If you have type 2 diabetes, you should be screened for thyroid abnormalities, according to researchers at the 20th Annual Meeting and Clinical Congress of the American Association of Clinical Endocrinologists (AACE). The recommendation came after a new study involving more than 5,000 people found that the prevalence of hypothyroidism was nearly 6% among people with type 2 diabetes, compared with just under 2% among those without.
Hypothyroidism is a well-recognized risk of type 1 diabetes, but this has generally not been extended to type 2 diabetes as well, until now.
What does your thyroid function have to do with diabetes?
Both thyroid disorders and diabetes involve dysfunction of the endocrine system. Type 1 diabetes and the most common cause of hypothyroidism, Hashimoto’s disease, are autoimmune diseases, and having one autoimmune disease increases your risk of developing another.
With type 2 diabetes, coexisting hypothyroidism could increase the risk of heart problems, and the researchers noted that early identification of both conditions could improve heart function, blood pressure and lipid profiles. [1]
Thyroid hormones also influence glucose homeostasis, including affecting circulating insulin levels, intestinal absorption, and glucose uptake into adipose and muscle tissues. [2]
Even Subclinical Thyroid Disorder May Be Associated With Diabetes
People with hypothyroidism often battle insulin resistance. This is true even at the subclinical level. How do you know if your thyroid is working at a subclinical level?
Often, you don’t.
This condition is usually diagnosed when thyroid hormone levels are normal but thyroid-stimulating hormone (TSH) is elevated. This is usually a sign that your pituitary gland is working very hard to keep your thyroid hormone levels in the normal range. Over time, and if left untreated, your TSH levels can continue to rise until your thyroid gland becomes unresponsive and your subclinical hypothyroidism develops into full-blown hypothyroidism.
It’s a tricky situation because subclinical hypothyroidism may not cause any symptoms at all, or it can lead to fatigue, memory problems, weight gain, dry skin, constipation, and a variety of other issues that may seem completely unconnected. Again, this often undiagnosed and misdiagnosed condition is also associated with insulin resistance, which typically occurs before type 2 diabetes.
As the researchers wrote in Clinical Diabetes: [3]
“Thyroid dysfunction is common in diabetic patients and can cause significant metabolic disturbances. Therefore, regular screening for thyroid abnormalities in all diabetic patients will allow early treatment of subclinical thyroid dysfunction.”
Like subclinical hypothyroidism, it can be insulin resistant for years before developing full-blown disease, and often a type 2 diabetes diagnosis is a person’s first sign that they are, in fact, insulin resistant.
Because cases of subclinical thyroid disease are often overlooked but can increase health risks for many people with coexisting diabetes or insulin resistance (as well as those without), researchers in the British Journal of Diabetes and Vascular Disease recommended “individualization of therapy” as the best solution.
What is the end result?
If you currently have type 2 diabetes, you should be aware of the connection to thyroid disorders, such as hypothyroidism and subclinical hypothyroidism. On a subclinical level, many do not have any symptoms and others are unaware that their fatigue, memory problems, and other seemingly unrelated symptoms are due to a thyroid problem.
You may need to ask your doctor to check this out, as it’s not yet part of the standard of care usually given to people with type 2 diabetes. But, even if you’ve had your thyroid levels tested and the lab results are normal, it’s still possible to have a low-functioning thyroid. In fact, the condition is often overlooked entirely due to inadequate testing and a general lack of understanding of the intricacies of thyroid function in the mainstream medical community.
There is some debate as to whether or not subclinical hypothyroidism needs to be treated, and I would absolutely emphasize that. At the very least, subclinical hypothyroidism can contribute to insulin resistance and increase the risk of cardiovascular events if you have type 2 diabetes.
Additionally, many at this early stage of thyroid imbalance will develop full-blown hypothyroidism if action is not taken…and they will miss out on the vitality and energy they deserve in life.
It is believed that at least 15 million Americans suffer from subclinical hypothyroidism that may or may not be related to diabetes. Fortunately, dietary approaches and other lifestyle changes can help return your thyroid function to normal ranges, as well as prevent, manage, and even reverse type 2 diabetes. Guidance from a holistic health professional familiar with thyroid disorders and diabetes is highly recommended to help you formulate and stick to an effective lifestyle plan.
References
1. DocGuide.com April 18, 2011
2. British Journal of Diabetes and Vascular Diseases. 2010;10(4):172-177.
3. Diabetes Clinic VOL. 18 no. 1 winter 2000