T3 and sugar crashes: Another question for... - Thyroid UK

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T3 and sugar crashes

thyroidqueen12 profile image
22 Replies

Another question for everyone on here, whilst i'm online. Since I have been taking T3 (sigma pharma) I have had hypoglycaemic symptoms. Depending on what I eat, or if I don't eat soon enough (say if I need to delay my lunch slightly because of work)- I will have hypoglycaemic symptoms. I start feeling extremely sick- really nauseous, weak, feeling shaky, etc. I often don't' notice that it's happening until it's too late and the worst symptoms appear, and by that time I am so nauseous it's hard to force myself to eat. However it improves and eventually goes away once I eat something (especially if it's something high in sugar)

I have seen someone mention that they had something similar on a comment for a different question- and was wondering if this is a common side effect of taking T3? Or if it is simply the brand of T3? Or a delayed effect of Hashimoto's/ hypothyroidism that I only noticed/became worse during the same time that I started taking T3 in addition to levothyroxine?

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thyroidqueen12
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radd profile image
radd

thyroidqueen12,

T3 is known to influence insulin synthesis, signaling & sensitivity.

Ongoing T3 levels that are either too low or too high can cause insulin resistance (although for different reasons), as thyroid hormones exert both insulin agonistic and antagonistic actions in different organs for normal glucose/carb metabolism, and in particularly the liver.

With high T3 levels gluconeogenesis becomes elevated leading to increased liver glucose output and higher & higher blood sugar levels.

In the hypothyroid state (which can also occur with high T3 due to changes in deiodinase behaviours) it involves reduced levels of gluconeogenesis decreasing liver glucose but further compounded by compromised adrenals inducing hypoglycaemia without adequate cortisol.

Two separate causes to be evaluated, that may be intertwined.

thyroidqueen12 profile image
thyroidqueen12 in reply to radd

Can you put that in layman's terms please

TiggerMe profile image
TiggerMe in reply to thyroidqueen12

I'll take a punt at the first one being that T3 speeds up metabolism and creates a sugar high when it spikes before fT3 levels drop and so does the blood sugar, could be altered by dose timings perhaps?

And the second one possibly that high fT3 results in some being turned into unusable rT3 leaving you still hypo due to excess or lack of cortisol necessary to utilise?

and also a mixture of the two! 🙃 but I'm sure     radd will put me right 😏

It's like University Challenge isn't it 👩‍🎓🧸

radd profile image
radd in reply to TiggerMe

Eeyore100,

Haha, 'another starter question now, you may not confer, one of you may buzz!' 😳

'I'll take a punt at the first one being that T3 speeds up metabolism and creates a sugar high when it spikes before fT3 levels drop and so does the blood sugar, could be altered by dose timings perhaps?' Absolutely but altered also by T3 dose, food timings, what food is consumed, and cortisol levels.

FT3 is converted into inactive T2 called 3,3′-T2, and will correlate with RT3 should T4 also be in the blood stream. Both are driven by D3 enzyme.

This Tania link gives all known metabolites ... thyroidpatients.ca/2021/08/...

There will be exams tomorrow! 👩‍🎓🧸

radd profile image
radd in reply to thyroidqueen12

thyroidqueen12,

Hypo slows the rate of glucose uptake by cells, and insulin response/clearance, where as hyper (or [excess] T3) increases the speed of everything.

Gluconeogenesis refers to ‘the process of making glucose (sugar) from its own breakdown products or from the breakdown products of lipids (fats) or proteins. It occurs mainly in liver and kidney cells.’ T3 can speed this process up beyond a healthy level resulting in high blood glucose levels.

Another common reason in the forum for blood glucose dysregulation are cortisol problems instigated by years of thyroid issues. Cortisol (& other hormones) help in the regulation of blood glucose levels and constant high cortisol is known to induce (pre) diabetes by raising blood glucose levels that eventually results in insulin resistance (when cells no longer effectively respond).

Likewise we need adequate cortisol to raise blood sugar by releasing stored glucose, and so hypothyroidism results in hypoglycemia. Then having low sugar is another stress that causes the release of further cortisol, and an additional stress when there isn’t enough, or when it switches on and won't turn off. Multiple vicious circles and often difficult to differentiate.

We obviously need that little bit of T3 but after years of hypothyroidism the synchronising of bodily systems have become so far apart, the T3 meds can help some parts but become unhelpful in others until we have resynchronised. Your issue isn't unusual, and T3 and cortisol levels should always be reviewed together.

Are you split dosing your T3 meds to avoid peaks and troughs? Also, if I was you I would be mindful that T3 levels aren't too high. Not everyone needs high in range labs (I don't) and only time will allow T3 to reach its full potential, not keeping levels higher than your body can deal with.

After starting T3 some years ago I suffered blood glucose issues in the form of hypoglycaemia from high glucose levels in the blood and insulin not working properly, making me feel drunk after any exercise. I rectified this with help from a nutritionist who put me on several smaller meals a day, including protein at every meal, never missing a meal and topping up in-between with protein shakes.

I also supplemented something called Glucofit by Allergy Research Group which contained lagerstroemia speciosa and corosolic acid. It has been discontinued but I notice NOW do one .... dolphinfitness.co.uk/en/now.... I also took high amounts of Vit C to support the adrenals and have continued to do so ever since.

in reply to radd

only time will allow T3 to reach its full potential, not keeping levels higher than your body can deal with.

I love the wisdom of this, I’m going to add that to my notes to remind myself!

I had terrible, terrible hypoglycemia for most of my life. Since I started on hydrocortisone (adrenal support) it has become a distant memory. It could be poor adrenals showing up x

thyroidqueen12 profile image
thyroidqueen12 in reply to

Very interesting to hear this. How did you know it was adrenal support you needed?

in reply to thyroidqueen12

I got a cortisol saliva test, which showed very very low cortisol and began investigating from there.

in reply to thyroidqueen12

I’ve just re-read your post and realized you mention severe nausea. That is a classic symptom of low cortisol, and really needs attention. It sounds to me like the presence of the T3 is aggravating some adrenal insufficiency. I’d ask your GP for a blood cortisol test and a synacthen if you can persuade them.

Bertwills profile image
Bertwills

Really interested to read your question & the answers. I take 50mcg, split into 3 doses & I'm very conscious of blood sugar difficulties. I tend to be just below the pre-diabetes level on Medichecks tests but I have to be careful, especially since I love dark chocolate!

I have to eat much more often than my husband & I always try to have protein in every meal. I use Berberine to help control blood sugar. Doing some more research recently I’ve discovered that it’s useful for gut health too. It might help smooth out your blood sugar highs & lows.

Decant profile image
Decant

Interesting question, thank you. I've "had the shakes" for decades but only occasionally. I had a hypo at hospital and when I had the glucose monitor through the Zoe program I noted I'd get a hypo quite regularly (mostly after a large spike). I largely ignore this, maybe I shouldn't. I take T3 all in one go for convenience (and T4) . I'll start splitting the dose. I've not followed this up with GP.

thyroidqueen12 profile image
thyroidqueen12 in reply to Decant

Interesting! I am actually on the waitlist for Zoe, so hoping the glucose monitor will give me some insights. How did you find the program?

Decant profile image
Decant

The continuous blood sugar monitoring was very interesting (it does cost more). Especially to see the quite regular hypos. I did learn quite a bit from seeing the spikes. The microbiome analysis was useful, to see mine was poor.

However I found the food entry too much hassle. It's ok if you can scan the barcodes and for simple things like individual fruit, but weighing every ingredient and entering it on the phone, and the hassle of cooking family meals (having to divide portions) and going out for meals just made it too much work. It needs some kind of AI that scans a photo and makes a good guess. Lastly it doesn't really track your progress. If you pause using it then it still carries on blindly. Not very clever.

When I stopped the subscription I lost access to the recommended foods and they're not responding to my emails asking for access.

My advice if you do it. Take screenshots of every days blood sugar graph and write down the good and bad foods.

Overall it's barely changed my habits, but then I struggle to make new habits!

thyroidqueen12 profile image
thyroidqueen12 in reply to Decant

Thanks for the advice, I will definitely take this onboard when I try it out in September. I just am very curious to see what foods are deemed 'good' for my gut and which aren't. I also hope to gain some understanding of how to better handle my nutrition and relieve some of these hypoglycaemic symptons!

Divine1990 profile image
Divine1990

I have been on the Zoe programme for approximately 6 months. Really interesting to see what foods spike your blood glucose. For me things like bananas were not my friend but combined with nuts much less of a response. My microbiome was apparently excellent which was a surprise but my blood sugar control was poor. Following the advice and guidance from the app I have changed the way I eat and feel better for it.

There are some great recipes available too(I am gluten free). There is online support if you need any help.

Daily lessons and reflections on your biology ( only take a few minutes to read/complete)

Recording your food intake can be a bit of a bind and I now also spend alot more time cooking from scratch. Then there is the cost.

andyjs2 profile image
andyjs2

Not sure if this is your situation, but it appears that your T3 is burning up all of your cortisol leaving you with low blood sugar, possibly because your adrenals can’t keep up with the cortisol demand from your higher T3.

I have exactly this condition because of secondary adrenal dysfunction (pituitary not kicking out enough of ACTH even with very low cortisol and DHEAS).

I have been taking Adrenal Cortex (cortisol supplement) and it has helped immensely.

andyjs2 profile image
andyjs2 in reply to andyjs2

I would get your saliva cortisol tested though before trying any cortisol therapy.

Bertwills profile image
Bertwills in reply to andyjs2

can I ask which brand of adrenal cortex you take. Thank you

andyjs2 profile image
andyjs2 in reply to Bertwills

Thorne Adrenal Cortex 50mg (4 pills twice a day) from Amazon. May switch to Klaire Labs Adrenal Cortex since 250mg pills and less expensive overall.

thyroidqueen12 profile image
thyroidqueen12

For anyone interested in an update- once I lowered my dose of T3 to alternating days of 5mcg and 7mcg, this symptom has largely disappeared. Although I am also more conscious of ensuring I have snacks and am eating at regular times daily. However, the extreme hypoglycaemic symptoms have disappeared- so it was definitely linked to overdosing on T3..

Bertwills profile image
Bertwills in reply to thyroidqueen12

That’s good to know. I’ve gone from 40 mcg T3 to 100mcg T4 & 10mcg T3. Last Medichecks showed another rise in blood sugar so it had to be done. Low carb diet too, not Keto yet.

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