Hypothyroidism & Diabetes

[serkaddis]

Hi, I just wanted to know if there is a relationship between hypothyroidism and diabetes? I have been taking levothyroxine for the last almost 4 years to treat hypo. Now my test results for FBS & HGA1C came 137mg/dl (range 115-126mg/dl) and 6.3% (pre-diabetis 5.7-6.4%) . My doctor told me that I am per-diabetes. Is there a relationship or can hypothyroidism or the medicine I am taking lead to per-diabetes? If so, how can i control the situation before it goes to full blown diabetes? Any opinion on the issue is helpful. Thanks.

[SlowDragon Administrator]

Year ago you were very under medicated, yet dose levothyroxine was only increased by 50mcg per week .....more likely needed 25mcg increase per day

Bloods should be retested 6-8 weeks after each dose increase or brand change in levothyroxine

What are your most recent thyroid and vitamin results?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Do you have autoimmune thyroid disease?

What vitamin supplements are you currently taking?

Ask GP to test vitamin levels

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

[serkaddis in reply to SlowDragon]

Thanks for your immediate reply. As I was told yesterday my TSH is 0.90mg/dl while vitamin d is 60.5. She (my endo) did not tell me the other details but she said they are ok. I will get back to you with the details. Thanks again.

[SlowDragon Administrator in reply to serkaddis]

Essential to test Ft3 ... rarely done via NHS

[SlowDragon Administrator in reply to serkaddis]

Vitamin D needs improving

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Calculator for working out dose you may need to bring to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[Hidden]

I have the same problem - hypoT and pre-diabetes (which I have managed to get under control using berberine and chromium).

I have read that there is a connection between low thyroid which in turn causes higher cortisol levels in the first stages of the disease which in turn raises blood sugar levels which in turn raises insulin...so a vicious circle.

I have found it very frustrating because doctors tend to assume that if you have pre-diabetes it´s because you eat too much junk food and don´t exercise enough...especially if you are overweight, and of course insulin is a fat-storing hormone so if you have higher than optimal levels (optimal is said to be fasting insulin <5uU/mL, with ref ranges of 2.5-25, and fasting blood glucose <80 mg/dL with ref ranges 70-105) your body will be in fat-storing mood...it´s very difficult to be told then that you need to need to get off the couch and eat less fat. To doctors, it´s so simple: calories in and out (and fat of course contains more calories than protein and carbs), so and so many hours spent at the gym. There are no other reasons for being overweight or having insulin resistance, period. And most of them have never heard of a connection between thyroid disease, deregulated cortisol levels, and the ensuing insulin resistance. One doctor told me they were unrelated as thyroid hormone comes from the thyroid gland and insulin from the pancreas and they are two different organs...!

I´ve heard so many stupid suggestions over the years...like: "Maybe you can try and get off the bus a few stops from your house and walk home" (when I walk to and from work every day) or "Maybe you should buy fat free food instead to get less calories" (fat free food of course tends to contain a lot of sugar/carbs...the last thing someone with pre-diabetes needs)...!

I have noticed that, during periods of increased stress, my insulin resistance tends to get worse. I attribute that to raising cortisol levels (I have used a 24 h saliva test to confirm it, and during times of increased stress my levels are elevated throughout the day). High cortisol raises blood sugar levels and that in turns stimulates more insulin production; only, in insulin resistance, you cannot use it effectively, so both your blood sugar and insulin levels remain highish = increased fat-storage.

For me, this was the missing link (the connection between high cortisol and high blood sugar/insulin). Of course, both low and high cortisol can affect thyroid hormone levels adversely, so it´s really like a puzzle where all the pieces have to fit together.

[serkaddis in reply to Hidden]

Thanks PurpleCat! I really appreciate your help. How much berberine & chromium do you take and when? It means a lot. Thanks again.

[Hidden in reply to serkaddis]

I take one capsule of Pharma Nord chromium (said to be more bio-available than other brands) and three capsules of 500 mg berberine (Thorne brand) with each main meal. Berberine is one of the few supplements that have been scientifically proven to be as effective as metformin/Glucophage at lowering blood sugar levels, but without the side effects. When my doctor wanted to prescribe metformin, I decided to try berberine instead, and then added chromium as it´s known to be beneficial in insulin resistance. Both have helped tremendously and literally halved my fasting insulin and blood glucose levels (after six months´consistent use). But I have also adapted my diet somewhat; I don´t eat low carb, but try to eat slow carbs (for instance, choose pasta made from chickpea flour instead of wheat), I have increased my fat intake (by that, I mean healthful fats such as eggs, coconut oil, butter, ghee, avocado, olive oil, some nuts/almonds), I eat less dairy, and try to eat enough protein. I am not much of a meat-eater, never was, but fish and poultry are ok. So, basically, cutting back on bad/fast carbs, eating enough healthful fat , and getting enough enough protein. I could never go off carbs completely, that affects my mood and energy levels adversely. I find it more important to choose the right carbs than to avoid them altogether (although some do great on a ketonic diet with hardly any carbs).

The most beneficial effect of the supplements has been the decreased need to snack; I can now eat three main meals a day, whereas I used to need two or three snacks a day as well.

I´d prefer to stay away from diabetes drugs, they all seem to have pretty horrible side effects.

[serkaddis in reply to Hidden]

Thank you very much, PurpleCat71. It really means a lot. I will try to do everything you did. You are also right about the side effects of diabetes drugs. Thus, I also prefer to stay away from them. You are very helpful, thank you again.

[Hidden in reply to serkaddis]

You´re more than welcome, nobody can understand your frustration more than someone who´s been there

Just one follow-up question: has PCOS been ruled out in your case? Insulin resistance and weight gain/inability to lose weight are two of the most common symptoms.

[mischa]

If you can manage to reduce your carbs to the very minimum and cut out all sugars, your blood sugar levels will drop. I follow a low carb high fat diet and it has worked in lowering my blood sugar levels significantly as well as losing weight too.

[Hidden in reply to mischa]

I know many people have had great success with low carb diets and even no carb diets.

However, right now, I´m reading Thierry Hertoghe´s book "The hormone solution", and he advocates lots of carbs from vegetables and fruit in thyroid patients. Fruit is supposed to be eaten on its own. I cut out fruit some time ago (except berries which are packed with nutrients and low in carbs), and would imagine that eating a fruit salad on its own would make my blood sugar skyrocket...especially since he recommends high GI fruit such as bananas.

He also writes that a diet high in protein can decrease thyroid hormone levels, so recommends a diet for thyroid patients moderate in protein, high in carbs from vegetables and fruit, and with enough healthful fats (eggs, meat, fish, nuts, olive oil, butter...cooked at low temperature...but low in dairy, preferably no dairy as he says we are unable to digest that...the same goes for grains). Of course, my edition is from 2002, so he may have updated his advice since.

But I found it interesting what he says about eating a lot of fruit...he even recommends fruit salad (not eaten together with either fat or protein) for breakfast. Not sure how filling that would be, plus how good it would be for someone with borderline diabetes 2...? I have read that it´s better to eat fruit with cottage cheese or nuts/almonds to add some protein and fat. Plus the advice about moderate amounts of protein...but that is what I imagine you get on a low carb diet anyway, as the focus is on increased fat intake, not protein intake...? But some do recommend protein shakes to increase muscle mass and fat burning, and after reading this book I would avoid that (I´ve never used them anyway as I prefer to get the nutrients I need from the food I eat).

[mischa in reply to Hidden]

I have been following the low carb high fat diet now for two and a half years.

My fasting blood sugar levels were high so I purchased a glucose monitoring machine and initially, tested my fasting level, just before a meal, an hour after a meal and two hours after a meal. I did this every day for about 3 weeks. Testing this way allowed me to note which foods spiked my sugar levels and which didn't.

I found that most carbs apart from vegetables spiked my levels. All fruit apart from some berries also spiked my sugar. I had to read the labels of most food products to find hidden sugars and carbs. I don't eat processed foods but rather cook my own food from scratch.

I don't eat carbs, i.e pasta, grains, etc nor any form of sugar whether in fruit or otherwise . I do eat a moderate amount of meat (including red and white meat), fish, loads of salads, a variety of vegetables and good fats, i.e. olive oil, avocado, cheese, butter,

The two books I found useful are: Dr Jason Fung - The Diabetes Code and Jenny Ruhl - Blood Sugar 101. Jenny Ruhl is a researcher and also Type II diabetic. Both advocate a high fat low carb diet and a moderate amount of protein.

Apparently, the best book on diabetes is by Dr Bernstein - Diabetes Solution. He has been a diabetic since a young age. He writes that he never seem to get well so he did his own research and, I believe, is the founder of the importance of diet in reducing blood sugar levels. It is an expensive book but is quite well researched and recommended.

These books are not just for diabetics for those of us who are pre-diabetic too.

I've not only been able to reduce my sugar levels substantially and to normal levels but also have lowered my high blood pressure where I now have had to reduce medication. In addition, I have lost 2 and a half stone in weight. I now weigh what I weighed before I had children.

The knock on effect has been on my thyroid medication where it seems to be working a lot more efficiently too.

It does require re-thinking your diet but I don't go hungry and I do enjoy my meals.

[Hidden in reply to mischa]

Makes a lot of sense...plus, there is nothing healthy in fruit that you cannot get from veggies. I also find the tip to eat fruit as a snack to be bad for my cravings.