magazine. Apple is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor and interviewees, and not of Sanofi US, its employees, agencies, or affiliates.

© 2016 The DX: The Diabetes Experience

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