In the general population, approximately 6% of people have some sort of thyroid problem. But, this percentage increases to more than 10% in people with diabetes.
Thyroid disorders are very common indeed in the western world... second only to diabetes as the most common condition affecting the endocrine system.
Abnormal thyroid function can have a major impact on diabetes control... untreated thyroid disorders can increase the risk of diabetic complications and can worsen diabetes symptoms.
But thyroid problems can be diagnosed with simple blood tests, and effective treatments are available. Everyone with diabetes should be screened for thyroid disorders.
What is the thyroid gland?
The thyroid gland is shaped like a butterfly and sits around the windpipe in the neck between your Adam's apple and collarbone. It makes two hormones, T3 and T4, that set your metabolic rate... how fast your heart beats, how you breathe, your body temperature, and how your body uses insulin are thyroid-related functions.
Hyperthyroidism, i.e. too much thyroid hormone produced, increases insulin resistance, while hypothyroidism, too little hormone produced, increases cholesterol.
Hypothyroidism is much more common than hyperthyroidism.
Both hypo- and hyperthyroidism increase the risk of heart disease.
Symptoms of thyroid problems
Symptoms vary by age and gender and whether you have hypo- or hyperthyroidism.
Symptoms of hypothyroidism include feeling tired, feeling cold, weight gain, depression, dry hair and skin, and constipation.
Both types of thyroid, hyper- and hypothyroid, can cause goiter, a swelling of the neck when the thyroid becomes enlarged.
Many of the symptoms are very like those of type 2 diabetes. For example, one of the symptoms of thyroid problems is cold feet.
Testing for thyroid problems
Since you can't tell if you have a thyroid problem based on symptoms alone, you should have your thyroid checked with blood tests. This is usually done by testing the blood for TSH, the thyroid-stimulating hormone.
TSH is the hormone your pituitary gland uses to get your thyroid going. If your thyroid function is low, the TSH level in your blood will be high, signaling that your thyroid should produce more thyroid hormone. If the thyroid is overactive, the TSH will be low, trying to slow it down.
A TSH level between 0.4 and 4.0 mU/L (milliunits per liter) is considered normal. But some people may have reduced thyroid function with a TSH of 2.0-4.0 mU/L. Levels in this range can already raise your lipids to harmful levels and glucose. In some European countries, patients with TSH above 2.0 mU/L may receive thyroid medication.
How to manage thyroid problems
There are three things you need to do to manage your thyroid problems... get tested regularly... take your prescribed medication and... eat a thyroid-friendly diet.
Testing... according to the American Diabetes Association (ADA), everyone diagnosed with type 2 diabetes should be screened for thyroid disorders at five-year intervals thereafter. Patients with type 1 diabetes should be screened every year. It's also a good idea to get tested whenever you have unexplained changes in your glucose levels.
Medicine... hypothyroidism can be treated with levothyroxine, a synthetic version of T4, the main thyroid hormone that is made and released by the thyroid gland. But, you need to try it at different doses to find the best dose for you, which may take several months.
But levothyroxine does not work for everyone.
Note that it is important to take your thyroid pills at the same time each day.
There are also medical and surgical treatments for hyperthyroidism.
Diet... eating the right foods makes all the difference.
It is added to most sold salt in Europe and North America. The best sources are sea vegetables (seaweed) and marine animals.
Medicine, food, and exercise
The most common form of thyroid problem is hypothyroidism, i.e. a sluggish thyroid that is underperforming.
To make your thyroid work faster, you should:
Medicines... take the correct amount of medicine as directed by your doctor. Do not skip doses and take them at the same time of day. Since you will need to take it for the rest of your life, make it part of your set daily routine.
Take your thyroid medication on an empty stomach. Food can reduce its absorption, especially foods high in fiber. High-fiber foods are good for you, so don't stop eating them... eat them a few hours before or after taking your thyroid medication.
Avoid taking calcium supplements or supplements that contain iron (such as multivitamins) along with your thyroid medication, as they can also block the absorption of the medication.
Food... cruciferous vegetables such as broccoli, cauliflower, Brussels sprouts, and cabbage can affect thyroid hormone production. They are very healthy foods so you need to continue to eat them... don't eat them at the same time you take your medication. Cooking these vegetables seems to reduce this effect.
Eat foods that increase thyroid hormone production.
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