Understanding The Relationship Between Hashimoto’s Disease And Diabetes

The relationship between Hashimoto's disease and diabetes is defined by a complex, interdependent relationship, as both conditions involve abnormalities of the endocrine system. It is important to learn about the interactions between Hashimoto's disease and diabetes and to find out how the two conditions can be treated.

What is Hashimoto's disease?

Hashimoto's disease is an autoimmune disorder that causes inflammation of the thyroid gland. As the disease progresses, it causes damage to the cells in the thyroid gland, affecting their ability to produce hormones and resulting in a condition known as hypothyroidism.

An autoimmune disorder means that the body's immune system turns against itself, producing antibodies that attack the thyroid gland. This causes a build-up of white blood cells in the thyroid gland, damaging it and reducing the amount of thyroid hormone produced (hypothyroidism).

However, in some cases, the disease goes through an initial phase of the thyroid becoming enlarged (goiter) and temporarily producing more thyroid hormones, causing hyperthyroidism, before eventually transitioning to the next phase of hypothyroidism.

Risk factors of Hashimoto's disease

These factors will increase your risk of developing Hashimoto's disease:

• Being a woman, particularly between the age of 30 to 50

• Having had previous thyroid problems

• If you have another autoimmune disease, such as type 1 diabetes, lupus, celiac disease, rheumatoid arthritis

• A family history of thyroid disease

• Exposure to radiation

• Excess iodine intake, especially among those susceptible to developing the disease.

Symptoms of Hashimoto’s disease

The symptoms of Hashimoto’s disease can be quite common to other conditions, as well, and include:

• Weight gain

• Fatigue

• Constipation

• Dry skin

• Slow heart rate

• Muscle aches

What is diabetes?

High sugar levels lead to a condition known as diabetes mellitus. The main source of energy in the body is blood glucose, which is derived from food. Insulin, a pancreatic hormone, helps regulate blood sugar levels.

At times, the body produces insufficient insulin, meaning that excess glucose remains in the blood. Over time, too much glucose leads to health problems. While diabetes is often a lifelong condition, one can incorporate several strategies to manage the condition.

Types of diabetes

The following are types of diabetes:

1. Type 1 diabetes

Type 1 diabetes is an autoimmune condition where the immune system attacks the pancreas,  leading to its failure to produce sufficient insulin. People with type 1 diabetes manage the condition using daily insulin shots.

The cause of type 1 diabetes has not yet been established. However, the condition may be genetically inherited, which is why it is more commonly diagnosed in children and adolescents.

2. Type 2 diabetes

With type 2 diabetes, the body doesn’t produce enough insulin or makes the best use of the available insulin in the blood. This is the most common type of diabetes and makes up 95% of all diabetes diagnoses.¹ 

While the condition can be diagnosed at any age, it is more common in middle-aged and older people.

Type 2 diabetes may be caused by, among many other factors, obesity, genetics, and poor lifestyle choices.

3. Gestational diabetes

Gestational diabetes is experienced by pregnant women, and it involves an increase in blood glucose level, but often not as high as in the case of regular diabetes. It usually doesn’t cause any symptoms and is instead discovered through regular prenatal check-ups.

Gestational diabetes can cause issues during pregnancy for both the mother and fetus, so it is important to regularly monitor the blood glucose levels. But complications are rare, and women with gestational diabetes usually have a healthy pregnancy and labor.

In most cases, gestational diabetes goes away on its own once the mother gives birth. However, people with gestational diabetes have a higher chance of developing type 2 diabetes.

4. Prediabetes

Prediabetes is simply an indication of higher than normal blood sugar levels. This is a warning sign that if care is not taken, the condition may progress to type 2 diabetes.

Symptoms of diabetes

the following are general symptoms of diabetes:

• Fatigue

• Extreme hunger

• Slow healing of wounds

• Increased thirst

• Unexplained weight loss

• Blurry vision

• Frequent urination

• Dry mouth

In addition to these symptoms, men may experience a low sex drive and suffer from erectile dysfunction. On the other hand, women can be more prone to urinary tract infections and vaginal yeast infections.

Risk factors of diabetes

The following are some of the common risk factors for diabetes:

1. Being overweight

2. Having an inactive lifestyle

3. Having hypertension and a high level of cholesterol

4. Being 45 years and older

5. Having a family history of diabetes

The relationship between diabetes and Hashimoto's disease

The following is a deep dive into the relationship between Hashimoto's disease and diabetes.

Hashimoto's disease and type 1 diabetes

Autoimmune thyroid disease is the most common autoimmune disorder² associated with type 1 diabetes, manifesting in 17–30%  of all diagnosed cases, with Hashimoto’s disease accounting for the majority of this percentage. It is more prevalent among children and adolescents under the age of 20.

Hashimoto’s disease is thought to develop as a result of the presence of antithyroid antibodies in those with type 1 diabetes, which attack the thyroid gland, destroying the cells and causing hypothyroidism.

The risk of developing this condition after the diagnosis of type 1 diabetes is higher in females, increases with age, and greater in those with more long-term uncontrolled or undiagnosed diabetes. 

Hashimoto's disease  and type 2 diabetes

Having Hashimoto's disease can cause metabolic disorders and type 2 diabetes. This is due to the following:

Hashimoto's disease and blood sugar

Hashimoto's disease will usually lead to hypothyroidism. Hypothyroidism involves the reduced ability of the thyroid gland to release enough of its hormones, which are essential in facilitating metabolism.

As a result, blood sugar that would have otherwise been broken down to produce energy accumulates in the blood. This puts a person at risk of developing diabetes and makes it harder for those with diabetes to manage their sugar levels.

Hashimoto's disease and insulin

Hypothyroidism, which is caused by Hashimoto's disease, decreases glucose absorption, leading to an accumulation of sugar.³ In turn, this accumulation of sugar causes more insulin to be produced to utilize excess glucose, eventually leading to insulin resistance.

Insulin resistance can create a vicious cycle, as the body will keep producing insulin, but cells will become even more resistant, eventually causing high blood sugar levels and diabetes.  

Can you suffer from both diabetes and Hashimoto's disease?

It is not uncommon for people to suffer from both diabetes and Hashimoto's disease at the same time.

The risk of developing thyroid problems almost doubles⁴ among the diabetic population. People with type 1 diabetes who are at a higher risk of developing Hashimoto's disease include:

• Older patients

• Those who have had type 1 diabetes for a long time

• Women

People, especially women with extended type 2 diabetes, have an increased chance of developing Hashimoto's disease. The following factors increase your chances of developing both type 2 diabetes and Hashimoto's disease:

• Having high levels of TPO antibodies 

• Being overweight and obese.

One significant overlapping symptom between diabetes and Hashimoto's disease is unexplained chronic fatigue.

How to lower your risk of developing diabetes or Hashimoto's 

There is a high genetic predisposition to developing type 1 diabetes and autoimmune disorders like Hashimoto’s disease. However, you can take the following measures to manage your risk.

These measures can also help to reduce your symptoms and improve your blood sugar if you have type 1 diabetes:

1. Make sure you eat a well-balanced diet. Eat a lot of vegetables,  fruits, and lean proteins.

2. Avoid refined carbohydrates. These include, but are not limited to, French fries, cookies, pasta, pizza, ice cream, and doughnuts, as these foods may lead to a sudden spike in your sugar levels.

3. Avoid high-fat high-carb food, particularly those including trans fats.

4. If you are overweight or obese, incorporate various lifestyle changes to maintain a normal body weight. In addition to watching what you eat, make sure to exercise and be physically active every day.

5. If you have Hashimoto's disease, check your sugar levels. If you have diabetes, monitor your thyroid hormone levels. 

How to manage diabetes with Hashimoto's disease

If you have Hashimoto's disease and were diagnosed with diabetes, maintaining a healthy weight is one of the most effective ways of managing diabetes. If you suffer from insulin resistance, Hashimoto's disease can make your condition even worse.

You can control your insulin levels using medications, adopting a healthy eating habit, and exercising regularly. This will not only help manage diabetes but will also help avoid complications that come with thyroid issues, such as high cholesterol and high blood pressure.

When to speak to a doctor

If you think you have any symptoms of diabetes or Hashimoto's disease, you should see a doctor right away. It can be easy to downplay specific symptoms, such as feeling tired, irritable, or having dry skin, because they can be caused by many other factors, such as a sudden change in weather.

Speaking to your healthcare provider about these symptoms will go a long way toward early detection and management of these conditions.

How to make the most out of your doctor's visit:

1. Know exactly why you made your appointment and be clear about the expected outcome.

2. Do your research beforehand and have a list of all the questions you want answered.

3. Bring a friend or family member with you to your appointment to help you ask important questions and to also help you remember all the important points.

4. Once you are done with your appointment, note down your new diagnosis, the medication provided, and any recommended tests.

5. Get to know the side effects of your medication, if any.

6. Ask your physician for alternative ways of treatment.

7. Write down the date and time for your follow-up appointment.

8. Make sure you know how to reach out to the healthcare provider if you need any questions answered.

 The lowdown

There is an increased risk of developing diabetes if you have Hashimoto's disease and vice versa. Having these two conditions at the same time may lead to complications. 

To avoid this, you should take precautions, such as changing your lifestyle habits and ensuring that you get regular checkups.

Most importantly, speak to your doctor about any complications and let them advise you on the right strategies to incorporate to manage either or both conditions.