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Hypothyroidism and Hypoglycemia: Understanding the Connection

A look at the link between hypothyroidism and hypoglycemia, a condition involving low blood sugar levels.
Hypothyroidism and Hypoglycemia: Understanding the Connection
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Hypothyroidism (an underactive thyroid) and hypoglycemia (low blood sugar) are distinct medical conditions that significantly impact your overall health and well-being. While they may seem unrelated, there is a connection that is worth exploring. Ahead, a look at the link between an underactive thyroid and low blood sugar.

What is hypoglycemia?

Hypoglycemia, also known as low blood sugar, is a medical condition characterized by abnormally low glucose levels in the bloodstream. Glucose is the primary energy source for the body’s cells and is essential for normal bodily function. When blood sugar levels drop below a certain threshold, typically around 70 milligrams per deciliter (mg/dL), individuals may experience various symptoms.

Several factors can contribute to the development of hypoglycemia. These include:

  • Diabetes Medications: One of the most common causes of hypoglycemia is using diabetes medications like insulin or oral medications. These medications are designed to lower blood sugar levels, but if the dosage is too high or if the timing of the medication is off, it can result in low blood sugar levels.
  • Skipping Meals or Delayed Meals: When you skip a meal or delay it for an extended period, your body doesn’t receive the necessary glucose to maintain normal blood sugar levels. Failing to eat can lead to hypoglycemia, especially in individuals with diabetes taking medications that lower blood sugar.
  • Excessive Alcohol Consumption: Alcohol affects the liver’s ability to release stored glucose into the bloodstream, causing a drop in blood sugar levels. The problem is more acute if alcohol is consumed on an empty stomach or in large quantities.
  • Certain Medical Conditions: Some conditions can affect the body’s ability to regulate blood sugar levels. Conditions such as adrenal insufficiency, liver disease, kidney disorders, and certain tumors can cause hypoglycemia.
  • Endocrine Disorders: Hormonal imbalances, such as an overproduction of insulin or deficiencies in other hormones like cortisol or growth hormone, can contribute to hypoglycemia.
  • Intense Physical Activity: Engaging in rigorous physical activity without consuming enough carbohydrates to fuel the body can lead to a drop in blood sugar levels. This drop is more common in athletes or individuals who engage in prolonged, intense workouts.
  • Malnutrition: Inadequate intake of nutrients, especially carbohydrates, can lead to hypoglycemia. This situation is more likely to occur in individuals with eating disorders or those who follow highly restrictive diets.

What are the symptoms of hypoglycemia?

Here are some common of the most symptoms of hypoglycemia:

  • Shakiness and Tremors: One of the most noticeable symptoms of hypoglycemia is feeling shaky or experiencing tremors. This shakiness is caused by the release of stress hormones when blood sugar levels are low.
  • Sweating: If you suddenly start sweating without any apparent reason, it could be a sign that your blood sugar is low. Excessive sweating should not be ignored, especially when accompanied by other symptoms.
  • Dizziness and Lightheadedness: Feeling dizzy or lightheaded is a common symptom of hypoglycemia. This lightheadedness can be dangerous, as it may lead to loss of balance and coordination, increasing the risk of accidents or falls.
  • Hunger and Cravings: A sudden feeling of extreme hunger – even after eating – may indicate low blood sugar levels. Cravings for sweet or high-carbohydrate foods can accompany this intense hunger.
  • Fatigue and Weakness: When your body doesn’t have enough glucose to produce energy, you may feel tired and weak. This fatigue can be quite severe and may affect your ability to carry out daily activities.
  • Irritability and Mood Swings: Low blood sugar can impact your mood, making you irritable, anxious, or even depressed. These mood swings can occur suddenly and may be challenging to manage.
  • Difficulty Concentrating: Hypoglycemia can affect your cognitive function, making it hard to concentrate or focus. You may experience confusion, have trouble remembering things, or find it challenging to complete tasks that require mental clarity.
  • Blurred Vision: Low blood sugar can cause vision problems, such as blurred or double vision. These vision issues are due to the impact of low glucose levels on the functioning of the eyes.
  • Paleness: If you suddenly appear pale or have a noticeable change in your skin color, it could be a symptom of hypoglycemia. This color change is caused by reduced blood flow and oxygen levels due to low blood sugar.
  • Rapid Heartbeat: When blood sugar levels drop, the body releases stress hormones to compensate. These stress hormones can cause your heart to beat faster than usual, leading to a rapid heartbeat or palpitations.

It is important to note that these symptoms can vary from person to person, and some individuals may experience mild symptoms while others may have more severe reactions.

What is the connection between hypoglycemia and hypothyroidism?

What is the connection between these two conditions? The thyroid hormones produced by the thyroid gland significantly impact the regulation of your body’s glucose metabolism. When you’re hypothyroid, the slowed metabolic rate can affect your body’s ability to use glucose for energy efficiently. This metabolic slowdown can contribute to fluctuations in blood sugar levels, leading to hypoglycemic episodes.

Furthermore, hypothyroidism can also lead to insulin resistance, a condition where your body becomes less responsive to the effects of insulin, resulting in higher blood sugar levels. This insulin resistance can increase the risk of developing hypoglycemia when blood sugar levels drop too low, as the body’s ability to regulate glucose becomes compromised.

One study published in the journal Thyroid examined the relationship between hypothyroidism and hypoglycemia in older adults. The researchers found that individuals with hypothyroidism were more likely to experience recurrent episodes of hypoglycemia compared to those without hypothyroidism. This study suggests a connection between these two conditions, although the exact mechanisms behind this relationship are not fully understood.

Another study investigated the impact of hypothyroidism on glucose metabolism in individuals with type 1 diabetes. The researchers discovered that individuals with hypothyroidism and type 1 diabetes had higher HbA1c levels, indicating poor long-term blood sugar control, compared to those with type 1 diabetes alone. This research suggests hypothyroidism may contribute to difficulties managing blood sugar levels in individuals with diabetes.

A comprehensive review analyzed various studies exploring the association between thyroid dysfunction, including hypothyroidism, and glucose metabolism. The review highlighted that both hypo- and hyperthyroidism can impair glucose balance, potentially leading to hypoglycemia or hyperglycemia. The authors emphasized the importance of closely monitoring thyroid function in individuals with glucose metabolism disorders to optimize treatment outcomes.

It is worth noting that while these studies provide evidence of a potential link between hypothyroidism and hypoglycemia, more research is needed to fully understand the underlying mechanisms and establish a definitive causal relationship.

Overall, studies suggest that people with hypothyroidism may be more prone to experiencing hypoglycemic episodes, and thyroid dysfunction can impact glucose metabolism.

How is hypoglycemia treated?

The treatment for hypoglycemia primarily focuses on raising blood sugar levels to a safe range. Here are some common methods used:

  • Consuming Fast-Acting Carbohydrates: The quickest way to raise low blood sugar levels in the short term is by consuming fast-acting carbohydrates. This can include foods or drinks high in sugar, such as fruit juice, regular soda, candy, or glucose tablets. The body rapidly absorbs these carbohydrates and can help quickly restore blood sugar levels to normal.
  • Eating a Balanced Meal or Snack: After consuming fast-acting carbohydrates, it is important to follow up with a balanced meal or snack that includes a combination of carbohydrates, proteins, and fats. This can help provide sustained energy and prevent another drop in blood sugar levels.
  • Glucagon Injection: In severe cases of hypoglycemia, where the individual cannot consume anything orally, a glucagon injection may be necessary. Glucagon is a hormone that stimulates the liver to release stored glucose into the bloodstream, helping to raise blood sugar levels. This injection should only be administered by a healthcare professional or someone trained to administer a Glucagon injection.
  • Adjusting Medications or Insulin: If hypoglycemia occurs as a side effect of certain medications or insulin treatment, changing the dosage or type of medication may be necessary. These changes should only be made under the guidance and supervision of a healthcare professional.
  • Regular Monitoring: Monitoring blood sugar levels on a regular basis is essential for managing hypoglycemia. This testing can be done using a glucometer, which measures the amount of glucose in a small blood sample, or a wearable continuous glucose monitor (CGM), like a Freestyle Libre or Dexcom device. By keeping track of blood sugar levels, individuals can take appropriate action to prevent or manage hypoglycemia.

Preventing hypoglycemia is also crucial in the long-term management of the condition, especially for individuals with diabetes who may experience recurrent episodes. Some tips to prevent future episodes include:

  • Consume a well-rounded diet that includes lean proteins, whole grains, fruits, and vegetables. Those with hypothyroidism may need to focus on including foods rich in iodine and selenium to support thyroid function.
  • Avoid prolonged periods without food. If you are prone to hypoglycemia, eat frequent small meals throughout the day to maintain stable blood sugar levels.
  • Exercise plays a vital role in managing both conditions. Regular physical activity can help improve insulin sensitivity, regulate blood sugar levels, and support overall thyroid function.
  • Monitor blood sugar levels regularly.
  • Adjust medications or insulin as recommended by healthcare professionals.

HA note from Paloma

If you suspect that you might be experiencing hypoglycemia, it is crucial to monitor your blood sugar levels and seek medical attention. If you are diagnosed with hypothyroidism and hypoglycemia, you should work closely with your healthcare providers to manage both conditions effectively. This management will typically involve regular monitoring of your thyroid hormone levels and blood sugar levels, as well as implementing lifestyle changes to support overall health.

The Paloma thyroid test kit makes it easy to monitor your thyroid hormone levels affordably from the comfort of your home. The test kit provides accurate thyroid levels with convenient and painless finger-prick testing.

If you want to work with a dedicated team of thyroid experts for your hypothyroidism care, consider becoming a Paloma member. You’ll have access to virtual visits with practitioners, discounted thyroid test kits, supplements, nutritional and health coaching, and much more to help you optimize your thyroid and overall health.

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Mullur, R., et al. Thyroid hormone regulation of metabolism. Physiological reviews, 94(2), 355-382. 2010.

Maratou, E. et al. Studies of insulin resistance in patients with clinical and subclinical hypothyroidism. European Journal of Endocrinology, 163(4), 591-597. 2010.

Vemula SL, et al. The Impact of Hypothyroidism on Diabetes Mellitus and Its Complications: A Comprehensive Review. Cureus. 2023 Jun 15;15(6):e40447. doi: 10.7759/cureus.40447. PMID: 37456384; PMCID: PMC10349367.

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Mary Shomon

Patient Advocate

Mary Shomon is an internationally-recognized writer, award-winning patient advocate, health coach, and activist, and the New York Times bestselling author of 15 books on health and wellness, including the Thyroid Diet Revolution and Living Well With Hypothyroidism. On social media, Mary empowers and informs a community of more than a quarter million patients who have thyroid and hormonal health challenges.

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