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Hashimoto's Disease and Blood Sugar Imbalance

Learn how to balance blood sugar levels to manage Hashimoto's in this article.
Hashimoto's Disease and Blood Sugar Imbalance
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In this article: 

  • Why is blood sugar important?
  • What is blood sugar imbalance?
  • Carbohydrates and blood sugar imbalance
  • How blood sugar affects Hashimoto’s disease
  • How to naturally control blood sugar levels

Feeling unwell is often the name of the game with Hashimoto’s thyroiditis. This autoimmune condition typically manifests in unexplained fatigue, irritability, joint and muscle pains, cold intolerance, weight gain, and depression. Making changes to your diet can give you a remarkable improvement in your symptoms. Here is an in-depth look at why blood sugar, in particular, is crucial in helping you control your Hashimoto’s symptoms.

Why is blood sugar important?

Blood sugar (or glucose) is the primary sugar carried in your blood. This sugar serves as the main source of fuel the provides energy to every cell in your body. Glucose comes from the food we eat. Your blood sugar rises and falls throughout the day and can be affected by several things. 

Factors that increase blood sugar levels include:

  • Eating a meal high in carbohydrates (which contain glucose)
  • Stress
  • Infection or illness
  • Some medications 
  • Changing hormone levels
  • Being sedentary

Factors that can lower blood sugar include: 

  • Missing meals or eating too few carbohydrates
  • Excess physical activity
  • Drinking excess alcohol
  • Some medications

We frequently hear how high blood sugar is bad for you, but low blood sugar is far more dangerous. If you do not have enough circulating blood sugar, your cells starve and cannot function. Unless you have diabetes, having critically low blood sugar is not that common. However, chronically high blood sugar levels are more prevalent as our diets tend to be high in carbohydrates and added sugars. 

What is blood sugar imbalance?

Large swings in blood sugar can take a toll on your organs and tissues. Because our diet tends to be rich in carbohydrates, our body has to work harder to restore balance. 

When you eat a meal high in carbohydrates, glucose is pulled from the small intestine and enters your bloodstream. The pancreas must release enough insulin to convert glucose to glycogen—where the liver stores it—to balance glucose levels. After glucose converts to glycogen, your blood sugar drops, and your body craves more carbohydrates to restore balance. Insulin also drives glucose into cells for fuel which also lowers blood sugar levels. A cycle ensues. Your body tells you to keep eating carbohydrates because your blood sugar levels are like a rollercoaster. Ultimately, this imbalance places stress on the body, which exacerbates existing health conditions and even creates new conditions.

Carbohydrates and blood sugar imbalance

For years, carbohydrates were an essential part of the food pyramid. However, most nutritional organizations now recommend much smaller portions of carbohydrates. For example, the USDA MyPlate encourages fewer carbohydrates than it did a few years ago. 

Carbohydrates are into three categories: starches, fiber, and sugars.

Examples of foods in each category include:

  • Starches - peas, corn, some beans, and grains
  • Fiber - fruits and vegetables where you can eat the skin and seeds, some beans (like black beans), some whole grains, and nuts
  • Sugars - naturally occurring sugars (found in milk and fresh fruit) and added sugars (cookies, canned fruit, etc.)

How blood sugar affects Hashimoto’s disease

Blood sugar imbalances are common in people with Hashimoto’s. Some research indicates that people with this autoimmune condition are more prone to spikes in blood sugar, followed by reactive hypoglycemia after eating a carbohydrate-rich meal. 

People with Hashimoto’s are likely to develop hypothyroidism. Thyroid hormones play a significant role in metabolism and energy storage and production. These hormones are also both insulin antagonists and agonists in different organs—meaning that they combine with insulin to render it active or inactive.

When thyroid hormones are too low, or insulin levels considerably fluctuate, the body becomes stressed. The adrenal glands release stress hormones like cortisol. When your body experiences high cortisol levels, it can increase inflammation, heightening the immune system’s activity. In Hashimoto’s, the immune system is already hyperactive as it attacks its healthy cells in the thyroid gland. Thus, a delicate balance is required between thyroid hormones and blood glucose levels.   

How to naturally control blood sugar levels

Specific symptoms may indicate you are on a blood sugar rollercoaster.

For example, you may experience:

  • Irritability if you miss a meal
  • Intense cravings for sugary foods and caffeine
  • Eating food to relieve fatigue
  • Feeling anxiety or nervousness
  • Getting shaky or jittery if you haven’t eaten
  • Brain fog
  • Difficulty losing weight
  • Increased weight gain around the waistline

If you experience these symptoms, you can rest easy knowing that many of these symptoms can improve with lifestyle and dietary adjustments. Ideally, you catch yourself on this rollercoaster early, as waiting too long may lead to insulin resistance or, eventually, type 2 diabetes. Try these natural solutions to balancing your blood sugar.


Managing your diet is the most effective way to balance your blood sugar. Understanding our nutritional needs can be overwhelming, especially if you have a health condition like Hashimoto’s. We know that carbohydrates are the primary source of glucose, so limiting carbs is imperative. However, knowing good carbs from not-so-good carbs can be challenging. The Glycemic Index is an easy-to-use tool to help you choose carbohydrates that have minimal blood sugar effects. When you eat carbohydrates, always eat some protein, too, to keep blood glucose levels steady.

Download free mobile app to manage hypothyroidism and Hashimoto's with AIP diet


Regular physical activity pulls glucose from your blood to your muscles, making your cells more receptive to insulin. Too much physical activity can be detrimental if you struggle with low blood sugar. An excellent place to start is with aerobic exercises like walking and swimming. 

Get quality sleep

When we do not get enough sleep, our cortisol levels increase, and our metabolic hormones can be affected. Often, these disturbances can lead to poor dietary choices that inevitably increase our blood sugar.

Drink water

Your kidneys can excrete glucose, so make sure to drink plenty of water to flush out excess sugar. 

A note from Paloma Health

Managing Hashimoto’s on top of everything else in life can be overwhelming. Work with a Paloma Health nutritionist in collaboration with a physician to determine nutritional status for your thyroid health and build healthy habits.

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Julia Walker, RN, BSN

Clinical Nurse

Julia Walker, RN, BSN, is a clinical nurse specializing in helping patients with thyroid disorders. She holds a Bachelor of Science in Nursing from Regis University in Denver and a Bachelor of Arts in the History of Medicine from the University of Colorado-Boulder. She believes managing chronic illnesses requires a balance of medical interventions and lifestyle adjustments. Her background includes caring for patients in women’s health, critical care, pediatrics, allergy, and immunology.

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