The hypoglycemic side of hypothyroidism

Hypothyroidism is one of the most common endocrinopathies worldwide, and its incidence is increasing rapidly.[3] It is frequently found to coexist with both type 1 and type 2 diabetes mellitus.[4,5] Cross-talk between thyroid and diabetes has been the topic of many reviews, which discuss the potential of hyperthyroidism to exacerbate diabetes,[6] and of antidiabetic therapy (metformin) to improve thyroid function.[7] The potential role of hypothyroidism in precipitating hypoglycemia has not been highlighted adequately in current literature. This brief communication aims to discuss the link between hypothyroidism and hypoglycemia, and suggest simple caveats for clinical practice.

11 Replies

  • Clutter, from the study you linked.

    "Other abnormalities in hypothyroidism include a reduction in glucagon secretion,[25] reduced effect of glucagon on hepatocytes,[26] and slowing of insulin clearance.[10] Contributory factors also include the effect of hypothyroidism on the gastro intestinal system. It slows gastric emptying[27] and decreases intestinal absorption of glucose as well as portal venous flow."

    From Dr. Kendrick's latest post. PR

    "As it stands, we are given to believe that glucagon is the reactive hormone, only produced when blood sugar levels drop. Insulin, on the other hand, is the key hormone, the controller of metabolism and blood sugar levels. Glucagon only activates to increase blood sugar after insulin (or exercise) has caused it to fall too far. Which is why we have these ten words: ‘Glucagon is released in response to low blood glucose levels’

    You think this is not important, just playing with words. Then try this alterative statement on, and see how it fits. ‘Glucagon keeps the blood sugar level high enough to ensure that the brain has sufficient glucose to function. If, however, the glucose levels rise too high, the body produces insulin to counteract the effects Glucagon. This brings blood sugar back down.’

    In one way, I am saying exactly the same thing as said. Looked at in another way, however, and I have just changed everything. No longer is insulin the key hormone, it is now ‘merely’ the subservient hormone, produced to counter the effects of too much glucagon."

  • PR, I enjoy Dr. K's different take on things.

  • I find this interesting as I was diagnosed with hypoglycemia in my 20s and hypothyroidism last year at 56. I was never treated for the hypoglycemia, just kept it in check with a low GI diet. My mother also hypothyroid and now in her 80s has all the symptoms of hypoglycemia but refuses to acknowledge them and just eats something sweet when she feels dizzy. It's a wonder she has never become diabetic.

  • I also found this interesting,as I have always had low blood sugar levels , bane of my life, no help from Gps, Hypothyroid at 42. I am now 61 and just starting to feel better with Hypothyroidism , no thanks to the NHS though.

  • "The wisdom collated by the pioneers of endocrinology seems to have been lost in modern textbooks' .

    Thank you for posting, a great article.

  • Aur2512, that comment struck me too.

  • Hi, I had assumed my hypoglycemic feelings were adrenal linked, can't even remember why. But this seems to suggest it is more likely to be thyroid. Hmm.

    Does an increase or decrease in hypoglycemic episodes therefore suggest better or worse thyroid control??


  • Mellybedhead, I really don't know much about hypoglycaemia. Perhaps you should have thyroid levels checked to see whether they are optimal, particularly if your diabetes meds or dose has been changed.

  • Hi Clutter,thanks for taking the time to comment.

    I'm not diabetic but am on T3 and prednisolone + nutriadrenal extra for thyroid/adrenal problems. I just wondered if hypoglycemic symptoms could be another prompt for thyroid monitoring..??

  • Melly, as I said, I don't know whether it is thyroid related, but if hypogycaemic incidences are increasing perhaps you should have thyroid and diabetes checked.

  • Thanks for that.

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