The thyroid-diabetes connection

The thyroid-diabetes connection

If you have type 2 diabetes, you should get screened for thyroid abnormalities, according to researchers at the 20th Annual Meeting and Clinical Congress of the American Association of Clinical Endocrinologists (AACE). The recommendation came after a new study of over 5,000 people found that the prevalence of hypothyroidism in people with type 2 diabetes is nearly 6 percent, compared to just under 2 percent in people without.

Hypothyroidism is a known risk for type 1 diabetes, but has generally not been extended to type 2 diabetes either.

What does your thyroid function have to do with diabetes?

Both thyroid disease and diabetes lead to dysfunction of the endocrine system. Type 1 diabetes and the most common cause of hypothyroidism - Hashimoto's disease - are both autoimmune diseases, and having one autoimmune disease increases the risk of developing another.

In type 2 diabetes, concurrent hypothyroidism can increase the risk of heart problems. The researchers found that early detection of both diseases can improve heart function, blood pressure and lipid profile. [1]

Thyroid hormones also influence glucose homeostasis, including affecting circulating insulin levels, intestinal absorption, and uptake of glucose into adipose and muscle tissue. [2]

Even subclinical thyroid disease can be associated with diabetes

People with hypothyroidism often have problems with insulin resistance. This also applies at the subclinical level. How do you know if your thyroid is functioning subclinically?

Often not.

This condition is usually diagnosed when your thyroid hormone levels are normal but your thyroid stimulating hormone (TSH) is elevated. This is generally a sign that your pituitary gland is working extra hard to keep your thyroid hormone levels within normal ranges. Over time and if left untreated, your TSH levels may continue to rise until your thyroid stops responding and your subclinical hypothyroidism becomes full-blown hypothyroidism.

This is a difficult situation because subclinical hypothyroidism may produce no symptoms at all, or may result in fatigue, memory problems, weight gain, dry skin, constipation, and a number of other miscellaneous problems that may seem completely unrelated. Again, this often undiagnosed and misdiagnosed condition is also associated with insulin resistance, which typically precedes type 2 diabetes.

As researchers wrote in Clinical Diabetes: [3]

"Thyroid dysfunction is common in diabetics and can lead to significant metabolic abnormalities. Therefore, regular screening for thyroid abnormalities in all diabetics allows early treatment of subclinical thyroid dysfunction."

As with subclinical hypothyroidism, you can be insulin resistant for years before developing full-blown disease. Often, a diagnosis of type 2 diabetes is the first sign that a person is actually insulin resistant.

Because cases of subclinical thyroid disease are often overlooked but can increase the health risk for a number of people with co-existing diabetes or insulin resistance (as well as those without), researchers in the British Journal of Diabetes and Vascular Disease recommended “individualization” of therapy “as the best solution.

What is the end result?

If you currently have type 2 diabetes, you should be aware of its connection to thyroid diseases such as hypothyroidism and subclinical hypothyroidism. At a subclinical level, many have no symptoms at all, and others are unaware that their fatigue, memory problems, and other seemingly unrelated symptoms are due to a thyroid problem.

You may need to ask your doctor to have this checked, as this is not yet part of the standard of care typically provided for people with type 2 diabetes. But even if you get your thyroid levels tested and the lab results come back normal, it's still possible that your thyroid is functioning poorly. In fact, the condition is often completely overlooked in the conventional medical community due to inadequate testing and a general lack of understanding of the complexities of thyroid function.

There is some debate about whether or not subclinical hypothyroidism even needs to be treated, and that's something I really want to point out. At a minimum, subclinical hypothyroidism may contribute to insulin resistance and increase the risk of cardiovascular events if you have type 2 diabetes.

Additionally, at this early stage of thyroid imbalance, if no action is taken, many will develop full-blown hypothyroidism...and miss out on the vitality and energy they deserve in life.

At least 15 million Americans are believed to have subclinical hypothyroidism, which may or may not be related to diabetes. Fortunately, nutritional approaches and other lifestyle changes can help bring your thyroid function back to normal range and prevent, control, and even reverse type 2 diabetes. Guidance from a holistic physician familiar with both thyroid disease and diabetes is highly recommended to help you formulate and stick to an effective lifestyle plan.

References

1. DocGuide.com April 18, 2011

2. British Journal of Diabetes and Vascular Disease. 2010; 10 (4): 172 - 177.

3. Clinical Diabetes VOL. 18 NO. 1 winter 2000

Inspired by Dr Brandon Credeur, D.C.