My dad has hypothyroidism, as does my grandmother. For my whole life, my dad has taken a tiny little pill every morning to make sure his metabolism functions properly. I always thought that compared to diabetes, thyroid disease wasn’t very “serious” — all my dad needed to do was pop a pill! — and that it was nothing I needed to worry about anyway. But then, because of my diabetes and my “genetic predisposition,” my endocrinologist insisted on starting to examine my thyroid regularly…
But despite my risk factors, I never knew much about thyroid disease. Now’s as good a time as any to learn.
January is actually National Thyroid Awareness Month, so for this edition of our 411 series on diabetes complications and co-morbidities, we’re taking a look at another body part in distress: the thyroid.
What Does It Do Again?
The thyroid is a little butterfly-shaped gland that lives in the middle of your neck, and it’s part of the body’s endocrine system, where diabetes also dwells. This system controls your body’s metabolism. One of the thyroid’s primary responsibilities is to manage your metabolism by producing two thyroid hormones: T3 and T4. An overactive thyroid can cause weight loss, a quick heartbeat, and other signs that your body is “on the go” a little too much. The opposite, an underactive thyroid, leaves people feeling sluggish, and causes weight gain and slow heartbeat. Essentially, your body’s normal equilibrium slows down.
Turns out, thyroid issues are incredibly common. They’re so widespread, in fact, that Oprah was all on about it a few years ago. Thyroid disease affects 30 million people in the US — and some experts think thyroid disease may affect nearly 56 million Americans.
Note that “thyroid disease” is actually an umbrella term for several different conditions that can affect this gland, including:
- hypothyroidism
- hyperthyroidism
- autoimmune thyroid disease, which includes Graves’ Disease and Hashimoto’s Disease
- goiter, which is an enlargement of the thyroid
- thyroiditis
- thyroid cancer
As you can imagine, none of these are good news for your body.
There are a whole host of different risk factors for thyroid disease, and you guessed it, diabetes is one of them! Experts estimate that about 30% of people with diabetes will be affected with a thyroid disease, so it’s a big one for us.
Diabetes itself does not cause thyroid issues, but those with an autoimmune condition are automatically at an increased risk for other conditions. In the case of thyroid disease, PWDs are at risk for the two autoimmune-type of thyroid diseases, Graves’ Disease (hyperactive thyroid) or Hashimoto’s Disease (underactive thyroid). Approximately 10% of type 1 PWDs will have a thyroid condition. Although type 2 diabetes is not an autoimmune disorder, there’s also an increased incidence in thyroid diseases, but for reasons that researchers can’t explain. One theory is that thyroid disease and type 2 diabetes both affect the elderly, although we’ve learned that’s not 100% true in all cases. On top of that, women are at a much greater risk for thyroid issues. Once again: lucky us!
How Can You Tell?
The symptoms of hyperthyroid and hypothyroid are starkly different, and it can be difficult to tell there is an issue right away because symptoms can develop very slowly. They also often match symptoms for a whole list of other conditions, so it can be tricky to figure out the culprit. This is why regular thyroid screenings are important.
Hyperthyroidism symptoms include quick pulse and pounding heart, weight loss despite an increased appetite, shortness of breath when exercising, muscle weakness or tremors, and trouble concentrating.
As you can probably guess, hypothyroidism symptoms are the polar opposite: fatigue and sleepiness, persistent feeling of being cold, dry skin, brittle hair, weight gain despite no change in diet, low blood pressure or a slow pulse. Hypothyroidism can also affect fertility in women. Yikes!
Symptoms of thyroid conditions can sometimes be confused with symptoms of diabetes, or attributed to other circumstances. Take veteran diabetes journalist David Mendosa, who wrote about his diagnosis with hypothyroidism last Spring. He writes, “My feet were cold most of the time. Even when I wore thick woolen socks to be, my feet were often so uncomfortable that they interfered with my sleep. Since I have diabetes, I assumed that my problem was that I had one of the most common complications of our condition, peripheral neuropathy. So I focused all the more on controlling my blood glucose levels in hopes of reversing my problem some day. Good strategy in general. But worse than useless when the assumption is faulty. My problem is hypothyroidism.”
Does the Thyroid Affect Diabetes Care?
One thing to note is that although hyperthyroidism and hypothyroidism do not directly affect blood sugar levels, not treating thyroid disease can cause lots of issues in managing your blood sugars because the effects the symptoms have on your body and how your body metabolizes glucose and insulin. For instance, with hyperthyroidism, insulin “clears” through your body faster, leaving you with higher blood sugars.
Hyperthyroidism can cause rapid heart rate and increases the risk of abnormal heart rhythm, so it increases the risk of heart problems, compounding the heart risks posed by diabetes.
Hypothyroidism can cause insulin to move through your body much slower, which could leave you with lower blood sugars. because the insulin “sticks around” longer. Hypothyroidism can also cause an increase in cholesterol and LDL levels, and an increase triglyceride levels, which adds to the danger of high cholesterol with diabetes.
So clearly it’s all bad news if you don’t catch the thyroid problem quickly!
What Up with Diagnosis & Treatment?
You’ll want to see your endocrinologist (endocrine system, remember?) or primary care physician asap. You may be referred to a doctor who specializes in thyroid issues (as opposed to diabetes), but your endocrinologist will know exactly how to diagnosis you. The primary way to diagnose thyroid disease is something called a TSH (Thyrotropin Stimulating Hormone) test, which checks the amount of thyroid-stimulating hormone in your system. It’s a very easy and inexpensive blood test, so don’t delay if you think you have symptoms!
However, sometimes the test will come back false-normal, so testing for antibodies or having a full Thyroid Panel can also turn up things that the TSH test might leave out.
Autoimmune thyroid diseases, like Hashimoto’s Disease, are usually much easier to manage than diabetes. The hormone replacement treatment comes in pill form, so taking the medication is easy-peasey. But some patients have difficulty finding the right type of thyroid replacement pill. While there are two types of natural thyroid hormones, called T3 and T4, only T4 is found in the common thyroid replacements. For many people, this doesn’t work well. In theory, T4 medication would also convert to T3, but research suggests this doesn’t always happen. You’ll want to do your homework and make sure you get on the right treatment for you!
Patient Lindsay O’Rourke writes on the TuDiabetes group for Hypothyroidism: “I went on my generic prescription, levothroid, and even at a very low dose it was an extreme difference. I felt back to normal. My energy was back, and a slew of other symptoms went away.”
Hyperthyroidism can be treated with anti-thyroid medicines such as methimazole (Tapazole) and propylthiouracil (PTU), but the most common way of treating hyperthyroidsim is radioactive iodine therapy. Weirdly, it kills off the thyroid, causing permanent hypothyroidism. So you’re really just trading one problem for another.
Because of the common problems with misdiagnosis and mistreatments, there’s a whole movement of Thyroid Patient Advocacy, both in the U.S. and abroad.
So far, I personally have been lucky in the thyroid department, and have not had any issues, although Amy has not been quite so lucky. I know that being a woman with type 1 diabetes puts me at a greater risk for thyroid disease and it’s something I fully intend to keep an eye on. If you’ve dealt with hyperthyroidism or hypothyroidism, we’d love to hear your story in the comments!
Wow Thanks for that info. I just want to share that I dealt with about 5 years of hypothyroidism and then by losing weight and changing my diet and exercising more and lowering my A1c, my thyroid has been functioning at proper levels for the past 7 years.
It doesn’t mean everyone can do that, but I think it’s always important to point out the possibility of lifestyle factors on regulating thyroid problems as it’s much easier on the body than medication (and treating the root of the issue). I hope I can hang on without medication for a long time.
It’s good to know that if I do need medication one day, that so many people are successfully managing their thyroids with medication.
Hypothyroidism or slow thyroid is extremely common in everybody. Treatment is replacing the hormone and it is important to get the dosage correct. Many people take their thyroid pills with other medications, vitamins or food, and this can lead to inconsistent levels of thyroid hormone and problems achieving and maintaining normal amounts of thryoid hormone in the blood. This medication should be taken on an empty stomach with no food for about 45 minutes and no vitamins for about 4 hours. People who maintain normal levels of thyroid hormone do very well.
FYI, the medication can be taken sublingually for stable absorption rates. I’ve taken it that way for 10 years, as advised by my GP. Around 30% of the dose is lost when you swallow thyroid medication, so people that have always taken it the traditional way will probably need to adjust to a lower dosage when they start taking it sublingually.
That also avoids the whole “can’t eat for 1h after taking thyroid medication” dilemma. You can eat as soon as it is done dissolving. And no vitamins or food in your stomach will affect it.
I was dx’d with graves disease when I was 13. Underwent two rounds of radioactive iodine and am now hypothyroid. I’ve been on synthroid, levothyroxine and armor thyroid and of the three, armor made me feel the best. When I got pregnant with my second, my thyroid went crazy and they had to up my dose from 125 to 200. I find it so weird that my levels still fluctuate, and I can totally tell when I’m off.
This was a great article! I was on a lower dose medication that worked well for years and then around when I turned 50, it was like the bottom dropped out. It took awhile to find a good doctor that knew how to treat it properly. I had a lot of BS problems until my thyroid was optimized.
I see my same endo for my Type 1 & my Hashimoto’s thyroid disease. Many years before I was dx’d low thyroid, we detected anti-thyroid antibodies in my bloodstream. Still, I was shocked when my routine test showed my thyroid levels had severely plummeted. The hypothyroidism had finally arrived.
My endo often says that my hypothyroidism is a complete non-issue – that we’ve solved problem by my taking thyroid replacement hormone, and routinely checking my levels. We just on the Type 1. I do run cold, but I don’t have other problems. p.s. my (non-diabetic) mom has hypothyroidism, so Allison, stay on top of those tests.
Keep getting tested! In March of last year I was diagnosed with Graves disease, after landing in the hospital with atrial fibrillations and VERY fast heart rate. Then just three months later, I developed Type 2 Diabetes. Now my cholesterol is up (just at 208) and my endocrinologist said that I will likely have to be on medication for that too! The bottom line – if you don’t feel “right” for you, go to the doctor and request a full panel of thyroid tests. I initially thought all my symptoms were menopause related: fatigue, sleeplessness, feeling hot all the time, weight gain and loss, hair loss, brain fog. How wrong I was!
[...] The 411 on Diabetes + Thyroid Disease : DiabetesMine: the all …Jan 26, 2012 … I always thought that compared to diabetes, thyroid disease wasn’t very “serious” — all my dad needed to do was pop a pill! — and that it was … [...]
I recently started using insulin and have since developed tremors. I had to go to the emergency room on Weds they were so bad. I started having them after starting with insulin and they are getting worse.
My doctor informed me that my T3 levels were way off. I have been struggling with mood swings weight gain and depression. I know now it is my thyroid gland. This post was very helpful thanks.
In 2002 I was diagnosed with Graves Disease. ( the name alone can scare you!) My symptoms were prevalent for a year, Weight loss, Sleeping disorder, weakness, my heart felt like it was beating as fast as a Hummingbird.. I complained to my PCP and she said..
” Hmm.. I think you might be depressed” ( psychiatric disorder)..
“Depressed? I don’t feel depressed.I feel weak and shaky and I am losing weight even though I am eating everything I can shove down my throat.”
Well, sometimes depression can manifest in many ways, and your symptoms suggest to me that you are probably dealing with depression. I am going to give you an anti-depressant, Rx- Wellbutrin!!!
A week into taking this CRAZY drug, I called her and told her. ” I am NOT taking this Drug.. I have lost another pound. I am not interested in reverting to my birth weight..”
Yes. Wellbutrin can sometimes cause some weight loss but I do think you need to give the drug a chance for your depression”
“NO!: I replied. I think YOU need a hearing aid.. I am now angry as hell and I am NOT TAKING THIS CRAZY DRUG.. YOU TAKE IT!.. I want a COMPLETE PHYSICAL.. Something is WRONG!
“You will have to call the office and schedule for a complete physical as that requires quite a bit of my time”
“Fine, I will hang up talking to my DOCTOR and schedule a COMPLETE PHYSICAL with my DOCTOR ( YOU) so that I can actually get an APPOINTMENT with YOU to schedule my COMPLETE PHYSICAL.. This is insane!”
CLICK. I hung up, then redialed the same office and I had to wait 3 months for my COMPLETE PHYSICAL
Meanwhile I was going BONKERS..
SHow up day of COMPLETE PHYSICAL APPT.
DOC walks in the room and says.” OH, I can’t give you a complete physical today.. It’s not on the schedule.!!!”
So how are you doing on the Wellbutrin?
UH, I am not taking it! I am not depressed.”
“Oh, It says here in your chart that I prescribed Wellbutrin for depression” Why did you stop taking the antidepressant? ”
At this point I asked her if I was ON CANDID CAMERA IN THE TWILIGHT ZONE!!! I called you, and told you I was not going to take the CRAZY drug.. I am not depressed. I just told you.. Are you trying to make me NUTS? I have lost 5 more pounds, I am here today because I schedule a complete physical
“Well, we will have to reschedule you for a complete physical, I don’t have time today”… she said so BLASE. ( I think she was drugged..I am SERIOUS)
FURIOUS. I left the office..In tears..Shaking, fatigued and Starving.
6 months later I went into Urgent Care because I was so sick that I could barely move.
Tests were run.. I got a call from a MALE doctor the very next day who told me..” You need to get over to the office IMMEDIATELY”
He said…You have Graves Disease and are in danger of having a thyroid storm. You need to start medication today..
Graves disease.? Thyroid Storm? I have never heard of this! What are you telling me? Am I dying? I proceeded to tell him my experience with my PCP..
The look on his face was enough to tell me.. OMG, THIS WOMAN COULD and SHOULD SUE FOR MALPRACTICE..!!!
Got treated.. For Graves. PTU/ Tapozole. 16 months.
TIP Of the ICEBERG FOLKS..
Changed HMO PLANS.. Was diagnosed with CFS.
by an infectious disease specialist. No treatment. But they are testing at UCLA for Ampligen. I will try to get you in on the last leg of the study.
AMPLIGEN Was originally created to treat AIDS.
Who treats Thyroid conditions with Ampligen? Bueller? Anyone?
Bottom Line:
I have Myalgic Encephalomyelitis and STILL fighting for my health…. ( also Falsely named as CFS for insurance companies. one time called THE YUPPIE FLU!) M.E. has 64 symptoms. Thyroid disorders is just one.
Now my New HMO PLAN has been trying to shove me into a psychiatric condition..
September 12, 2012, The FDA pronounced
ME/ CFS is a life-threatening, debilitating illness.
Guess what? We are not Crazy, we are ill.. What a concept!
Oh yeah. The first HMO PLAN?.. Lost my records.. How?
MALPRACTICE ON SO MANY LEVELS..
Thing is. I don’t want to sue anyone. I want my life back!
Thyroid issues are so pervasive.. It’s an epidemic. Theories are that we are Iodine deficient. One leading doctor is name Dr.Brownstein. I used to live in Michigan where he actually HEALS people…From Sjorens, RA, Diabetes.. Etc. He actually takes Patients Seriously.
Imagine that. AN MD who doesn’t push Anti-depressants that would have KILLED ME had I continued to take it!
My cholesterol is Insanely High, My diet is VEGAN. Not Vegetarian- VEGAN.. Raw foods..
I am one number away from having type 11 Diabetes.. With OVER THE TOP B-12 and FOLATE. ( It’s easier to win the LOTTERY Than have HIGH B-12)
Just got my blood tests back this morning in my e-mail.My personal opinion :
HMO plans are PHARMA COMPANIES disguised as Health Care Facilities. The doctor’s are wearing their Straight Jackets backwards…
Thank you for reading this if you did..
A thousand pardons for anyone who thinks I am self indulgent. My goal is to share that You must be PRO-ACTIVE In your health… Not all Doctors are created equal..
Here’s to the TRUTH. Truth has no enemies, but it takes no prisoners.. It’s like Gravity- a field of energy that you either obey the rules or KERSPLAT!
AMEN