Ask the Expert: Explain Hypothyroidism and Hyperthyroidism and how this disease can affect those of us with diabetes

May 26, 2009

By Jessica Gibbons, Certified Diabetes Educator and Registered Dietitian

First of all, although there are some exceptions to the rule, thyroid disease is usually an autoimmune disease and goes hand in hand with diabetes. It is hereditary and will often be seen in many family members. It is also more common in women than in men and is more common in older persons.

Hypothyroidism happens when antibodies attack the thyroid gland, and the thyroid gland does not produce enough thyroid hormone anymore. About three percent of the general population has low thyroid levels. \nSome symptoms of hypothyroid include the following: fatigue, poor muscle tone, an increased sensitivity to cold, depression, muscle cramps, goiter, thin brittle fingernails, thin brittle hair, paleness, decreased sweating, dry and itchy skin, weight gain, water retention, low heart rate (less than 60 beats/min), and constipation. If ignored, symptoms can become worse and include slow speech, a hoarse voice, dry puffy skin on one’s face, abnormal menstrual cycles and low body temp. Osteoporosis and hgh cholesterol are other dangerous side effects. There are some other less common symptoms, including impaired memory, hair loss, irritability, and shortness of breath.

To diagnose hypothyroidism, doctors generally measure TSH (thyroid stimulating hormone), which is produced by the pituitary gland. TSH should be between 0.5-4.7 u/L. If TSH is high, the thyroid is not producing enough thyroid hormone (T4 and T3). Hypothyroidism is generally treated with thyroxine (synthroid, levoxyl, levothyroxine re some common names of thyroxine). The medication must be taken daily and not with a multivitamin as iron binds thyroxine and will make it not work effectively.

Hyperthyroidism is when the thyroid gland is overactive, leading to an overproduction of thyroid hormone. When too much hormone is released, body systems “speed up” leading to symptoms including fast heartbeat, nervous system tremors and anxiety, diarrhea and weight loss. Symptoms also include intolerance to heat, hair loss, weakness, rritability, osteoporosis, and tremors. Doctors measure TSH to determine whether you have hyperthyroidism. Generally a physician will use a drug or surgery or radiation treatment to “slow down” the thyroid gland and then eventually the person will end up needing thyroid replacement, long-term. They kind of develop a “secondary” hypothyroidism once the gland has been slowed down.

The most important thing to understand when a person has a problem with their thyroid, is that as long as it is teated and one’s TSH level is normal, there will be no dangerous side effects. One cannot take prescribed pills randomly, pills should be taken as recommended by their physician every single day, preferably at the same time. The side effects of hypothyroidism will resolve once thyroid levels are normal again. One study indicated that if a person has hypothyroidism, the metabolism of insulin may slow down, thus leading to a decreased need for insulin for a short amount of time. Warfarin, dopamine and teroids can effect how thyroid medication works, so just be sure that your physician knows what medications you are taking and that you are taking them the way the doctor recommends. Once again, it is kind of a pain to take yet another med, but at least it is one of the cheapest pills available and is very easy to take. No syringes involved! (Whew!)

Jack DeRuiter (2002) (PDF). Thyroid Pathology. pp. 30. http://www.auburn.edu/~deruija/endp_thyroidpathol.pdf.

From	Comment
Edie	July 30, 2009 7:10 PM I thought I might have this problem and asked the Dr. to check me for it. He said nope don't have it. So I will save this to my computer and follow it and if I ever do get it will know for sure by keeping up with this. I tried to go to the web site at the end of the article and could not find it.
anthonesia	July 21, 2009 8:02 PM HELLO , I HAVE LOW THYROID. IVE HAD THE ALL THE SYMTOMS. WAS VERY SICK FROM IT FOR YRS. WITH PNAUMONIA. HAIR FALLING OUT. WAS VERY FIT. AND BECAME VERY LAZY . NEVER IN MY LIFE DID I WANT TO WERE SOCKS TO BED FROM COLD FEET. BUT I DID. HAD CARPEL TUNNEL IN BOTH WRIST. A TICKLE IN MY THROAT. WAS ANGRY LIKE IVE NEVER BEEN . WOULD CRY EASY. HAD LOTS OF WOMENS ISSUES. DEPRESSED TO THE POINT OF WANTING TO BE PUT IN WARD B. HA. NO JOKE. WOULD LAY UNDER TREE ALL DAY . WOULDNT BRUSH MY HAIR ,TAKE SHOWER, GET DRESSED, CLEAN HOUSE, COOK. NOTHING . I DIDNT WANT TO DO ANY THING. I HAD NEVER BEEN LAZY IN MY LIFE. I HAD BAD VISION . LIGHT HURT MY EYES. AND ICE TEA WOULD CHOKE ME. I GAINED 70 PDS NEVER TO LOOSE IT TILL KNOW. COULD NOT CONCENTRATE VERY WELL. WOULD TALK AND WALK OFF. MY MEMORY WAS GOING. MY MOM FINALLY TOOK ME TO DR AND HE KNEW MY MOM HAD DIABETES. AND SAID TO ME I BET YOU HAVE A THYROID PROBLEM I SAID WHAT THE HECK IS A THYROID. ????? AND YES I DID A BAD ONE. HAD GONE FOR YRS WITH IT NOT WORKING. I TELL EVERY WOMEN TO CHECK THERES. WOULD NOT WISH THIS ON MY WORST ENEMY . MY HUSBAND CALLED ME HYPOCONGREACT. CANT SPELL IT VERY WELL. SO GLAD TO BE TAKING A PILL FOR THE REST OF MY LIFE TOOK ME YRS TO GET IT UNDERCONTROL AND CORRECT DOSE TAKE A LARGE ONE . AND AM DOING SOME MUCH BETTER . HAVE THE WILL TO LIVE. KAREN.
ginger.louise	July 12, 2009 1:00 AM Thanks...very informative.
Meemaw9	June 3, 2009 10:04 PM This article was an eye opener,,too bad it wasn't out there in February when I "blacked out" at work and was taken to hospital by ambulance..I have had some major midical problems over the past year; a stoke, vacular surgery, dry skin, thickend throat and a host of the symptems just described..rapid weight gain was also a factor, but since I had quit smoking about the time the symptoms occured, my dr and myself put it down to not smoking....so thanks for the information my hypothroidism is responding fairly well....Thank you for putting information out there for us to read and learn
majeral	May 31, 2009 3:23 AM I did not know I had thyroid problem till 2 years ago when I was 64. I landed in the hospital for 48 hours while they ran every test they could find. Turns out I have a low thyroid , I then remembered 40 years ago a Doctor had radiated the gland and dissolved it . But he did not put me on any medication to replace it. I have been fighting weight for 40 years. I even told my last diabetic doctor about it and she said it was normal but I was felling so very tired and ichey all over. A friend sent me a site stopthethyroidmaddness.com Boy did I have my eyes open. I found another Doctor who ran T3 and T4 and TSH I was low in T3 I feel better YOU have got to go after the answers. The Problem is Doctors don't like YOU telling Them what you have read test you want taken. We have to be pro health for ourselves.