The Connection Between Weight, Diabetes, and Hypothyroidism

The Connection Between Weight, Diabetes, and Hypothyroidism

Patients with diabetes are prone to many other comorbid conditions such as thyroid disorders, cardiovascular diseases, weight issues, and even hearing loss and anxiety. A study showed that 12.5% of diabetic patients have thyroid disorders, and 7.5% of diabetic patients have subclinical hypothyroidism⁽¹⁾. 

Excess weight is often seen as a risk factor associated with diabetes and hypothyroidism^(2-3). Thus, weight management methods and procedures are done to help with obesity and prevent diabetes and thyroid problems.

According to the Journal of Clinical Investigation, obesity can risk insulin resistance and type II diabetes⁽⁴⁾.

Moreover, another study suggested that thyroid disorders and diabetes can coexist in patients⁽⁵⁾. These thyroid disorders affect glucose control and the management of diabetes⁽⁶⁾.

This article tackles the relationship between diabetes and hypothyroidism and how to manage them to help prevent weight issues.

How Thyroid Disease and Diabetes Are Linked

The thyroid gland and hormones are crucial in regulating the body’s development, growth, and metabolism. They can also alter the body’s blood sugar level⁽⁷⁾. 

Studies show that diabetes can affect how your body utilizes blood sugar (glucose)⁽⁸⁾. It can lead to increased blood sugar levels, which may lead to serious diseases. 

Meanwhile, thyroid dysfunction can influence the management of diabetes⁽⁹⁾. Chronically high blood sugar induced by thyroid diseases may contribute to the progression of metabolic syndrome⁽¹⁰⁾.

Metabolic syndrome, a medical term used to refer to a combination of hypertension, diabetes, and obesity may result in type II diabetes.

A study reported that reduced thyroid hormone (hypothyroidism) may result in weight gain, reduced glucose level (hypoglycemia), and high cholesterol levels⁽¹¹⁾. 

Meanwhile, diabetes may affect thyroid dysfunction in different levels⁽¹²⁾. A correlation study discussed the elevated prevalence of hypothyroidism among patients with diabetes⁽¹³⁾. 

It was also mentioned a reduced glucose absorption in the gastrointestinal tract of patients with hypothyroidism⁽¹⁴⁾. 

Several studies suggest that hypothyroidism’s influence on blood sugar levels can be due to the thyroid’s effects on the body’s metabolic process⁽¹⁵⁾. 

In addition, it was noted that patients with diabetes and hypothyroidism have an increased level of Hemoglobin A1C, which is a sign of poor diabetes management⁽¹⁶⁾. 

Another study showed the relationship between adiposity (being severely overweight) and insulin resistance⁽¹⁷⁾. Results showed that the changes in thyroid hormones may be impacted by the two conditions mentioned

Hyperthyroidism is often linked to insulin resistance. On the other hand, hypothyroidism has been associated with reduced sensitivity to insulin⁽¹⁸⁾. 

This paradox could best be explained by the different effects of thyroid hormones in the liver and other tissues.  

People with hypothyroidism have increased metabolism that can cause insulin to be eliminated and processed faster than average⁽¹⁹⁾. 

These metabolic changes in thyroid diseases interfere with the effects of insulin taken as a treatment for diabetes⁽²⁰⁾.

Insulin sensitivity may contribute to hypoglycemia⁽²¹⁾.

Hypothyroidism vs. Diabetes

Below are some similarities and distinctions between hypothyroidism and diabetes in terms of their causes, symptoms, and risks^(22-23).

	Causes	Symptoms	Risk Factors
Hypothyroidism	Low levels of thyroid hormones Pituitary gland failure An autoimmune dysfunction that attacks the thyroid (Hashimoto’s disease) Over response to hypothyroidism treatments Radiation therapy	Weight gain Constipation Fatigue Muscle weakness High blood cholesterol level Increased sensitivity to cold Pain and stiffness in the joints	Type I diabetes Family history of thyroid diseases Thyroid surgery  Radiation in the neck or upper chest
Diabetes	An autoimmune disorder that kills insulin-producing cells in the pancreas Insulin resistance Overweight	Fatigue Frequent infections Slow healing of wounds Extreme hunger Increased thirst	Family history of diabetes Inactivity Weight Polycystic Ovary Syndrome High blood pressure Abnormal cholesterol levels age

Management of Thyroid Diseases and Diabetes

One consideration for the prevention and management of thyroid disease and diabetes is weight management. 

It is best to maintain close control over the body’s thyroid and glucose levels to help prevent diabetes among people with thyroid disease⁽²⁴⁾. 

There are specific tools and methods to monitor the thyroid hormone and glucose levels in the body. 

Thyroid Diseases Diagnostic Tests

T4 by Radioimmunoassay (RIA)

This thyroid hormone test is the most commonly used to monitor the amount of thyroxine (the primary hormone of the thyroid gland) in the blood⁽²⁵⁾. 

T4 by RIA confirms thyroid dysfunction or the presence of hypothyroidism or hyperthyroidism. It is the primary test to differentiate between thyroid gland failure and pituitary failure in hypothyroidism⁽²⁶⁾.

This tool monitors high concentrations of thyroid-stimulating hormone.

Thyroid Scan

This scan assesses thyroid function and malfunction. Some of the imaging tests used in thyroid scans are⁽²⁷⁾:

• Ultrasound
• Magnetic resonance imaging (MRI)
• Computed tomography (CT) scan.

These diagnostic tests may assist in identifying the nature of thyroid nodules. This test is often performed with an iodine uptake test. 

The iodine uptake test assesses the thyroid function by measuring how much radioactive iodine is taken by the thyroid gland.

This scan can be utilized to measure the goiter’s size, determine the hot or cold nodules, location of thyroid tissue outside the neck, and as a follow-up for thyroid cancer patients who underwent surgery.

Diabetes Tests

A1C Tests

The A1C test is a blood test that aims to provide patients with blood sugar level reading to indicate glucose amount over the last three months. 

This test does not require fasting as it measures the rate of blood sugar attached to the oxygen-carrying protein in the blood (hemoglobin). 

A high sugar level is indicative of a high level of hemoglobin. This test can determine prediabetes.

Testing Strips and Glucose Monitors

These home testing strips and monitors can measure the blood sugar levels in the body. It uses the blood sample from the fingertips to self-check if the blood sugar levels are normal.

This test is often used to track the body’s response to exercise and diet changes. Strip tests and glucose monitoring can be done multiple times a day, depending on the doctor’s recommendation.

It is best to jot down all of the results accumulated in the glucose monitor to properly track the condition’s status and know what interventions are working for the patient. 

Oral Glucose Tolerance Test

This glucose test is often done to measure your blood sugar level when in a fasted state. 

You will be asked to consume a sugary drink after your overnight fast. Then, your blood sugar level will be tested. 

The results of this test can show either normal blood sugar level, prediabetes, or diabetes.

In conclusion, if you have been diagnosed with diabetes or thyroid disease, weight management is an effective strategy for preventing either condition.

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References

1. Raval, R., Mehta,R., Sharma, P. K., (January 2017) Correlation between Hypothyroidism and Diabetes – A Hospital based Study, retrieved from https://www.ijcmr.com/uploads/7/7/4/6/77464738/ijcmr_1196_feb_18.pdf
2. Barnes A. S. (2011). The epidemic of obesity and diabetes: trends and treatments. Texas Heart Institute journal, 38(2), 142–144.
3. Song, R. H., Wang, B., Yao, Q. M., Li, Q., Jia, X., & Zhang, J. A. (2019). The Impact of Obesity on Thyroid Autoimmunity and Dysfunction: A Systematic Review and Meta-Analysis. Frontiers in immunology, 10, 2349. https://doi.org/10.3389/fimmu.2019.02349
4. Kahn, B. B., & Flier, J. S. (2000). Obesity and insulin resistance. The Journal of clinical investigation, 106(4), 473–481. https://doi.org/10.1172/JCI10842
5. Hage, M., Zantout, M. S., & Azar, S. T. (2011). Thyroid disorders and diabetes mellitus. Journal of thyroid research, 2011, 439463. https://doi.org/10.4061/2011/439463
6. Ibid.
7. Mullur, R., Liu, Y. Y., & Brent, G. A. (2014). Thyroid hormone regulation of metabolism. Physiological reviews, 94(2), 355–382. https://doi.org/10.1152/physrev.00030.2013
8. The Mayo Clinic, (n.d.), Diabetes Causes and Symptoms, retrieved from https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
9. Wu, P., (2000), Thyroid Disease and Diabetes, retrieved from http://journal.diabetes.org/clinicaldiabetes/.
10. National Heart, Lung, and Blood Institute. Metabolic syndrome. Retrieved from https://www.nhlbi.nih.gov/health-topics/metabolic-syndrome
11. Stuff that works – Hypothyroidism – Website
12. Mullur, Op. Cit
13. Raval, Op. Cit.
14. Ibid.
15. Ibid.
16. American Thyroid Association, (February 2016), Hypothyroidism, retrieved from https://www.thyroid.org/patient-thyroid-information/
17. Ibid.
18. Kouhidi, S., Berhouma, R., et al., (June, 2012), Relationship of Thyroid Function with Obesity and Type 2 Diabetes in Euthyroid Tunisian Subjects, retrieved from https://www.researchgate.net/publication/228098621_Relationship
19. Brenta G. Why can insulin resistance be a natural consequence of thyroid dysfunction?. J Thyroid Res. 2011;2011:152850. doi:10.4061/2011/152850
20. Mitrou P, Raptis SA, Dimitriadis G. Insulin action in hyperthyroidism: a focus on muscle and adipose tissue. Endocr Rev. 2010;31(5):663-79. doi:10.1210/er.2009-0046
21. Ibid.
22. Kalra S, Unnikrishnan AG, Sahay R. The hypoglycemic side of hypothyroidism. Indian J Endocrinol Metab. 2014;18(1):1–3. doi:10.4103/2230-8210.126517
23. The Cleveland Clinic, (nd.), Hypothyroidism, retrieved from https://my.clevelandclinic.org/health/diseases/12120-hypothyroidism
24. The Mayo Clinic, (n.d.), Diabetes, retrieved from https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
25. Johnson, J. L., (July 2006), Diabetes Control in Thyroid Disease, retrieved from https://spectrum.diabetesjournals.org/content/19/3/148
26. Thyroid Cancer Survivors Association, (n.d.), Common Tests to Examine Thyroid Gland Function, retrieved from https://www.thyca.org/about/lab-tests/.
27. Melish JS. Thyroid Disease. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 135. Available from: https://www.ncbi.nlm.nih.gov/books/NBK241/
28. Ibid.